1
|
Ramanauskaite E, Machiulskiene Visockiene V, Shirakata Y, Friedmann A, Pereckaite L, Balciunaite A, Dvyliene UM, Vitkauskiene A, Baseviciene N, Sculean A. Microbiological Effects of Sodium Hypochlorite/-Amino Acids and Cross-linked Hyaluronic Acid Adjunctive to Non-surgical Periodontal Treatment. Oral Health Prev Dent 2024; 22:171-180. [PMID: 38687029 DOI: 10.3290/j.ohpd.b5281925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
PURPOSE To investigate the microbiological outcomes obtained with either subgingival debridement (SD) in conjunction with a gel containing sodium hypochlorite and amino acids followed by subsequent application of a cross-linked hyaluronic acid gel (xHyA) gel, or with SD alone. MATERIALS AND METHODS Forty-eight patients diagnosed with stages II-III (grades A/B) generalised periodontitis were randomly treated with either SD (control) or SD plus adjunctive sodium hypochlorite/amino acids and xHyA gel (test). Subgingival plaque samples were collected from the deepest site per quadrant in each patient at baseline and after 3 and 6 months. Pooled sample analysis was performed using a multiplex polymerase chain reaction (PCR)-based method for the identification of detection frequencies and changes in numbers of the following bacteria: Aggregatibacter actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g), Tannerella forsythia (T.f), Treponema denticola (T.d), and Prevotella intermedia (P.i). RESULTS In terms of detection frequency, in the test group, statistically significant reductions were found for P.g, T.f, T.d and P.i (p < 0.05) after 6 months. In the control group, the detection frequencies of all investigated bacterial species at 6 months were comparable to the baseline values (p > 0.05). The comparison of the test and control groups revealed statistically significant differences in detection frequency for P.g (p = 0.034), T.d (p < 0.01) and P.i (p = 0.02) after 6 months, favouring the test group. Regarding reduction in detection frequency scores, at 6 months, statistically significant differences in favour of the test group were observed for all investigated bacterial species: A.a (p = 0.028), P.g (p = 0.028), T.f (p = 0.004), T.d (p <0.001), and P.i (p = 0.003). CONCLUSIONS The present microbiological results, which are related to short-term outcomes up to 6 months post-treatment, support the adjunctive subgingival application of sodium hypochlorite/amino acids and xHyA to subgingival debridement in the treatment of periodontitis.
Collapse
|
2
|
Palacionyte J, Januskevicius A, Vasyle E, Rimkunas A, Bajoriuniene I, Vitkauskiene A, Miliauskas S, Malakauskas K. Novel Serum Biomarkers for Patients with Allergic Asthma Phenotype. Biomedicines 2024; 12:232. [PMID: 38275403 PMCID: PMC10813071 DOI: 10.3390/biomedicines12010232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
In distinguishing the allergic asthma (AA) phenotype, it has been identified that specific biomarkers could assist; however, none of them are considered ideal. This study aimed to analyze three groups of biologically active substances in the serum. Twenty steroid-free AA patients, sensitized to Dermatophagoides pteronyssinus, and sixteen healthy subjects (HSs) were enrolled in this study. Blood samples were collected from all patients. Additionally, all AA patients underwent a bronchial allergen challenge (BAC) with Dermatophagoides pteronyssinus, all of which were positive, and blood samples were collected again 24 h later. The concentrations of ten biologically active substances were measured in the serum samples, using enzyme-linked immunosorbent assay (ELISA) and the Luminex® 100/200™ System technology for bead-based multiplex and singleplex immunoassays. Descriptive and analytical statistical methods were used. A p-value of 0.05 or lower was considered statistically significant. The soluble interleukin 5 receptor subunit alpha (sIL-5Rα) and thioredoxin 1 (TRX1) concentrations were significantly increased, whereas those of tyrosine-protein kinase Met (MET), pentraxin 3 (PTX3), and I C-telopeptide of type I collagen (ICTP) were decreased in the AA group compared with the HS group. A significant positive correlation was noted for sIL-5Rα with fractional exhaled nitric oxide (FeNO), blood eosinophil (EOS) count, and total immunoglobulin E (IgE) levels, and a negative correlation was noted with forced expiratory volume in 1 s (FEV1). Moreover, PTX3 showed negative correlations with blood EOS count and total IgE levels, whereas ICTP exhibited a negative correlation with the blood EOS count. In conclusion, this study demonstrated that the serum concentrations of MET, PTX3, TRX1, ICTP, and particularly sIL-5Rα could potentially serve as biomarkers of the AA phenotype.
