Dereškevičiūtė, Ieva

Objectives (oral/poster only) Objectives: 1. To assess cerebral tissue oxygenation in neurosurgical patients having carotid endarterectomy using near-infrared spectroscopy (NIRS). 2. To assess the relationship between end-tidal carbon dioxide (EtCO2) and near-infrared spectroscopy (NIRS). 3. To analyze how frequently patients having carotid endarterectomy in the field of neurosurgery experience episodes of desaturation of the cerebral tissue, as well as any potential causes of this desaturation. Materials and methods (oral/poster only) The study was conducted at the Hospital of LUHS Kaunas Clinics Anesthesiology department. Twenty individuals who had carotid artery endarterectomy were included in the study. Measurements recorded after induction, before first surgical incision, after clamping of carotid artery of the operated side, (4) after restoration of carotid artery blood flow, before extubation or before transferring the not extubated patient to the intensive care unit. All patients were prepared for surgery according to a standard protocol, with additional NIRS sensors in the forehead area. MAP, SpO2, EtCO2, and rSO2 were monitored during the procedure. Results (oral/poster only) A marginal and statistically insignificant correlation between NIRS and MAP was discovered by the study. While there was no correlation between SpO2 and NIRS, there was a relatively high and statistically significant correlation when looking at the relationship with EtCO2. One-fifth (N = 4) of all patients experienced outbreaks of brain desaturation. The left carotid artery's functioning showed the most abnormalities (N = 3). Conclusions 1. After clamping the carotid artery of the operated side, patients' lowest NIRS readings (lowest regional oximetry values) were discovered. 2. There is a statistically significant and relatively strong connection between rSO2 and end-tidal exhaled carbon dioxide (EtCO2). Therefore, it may be claimed that as EtCO2 concentration rises, the body works to oxygenate the brain tissue better and guard against potential desaturation. 3. Throughout the entire carotid endarterectomy process, episodes of brain tissue desaturation are possible.

Elektroninės cigaretės kiekvienais metais vis labiau populiarėja visame pasaulyje. Jau ir dabar galima teigti, jog e. cigarečių vartojimas plinta tarsi epidemija. Jas vartoja tiek suaugusieji, tiek mokyklinio amžiaus vaikai ir tai kelia daug klausimų dėl saugumo ir ilgalaikio poveikio sveikatai. Nors duomenų apie e. cigarečių reliatyvią naudą yra nepakankamai, tačiau visuomeniniuose informacijos sklaidos šaltiniuose galima rasti, kad e. cigaretės pateikiamos kaip saugi alternatyva tradiciniam rūkymo būdui, kai iš tiesų jų ilgalaikis poveikis nėra iki galo ištirtas. Pagal turimas žinias galima daryti išvadą, jog e. cigaretės nesuteikia jokios naudos sveikatai, išskyrus atvejus, kai jos pasirenkamos metant rūkyti tradicines, remiantis mažesnės žalos principu.

Demencija yra lėtinis ir progresuojantis kognityvinių funkcijų sutrikimas, sukeltas neurodegeneracinių pakitimų žmogaus smegenyse. Dėl ilgėjančios gyvenimo trukmės pastebimas drastiškas demencija sergančių žmonių skaičius, kuris skatina ieškoti šios būklės atsiradimo priežasčių ir jas koreguoti. Šio tyrimo tikslas yra išsiaiškinti anestezijos įtaką demencijos atsiradimui. Buvo nagrinėjami 2018-2021 m. publikuoti moksliniai straipsniai. Rezultatai parodė, kad tiesioginė anestezijos įtaka demencijos atsiradimui, jos progresavimui yra abejotina, o atlikti tyrimai išlieka prieštaringi. Stebima pooperacinio delyro įtaka kognityvinių funkcijų sutrikimui, kuris gali turėti įtakos ir demencijos eigai. Lyginant atskirų anestezijos rūšių įtaką demencijos pasireiškimui, sąsajų nerasta, tačiau regioninė anestezija sietina su mažesniu poveikiu atskiroms kognityvinėms funkcijoms pooperaciniu laikotarpiu.

Nuo pirmųjų COVID-19 apraiškų 2019 metais iki 2022 m. gegužės pasaulyje užregistruota daugiau nei 515 mln. COVID-19 infekcijos atvejų. Šiuo metu atliekami įvairūs moksliniai tyrimai, nagrinėjantys ilgalaikes pasekmes ir atrandama vis daugiau ligos komplikacijų. Nors duomenys apie viruso sukeltas komplikacijas yra reliatyviai nauji, tačiau literatūroje galima rasti, kad apie 80 proc. pacientų, pasveikusių nuo COVID-19, praneša apie bent vieną ilgalaikį simptomą, pasireiškusį praėjus mažiausiai 2 savaitėms nuo ūmios infekcijos. Iš turimų žinių galima daryti išvadą, jog šiuo metu mums trūksta epidemiologinių duomenų apie skausmą po COVID-19, o didelis jo paplitimas leidžia manyti, jog artimiausioje ateityje tai gali tapti pasauline sveikatos priežiūros problema.

