DSpace-CRIS 8

SUMMARY Fanny Alma Maria Hilding. Traditional and Modern Contraceptive Methods and Their Effect on the Vaginal Microbiota. Scientific supervisor Dr. Daiva Janulaitytė-Gunther MD PhD. Lithuanian University of Health Sciences, Medical Academy, Institute of Microbiology and Virology. Aim of the study - To conduct a comparative analysis of the microbiological and vaginal health impacts of Phexxi®, IUB™ Ballerine® and Ovaprene®, focusing on their safety, influence on bacterial diversity, and susceptibility to infections compared to traditional contraceptive methods. Objectives of the study - To assess the safety profile of Phexxi®, IUB™ Ballerine®, and Ovaprene®. To explore the microbiological safety of these methods. To evaluate the susceptibility to vaginal infections. To compare safety profiles of innovative non-hormonal methods to traditional approaches. Research methodology and methods - A detailed and comprehensive literature review was conducted using a systematic principle to investigate the research problem, primarily utilising established scientific research databases, followed by supplementary resources intended for physicians and healthcare professionals. The references underwent a three-step selection process, and five inclusion criteria were applied. The research was conducted from December 2024 to May 2025. It was completed by searching the references in the reference section of the selected publications. Results - Phexxi® offers a safe profile, although it potentially results in local discomfort with frequent and prolonged use, as well as an increased susceptibility to UTIs, compared to traditional methods. It is safer than N-9, poses less infection risk than invasive devices, but lacks the same protection as condoms. Phexxi® is microbiologically safe, seems to maintain Lactobacillus dominance and is not associated with dysbiosis. IUB™ users experienced vaginal infections and discharge, which resemble the findings associated with the Cu-IUD. Pain-related symptoms were lower in IUB™ users, suggesting better tolerability. Overall, all measured symptoms are improved with IUB™ rather than the Cu-IUD, supporting that IUB™ may contribute to a better user experience; however, the significance of the data is unknown and further research is warranted. Conclusions - Phexxi® is more frequently associated with local irritation and discomfort than its hormonal vaginal equivalents. However, the absence of systemic side effects and serious infections supports it being a safe contraceptive option. The IUB Ballerine® may share a similar safety profile with the Cu-IUD and appears to be less favourable than that of traditional methods, though safety data remain limited. The safety profile of Ovaprene® remains reassuring, with mild to moderate local side effects that needs monitoring due to increased BV-rates in susceptible individuals. The vaginal microbiota remains stable and is compatible with vaginal health. Ovaprene® is currently in Phase III trials with the expectation that it will become the first FDA-approved long-acting, reversible, user-controlled non-hormonal contraceptive.

Author of the study: Timofej Postarnakov Full title of the study: Microbiological Trends in Blood Cultures: A Retrospective Study on Pathogen Patterns and Antibiotic Resistance Aim of the study: To evaluate the changes of microorganisms causing bacteremia spectrum and their antimicrobial susceptibility during of 2019-2023 years period. Objectives of the study:

1. To evaluate the spectrum of microorganisms causing bacteremia
2. To detect possible associations between type of microorganism and patient's sex and age group
3. To evaluate the susceptibility to antimicrobials of three most often isolated microorganism types
4. To find changes in spectrum of microorganisms causing bacteremia and their susceptibility to antimicrobials over 5 years period. Object and methods of the study. In this study the laboratory result data of patients with confirmed bacteremia, treated in the Hospital of Lithuanian University of Health Sciences Kauno Clinics during the period between 2019 and 2023 were analyzed retrospectively. Antimicrobial resistance of all isolated strains was assessed according to the requirements of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Long-term dynamics of bacteremia case structure and antimicrobial resistance of pathogens were also assessed. Statistical analysis was performed with IBM SPSS 29.0 statistical package. Results. 5013 cases of BSI were registered in the Laboratory Medicine Clinic of hospital of the Lithuanian University of Health Sciences (HLUHS) Kauno Clinics, within which 5735 microorganisms were identified during the period 2019–2023. Most often isolated pathogen was Escherichia coli – 23.55 %, second group was Staphylococcus aureus – 16.39 %, following by Klebsiella species – 11.24 %. More than half of the overall BSI cases were recorded among men (55.91 %) than among women (44.09 %) but the differences were not statistically significant (p > 0.05). Patients over 60 years are most significantly represented in BSI structure. Escherichia coli had high resistance rate to ampicillin ¬– 59.57 % amoxicillin-clavulanate – 34.28 %, ampicillin-sulbactam – 27.11 %. Near quater of Escherichia coli isolates (22.20 %) had multi-drug resistance (MDR). Escherichia coli resistance rates to amoxicillin-clavulanate showed significant increase – 33 % to 41 %, resistance rates to ciprofloxacin had been decreased – 26 % to 17 %. Staphylococcus aureus showed significantly high resistance level to penicillin G – 71.08 % and low MRSA rate. Klebsiella species appears to be critical pathogen for BSI, as it has huge resistance levels to multiple drugs and 51 % of MDR strains. Resistance of Klebsiella species to ampicillin-sulbactam increased from 50 % in 2021 to 53.62 % in 2023 year. Conclusions.
5. Most frequent microorganisms which caused bacteremia were: Escherichia coli – 23.55 %, Staphylococcus aureus – 16,39 % and Klebsiella species – 11.24 %.
6. Overall BSI patients more often of male sex – 55.91 %. Enterococcus species was isolated from male patients in 64.57 % of cases, Enterobacter species has biggest probability to be found in female patient – 48.35 %. BSI in general most likely to affect elderly patients (> 60 years old) – 67.7 % of all cases.
7. Susceptibility to antimicrobials of three most often isolated microorganism groups: Escherichia coli had high resistance rates to ampicillin ¬– 59.57 % amoxicillin-clavulanate – 34.28 %, ampicillin-sulbactam – 27.11 %. 22.20 % of isolates had MDR. Staphylococcus aureus showed significantly high resistance to penicillin G – 71.08 % and low MDR rate of 8.87 %. Klebsiella species appears to be critical pathogen for BSI, as it has huge resistance levels to multiple drugs and 51 % of MDR strains.
8. Changes in spectrum of microorganisms causing bacteremia and their susceptibility to antimicrobials: • Most of BSI pathogens quantity yearly changes do not have a clear trend. Streptococcus viridans, Streptococcus β-haemolyticus and the "Other" groups showed trends to rise. • Escherichia coli resistance rates to amoxicillin-clavulanate showed significant increase – 33 % to 41 %, resistance rates to Ciprofloxacin had been decreased – 26 % to 17 % (p = 0.04; R² = 0.57). • Resistance of Klebsiella species to ampicillin-sulbactam increased from 50 % in 2021 to 53.62 % in 2023 year (p = 0.05; R² = 0.99).

The final Master Thesis of Miglė Sakalauskaitė on the topic of "Cognitive and software fusion MRI-targeted biopsy diagnostic accuracy in the detection of clinically significant prostate cancer; retrospective study at a single tertiary cancer center in Lithuania", supervised by prof. dr. Mindaugas Jievaltas and consultant dr. Aušvydas Patašius. Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Urology, Kaunas, 2025.

Aim of the study: The study aims to compare software-assisted and cognitive fusion biopsies in the detection of clinically significant prostate cancer at a tertiary cancer center in Lithuania. Objectives: 1. Collect the data and analyze the histopathological results of men who underwent software-assisted or cognitive MRI-ultrasound fusion biopsy at the tertiary cancer center in Lithuania in the years 2019-2022. 2. Determine and compare the diagnostic accuracy of the two methods. 3. To compare the findings of the retrospective study to other studies, free of cost and published in English. Materials and Methods: The retrospective single-center study included 770 previously biopsy-naive men with PI-RADS lesions 3, 4, or 5 identified on mpMRI who underwent software-assisted MRI-US fusion biopsy or cognitive MRI-US fusion target biopsy in the years 2019-2022. Clinically significant prostate cancer was defined as ISUP ≥2. The data analysis was carried out using descriptive statistics and a non-parametric Mann–Whitney U test. Categorical variables were analyzed using the Chi-square test. Crosstabulations were used to compare cancer detection rates between biopsy methods across PIRADS subgroups. Statistical significance was set at p < 0.05. Results: In total, 770 previously biopsy-naive men with PIRADS 3, 4, or 5 lesions (n=42, n=536, and n=192, respectively) were categorized based on the biopsy method received: software-assisted MRI-US fusion biopsy (n=477) and cognitive MRI-US fusion biopsy (n=293). PCa was detected in 72.7% (n=560) of cases, of which 36.8% (n=206) were clinically significant (ISUP≥2) regardless of the method. Any PCa (ISUP≥1) detection was significantly higher in the saFB group (75.7%) compared to cognitive (67.9%, p = 0.019). Clinically significant PCa (ISUP ≥2) was detected in 30.6% of saFB cases and 20.5% of cognitive cases (p = 0.002). Among PIRADS 4 patients, saFB detected more csPCa than cognitive biopsy (26.1% vs. 16.1%, p = 0.023) and more overall cancer without any statistically significant difference (71.8.0% vs. 64.3%, p = 0.07). In PIRADS 5, csPCa detection remained higher (+15.3%) with saFB (46.7% vs. 32.9%, p = 0.061), while overall cancer detection did not differ (91.0% vs. 85.7%, p = 0.260). Conclusions: The study supports the use of software-assisted MRI-ultrasound fusion biopsy, which significantly outperformed its cognitive alternative in the detection of clinically significant prostate cancer, particularly in the PIRADS 4 patient group.