Collapse
Affiliation(s)
- Jolita Palacionyte
- Department of Pulmonology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (S.M.); (K.M.)
| | - Andrius Januskevicius
- Laboratory of Pulmonology, Department of Pulmonology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (A.J.); (E.V.); (A.R.)
| | - Egle Vasyle
- Laboratory of Pulmonology, Department of Pulmonology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (A.J.); (E.V.); (A.R.)
| | - Airidas Rimkunas
- Laboratory of Pulmonology, Department of Pulmonology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (A.J.); (E.V.); (A.R.)
| | - Ieva Bajoriuniene
- Department of Immunology and Allergology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | - Skaidrius Miliauskas
- Department of Pulmonology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (S.M.); (K.M.)
| | - Kestutis Malakauskas
- Department of Pulmonology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (S.M.); (K.M.)
- Laboratory of Pulmonology, Department of Pulmonology, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (A.J.); (E.V.); (A.R.)
| |
Collapse
|
3
|
Bartkeviciene A, Jasukaitiene A, Zievyte I, Stukas D, Ivanauskiene S, Urboniene D, Maimets T, Jaudzems K, Vitkauskiene A, Matthews J, Dambrauskas Z, Gulbinas A. Association between AHR Expression and Immune Dysregulation in Pancreatic Ductal Adenocarcinoma: Insights from Comprehensive Immune Profiling of Peripheral Blood Mononuclear Cells. Cancers (Basel) 2023; 15:4639. [PMID: 37760608 PMCID: PMC10526859 DOI: 10.3390/cancers15184639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Pancreatic cancer, particularly pancreatic ductal adenocarcinoma (PDAC), has an immune suppressive environment that allows tumour cells to evade the immune system. The aryl-hydrocarbon receptor (AHR) is a transcription factor that can be activated by certain exo/endo ligands, including kynurenine (KYN) and other tryptophan metabolites. Once activated, AHR regulates the expression of various genes involved in immune responses and inflammation. Previous studies have shown that AHR activation in PDAC can have both pro-tumorigenic and anti-tumorigenic effects, depending on the context. It can promote tumour growth and immune evasion by suppressing anti-tumour immune responses or induce anti-tumour effects by enhancing immune cell function. In this study involving 30 PDAC patients and 30 healthy individuals, peripheral blood samples were analysed. PDAC patients were categorized into Low (12 patients) and High/Medium (18 patients) AHR groups based on gene expression in peripheral blood mononuclear cells (PBMCs). The Low AHR group showed distinct immune characteristics, including increased levels of immune-suppressive proteins such as PDL1, as well as alterations in lymphocyte and monocyte subtypes. Functional assays demonstrated changes in phagocytosis, nitric oxide production, and the expression of cytokines IL-1, IL-6, and IL-10. These findings indicate that AHR's expression level has a crucial role in immune dysregulation in PDAC and could be a potential target for early diagnostics and personalised therapeutics.
Collapse
Affiliation(s)
- Arenida Bartkeviciene
- Laboratory of Surgical Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (A.J.); (I.Z.); (D.S.); (S.I.); (Z.D.); (A.G.)
| | - Aldona Jasukaitiene
- Laboratory of Surgical Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (A.J.); (I.Z.); (D.S.); (S.I.); (Z.D.); (A.G.)
| | - Inga Zievyte
- Laboratory of Surgical Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (A.J.); (I.Z.); (D.S.); (S.I.); (Z.D.); (A.G.)
| | - Darius Stukas
- Laboratory of Surgical Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (A.J.); (I.Z.); (D.S.); (S.I.); (Z.D.); (A.G.)
| | - Sandra Ivanauskiene
- Laboratory of Surgical Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (A.J.); (I.Z.); (D.S.); (S.I.); (Z.D.); (A.G.)
| | - Daiva Urboniene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (D.U.); (A.V.)
| | - Toivo Maimets
- Department of Cell Biology, Institute of Molecular and Cell Biology, University of Tartu, Riia 23, 51010 Tartu, Estonia;
| | - Kristaps Jaudzems
- Department of Physical Organic Chemistry, Latvian Institute of Organic Synthesis, Aizkraukles 21, LV-1006 Riga, Latvia;
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (D.U.); (A.V.)