Introduction Asthma is the most common chronic respiratory illness that affects more than 300 millionpeople worldwide [1,2]. Symptoms are non-specific, but the most common ones include wheezing, shortness of breath, chest tightness, and cough [3,4]. Difficulties with self- management are associated with reduced quality of life [5]. Aim To evaluate if asthma symptoms have association on quality of life among LUHS students. Methods The study was approved by the Kaunas regional biomedical research ethics committee (No. BEC-MF-335). There were 361 study participants aged between 19-41 who completed a self-administered anonymous questionnaire, which consisted of questions about gender, age, asthma symptoms and quality of life (5 questions: current wellbeing, restriction of daily activities, sleep disorders, fatigue during the day, emotional state). 24 (6.6%, p=<0,001, x2=271,38) of participants had a confirmed diagnosis of asthma. 337 (93,4%, p=<0,001, χ2 = 271,38) of participants had not confirmed diagnosis of asthma. Research objectives χ2 criteria was used. The results are statistically reliable when p<0.05. The statistical analysis was performed by using Microsoft Excel and statistical software SPSS 17.0. Results Among confirmed diagnosis of asthma, there was a statistical significance between the respondents who selected their well-being as bad(n=1, 4,2%),responders who picked their well-being as great(0%). Among those without allergic asthma, there were statistically significantly more respondents who rated their health as excellent(n=45, 13.4%) than as poor(1, 0,3%). […].

Introduction COVID-19 is accompanied by multiorgan disfunction [1]. Virus enters the target hostcells via the angiotensin-converting enzyme 2 (ACE2) and causes viral pathogenicity and organ damage[2]. It is reported that ACE2 are expressed in kidneys and male genitalia organs [3,4]. AimTo review COVID-19 infection impact on male urogenital system. Methods We performed a systematic literature study in Pubmed, Web of Science following the PRISMA guidelines. In the current narrative review databases were searched to identify all the related reports discussing the impact of COVID-19 on the urogenital field. Keywords: urogenital system, COVID-19, secondary damage. Analysis of 657 articles was performed. We excluded articles of children, female patients, non- English language, non-full text articles focused on other topics. Results Titles and abstracts were screened of 657 publications. Selection criteria were applied and only 7 [5–11] publications were selected. One of the key points about COVID-19 impact on urogenital system is its effect on kidneys. […].

Objectives. Postpartum hemorrhage (PPH) is the principal cause of maternal mortality, accounting for nearly a quarter of the maternal deaths that occur worldwide. The typical cause of PPH is uterine atony, therefore increasing the use of uterotonic agents for all women during delivery has been a key component of worldwide efforts to decrease PPH-associated morbidity and mortality. The administration of exogenous oxytocin is the most typical method because it is thought that additional oxytocin further stimulates uterine contractility. The aim of this study is to compare the effect of oxytocin when it is administrating by different routes during caesarean section. Materials and methods. This retrospective study was conducted at LUSH KK. 20 patients were registered who were administrated to oxytocin during cesarean section between December 2020 and March 2021. Patients were randomly divided into two groups: the first group received oxytocin by infusion (N=10) and others received oxytocin through an automatic injection pump (AIS) (N=10). Data were analyzed in the SPSS. P-value less then 0,05 considered reliable. Results. The total dose of oxytocin was found to be 2.5 times lower in the AIS group (15 ± 5.7 IU and 6 ± 2.1 IU respectively, p <0.001). The need for additional oxytocin dose was higherin the infusion group (n = 8 respectively n = 2, p = 0.023,). The greater amount of blood loss(1280 ± 181.353 and 460 ± 54.64 respectively, p <0.001) and need for intravenous fluid (2300± 258.19 and 2000 ± 0 respectively, p <0.023) were observed in the infusion group. There wereno differences in heart rate or peripheral oxygen saturation between the groups, but changesin systolic and diastolic blood pressure are more affected by oxytocin infusion.Conclusions. The initial prophylactic dose of oxytocin is lower when it is delivered by anautomatic syringe pump.

Introduction. Uterine rupture is very rare, but serious complication of pregnancy. It could be fatal for both, mother and fetus. There are a few golden minutes to save fetus and dramatic fight for parturient life and further fertility. Case description. 49 years old parturient at 31 weeks of gestation after in vitro fertilization(IVF) procedure was admitted to the hospital due to mild pain and irregular uterus contractions. Her obstetric anamnesis was complicated: one miscarriage at 16 weeks of gestation after IVF procedure, Group B streptococcus colonization, cervical cerclage at 13th week of pregnancy was performed to prevent premature birth, laparoscopic removal of myoma 4 years ago. Patients vital signs were stable, cardiotocography was normal, just minimal vaginal bleeding about150ml of fresh blood was detected. Placental abruption was suspected. First urgency category Cesarean section was performed under general anesthesia. Two 16G intravenous lines were inserted and infusion with crystalloids was started. Blood products were ordered. After incision of abdominal wall the fetus and placenta were removed from peritoneal cavity together with two liters of blood. Apgar scores 1 and 5 minutes were 5 and 8 respectively. Uterine fundus rupture was detected. As uterine atony was resistant to conservative treatment, total hysterectomy was performed. Total blood loss was 2500 ml. Two units of red blood cells, 2 units of fresh frozen plasma and 6 units of cryoprecipitate were transfused. Summary. This case report presents a rare complication - rupture of uterus and demonstrates that despite of many risk factors it is hard to predict or prepare to such challenge and good results depend on fast reaction to changing circumstances. Conclusions. Multiple intrauterine manipulations increases the risk of fatal complications during pregnancy. Event a few milliliters of fresh blood can be a sign of dramatic situation and requires immediate decisions.