Gerbutavičienė, Rima Jūratė

Background: Toxic epidermal necrolysis (TEN) is a rare but life-threatening complication that may occur in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT), particularly in the context of extensive drug exposure. In this population, TEN can closely resemble severe acute graft-versus-host disease (GVHD), making diagnosis and management challenging. Case presentation: We report the clinical course of an allo-HSCT recipient who developed a rapidly progressive skin rash early after transplantation, and we analyzed the clinical features, histopathology, treatment and outcome. Results: The patient developed rapidly progressive epidermal detachment with severe oral, ocular, and genital mucosal involvement shortly after exposure to trimethoprim/sulfamethoxazole (TMP-SMX). Disease severity was reflected by a SCORTEN score of 5, corresponding to a very high predicted mortality risk. The clinical picture raised concern for both TEN and severe acute GVHD, while histopathological findings favored TEN but were not definitive. Management included systemic corticosteroids, intravenous immunoglobulin, ruxolitinib, and intensive supportive care. The patient gradually re-epithelialized and recovered without long-term sequelae. Conclusions: This case underscores the diagnostic difficulty of distinguishing TEN from severe acute GVHD in the early post-transplant period. Careful assessment of drug exposure, clinical evolution, and multidisciplinary evaluation are essential to guide timely and appropriate management.

Objectives: this study aimed to develop and optimize an intranasal delivery system for Eplerenone (EPL) by incorporating Eplerenone-loaded liposomes (Elip) into an in situ gel system (Elip-GG). The goal was to prolong the residence time of the drug in the nasal cavity and ensure sustained release. Methods: Elip and unloaded liposomes were prepared using the thin-film hydration method. Key formulation variables such as encapsulation efficiency (EE%), mean particle size (MPS), polydispersity index (PDI), and zeta potential (ZP) were optimized. The Elip was then incorporated into a gellan gum (GG) in situ gel to form Elip-GG. The Elip-GG formulation was evaluated based on parameters such as pH, viscosity, rheological behavior, mechanical properties, and in vitro release. Results: the optimal Elip formulation exhibited an EE of 86.3%, a mean particle size of 86.56 nm, a PDI of 0.29, and a ZP of −29.86 mV. The cumulative drug release from the Elip-GG formulation exceeded 93% after 2.5 h. The Elip-GG formulation significantly increased the sustained release of Eplerenone when administered intranasally, offering a promising alternative to oral and parenteral delivery methods for hydrophilic antihypertensive drugs.

Background: 100 years ago, the first Lithuanian pharmacy diploma was awarded. A graduation diploma opens new opportunities, making this event significant and widely celebrated throughout history. Traditionally, graduates have marked this milestone together with professors, students, and family members. Aim(s): To analyze the historical development of pharmacy diploma awarding traditions and their transformation under political, historical and cultural influences. Methods: The study employs a historical approach and a photographic analysis to examine the evolution of pharmacy diploma awarding traditions Results: Political changes have influenced the traditions of diploma awarding ceremonies. There is little information about how pharmacy graduates in interwar Lithuania celebrated this occasion. During the post-war period, economic hardships affected graduation events. However, over time, a tradition of the "last lecture" emerged, characterized by a student-organized artistic program, a symbolic will for future pharmacy students, and an abundant feast during the final lecture. The diploma ceremony took place in the Great Hall, where the rector awarded diplomas, and the dean delivered congratulatory speeches. In the years of regained independence, around the 2000s, the tradition of wearing academic regalia emerged. Students rented regalia, following a practice that likely originated in Western Europe or the United States. In interwar Lithuania, academic regalia were not used, although female graduates may have occasionally worn traditional national attire. Over time, the diploma awarding ceremony moved to Žalgiris arena. Certain traditions faded, such as the presence of alcohol, which had been a prominent element for many years, as well as the "last lecture" tradition and the symbolic student testament. Conclusion: Graduation traditions have evolved under the influence of political changes. In the years of independence, Western-style traditions gained prominence, shaping a modernized approach to pharmacy diploma awarding ceremonies.