| | - Jason Matthews
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 1046 Blindern, 0317 Oslo, Norway;
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Zilvinas Dambrauskas
- Laboratory of Surgical Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (A.J.); (I.Z.); (D.S.); (S.I.); (Z.D.); (A.G.)
| | - Antanas Gulbinas
- Laboratory of Surgical Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Eiveniu 4, 50103 Kaunas, Lithuania; (A.J.); (I.Z.); (D.S.); (S.I.); (Z.D.); (A.G.)
| |
Collapse
|
4
|
Braukyliene R, Aldujeli A, Zajanckauskiene L, Jurenas M, Unikas R, Gustiene O, Baksyte G, Zabiela V, Steponaviciute R, Vitkauskiene A, Hedayat B, Hedayat K, Zaliaduonyte D. Genito-thyroid index (Neutrophil-to-lymphocyte ratio) and basophils as predictors of left ventricular remodeling after acute myocardial infarction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The neutrophil-to-lymphocyte ratio (NLR) is associated with inflammation. The theory of Endobiogeny is a complex systems theory of physiology that evaluates the relationship between biomarkers and endocrine management of adaptation response. NLR is referred to in this system as the "Genito-thyroid index" (GTI) due to the roles of estrogen and thyroid hormones in immune response. Basophils correlate with worse outcomes in critical illness and are stimulated by ACTH when there is delayed cortisol excretion from the adrenal cortex. These biomarkers are routinely obtained after acute myocardial infarction (AMI), but their relationship to AMI and left ventricular ejection fraction (LVEF) have not been established.
Purpose
The aim of this study was to assess the relationship between the GTI and %Basophils to LVEF in first time AMI.
Methods
This prospective study included 52 consecutive patients diagnosed with AMI, admitted to the intensive care unit of our university hospital from April 2017 to November 2017. Percent neutrophils, lymphocytes and basophils were determined on admission (GTI1, Basophil1) and before discharge (GTI2, Basophil2). Diagnostic coronary angiography and percutaneous coronary intervention (PCI) was performed for all patients. All patients underwent transthoracic echocardiography within hospitalization period (LVEF1) and after 6 months (LVEF2) during follow up period. Echocardiography was performed using a Philips machine. LV function was assessed by the measurement of EF using the biplane Simpson’s disc summation method through QLAB ultrasound cardiac analysis on apical two- and four-chamber views. Statistical analyses were performed using the SPSS 20.0 software. Spearman’s rank correlation coefficient was used to examine the relationship between different variables. A p-value <0.05 was considered statistically significant.
Results
Study population mean age was 63.9 ± 11.6 years. Mean GTI1 was 4.5 ± 2.8 (1.5-2.5). Mean GTI2 was 2.8 ± 1.4. Δ GTI1-2 significantly and positively correlated with Δ LVEF1-2 (r = 0.380, p = 0.019). Mean Basophils1 was 0.3 ± 0.2% (<0.2%). Mean Basophil2 was 0.4 ± 0.3%. Δ Basophil1-2 positively correlated with Δ LVEF 1-2 (r = 0.435, p = 0.015). No significant correlation was found between GTI1 and Δ LVEF1-2 (r = 0.137, p = 0.332), or Basophil1 and Δ LVEF1-2 (r = -0.186, p = 0.196).
Conclusion
Admission values of GTI and basophils, while both elevated did not correlate with LVEF1-2. However, Δ GTI1-2 and Δ basophils1-2 did. From this we conclude that relative recovery of the systemic response to AMI is more significative than initial response and affects myocardial recovery. Monitoring GTI and basophils is commonly performed and inexpensive. It reflects a role of the endocrine system not before investigated in myocardial recovery post-AMI. It may be useful for identifying patients at risk of poor LVEF post-AMI.
