Lukoševičiūtė, Urtė

Acute ischemic stroke (AIS) is a medical emergency that occurs when a thrombus or embolus suddenly blocks blood flow to the brain, depriving a specific region of oxygen. If circulation is not restored in time, brain tissue damage and cell death follow. Stroke remains the second leading cause of death worldwide, making early diagnosis and rapid treatment essential to minimize neurological damage. Despite advances in research and treatment, human factors still play a role in emergency care. Triaging patients, providing consultations, selecting the right tests, and accurately interpreting results all take valuable time, which can impact patient outcomes. Aim. This article aims to evaluate the diagnostic time values for acute strokes in one Hospital center. Methods. A retrospective analysis of adult patients diagnosed with acute ischaemic stroke (International Classification of Diseases I63.5) in the Trauma and Emergency Department in one Hospital center, that required head enhanced CT scan. Conclusion. Most door-to-CT orders were placed within five minutes, with a median time from door to CT interpretation of 1 hour 5 minutes. While reducing this delay is crucial for AIS management, the lack of of significant differences between shifts suggests operational factors play a role. To improve efficiency, future efforts should prioritize minimizing the interval between CT completion and radiological interpretation.

Kontrastinės medžiagos radiologijoje yra labai svarbios vaizdų diagnostiniam tikslumui. Jos naudojamos įvairiuose tyrimuose, tokiuose kaip kompiuterinė tomografija (KT), magnetinio rezonanso tomografija (MRT) ir ultragarsas (UG). Kontrastinės medžiagos, pvz., jodo junginiai KT tyrime ir gadolinio pagrindu pagaminti preparatai MRT tyrime, pagerina audinių ar organų vizualizaciją, keisdamos kontrastą tarp skirtingų struktūrų.

Introduction Adrenal tumors (AT) are commonly discovered incidentally on cross-sectional abdominal imaging performed for reasons unrelated to an adrenal mass (AM). AT affect around 4–10% of the general population, with the highest incidence occurring in the seventh decade of life1,2. In any patient with a newly discovered AM, determining whether it is malignant and whether it is hormonally active are equally important to guide optimal management3. All patients found to have an AT should undergo a detailed clinical, biochemical and radiological evaluation to select those requiring surgical management2. Modern image techniques play a central role in the diagnosis of AT. Unenhanced computed tomography (CT) attenuation is the preferred method for evaluating primary AT, as it helps differentiate between malignant and benign tumors4. CT radiographic characteristics of malignant AM include a tumor size > 4 cm, irregular margins, heterogeneous enhancement, and lesions exhibiting < 40% relative percentage washout (RPW) or < 60% absolute percentage washout (APW) of intravenous contrast5. AT can affect the synthesis of hormones produced by the adrenal glands (i.e. cortisol, aldosterone, and androgens) leading to hyperadrenalism from excess hormones or hypoadrenalism if non-functional6. In either case, the presence of an AT can significantly affect the levels of adrenal hormones, leading to various health symptoms. Aim To evaluate the distribution of different AT types, hormonal profiles, and radiological data of patients diagnosed with AT. Methods We retrospectively analyzed the medical documentation from database of the Hospital of LUHS KK of 80 patients (40 female, 40 male) who were diagnosed with AT in 2017-2018 using CT. Formal Bioethical Permit from regional legal body was obtained. Clinical and laboratory data, including hormone levels (DHEAS, testosterone, aldosterone, ACTH, cortisol, renin, metanephrine, normetanephrine), were recorded. CT features (tumor size, contrast enhancement) and hormone levels were analyzed, with statistical significance set at p<0.05 using "IBM SPSS Statistics 29.0." Results The most frequently occurring AT (42.5%) was adenoma, whereas aldosteronoma was the least common (3.8%). Analyzing the distribution of the AT types and blood hormone concentrations, it was found that the percent increase in metanephrine and noretanephrine was significantly higher in pheochromocytoma than in other tumors. There was a statistically significant difference in tumor sizes between adenomas and pheochromocytomas, with pheochromocytomas being notably larger. Additionally, pheochromocytomas showed significantly greater contrast enhancement compared to all other AT. Conclusions The most common AT type was adenoma. Pheochromocytomas showed significantly higher metanephrine and normetanephrine levels, larger tumor sizes, and greater contrast enhancement compared to other AT.

