Jurėnienė, Kristina

The aim of this study was to assess the diagnostic ability of transcranial sonography (TCS) for the evaluation of the medial temporal lobe (MTL) in Alzheimer’s disease (AD). Standard neuropsychological evaluation, TCS and 1.5 T MRI were performed for 20 patients with AD and for 20 age- and sex-matched healthy controls in a prospective manner. Measurements of the size of the third ventricle and heights of the MTL (A) and the choroidal fissure (B) were performed twice on each side by two independent neurosonologists for all participants. On MRI, both conventional and volumetric analyses of the third ventricle and hippocampus were performed. Receiver operating characteristic (ROC) curves analyses were applied. Height of the MTL on TCS had sensitivities of 73.7% (right)/63.2%(left) and specificities of 65% (right)/65–70% (left) Area under a curve (AUC) 75.4–77.2% (right), 60.4–67.8% (left)) for AD. A/B ratio on TCS had sensitivities of 73.7% (right)/57.9% (left) and specificities of 70.0% (right)/55.0% (left) (AUC 73.3% (right), 60.4% (left)) by the experienced neurosonologist, and sensitivities of 78.9% (right and left) and specificities of 60.0% (right)/65.0% (left) (AUC 77.8–80.0%) by the inexperienced neurosonologist for AD. On MRI, linear measurement of the hippocampus and parahippocampal gyrus height had sensitivities of 84.2% (right)/89.5% (left) and specificities of 80.0% (right)/85% (left) (AUC 86.1–92.9%) for AD. Hippocampal volume had sensitivities of 70% (right and left) and specificities of 75% (right)/80% (left) (AUC 77.5–78%) for AD. Atrophy of the right MTL in AD could be detected on TCS with a good diagnostic ability, however MRI performed better on the left.

Background. The immune system is affected by many endogenous and exogenous factors. Previous studies have showed that one of the main exogenous factors effecting the immune system is nutrition. Connection between immune system and nutrition in considered to be one of the main research topics starting from 20th century. Many researchers have demonstrated that some food components can modulate immune system response. Objective. To evaluate students’ nutritional habits in relation to the condition of their immune system. Methods. The nutritional habits of the students from the Faculty of Medicine of the Lithuanian University of Health Sciences from 1st to 6th year of studies were analyzed using a questionnaire survey. Data analysis was performed using “SPSS 22.0 for Windows” and “Microsoft Excel” programs. χ2 test was performed for qualitative analysis. Data was considered statistically significant when p ≤ 0,05. Results. The study involved a total of 319 students. Only about a half of the study participants consume food in accordance with the recommendations by WHO (frequency, consumption of water, no additional consumption of salt and sugar). Most students use the right amount of vegetables, choose poultry meat more often than beef and pork. The study also found a decreased consumption of fish products and over-use of sweets. 93.1 percent of students reported their health as good or very good. Only a small part of them often suffer from cold, allergies, while only isolated cases of oncological and autoimmune diseases were found. Conclusions. Students’ nutrition habits only partially correspond to WHO healthy dietary recommendations. [...].