Introduction: Hypothyroidism disrupts multiple metabolic processes, affecting energy balance, lipid metabolism, thermoregulation, and insulin sensitivity.

Aim: To systematically assess the impact of hypothyroidism on metabolic health.

Methods: A systematic literature review was conducted using databases including PubMed, NCBI, ScienceDirect, SpringerLink, and Google Scholar, focusing on human studies published in the last 15 years.

Results: Hypothyroidism significantly reduces basal metabolic rate, increases lipid abnormalities, impairs thermoregulation, and raises insulin resistance, even in subclinical cases. These effects contribute to higher risks of cardiovascular disease and type 2 diabetes. Monitoring free T3 levels and implementing personalized treatment are crucial for preventing long-term complications.

Conclusions: Hypothyroidism, including subclinical forms, adversely affects metabolic health and increases the risk of serious complications. Early diagnosis and individualized management focusing on metabolic indicators are essential to improve outcomes and prevent long-term health issues.

„Kardiologijos pagrindai studentams “ apima širdies ir kraujagyslių ligų sindrominę diagnostiką, paciento ištyrimo metodiką, kardiologijoje vartojamų vaistų klinikinę farmakologiją, vaizdinius tyrimo metodus, taip pat atskirų širdies ir kraujagyslių ligų diagnostiką bei gydymą. Jis skirtas medicinos specialybės studentų, taip pat kardiologijos ir kitų vidaus ligų specialybių gydytojų rezidentų mokymui, vidaus ligų, skubiosios pagalbos gydytojų, gydytojų kardiologų bei kitų specialybių gydytojų kvalifikacijos kėlimui.

Mokomoji knyga skirta pirmojo kurso Veterinarinės medicinos studentams, studijuojantiems „Atramos ir judėjimo“ modulį. Osteologija – mokslas apie kaulus – sudaro didelę šio modulio dalį. Šia mokomąja knyga galės naudotis ir studentai, studijuojantys modulio „Gyvybės mokslai – 1“ bendrosios anatomijos dalį. Knyga taip pat bus naudinga aukštesniojo kurso studentams, studijuojantiems chirurgijos ir ortopedijos studijų dalykus, žemės ūkio srities magistrantams bei doktorantams, veterinarijos gydytojams. Veterinarinės anatomijos literatūros studijoms lietuvių kalba labai trūksta, o vos keli išleisti vadovėliai mena praeitą šimtmetį. Manome, kad šis leidinys atitiks šiuolaikinės veterinarinės medicinos poreikius savo turiniu, struktūra bei iliustracijomis ir padės studentams geriau įsisavinti veterinarinės osteologijos žinias. Šiame naujame leidinyje išsamiai apžvelgta mėsėdžių griaučių struktūra, kuri iki šiol nebuvo labai akcentuojama, tačiau laikui bėgant tapo viena aktualiausių ir labiausiai tiriamų sričių veterinarinėje praktikoje. Studentams osteologija yra vienas pirmųjų prisilietimų prie veterinarinės anatomijos mokslo, todėl svarbu užtikrinti, kad šis įspūdis neišblėstų ir motyvuotų toliau semtis anatomijos žinių. Knygoje pateikiama išsami ašinių ir pridėtinių griaučių anatominė sandara, nagrinėjami visų aktualiausių naminių gyvūnų – atrajotojų (galvijų, avių, ožkų), arklių, kiaulių, mėsėdžių (šunų ir kačių) rūšiniai skirtumai. Knyga gausiai iliustruota geros kokybės nuotraukomis, kurių didžioji dalis yra nufotografuota pačių autorių. Pateikiami anatomijos terminai (lietuvių ir lotynų kalbomis) suderinti su „Veterinarinės anatomijos, histologijos ir embriologijos terminų žodynu“ (2013).

[...]. Tyrimo tikslas. Nustatyti neurosonografinių galvos ir kaklo arterijų parametrų vertę prognozuojant demenciją lengvą kognityvinį sutrikimą turintiems pacientams. Tyrimo uždaviniai. 1. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų demografines ir klinikines charakteristikas ir įvertinti jų ir progresavimo į demenciją ryšį. 2. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų ekstrakranijinės kraujotakos parametrus ir įvertinti jų ir progresavimo į demenciją ryšį. 3. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų intrakranijinės kraujotakos parametrus ir įvertinti jų ir progresavimo į demenciją ryšį. 4. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų miego arterijų sienelių parametrus ir įvertinti jų ir progresavimo į demenciją ryšį. 5. Ištirti lengvą kognityvinį sutrikimą turinčių pacientų miego arterijų aterosklerozinius požymius ir įvertinti jų ir progresavimo į demenciją ryšį. 6. Įvertinti bendrą tiriamųjų demografinių ir klinikinių charakteristikų bei neurosonografinių parametrų diagnostinę reikšmę prognozuojant progresavimą iš lengvo kognityvinio sutrikimo į demenciją. [...].