Background: Antimicrobial resistance threatens modern medicine, making hospital antimicrobial stewardship crucial. Internal guidelines help manage drug use and resistance. This study analyzed compliance with these guidelines at X Hospital from 2023 to 2024. Aim(s): to analyze X hospitals adherance to empirical antimicrobial prescription guidelines during the period of 2023 January – 2024 June. Methods: The study was conducted from September to December 2024, following the necessary bioethics approval and hospital administration permissions. We analyzed patient data for those prescribed antimicrobial drugs for treating pneumonia (J), pyelonephritis (N), and abdominal infections (K). Compliance with the hospital's internal empiric antimicrobial prescription guidelines was assessed. These guidelines recommend specific first-choice drugs for each diagnosis and second-choice drugs if the first fails. We also evaluated the rationality of prescriptions, including dosage, effectiveness, safety, and monitoring. All data were analyzed using the latest version of SPSS. All data were analyzed using the latest version of SPSS. Results: A total of 607 patient cases were analyzed: 568 from the Department of Internal Medicine and 39 from the Intensive Care Unit, spanning January 2023 to June 2024. Key findings include. Pneumonia: adherence to guidelines declined, with first-line antibiotic use decreasing from 70.5% to 56%, a 20.5% reduction. Second-line antibiotics increased by 6%, from 19% to 25% by mid-2024 (Fig. 1). Abdominal Infections: first-line antibiotic use decreased by 28.3%, with a 12.2% decline in second-line prescriptions. Pyelonephritis: first-line antibiotics were no longer prescribed in 2024, with clinicians favoring second-line or alternative treatments. Conclusion:the adherence to hospital antimicrobial drug prescription guidelines is declining, as physicians are increasingly deviating from the recommended first-line treatments in favor of second-line drugs or alternative therapies. This trend underscores the necessity for a reassessment of the current antimicrobial prescribing guidelines, with a particular focus on enhancing physician education and updating the recommendations to reflect current clinical practices.

Background and Objectives A pandemic of the coronavirus disease (COVID-19) has been declared in Lithuania and the world in 2020 (1). The misuse of antibiotics has intensified during the COVID-19 pandemic, leading to continued irrational use of antibiotics (2). The irrational prescribing and use of antibiotics is a universally recognized threat to health systems worldwide (3). The main objective of this study was to compare the consumption of antimicrobial J01 systemic drugs in different divisions of Lithuanian University of Health Sciences (LUHS) Hospital of Kaunas in 2020 – 2022. [...]. Conclusions and Recommendations The consumption of antibiotics, either in general or assigned to Reserve fund, was greater in Division B than in A in all study period. The yearly dynamics of consumption of antibiotics may have been influenced by the high number of complications caused by the COVID –19 disease and other seasonal viruses. The yearly decrease of consumption of antibiotics assigned to Reserve fund in both divisions might have been influenced by the implementation of Antimicrobial Reserve Fund management and the position of a physician clinical pharmacologist who had a positive impact on more rational prescription of antibiotics.

Background: Despite the fact that for over ten years, Lithuanian consumers have been able to report adverse drug reactions (ADR) directly to the competent authority, reporting rates remain low. A comprehensive understanding of consumer perceptions and experiences regarding ADRs is needed to ascertain further factors impacting their engagement in ADR reporting. This study aimed to assess consumer knowledge of, attitude toward, and practice of reporting ADRs. Methods: A questionnaire-guided cross-sectional survey among 404 consumers between October 2021 and June 2022 was conducted. The semi-structured questionnaire comprised open-ended and closed-ended questions to explore the sociodemographic characteristics and general knowledge of ADRs and pharmacovigilance. Other question items evaluated attitudes toward ADR reporting and ADR reporting practice. The data were summarised using descriptive statistics, while the chi-square test was used to assess categorical variables at p < 0.05. The overall percent score in the knowledge and attitude domains was divided into groups of “poor”, “moderate”, and “good” knowledge, as well as “positive” and “negative” attitudes. Results: While having a generally poor understanding, this study demonstrates that Lithuanian consumers have a favourable attitude toward pharmacovigilance, particularly regarding issues involving the requirement for reporting. The data also revealed the justifications for reporting and not reporting ADRs. Conclusions: The current study provided the first understanding of consumer awareness and ADR reporting intentions, which can help to develop educational campaigns and interventions addressing pharmacovigilance and ADR reporting.