BACKGROUND: The objective of study was to determine the effect of anthracycline dose reduction and chemotherapy delays on 5-year overall survival in patients with stage I-III breast cancer, to establish the impact of molecular subtypes on the anthracycline modification effects and to analyze reasons for such chemotherapy scheme modifications. METHODS: Medical records of patients with stage I-III breast cancer were reviewed. Inclusion criteria involved stage I- III breast carcinoma; radical surgery performed and 4 courses of AC regimen (doxorubicin and cyclophosphamide), or at least 6 courses of FAC regimen (fluorouracil, doxorubicin and cyclophosphamide) completed; no neoadjuvant chemotherapy applied; no taxane group medications administered; medical records maintain comprehensive data on treatment and follow-up. 5- year overall survival were analyzed using Kaplan-Meier and Cox proportional hazards models. RESULTS: Significant 3.17 times higher death risk at 5 year period in patients who experienced anthracycline dose reduction compared with patients who did not experience any modifications was established (HR = 3.17, 95% CI 1.7-5.9, p < 0.001). Increased death risk in patients who experienced both chemotherapy dose reduction and treatment delays compared with patients who did not experience any modifications was also established (HR = 2.76, 95% CI 1.3-5.6, p < 0.05). 5- year overall survival was affected by anthracycline dose reduction by more than 15% in ER-HER2- group (80% v. 55.6%, p = 0.015), ER + HER2- group (90.7% v. 64.9%, p < 0.01) and ER+/-HER2+ group (100% v. 84.4%, p = 0.019). 5-year overall survival was affected by chemotherapy delays more than 2 cycles in ER-HER2- group (79.2% v. 51.4%, p = 0.002), ER + HER2- group (86.3% v. 58.8%, p = 0.014) and there was no difference in ER+/-HER2+ group. [...].

Aims The objective of this study was to evaluate the impact of platinum dose reduction and delays on progression free survival (PFS) and overall survival (OS) in patients with stage I-IV ovarian cancer. Method Medical records of patients with FIGO stage I-IV ovarian cancer were reviewed. PFS was calculated as the time from surgery until the date of progression or death, OS from surgery until the date of death. Last follow up was on 2016-05-30. Results Patients were divided into four platinum response status groups: 1) platinum refractory (N=19 ), OS 17 months (95% Cl: 2,4-31,5 ) ; 2) platinum resistant (N=26) OS 20 months (95% Cl: 15,1-24,8) ; 3) partially platinum sensitive (N=16 patients), OS 33 months (95% Cl: 19,8-46,1 ); 4) platinum sensitive (N=39), OS not reached (Figure 1), P <0,0001. Patients were divide into four chemotherapy delay/platinum reduction groups. 38 patients experienced no dose delay or reductions, OS was 40 months (95% Cl: 23,8-56,1); 12 patients had a dose reduction, OS was 21 months (95% Cl: 15,6-26,3); 38 patients had a delay, OS was 45 months (95% Cl: 17,5-72,4); 12 patients had both schedule and dose modifications, OS was 33 monts (95% Cl: 29,836,2 ), P>0,05 (Figure 2). The main reason of chemotherapy modification was neutropenia (52 %) (Figure 3). Conclusion There were no statistically significant OS differences the the four groups of chemotherapy modifications. Neutropenia is the mos common side efect affecting dose modifications.

BACKGROUND: Ovarian cancer is a common gynaecological malignancy still remaining a challenge to treat. The objective of this study was to evaluate the impact of platinum dose reduction and chemotherapy delays on progression free survival and overall survival in patients with stage III ovarian cancer and to analyze reasons for such chemotherapy scheme modifications. METHODS: Medical records of patients with FIGO stage III ovarian cancer were reviewed. Inclusion criteria involved FIGO stage III epithelial ovarian carcinoma; cytoreductive surgery performed and 6 courses of platinum-based chemotherapy completed; no neoadjuvant chemotherapy applied; and no history of previous malignancies. Progression free survival and overall survival were analyzed using Kaplan-Meier and Cox proportional hazards models. RESULTS: Significant 3.3 times higher death risk in patients who experienced only chemotherapy delays compared with patients who did not experience any chemotherapy scheme modifications was established (HR = 3.3, 95% Cl: 1.2 - 8.5, p = 0.016). Increased death risk in patients who experienced only chemotherapy delays compared with patients who experienced both chemotherapy delays and platinum dose reduction was also established (HR = 2.3, 95% Cl: 1.1 - 4.8, p = 0.021). Main reasons for chemotherapy scheme modifications (in decreasing order) were the following: neutropenia, modifications with no objective medical reasons, renal disorders, anaemia, poor performance status, gastrointestinal symptoms and neuropathy. Overall survival in patients who experienced chemotherapy scheme modifications with no objective medical reasons was non-inferior than in patients who did not experience any chemotherapy scheme modifications. CONCLUSIONS: Chemotherapy delays in patients with FIGO stage III ovarian cancer caused lower overall survival. The most common reason for chemotherapy scheme modifications was neutropenia.