Purpose: Subcutaneous fat accumulation has been linked to adverse brain health outcomes. This study examines the relationship between thigh muscle mass, subcutaneous fat distribution, and brain structure in elderly adults. It explores how body composition affects cortical thickness in brain regions linked to cognitive function. Methods or Background: Fifty-four healthy elderly individuals underwent imaging of the right thigh and brain using a 3T Siemens Avanto MRI system. Muscle and subcutaneous fat cross-sectional areas (CSA) were measured at 50% and 20% of thigh length, with the muscle-to-fat ratio calculated at the 50% mark. Cortical thickness was assessed through brain volumetric analysis using Freesurfer 7.4.1 software. Results or Findings: Significant positive correlations (r ≥ 0.2, p ≤ 0.05) were found between the muscle-to-fat ratio and cortical thickness in the left cerebellum, cuneus, and transverse temporal cortex, in the right entorhinal cortex, inferior temporal cortex, postcentral gyrus, superior temporal cortex, and the banks of the superior temporal sulcus (BANKSSTS). Additionally, significant negative correlations (r ≤ -0.2, p ≤ 0.05) were observed between subcutaneous fat CSA at 50% of thigh length and cortical thickness in the left cuneus and entorhinal cortex, in the right BANKSSTS, postcentral gyrus, and superior temporal cortex. Additionally, subcutaneous fat CSA at 20% of thigh length was inversely correlated with cortical thickness in the left cuneus and right BANKSSTS (r ≤ -0.2, p ≤ 0.05). Conclusion: Our findings demonstrate that increased thigh muscle mass correlates with greater cortical thickness in cognitive regions, while elevated subcutaneous fat is linked to reduced thickness. These results highlight the role of body composition in maintaining brain health in the elderly and underscore the importance of muscle mass in mitigating age-related cortical decline. Limitations: With only 54 participants, the study's findings may lack generalizability.

Šios naujoviškos Mokymo priemonės tikslas - ne tik supažindinti studentus su mokymo medžiaga, bet ir teikti antrinę informaciją - apie LSMU kaip inovatyvios naujoviškos aukštosios mokyklos galimybes, mokymo proceso lankstumą, ateities aspiracijas. Peržiūrėję mokymo medžiagą studentai galės lengviau orientuotis Klinikų miestelyje, medžiaga jiems padės suprasti radiologinio ištyrimo svarbą ir galimybes. Tai pat glaustai pateikiamos diagnostikos metodų galimybės, pačios fundamentalios indikacijos, tyrimų tvarka. Mokymo priemonė trumpai ir koncentruotai informuoja studentus apie tvarką Kauno klinikose, pateikiamas savotiškas įvadas i tolimesnį Radiologijos dalyko LSMU MF III kurso studentams mokymą (Radiologijos pagrindai. Regionų anatomija MF/RAD/M-V31). Neabejotinai, ši mokymo priemonė yra svarbi ne tik ja besinaudosiantiems ir įsisavinantiems studentams, tačiau svarbi ir kaip įdomi ir naujoviška papildoma mokymosi priemonė, naudotina ir ateityje kaip naujų skaitmeninamų ir virtualizuojamų mokymo dalykų pagrindas. Rekomenduoju Medicinos fakulteto tarybai pritarti ir aprobuoti šią inovatyvią mokymo priemonę. (LSMU MA Radiologijos klinikos prof. A. Basevičius)

Aim: To evaluate the clinical, laboratory and radiological data of patients diagnosed with adrenal tumors. Methods: Analysis of medical histories of patients diagnosed with adrenal tumor in 2017-2018. 40 males and females with a mean age of 59.48 ± 12.45 and 63.83 ± 14.92, respectively. Results: 35% of the patients were overweight, and 41.3% - obese. Arterial blood pressure was elevated in 66 (82%) patients. The average heart rate in female patients was 77.48 ± 11.43 bpm, while in male – 78.53 ± 13 bpm. The most common: 1) complaint was high blood pressure (63,8%); 2) comorbidity - arterial hypertension (42,5%); 3) adrenal tumor - adenoma (42,5%); 4) tumor size - 3 cm (25%); and the least common adrenal tumor was aldosteronoma (3,8%). 37 tumors were enhanced according to the CT with a contrast enhancement. Males (30%) were more often diagnosed with bilateral tumors than females (5%). Finally, percental increase of metanephrine and noretanephrine was significantly higher in pheochromocytoma than in other tumors. Conclusions: 1) Differences between gender in BMI, blood pressure and heart rate were not significant. No significant differences were found between male and female complaint analysis. 2) The most common adrenal tumors were adenomas, and the changes in the hormone concentration of adenomas were not statistically significant. Pheochromocytomas were significantly larger than adenomas. Pheochromocytomas enhance statistically significantly more compared to other adrenal tumors. 3) In case of pheochromocytoma, the percentage of increase of metanephrine and normetanephrine is significantly higher than in other tumors.

