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  • 1
    Online Resource
    Online Resource
    Factors associated with bone mineral density loss in patients with spondyloarthropathies: A 4-year follow-up study
    MDPI AG ; 2015
    In:  Medicina Vol. 51, No. 5 ( 2015-11), p. 272-279
    Details
    In: Medicina, MDPI AG, Vol. 51, No. 5 ( 2015-11), p. 272-279
    Type of Medium: Online Resource
    ISSN: 1010-660X
    URL: Article
    DOI: 10.1016/j.medici.2015.08.001
    Language: English
    Publisher: MDPI AG
    Publication Date: 2015
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  • 2
    Online Resource
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    AUDIT OF DIABETES CARE AT THE CENTRE OF FAMILY MEDICINE OF VILNIUS UNIVERSITY HOSPITAL SANTARISKIU KLINIKOS
    Medicinos Mintis ; 2014
    In:  Medicinos teorija ir praktika Vol. 20, No. 4 ( 2014-02-20), p. 387-394
    Details
    In: Medicinos teorija ir praktika, Medicinos Mintis, Vol. 20, No. 4 ( 2014-02-20), p. 387-394
    Abstract: Raktiniai žodžiai: cukrinis diabetas, metabolinė kontrolė, ambulatorinė priežiūra, klinikinis auditas. Tikslas. Įvertinti cukriniu diabetu sergančių pacientų, gydomų Vilniaus universiteto ligoninės Santariškių klinikų Šeimos medicinos centre, priežiūrą, palyginti su Lietuvoje galiojančiomis rekomendacijomis. Tyrimo medžiaga ir metodai. Diabetu sergančiųjų, 2011–2012 metais gydytų Šeimos medicinos centre duomenys surinkti retrospektyviai iš elektroninės duomenų bazės ir pacientų ambulatorinių kortelių. Duomenų rinkimo forma sudaryta atsi- žvelgiant į rekomendacijose apibrėžtus parametrus. Vertintos pagrindinės charakteristikos, diabeto komplikacijos, lydinčios ligos bei diabeto priežiūros rodikliai: glikuotas hemoglobinas, rekomenduojami atlikti tyrimai (lipidograma, kreatinino kiekis kraujyje, šlapimo tyrimas, albuminurija), oftalmologo, endokrinologo konsultacijos, pacientų mokymas bei pėdų apžiūra. Rezultatai. Atlikta restrospektyvi 315 pacientų (53 proc. moterų; 90 proc. 2 tipo cukriniu diabetu sergantieji) duomenų analizė. Vidutinis pacientų amžius – 64,4 ± 13,9 metų (sergančių 1 tipo diabetu – 38,2 ± 15,9; 2 tipo diabetu – 67,3 ± 10,2); vidutinė diabeto trukmė – 8,2 ± 8,1 metų (15,6 ± 14,1; 7,4 ± 6,6); kūno masės indeksas – 31,8 ± 5,9 kg/m2 (24,9 ± 4,9; 32,5 ± 5,6); liemens apimtis – 106,1 ± 12,8 cm (94,5 ± 6,4; 107,4 ± 12,7). Vidutinis glikuotas hemoglobinas – 6,9 ± 1,3 proc. (8,1 ± 1,9; 6,7 ± 1,1), tikslinį glikuotą hemoglobiną ( 7 proc.) pasiekusių pacientų dalis – 67 proc. (29; 71). Diabetinė nefropatija, polineuropatija, retinopatija ir angiopatija nustatyta atitinkamai 15,6; 38,4; 19,4 ir 6 proc. pacientų, dažniau – 1 tipo diabetu sergantiesiems. Arterinė hipertenzija, širdies ir kraujagyslių ligos, dislipidemija nustatyta atitinkamai 88,9; 40,6 ir 73,4 proc. pacientų, dažniau 2 tipo diabeto grupėje. Duomenų apie kūno masės indeksą, liemens apimtį, pacientų mokymą trūko atitinkamai 44,2; 74,3 ir 91,4 proc. atvejų. Informacijos apie pėdų apžiūrą, akių dugną, šlapimo tyrimą, albuminuriją, kreatinino kiekį kraujyje, lipidogramą trūko atitinkamai 81,4; 47,6; 64,8; 89,8; 31,1 ir 44,8 proc. atvejų. Esant nepakankamai glikemijos kontrolei, tik 68 proc. pacientų nukreipti į endokrinologo konsultaciją. 2011 ir 2012 metų diabeto priežiūros rodikliai reikšmingai nesiskyrė. Išvados. Klinikinio audito metu nustatyta, jog Vilniaus universiteto ligoninės Santariškių klinikų Šeimos medicinos centre didžiajai daliai diabetu sergančių pacientų pasiekta labai gera glikemijos kontrolė, ypač 2 tipo cukrinio diabeto grupėje. Ta- čiau pacientų mokymas, diabeto komplikacijų ir kardiovaskulinės rizikos veiksnių išaiškinimas, lyginant su galiojančiomis rekomendacijomis, yra nepakankamas. Tyrimo rezultatai nubrėžia gaires diabetu sergančiųjų priežiūros gerinimui centre bei pagrindžia panašių tyrimų poreikį kitose ambulatorinės sveikatos priežiūros įstaigose.