The paper explores the link between new product innovativeness and performance, as well as its moderation by commercial environment in retail. It analyzes the linkage and context built on marketplace, company's characteristics and retail category management decisions as an integral commercial environment. The research employs a unique data set - new product introductions with their actual sales results as a performance indicator. The research concludes that the innovativeness - performance link cannot be evaluated unilaterally, confirming the role of the commercial environment as a moderator of the link. The commercial environment is associated with a favorable and non-favorable economic climate that leads to performance-related opportunities or barriers in the marketplace for product innovations. Findings add value to the theoretical development of innovativeness-performance linkage studies, and also are valid pratically. It provides practical guidance to the integral understanding of commercial environment to which companies might be able to adapt during the new product launch.

Objective: Ginkor Fort® (Tonipharm, Recordati Group; GB-T-H combined treatment) comprises ginkgo biloba extract, troxerutin and heptaminol chlorhydrate. It is a venotonic and vasculoprotective agent that strengthens veins, increases vessel resistance, and reduces permeability. Thanks to these synergistic actions, it is indicated for the treatment of signs and symptoms of venous insufficiency (VI) and signs related to the hemorrhoidal crisis. This review recapitulates the rationale for using venotonics to manage VI and discusses available evidence on the use of GB-T-H combined treatment to manage VI and hemorrhoidal crisis. Materials and methods: Papers were retrieved by a PubMed search using different keywords. No language or publication date restrictions were used. Documents from the Authors’ literature collection were also considered. Papers were selected for inclusion according to their relevance to the topic. RESULTS: Preclinical and clinical studies showed that the GB-T-H combined treatment acts on both the acute phase symptoms and the pathogenetic mechanisms of the VI, through the prevention of the hypoxia-induced activation of endothelial cells, the reduction of the capillary tone and the hemostatic activity. This leads to the long-term slowing of the disease progression, suggesting that the GB-T-H combined treatment can manage the acute clinical manifestations and as a prevention measure with prolonged use in both VI and hemorrhoidal crises. In the available study, the GB-T-H combined treatment showed excellent tolerability. Conclusions: Available literature evidence and extensive clinical experience support the use of the GB-T-H combined treatment as an effective and safe option for treating and preventing the clinical manifestation of VI and hemorrhoidal crisis.

Cyano-phycocyanin is one of the active pigments of the blue-green algae and is usually isolated from the filamentous cyanobacteria Arthrospira platensis Gomont (Spirulina). Due to its multiple physiological functions and non-toxicity, cyano-phycocyanin may be a potential substance for the topical treatment of various skin diseases. Considering that the conventional medicine faces drug resistance, insufficient efficacy and side effects, the plant origin compounds can act as an alternative option. Thus, the aim of this paper was to review the wound healing, antimicrobial, antioxidative, anti-inflammatory, antimelanogenic and anticancer properties and mechanisms of cyano-phycocyanin topical activities on human skin. Moreover, possible applications and biotechnological requirements for pharmaceutical forms of cyano-phycocyanin for the treatment of various skin diseases are discussed in this review.

Higher education studies often use complex texts in the learning process. Remembering the information presented in this way takes longer and is harder than by using imaginary maps. Mind Maps are used in many areas. The usage of Mind Maps makes learning easier and more effective. Contemporary learning does not recognize mechanical knowledge. Instead, it suggests looking for innovative and interactive learning methods and tools. Mind Maps help the learner to understand the teaching material and to organize knowledge into a particular structure. Furthermore, by using Mind Maps, it is easier to memorize and to retain the necessary information in the memory. Purpose of the research: To reveal the students' attitude towards the use of Mind Maps in the creation of an innovative and interactive learning environment in learning languages at the Lithuanian University of Health Sciences. The use of Mind Maps has many positive aspects of the learning process. T. Longeon (2010) argues that drawing a map brings the participants closer together during the sessions. Team members work harder than working individually. Besides, it helps to improve the systematic thinking of the group. Drawing diagrams in the discussion makes it easier for students to create ideas, understand them, and connect them. Thus, the use of Mind Maps improves not only learning abilities but also social abilities (Dambreville, 2014). Buzan (2007) argues that Mind Maps make it easier to remember when learning languages, and drawing and creation facilitate learning. The use of this method improves critical thinking, reading and writing skills, and the ability to learn and think. Besides, the use of Mind Maps reinforces creative thinking, helps to think visually and to solve problems openly, to systematize knowledge, and to collect, store, process, and organize information obtained from the environment. Methods/methodology: A study on the use of Mind Maps in