BACKGROUND: The roots of adult hypertension go back to childhood. This study aimed to examine the independent effects of physical, behavioural and genetic factors identified in childhood and mid-adulthood for prediction of adult hypertension. METHODS: The study subjects were participants of the Kaunas Cardiovascular Risk Cohort study started in 1977 (n = 1082, age 12-13 years). In 2012, a total of 507 individuals (63.9% of eligible sample) participated in the 35-year follow-up survey. Health examination involved measurements of blood pressure (BP), anthropometric parameters, and interview about health behaviours. Subjects were genotyped for AGT (M235T), ACE (I/D, rs4340), ADM (rs7129220), and CACNB2 (rs12258967) genes polymorphisms. A genetic risk score was calculated as the sum of the number of risk alleles at each of four single nucleotide polymorphisms. RESULTS: AGT TT genotype male carriers had the highest mean values of systolic BP in childhood. In females, ADM genotype AA was associated with the highest values of systolic and diastolic BP, while CACNB2 genotype CC carriers had the highest values of diastolic BP in childhood. Systolic and diastolic BP in childhood, gain in BMI from childhood to adulthood, and risky alcohol consumption predicted hypertension in middle-aged men. In women, genetic risk score together with diastolic BP in childhood and gain in BMI were significant predictors of adult hypertension. The comparison of four nested logistic regression models showed that the prediction of hypertension improved significantly after the addition of BMI gain. Genetic risk score had a relatively weak effect on the improvement of the model performance in women. CONCLUSIONS: BP in childhood and the gain in BMI from childhood to adulthood were significant predictors of adult hypertension in both genders. Genetic risk score in women and risky alcohol consumption in men were independently related with the risk of adult hypertension.

Background: The relation between chemotherapy dose Intensity and patient outcome in the management of early stage Breast cancer is still arguable. Evidence-based randomised trials Benefit the choice of full standard doses of chemotherapy on Schedule. The aim of this study is to assess the impact of Chemotherapy dose and intensity related factors on 5-year Overall survival in group of early breast cancer (EBC) patients, Treated with anthracycline based chemotherapy. Methods: 1826 EBC (I-IIIA) cases diagnosed and treated in Affiliate of Lithuanian University of Health Sciences Kaunas Oncology Hospital from January 2004 to December 2007 were retrospectively analysed. All of them received adjuvant anthracycline based chemotherapy. Only 294 patients that were fully completed were included in the analysis. Survival related endpoints were analysed with Kaplan-Meier estimates, long rank tests and Cox proportional hazards models. Results: With a median follow- up of 5 years, patients have undergone either > 2 cycle-delay (delay at any cycle defined as >3 Days vs. Plan), or 7 day-delay across the whole chemotherapy systematic plan, or < 85% relative dose intensity (RDI) showed Significantly worse 5-year overall survival as compared to patients with no dose and intensity modifications (p< 0,001, p = 0,04, P< 0,001, respectively) According to RDI level 4 groups was analysed: RDI > 85%, 75%