    Type of Medium: Online Resource
    ISSN: 1392-1312
    URL: Article
    DOI: 10.15591/mtp.2014.061
    Language: Unknown
    Publisher: Medicinos Mintis
    Publication Date: 2014
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  • 3
    Online Resource
    Online Resource
    Guidelines for diagnostics and treatment of aromatase inhibitor-induced bone loss in women with breast cancer
    MDPI AG ; 2014
    In:  Medicina Vol. 50, No. 4 ( 2014), p. 197-203
    Details
    In: Medicina, MDPI AG, Vol. 50, No. 4 ( 2014), p. 197-203
    Type of Medium: Online Resource
    ISSN: 1010-660X
    URL: Article
    DOI: 10.1016/j.medici.2014.09.004
    Language: English
    Publisher: MDPI AG
    Publication Date: 2014
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  • 4
    Online Resource
    Online Resource
    Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey
    MDPI AG ; 2020
    In:  Medicina Vol. 56, No. 3 ( 2020-03-18), p. 134-
    Details
    In: Medicina, MDPI AG, Vol. 56, No. 3 ( 2020-03-18), p. 134-
    Abstract: Background and Objectives: Cardiovascular disease (CVD) prevention guidelines define targets for lifestyle and risk factors for patients at high risk of developing CVD. We assessed the control of these factors, as well as CVD risk perception in patients enrolled into the primary care arm of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in Lithuania. Materials and Methods: Data were collected as the part of the EUROASPIRE V survey, a multicenter, prospective, cross-sectional observational study. Adults without a documented CVD who had been prescribed antihypertensive medicines and/or lipid-lowering medicines and/or treatment for diabetes (diet and/oral antidiabetic medicines and/or insulin) were eligible for the survey. Data were collected through the review of medical records, patients’ interview, physical examination and laboratory tests. Results: A total of 201 patients were enrolled. Very few patients reached targets for low-density lipoprotein cholesterol (LDL-C) (4.5%), waist circumference (17.4%) and body mass index (15.4%). Only 31% of very high CVD risk patients and 52% of high-risk patients used statins. Blood pressure target was achieved by 115 (57.2%) patients. Only 21.7% of patients at very high actual CVD risk and 27% patients at high risk correctly estimated their risk. Of patients at moderate actual CVD risk, 37.5% patients accurately self-assessed the risk. About 60%–80% of patients reported efforts to reduce the intake of sugar, salt or alcohol; more than 70% of patients were current nonsmokers. Only a third of patients reported weight reduction efforts (33.3%) or regular physical activity (27.4%). Conclusions: The control of cardiovascular risk factors in a selected group of primary prevention patients was unsatisfactory, especially in terms of LDL-C level and body weight parameters. Many patients did not accurately perceive their own risk of developing CVD.
