Jonušaitė, Danielė

Introduction. Priapism is a condition that often requires emergency treatment to spare erectile function. Case report. This is a case report on a patient from the Lithuanian University of Health Sciences Kaunas Clinics with a very rare cause of priapism. The 41-year-old patient was hospitalized with a diagnosis of myocardial infarction, which was being treated with stent insertion, followed by conservative therapy with antiaggregants and heparin. A few hours later after the initiation of the treatment, a genitourinary examination revealed a rare case of heparin-induced priapism. The condition was treated conservatively with multiple cold and mechanical pressure applications, followed by blood aspirations, which led to surgical shunt insertion due to ineffective outcomes. Conclusion. Although the only known pathogenetic mechanism of heparin-induced priapism is associated with heparin-induced thrombocytopenia, the patient’s blood test didn’t reveal any abnormalities so the real pathogenetic mechanism of this priapism case remains unclear. Clinicians should acknowledge the possibility of priapism development after treatment initiation with heparin and inform their patients about this rare adverse effect.

Background: The study aimed to assess predictors and to identify patients at increased risk of prostate-cancer-specific mortality (CSM) after radical prostatectomy (RP). Methods: A total of 2421 men with localized and locally advanced PCa who underwent RP in 2001–2017 were included in the study. CSM predictors were assessed using multivariate competing risk analysis. Death from other causes was considered a competing event. Cumulative CSM and other-cause mortality (OCM) were calculated in various combinations of predictors. Results: During the median 8 years (interquartile range 4.4–11.7) follow-up, 56 (2.3%) of registered deaths were due to PCa. Cumulative 10 years CSM and OCM was 3.6% (95% CI 2.7–4.7) and 15.9% (95% CI 14.2–17.9), respectively. The strongest predictors of CSM were Grade Group 5 (GG5) (hazard ratio (HR) 19.9, p < 0.0001), lymph node invasion (HR 3.4, p = 0.001), stage pT3b-4 (HR 3.1, p = 0.009), and age (HR 1.1, p = 0.0007). In groups created regarding age, stage, and GG, cumulative 10 years CSM ranged from 0.4–84.9%, whereas OCM varied from 0–43.2%. Conclusions: CSM after RP is related to GGs, pathological stage, age, and combinations of these factors, whereas other-cause mortality is only associated with age. Created CSM and OCM plots can help clinicians identify patients with the most aggressive PCa who could benefit from more intensive or novel multimodal treatment strategies.

Introduction Hepatocellular carcinoma (HCC) is the fifth most common cancer which has an increasingly high mortality rate worldwide [1]. It is predicted that the incidence and mortality of HCC will significantly increase in the next decade [2]. Aim To assess the efficacy of different treatment methods in patients with hepatocellular carcinoma in the Hospital of LUHS Kauno Klinikos and to compare survival times with global BCLC guidelines. Methods We retrospectively analyzed 105 patients treated in the Hospital of LUSH Kauno Klinikos with an HCC diagnosis in 2012-2022. Patients were divided into 2 groups based on their Barcelona Clinic Liver Cancer (BCLC) stage at the time of diagnosis: 39 (37.14%) patients in Group A with stages 0-A (very early, early) and 66 (62.86%) patients in Group B with stages B-D (intermediate, advanced, terminal). Treatment methods were grouped into 4 groups: transarterial embolization (TAE+TACE), systemic, radical (radiofrequency ablation, tumor resection, liver transplantation) and multiple (2 or more combined). Outcomes were compared between groups A and B, survival times were compared with BCLC guidelines [3]. The normality of data was assessed with Kolmogorov–Smirnov, Shapiro-Wilk tests. For descriptive statistics, median values (min-max) were used. For nonparametric statistics, a Mann–Whitney test was performed for a comparison between two groups and Kruskal-Wallis for more than two groups. Statistical significance: p<0.0. Results The most used treatment method was radical (48.7%, n=19) in group A and systemic in group B (40.9%, n=27). In both groups, patients survived the longest after receiving multiple treatment methods: in group A: 38.5 months (15-120; p=0.031), in group B: 23 months (2-89). […].

Introduction Hepatocellular carcinoma (HCC) is a malignant primary liver cancer. In recent years, the number of diagnoses and mortality rate of HCC has been increasing in many regions of the world [1]. It is very important to identify prognostic factors for survival time of HCC patients. Aim The aim of this study is to identify factors that affect the survival time of patients with hepatocellular carcinoma before they undergo a specific treatment. Methods This retrospective study analysed 127 patients with diagnosis of hepatocellular carcinoma (HCC) who were treated in The Hospital of Lithuanian University of Health Sciences (LSMU) Kauno klinikos between 2016 June and 2020 December (LSMU Centre for Bioethics permission No. BE-2-31). The following data were collected: the concentration of the first time measured alpha-fetoprotein (AFP) in serum, Child- Pugh classes, patients age and sex, diameter of the largest tumour node, multinodular/nonmultinodular HCC. The normality of data was assessed with Kolmogorov–Smirnov, Shapiro-Wilk tests. For descriptive statistics means (SD), median values (min-max) were used. For nonparametric statistics, a Mann–Whitney U‐test was performed for a comparison between two groups and Kruskar-Wallis for more than two groups. The association between two quantitative variables was counted with Spearman’s correlation coefficient. Statistically significant difference is when p<0,05.Results The mean of patient age was 63,99 (±10,066). The median of survival time in months was 20 (0–139). […].