Collapse
Affiliation(s)
- R Braukyliene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Aldujeli
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - M Jurenas
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - R Unikas
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - O Gustiene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - G Baksyte
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - V Zabiela
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - A Vitkauskiene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - B Hedayat
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - K Hedayat
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Zaliaduonyte
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
5
|
Urbonas T, Ianiro G, Gedgaudas R, Sabanas P, Urba M, Kiudelis V, Kiudelis G, Petkevicius V, Vitkauskiene A, Cammarota G, Gasbarrini A, Kupcinskas J. Fecal Microbiome Transplantation for Recurrent Clostridioides difficile Infection: Treatment Efficacy, Short and Long-term Follow-up Results from Consecutive Case Series. J Gastrointestin Liver Dis 2021; 30:470-476. [PMID: 34752587 DOI: 10.15403/jgld-3800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Many studies have shown a high effectiveness of fecal microbiota transplantation (FMT) in treatment of recurrent or refractory Clostridioides difficile infection (CDI). Nevertheless, data on long term outcomes and complications after FMT are still lacking. We aimed to evaluate the efficacy, the peri- procedural safety profile and the long-term efficacy and safety of FMT for recurrent CDI during a median follow up period of 24 months. METHODS Our study included 60 consecutive patients that were treated from 2015 to 2019 for recurrent CDI. In all patients FMT was performed through the nasoenteric tube placed during gastroscopy. Fresh donor feces were used for FMT from unrelated donors. Pre-FMT preparation included CDI treatment with oral vancomycin 500 mg q.i.d. for at least five days and proton pump inhibitor (PPI) administration before FMT. Follow up data included information about recurrent CDI episodes, early and late complications, health status at 3, 12 and 24 months after FMT. RESULTS FMT was performed for 60 patients (median age 72.5 years) with recurrent CDI. Clinical improvement after the first FMT procedure was observed in 48 patients (80%). Ten of 12 initially non-responding patients had a clinical resolution after a second FMT leading to an increased overall cure rate of 96.7 %. The remaining two patients needed a third FMT with a final overall cure rate of 100%. Nine of 60 patients were under immunosuppressive therapy. Six immunosuppressed patients were in the group of initial responders and the remaining three in the initially non-responder group. We observed a very low rate of adverse events in the short and long-term after FMT. During the first eight weeks after the FMT procedure, the death of three patients occurred, but they were not related to the FMT procedure. Patients were followed up for a median of 20 months, with the range from 12 to 55 months. During the follow-up period no long-term serious adverse events (SAE) were documented. CONCLUSIONS Our study confirms excellent efficacy rates of FMT in the treatment of recurrent CDI. In addition, this study shows that it is possible to avoid short term SAE when FMT is administered via a nasoenteric tube by following a very stringent peri-procedural patient follow-up protocol. Our study also demonstrates good safety with a low rate of long-term adverse events after FMT.
Collapse
Affiliation(s)
- Tadas Urbonas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Gianluca Ianiro
- Department of Gastroenterology, Gemeli Hospital, Rome, Italy.
| | - Rolandas Gedgaudas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Povilas Sabanas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Mindaugas Urba
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Vytautas Kiudelis
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Gediminas Kiudelis
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Vytenis Petkevicius
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Astra Vitkauskiene
- Departament of Laboratory Medicine, Lithuannian University of Health Science, Kaunas, Lithuania.
| | | | | | - Juozas Kupcinskas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| |
Collapse
|
6
|
Gleiznys D, Kriauciunas A, Maminskas J, Stumbras A, Giedrimiene D, Niekrash C, Gleiznys A, Sakalauskiene J, Vitkauskiene A. Expression of Interleukin-17, Tumor Necrosis Factor-Alpha, and Matrix Metalloproteinase-8 in Patients with Chronic Peri-Implant Mucositis. Med Sci Monit 2021; 27:e932243. [PMID: 34697283 PMCID: PMC8556698 DOI: 10.12659/msm.932243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The present study aimed to evaluate whether non-surgical treatment interferes with clinical parameters and local patterns of osteo-immunoinflammatory mediators (IL-17 and TNF-α) and matrix metalloproteinase-8 (MMP-8) that are found in peri-implant crevicular fluid (PICF) and biofilms during the progression of peri-implant mucositis. Material/Methods We selected 30 patients with peri-implant caused mucositis before (MP) and after treatment (TP) and 30 healthy people (HP) for the analysis of IL-17, TNF-α cytokine, and MMP-8 production in PICF and for analysis of colonization dynamics of periodontopathogenic bacteria in supra- and subgingival plaque samples. The levels of IL-17 and MMP-8 concentrations in samples were assayed by enzymatic immunosorbent assay (ELISA) and TNF-α levels were determined by enzyme amplified sensitivity immunoassay (EASIA) method in PICF. The micro-IDent test was used to detect 11 species of periodontopathogenic bacteria in subgingival biofilm. Results We found significantly (P<0.001) higher levels of IL-17, TNF-α, and MMP-8 in the PICF of the MP and TP groups in comparison to the HP group. A significant association was found in MP associated with Parvimonas micra, as TNF-α in PICF was significantly higher (P=0.034) than in patients without Parvimonas micra. TNF-α levels in the samples of PICF showed a moderate correlation with clinical parameters, including plaque index (PI) (P=0.007) and MMP-8 levels (P=0.001), in the MP group. Conclusions Assessment of levels of inflammatory cytokines in PICF can aid in the identification of peri-implant mucositis, which can assist in early diagnosis, prevention, and treatment.