    Type of Medium: Online Resource
    ISSN: 1010-660X
    URL: Article
    DOI: 10.3390/medicina56030134
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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  • 5
    Online Resource
    Online Resource
    Cross-cultural adaptation and validation of Lithuanian questionnaires for the spondyloarthropathies
    MDPI AG ; 2009
    In:  Medicina Vol. 45, No. 3 ( 2009-03-11), p. 177-
    Details
    In: Medicina, MDPI AG, Vol. 45, No. 3 ( 2009-03-11), p. 177-
    Abstract: Original English questionnaires – Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Patient Global Score, and Bath Ankylosing Spondylitis Disease Activity Index – are designed to evaluate health, physical and psychical state of patients with spondyloarthropathies and to assess efficiency of the treatment. Objective. The objective of the study was to adapt Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Patient Global Score, Bath Ankylosing Spondylitis Disease Activity Index questionnaires to the Lithuanian context and examine their psychometric aspects: reliability and validity. Patients and methods. Validation and linguistic and cultural adaptation of Lithuanian questionnaires were performed according to the requirements for adaptation of the international questionnaires. Psychometric features of Lithuanian questionnaires were examined in 139 patients with spondyloarthropathies. The validity of questionnaires was tested by comparing these questionnaires with Health Assessment Questionnaire Modified for Spondyloarthropathies, metrology indices (tragus-to-wall distance, lateral flexion, modified Schober’s distance, intermalleolar distance), pain intensity, patient’s well-being, physician’s assessment of the disease activity, and total enthesis count. The reliability of questionnaires was assessed by determining internal consistency of scales and scale stability and by calculating the intraclass correlation coefficient. Results. The linguistic and cultural adaptation of these questionnaires was made during the study. Internal consistency was high for functional and disease activity index (Cronbach a³0.80) and moderate for the Bath Ankylosing Spondylitis Patient Global Score (Cronbach a=0.58). High stability in regard to time was characteristic of all three questionnaires (intraclass correlation coefficient 〉 0.95). A significant association between the separate questions of examined instruments, their joint results and other factors reflecting patient’s health was established. Conclusions. Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Patient Global Score, and Bath Ankylosing Spondylitis Disease Activity Index questionnaires in Lithuanian fully correspond to psychometric requirements. They are appropriate and relevant in assessing the influence of spondyloarthropathies on a patient’s health.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina45030023
    Language: English
    Publisher: MDPI AG
    Publication Date: 2009
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  • 6
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    Vitamin D and VDR Gene Polymorphisms’ Association with Rheumatoid Arthritis in Lithuanian Population
    MDPI AG ; 2021
    In:  Medicina Vol. 57, No. 4 ( 2021-04-03), p. 346-
    Details
    In: Medicina, MDPI AG, Vol. 57, No. 4 ( 2021-04-03), p. 346-
    Abstract: Background and Objectives: Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune, multi-factorial disease, in which environmental and genetic factors play a major role. RA is possibly linked to vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms, and research demonstrates that FokI variant susceptibility is associated with increased disease risk among Caucasians. The aim of this study was to evaluate vitamin D deficiency prevalence and its correlation to RA clinical parameters, and to determine the possible association of VDR gene polymorphisms and RA susceptibility in the Lithuanian population. Materials and Methods: Overall, 206 RA patients and 180 age- and sex-matched healthy controls were enrolled at Vilnius University Hospital Santaros Klinikos after informed consent was obtained. The disease activity score 28 C-reactive protein (DAS28 CRP), rheumatoid arthritis impact of disease (RAID) score, and health assessment questionnaire (HAQ) were recorded in RA patients, and 25(OH)D serum levels were evaluated by chemiluminescent microparticle immunoassay for all subjects. Four VDR gene polymorphisms, BsmI, FokI, ApaI, and TaqI, were assessed using real-time PCR instruments and genotyping assays in both groups. Results: The study registered a high prevalence of 25(OH)D deficiency ( 〈 50 nmol/L) in RA patients (61.55% (n = 127)). The mean serum concentration in RA patients (44.96 ± 21.92 (nmol/L)) was significantly lower than in the healthy controls (54.90 ± 22.82 (nmol/L)), p 〈 0.0001. A significant inverse correlation between vitamin D level, DAS28 CRP, and HAQ scores was confirmed in RA patients, with p 〈 0.05. Still, there was no significant association between the overall risk of RA disease for any allele or genotype of the four VDR loci tested. Conclusions: The study confirmed that vitamin D deficiency is prevalent among RA patients and the 25(OH)D level is significantly lower compared with healthy controls. Lower vitamin D concentration was related with increased disease activity and disability scores. However, genetic analysis of four VDR polymorphisms did not confer the susceptibility to RA in Lithuanian population.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina57040346