Background and objectives. A synthetic ACTH stimulation test is a gold standard to detect occult adrenal insufficiently. The advantages of the test are the ability to perform it at any time and well-known normal or pathological levels of cortisol during the test 30 or 60 minutes after the injection of synthetic ACTH. The aim. Of the work was to find out how often ACTH stimulation test was performed at the Kaunas Endocrinology Center in 2014-2017. Material and methods. Medical documentation of 1471 patients (764 - 52% - women, 707 - 48% - males) was performed for 3 main reasons: 1100 -for investigation of importance of DHEAS in males, 220 - for investigation of adrenal function in ENSAT study and 151 patients for the recent study of clinical expressions in the patients with adrenal tumors. Since cortisol is the most important vital hormone of the adrenal glands, we analyzed the conditions under which it was studied. Results. A suppression test of 1 mg of dexamethasone was usually performed. It was followed by small or high dose dexamethasone suppression tests. It was not possible to determine what time of day cortisol was tested. Of 1471 patients no patient could be found who underwent an ACTH stimulation test. [...].

Objective To analyse the radiological and clinical features of patients with adrenal tumours in one university center (Hospital of Lithuanian University of Health Sciences, Kauno klinikos) and to try to find any regularities, related to clinical data. Methods Medical documentation of 150 patients (53 women and 97 men), who had adrenal tumors diagnosed by CT or/and by MRI, were analysed. Essential clinical and laboratory (hormone assessment) data were documented. Age, height, weight, BMI, systolic and diastolic blood pressure, pulse were recorded together with results of investigation of DHEAS, testosterone, TTH, aldosterone, ACTH, fT4, cortisol, renin, metanefrine, normethanefrine, aldosterone/renin ratio. Results Age of women and men at the moment of AT diagnosis was the same (60,9 and 60,5 years respectively). No difference of systolic and diastolic blood pressure, pulse and BMI was detected between women and men. Concentration of aldosterone (around 70%), ACTH (around 40%), cortisol (around 70%), renin (around 60%), methanephrine and normethanephrine (around 65%) and aldosterone/renin ratio (around 25%) were investigated with the same frequency both in women and men. TTH, fT4 and DHEAS were assessed more frequently in female, than in male patients (48, 41 and 50% and 32, 28 and 40% respectively). Surprisingly, testosterone was assessed rarely both in women (7%) and men (8,25%). Without hormone investigations remained 5,5 % of women and 20,6% of men. Unilateral, as well as bilateral, adrenal tumours were detected with the same frequency (64,8% female vs 63,9% male, as well as 11,1% of female vs 16,5% of male patients). Minor visual changes of adrenals were detected with similar frequency in both genders (3,7% in females and 5,2% in males). Surgery was performed in 7,4% of female, and in 5,2% of male patients. In female patients all resections were unilateral, in male 3,1% of cases were unilateral. In case of bilateral AT, unilateral resection was performed more frequently in female, compared to male patients (5,6% vs 2,1%).ConclusionsTTH, fT4 and DHEAS were assessed more frequently in female, than in male patients. Surprisingly, testosterone was assessed rarely both sexes. Without hormone investigations remained 5,5 % of women and 20,6% of men. Unilateral, as well as bilateral, adrenal tumours were detected with the same frequency (female vs male patients). Minor visual changes of adrenals were detected with similar frequency in both genders, as well. In case of bilateral AT, unilateral resection was performed more frequently in female, compared to male patientsB rief description of the abstractAdrenal tumors are common a finding. Modern image techniques occupie a central place in the diagnosis of adrenal tumors. After diagnosis of an adrenal tumor, a multidisciplinary team clarifies the diagnosis and prescribes treatment for the patients. This is usually performed in tertiary hospital (university clinic in our case). We attempted to analyse retrospectively, how this system works in real life, and tried to find any regularities, related to clinical data and radiological findings.

Objective: To analyse the radiological and clinical features of patients with adrenal tumors in one university center, and to tr y to find any regularities, related to clinical data. Methods: Medical documentation of 53 women and 97 men, who had adrenal tumors diagnosed by CT or/and by MRI, were analysed. Essential clinical and laboratory data were documented. Age, height, weight, B MI, systolic and diastolic blood pressure, pulse were recorded together with results of investigation of DHEAS, testosterone, TTH, aldosterone, ACTH, fT4, cortisol, renin, metanefrine, normethanefrine, aldosterone/renin ratio. Results: Age of women and men at the time of AT diagnosis was the same. Concentration of aldosterone, ACTH, cortisol, renin, methanephrine and normethanephrine and aldosterone/renin ratio were investigated with the same frequency in both sexes. TTH, fT4 and DHEAS were assessed more fr equently in female, than in male patients (48, 41 and 50% and 32, 28 and 40% respectively). Surprisingly, testosterone was assessed rarely both in women and men. Without hormone investigations remained 5,5 % of women and 20,6% of men. Unilateral, as well a s bilateral, adrenal tumours were detected with the same frequency in both sexes. Surgery was performed in 7,4% of female, and in 5,2% of male patients. Conclusions: TTH, fT4 and DHEAS were assessed more frequently in female patients. Surprisingly, testos terone was assessed rarely in both sexes. Unilateral, as well as bilateral, adrenal tumours were detected with the same frequency (female vs male patients). In case of bilateral AT, unilateral resection was performed more frequently in female patients.