Collapse
Affiliation(s)
- Darius Gleiznys
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Albertas Kriauciunas
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Julius Maminskas
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Arturas Stumbras
- Department of Maxillofacial Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Giedrimiene
- School of Health and Natural Sciences and School of Pharmacy, University of Saint Joseph, West Hartford, CT, USA
| | - Christine Niekrash
- Frank H Netter MD School of Medicine Quinnipiac University, North Haven, CT, USA
| | - Alvydas Gleiznys
- Department of Dental and Maxillofacial Orthopedics, Lithuania University of Health Sciences, Kaunas, Lithuania
| | - Jurgina Sakalauskiene
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
7
|
Abramavicius S, Stundziene A, Jankauskaite L, Vitkauskiene A, Kowalski IM, Wojtkiewicz J, Stankevicius E. Novel approach towards antimicrobial chemotherapy optimization in lower respiratory tract infections in children: An observational study. Medicine (Baltimore) 2021; 100:e26585. [PMID: 34596107 PMCID: PMC8483859 DOI: 10.1097/md.0000000000026585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 06/19/2021] [Indexed: 01/05/2023] Open
Abstract
The use of local antibiogram in guiding clinical decisions is an integral part of the antimicrobial stewardship program. Conventional antibiograms are not disease-specific, ignore the distribution of microorganisms, obscure the in-vitro efficacy interrelationships, and have limited use in polymicrobial infections.We aimed to develop an in-house empiric, disease-specific, antimicrobial prescription auxiliary for the treatment of hospitalized pediatric pneumonia patients and to present the methods which help to choose the first and the second line antimicrobial therapy, while accounting for cost and safety aspects.A retrospective single center observational study was conducted on bronchoscopy obtained sputum culture. Analysis of probabilities, variance minimization, Boolean network modeling, and dominance analysis were applied to analyze antibiogram data. The Kirby-Bauer disk diffusion method was used to test the susceptibility of all isolates. Final optimization analysis included local drug acquisition cost (standardized to price per DDD) and safety profile.Data of 145 pediatric patients hospitalized with pneumonia with 218 isolates over 5 years was collected. A combination of statistical methods such as probabilities of drug efficacy, variance minimization, Boolean network modeling, and dominance analysis can help to choose the optimal first-line and the second-line antimicrobial treatment and optimize patient care. This research reveals that ampicillin is the optimal choice as the first-line drug and piperacillin-tazobactam is the second-line antimicrobial drug if the first one is not effective, while accounting for cost and safety aspects.The paper proposes a new methodology to adapt empiric antimicrobial therapy recommendations based on real world data and accout for costs and risk of adverse events.
Collapse
Affiliation(s)
| | - Alina Stundziene
- School of Economics and Business, Kaunas University of Technology
| | | | - Astra Vitkauskiene
- Department of Laboratory medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Joanna Wojtkiewicz
- Department of Pathophysiology, School of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | | |
Collapse
|
8
|
Vaitkus J, Vitkauskiene A, Matuseviciute V, Naudziunas A, Siupsinskiene N, Vaitkus S. Local inflammatory marker production in Lithuanian patients with chronic rhinosinusitis with nasal polyps. J Immunotoxicol 2021; 17:202-206. [PMID: 33307887 DOI: 10.1080/1547691x.2020.1850938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
There are two clinical subtypes of chronic rhinosinusitis (CRS): chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP). The aim of the study here was to determine the levels of invasive inflammatory markers in nasal mucosa samples taken from CRSwNP patients during the surgery and to identify markers that could serve as targets for potential clinical and therapeutic interventions. The study was carried out in 59 patients with proven CRSwNP and a control group consisting of 52 healthy individuals. Concentrations of the inflammatory markers of interest were determined using a LuminexR Assay multiplex kit. The data obtained indicated that levels of inflammatory cytokines interleukin (IL)-2, -4, -5, -7, -12, -17 and -22 were all significantly higher in the nasal polyps (NP) than those in the mucosa of control participants. No differences were seen between the study groups for IL -6, -10, -13, -21 and interferon (IFN)-γ. OR (Odds Ratio) analyses confirmed that elevations in mucosal levels of IL-2, -4, -5, -7, -12, -17, and -22 were likely immune markers of CRSwNP. In conclusion, the present study demonstrated that IL-2, -4, -12 and -22 may be important in the etiopathogenesis of CRSwNP; as markers, each show moderate sensitivity, but high specificity in the Lithuanian population. IL-17 had good sensitivity, but low specificity in the CRSwNP patients.