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 7
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    Evaluation of Satisfaction with Healthcare Services in Multimorbid Patients Using PACIC+ Questionnaire: A Cross-Sectional Study
    MDPI AG ; 2023
    In:  Medicina Vol. 59, No. 2 ( 2023-01-31), p. 276-
    Details
    In: Medicina, MDPI AG, Vol. 59, No. 2 ( 2023-01-31), p. 276-
    Abstract: Background and Objectives: Although multimorbidity poses many challenges for both individuals and healthcare systems, information on how these patients assess the quality of their healthcare is lacking. This study assessed the multimorbid patients’ satisfaction with their healthcare. Materials and Methods: This cross-sectional study was a part of a project Joint Action—Chronic Diseases and Promoting Healthy Ageing across the Life Cycle and its implementation. The study included 400 patients with arterial hypertension and at least one concomitant chronic disease. Patients completed The Patient Assessment of Care for Chronic Conditions Plus (PACIC+) questionnaire, EuroQol Five-Dimensions—Three-Level Quality of Life questionnaire, and Hospital Anxiety and Depression scale. Results: The mean age of the participants was 65.38 years; there were 52.5% women. The mean PACIC+ 5As summary score was 3.60. With increasing age, participants rated worse on most PACIC+ subscales. Participants who assessed their quality of life as worse were also less satisfied with their healthcare. The presence of three or more concomitant diseases negatively affected PACIC+ scores. Patients with ischemic heart disease and heart failure had lower PACIC+ scores on most subscales, whereas patients with atrial fibrillation had lower scores only on the Agree subscale. The presence of diabetes was not associated with worse PACIC+ scores; moreover, the scores in Assist and Arrange subscales were even better in diabetic patients (3.36 vs. 2.80, p = 0.000 and 3.69 vs. 3.13, p = 0.008, respectively). Patients with chronic obstructive pulmonary disease, asthma, and musculoskeletal disorders showed lower PACIC+ scores. Conclusions: Older age, worse self-assessed health state, presence of three or more diseases, and certain chronic diseases were associated with lower patients’ satisfaction with their healthcare. Personalized healthcare, increasing competencies of primary healthcare teams, healthcare services accessibility, and financial motivation of healthcare providers may increase multimorbid patients’ satisfaction with their healthcare.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina59020276
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
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  • 8
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    Šeimos gydytojo laboratorinės diagnostikos galimybės
    JSC Vitae Litera ; 2022
    In:  Lithuanian General Practitioner Vol. 26, No. 2 ( 2022-02-24), p. 87-96
    Details
    In: Lithuanian General Practitioner, JSC Vitae Litera, Vol. 26, No. 2 ( 2022-02-24), p. 87-96
    Abstract: Įvadas. Remiantis įsigaliojusia šeimos gydytojo norma, pateikiamos lentelės, kuriose apibrėžiami tyrimai, reikalingi šeimos gydytojo kompetencijai priskiriamoms ligoms ir sveikatos sutrikimams diagnozuoti bei gydyti. Lentelėse pateikiamos tyrimų skyrimo indikacijos bei dažniai yra nurodyti remiantis šiuo metu galiojančiais LR SAM ministro įsakymais. Tikimasi, kad pateikiama informacija bus aktuali, naudinga ir palengvins šeimos gydytojo kasdienį darbą. Metodai. Literatūros apžvalga parengta remiantis mokslinių straipsnių, tarptautinių gairių, Lietuvos diagnostikos ir gydymo metodikų atranka pagal reikšminius žodžius: testings, diagnostics ir prevention. Lietuvos Respublikos įsakymų ir gydymo metodikų atranka vykdyta tinklalapyje e-seimas.lrs.lt. Išvados. Pagal pateikiamas lenteles nustatyta, kad šeimos gydytojo klinikinis darbas yra griežtai reglamentuojamas daugybės LR SAM ministro įsakymų, kurie apibrėžia laboratorinių tyrimų skyrimą pacientui. Šiuo metu galiojantys įsakymai yra nuolatos atnaujinami, todėl pateikiamos lentelės su nurodytais šaltiniais turėtų būti nuolat peržiūrimos ir papildomos.