BACKGROUND: Dyslipidemia is one of several known risk factors for coronary heart disease, a leading cause of death in Lithuania. Blood lipid levels are influenced by multiple genetic and environmental factors. Epidemiological studies demonstrated the impact of nutrition on lipid levels within the Lithuanian population although the role of genetic factors for dyslipidemias has not yet been studied. The objective of this study was to assess the distribution of the APOE, SCARB1, PPARα genotypes in the Lithuanian adult population and to determine the relationship of these genotypes with dyslipidemia. METHODS: A cross-sectional health survey was carried out in a representative random sample of the Lithuanian population aged 25-64 (n=1030). A variety of single-nucleotide polymorphisms (SNPs) of the APOE (rs429358 and rs7412), SCARB1 (rs5888) and PPARα (rs1800206) genes were assessed using real-time polymerase chain reaction. Serum lipids were determined using enzymatic methods. RESULTS/PRINCIPAL FINDINGS: Men and women with the APOE2 genotype had the lowest level of total and low-density lipoprotein cholesterol (LDL-C). Men with the APOE2 genotype had significantly higher levels of triglycerides (TG) than those with the APOE3 genotype. In men, the carriers of the APOE4 genotype had higher odds ratios (OR) of reduced (<1.0 mmol/L) high density lipoprotein cholesterol (HDL-C) levels versus APOE3 carriers (OR=1.98; 95% CI=1.05-3.74). The odds of having elevated (>1.7 mmol/L) TG levels was significantly lower in SCARB1 genotype CT carriers compared to men with the SCARB1 genotype CC (OR=0.50; 95% CI=0.31-0.79). In men, carriers of the PPARα genotype CG had higher OR of elevated TG levels versus carriers of PPARα genotype CC (OR=2.67; 95% CI=1.15-6.16). The odds of having high LDL-C levels were lower in women with the APOE2 genotype as compared to APOE3 genotype carriers (OR=0.35; 95% CI=0.22-0.57). [...].

BACKGROUND: The purpose of this study was to examine associations between cardiovascular risk factors and cognitive ability in middle aged and elderly Lithuanian urban population. METHODS: Data from the survey performed in the framework of the HAPIEE (Health, Alcohol, Psychosocial Factors in Eastern Europe) study were presented. A random sample of 7,087 individuals aged 45--72 years was screened in 2006--2008. RESULTS: The scores of immediate recall and delayed verbal recall, cognitive speed and attention were significantly lower in men than in women; yet numerical ability scores were higher in men. Significant associations between lowered cognitive functions and previous stroke (in male OR = 2.52; 95% CI = 1.75-3.64; in female OR = 2.45; 95% CI = 1.75, 3.64) as well as ischemic heart disease history (among male OR = 1.28; 95% CI = 1.03-1.60) have been determined. Higher level of physical activity in leisure time (among female OR = 1.32; 95% CI = 1.03-1.69), poor self-rated health (among male OR = 1.57; 95% CI = 1.15-2.14) and poor quality of life (in male OR = 1.67; 95% CI = 1.07-2.61; in female OR = 2.81; 95% CI = 1.92-4.11) were related to lowered cognitive function. CONCLUSIONS: The findings of the study suggest that associations between cardiovascular risk factors and lowered cognitive function among healthy middle-aged and elderly adults strongly depend on gender.

Objective. The objective of the study was to assess mortality risk in the subjects with diagnosed metabolic syndrome (MS) using National Cholesterol Educational Program (NCEP-ATPIII), American Heart Association and National Heart Lung and Blood Institute (AHA/NHLBI) International Diabetes Federation (IDF) and Joint Interim Societies (JIS) definitions. Methods. Two randomsamples aged 35–64 yearswere examined in 1992–2002 in the frameworkwithin the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study (N=2455). The follow-up was carried out in terms of the end points reached from the baseline health examinations until December 31, 2009. Results. Cox regressions demonstrated that MS defined by IDF and JIS definitions remained the only significant determinants for all-cause mortality (RR=1.48 and RR=1.41; pb0.05) and cardiovascular disease (CVD) mortality inmen (RR=1.81 and RR=1.66; pb0.05). In men (without previous CVD) the NCEP-ATPIII definition had increased mortality risk from CVD (RR=1.98; p=0.012), than in men with identified MS by the IDF and the new JIS definition. In women the MS was not associated with risk of mortality from CVD. Conclusion. The MS definitions according to the IDF and JIS criteria appear to be a slightly better predictor of all-causemortality andmortality from CVD; MS according to the NCEP-ATPIII criteria appears to be a better predictor of mortality from CVD in men.