Collapse
Affiliation(s)
- Justinas Vaitkus
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilte Matuseviciute
- Medicine Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Albinas Naudziunas
- Departament of Internal Medicine, Medicine Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Saulius Vaitkus
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
9
|
Eimonte M, Paulauskas H, Daniuseviciute L, Eimantas N, Vitkauskiene A, Dauksaite G, Solianik R, Brazaitis M. Residual effects of short-term whole-body cold-water immersion on the cytokine profile, white blood cell count, and blood markers of stress. Int J Hyperthermia 2021; 38:696-707. [PMID: 33910456 DOI: 10.1080/02656736.2021.1915504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: One of the most challenging environmental extremes is immersion in cold/icy water, and consequent common assumption is that even a brief exposure to cold can lead to cold-related illnesses. The increase in the concentrations of the stress hormones cortisol, epinephrine (Epi), and norepinephrine (NE) in response to acute cold stress are thought to suppress the release of proinflammatory cytokines. No previous study has explored the residual consequences of whole-body short-term cold-water immersion (CWI; 14 °C for 10 min) on the immune response in healthy non-acclimated young adult men (aged 20-30 years).Materials and methods: In the current study, we tested the hypothesis that short-term acute whole-body CWI would induce high blood levels of cortisol, NE, and Epi, which in turn would increase circulating leukocyte numbers and delay the production of proinflammatory cytokines (tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6). Results: Short-term whole-body CWI produced a stressful physiological reaction, as manifested by hyperventilation and increased muscle shivering, metabolic heat production, and heart rate. CWI also induced the marked release of the stress hormones Epi, NE, and cortisol. The change in IL-6 concentration after CWI was delayed and TNF-α production was decreased, but IL-1β was not affected within 48 h after CWI. A delayed increase in neutrophil percentage and decrease in lymphocyte percentage occurred after CWI.Conclusion: These findings suggest that, even though CWI caused changes in stress and immune markers, the participants showed no predisposition to symptoms of the common cold within 48 h after CWI.
Collapse
Affiliation(s)
- Milda Eimonte
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Henrikas Paulauskas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Laura Daniuseviciute
- Faculty of Social Sciences, Arts and Humanities, Kaunas University of Technology, Kaunas, Lithuania
| | - Nerijus Eimantas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintare Dauksaite
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Rima Solianik
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| |
Collapse
|
10
|
Braukyliene R, Hedayat K, Zajanckauskiene L, Jurenas M, Unikas R, Aldujeli A, Petrokas O, Zabiela V, Steponaviciute R, Vitkauskiene A, Hedayat B, Simonyte S, Lesauskaite V, Lapraz JC, Zaliaduonyte D. Prognostic Value of Cortisol Index of Endobiogeny in Acute Myocardial Infarction Patients. ACTA ACUST UNITED AC 2021; 57:medicina57060602. [PMID: 34208003 PMCID: PMC8230642 DOI: 10.3390/medicina57060602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 01/10/2023]
Abstract
Background and Objectives: Serum cortisol has been extensively studied for its role during acute myocardial infarction (AMI). Reports have been inconsistent, with high and low serum cortisol associated with various clinical outcomes. Several publications claim to have developed methods to evaluate cortisol activity by using elements of complete blood count with its differential. This study aims to compare the prognostic value of the cortisol index of Endobiogeny with serum cortisol in AMI patients, and to identify if the risk of mortality in AMI patients can be more precisely assessed by using both troponin I and cortisol index than troponin I alone. Materials and methods: This prospective study included 123 consecutive patients diagnosed with AMI. Diagnostic coronary angiography and revascularization was performed for all patients. Cortisol index was measured on admission, on discharge, and after 6 months. Two year follow-up for all patients was obtained. Results: Our study shows cortisol index peaks at 7–12 h after the onset of AMI, while serum cortisol peaked within 3 h from the onset of AMI. The cortisol index is elevated at admission, then significantly decreases at discharge; furthermore, the decline to its bottom most at 6 months is observed with mean values being constantly elevated. The cortisol index on admission correlated with 24-month mortality. We established combined cut-off values of cortisol index on admission > 100 and troponin I > 1.56 μg/las a prognosticator of poor outcomes for the 24-month period. Conclusions: The cortisol index derived from the global living systems theory of Endobiogeny is more predictive of mortality than serum cortisol. Moreover, a combined assessment of cortisol index and Troponin I during AMI offers more accurate risk stratification of mortality risk than troponin alone.