    Type of Medium: Online Resource
    ISSN: 1392-3218
    URL: Article
    DOI: 10.37499/LBPG.883
    Language: Unknown
    Publisher: JSC Vitae Litera
    Publication Date: 2022
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  • 9
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    Significantly elevated phosphatidylethanol levels in recent suicide attempters, but not in depressed controls and healthy volunteers
    Elsevier BV ; 2023
    In:  Journal of Psychiatric Research Vol. 158 ( 2023-02), p. 245-254
    Details
    In: Journal of Psychiatric Research, Elsevier BV, Vol. 158 ( 2023-02), p. 245-254
    Type of Medium: Online Resource
    ISSN: 0022-3956
    URL: Article
    DOI: 10.1016/j.jpsychires.2022.12.043
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 1500641-4
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  • 10
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    Analysis of Epigenetic Changes in Vitamin D Pathway Genes in Rheumatoid Arthritis Patients
    Vilnius University Press ; 2022
    In:  Acta medica Lituanica Vol. 29, No. 1 ( 2022-01-31), p. 7-
    Details
    In: Acta medica Lituanica, Vilnius University Press, Vol. 29, No. 1 ( 2022-01-31), p. 7-
    Abstract: Background: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease with complex etiopathogenesis launched by multiple risk factors, including epigenetic alterations. RA is possibly linked to vitamin D that is epigenetically active and may alter DNA methylation of certain genes. Therefore, the study aimed to evaluate the relationship between DNA methylation status of vitamin D signaling pathway genes (VDR, CYP24A1, CYP2R1), vitamin D level and associations with RA.Materials and Methods: Totally 76 participants (35 RA patients and 41 healthy controls) were enrolled from a case-control vitamin D and VDR gene polymorphisms study regarding age and vitamin D concentration. CpG islands in promoter regions of the VDR, CYP24A1, CYP2R1 genes were chosen for DNA methylation analysis by means of pyrosequencing. Chemiluminescent microplate immunoassay was used to assess 25(OH)D serum levels. RA clinical data, i.e. the disease activity score C-reactive protein 28 (DAS28 – CRP) as well as patient-reported outcome questionnaires were recorded.Results: The study showed similar methylation pattern in the promoter regions of vitamin D pathway genes in RA and control group with p 〉 0.05 (VDR gene 2.39% vs. 2.48%, CYP24A1 gene 16.02% vs. 15.17% and CYP2R1 2.53% vs. 2.41%). CYP24A1 methylation intensity was significantly higher in compare to methylation intensity of VDR and CYP2R1 genes in both groups (p 〈 0.0001). A tendency of higher vitamin D concentration in cases having methylated VDR (57.57±28.93 vs. 47.40±29.88 nmol/l), CYP24A1 (53.23±26.22 vs. 48.23±34.41 nmol/l) and CYP2R1 (60.41±30.73 vs. 44.54±27.63 nmol/l) genes and a positive correlation between VDR, CYP2R1 methylation intensity and vitamin D level in RA affected participants was revealed (p 〉 0.05). A significantly higher CYP24A1 methylation intensity (p=0.0104) was detected in blood cells of vitamin D deficient ( 〈 50 nmol/l) RA patients vs. vitamin D deficient controls.Conclusions: Our data suggests some indirect associations between DNA methylation status of vitamin D pathway genes and vitamin D level in RA.
    Type of Medium: Online Resource
    ISSN: 2029-4174 , 1392-0138
    URL: Article
    DOI: 10.15388/Amed.2021.29.1.7
    Language: Unknown
    Publisher: Vilnius University Press
    Publication Date: 2022
    detail.hit.zdb_id: 2559084-4
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