Collapse
Affiliation(s)
- Rima Braukyliene
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
- Correspondence:
| | - Kamyar Hedayat
- Systems Biology Research Group, Chicago, IL 60603, USA; (K.H.); (B.H.); (J.C.L.)
| | - Laura Zajanckauskiene
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Martynas Jurenas
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Ramunas Unikas
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Ali Aldujeli
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Osvaldas Petrokas
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Vytautas Zabiela
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Rasa Steponaviciute
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Astra Vitkauskiene
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Brigita Hedayat
- Systems Biology Research Group, Chicago, IL 60603, USA; (K.H.); (B.H.); (J.C.L.)
| | - Sandrita Simonyte
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Vaiva Lesauskaite
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| | - Jean Claude Lapraz
- Systems Biology Research Group, Chicago, IL 60603, USA; (K.H.); (B.H.); (J.C.L.)
| | - Diana Zaliaduonyte
- Cardiology Department, Lithuanian University of Health Sciences, LT 50161 Kaunas, Lithuania; (L.Z.); (M.J.); (R.U.); (A.A.); (O.P.); (V.Z.); (R.S.); (A.V.); (S.S.); (V.L.); (D.Z.)
| |
Collapse
|
11
|
Kiudulaite I, Belousoviene E, Vitkauskiene A, Pranskunas A. Effects of remote ischemic conditioning on microcirculatory alterations in patients with sepsis: a single-arm clinical trial. Ann Intensive Care 2021; 11:55. [PMID: 33829305 PMCID: PMC8025901 DOI: 10.1186/s13613-021-00848-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/29/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Remote ischemic conditioning (RIC) is a promising technique that may protect organs and tissues from the effects of additional ischemic episodes. However, the therapeutic efficacy of RIC in humans with sepsis remains unknown. We hypothesized that RIC might improve sublingual microcirculation in patients with sepsis. METHODS This prospective single-arm trial was performed in a mixed ICU at a tertiary teaching hospital. We included patients with sepsis or septic shock within 24 h of ICU admission. The RIC procedure comprised 3 cycles of brachial cuff inflation to 200 mmHg for 5 min followed by deflation to 0 mmHg for another 5 min. The procedure took 30 min. RIC was performed at the time of study inclusion and repeated after 12 and 24 h. Sublingual microcirculatory measurements were obtained before and after each RIC procedure using a Cytocam®-incident dark-field (IDF) device (Braedius Medical, Huizen, The Netherlands). The microcirculatory data were compared with a historical control. Data are reported as the medians along with the 25th and 75th percentiles. RESULTS Twenty-six septic patients with a median age of 65 (57-81) years were enrolled in this study. The median Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at admission were 20 (13-23) and 10 (9-12), respectively. All patients were receiving vasopressors. After the 1st RIC procedure, the microvascular flow index (MFI) and the proportion of perfused vessels (PPV) among small vessels were significantly higher than before the procedure, with pre- and post-treatment values of 2.17 (1.81-2.69) and 2.59 (2.21-2.83), respectively, for MFI (p = 0.003) and 87.9 (82.4-93.8) and 92.5 (87.9-96.1) %, respectively, for PPV (p = 0.026). This result was confirmed by comparison with a historical control group. We found no change in microcirculatory flow or density parameters during repeated RIC after 12 h and 24 h. CONCLUSION In patients with sepsis, the first remote ischemic conditioning procedure improved microcirculatory flow, whereas later procedures did not affect sublingual microcirculation. Trial registration NCT04644926, http://www.clinicaltrials.gov . Date of registration: 25 November 2020. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04644926 .
Collapse
Affiliation(s)
- Inga Kiudulaite
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, 50161, Kaunas, Lithuania
| | - Egle Belousoviene
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, 50161, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, 50009, Kaunas, Lithuania
| | - Andrius Pranskunas
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, 50161, Kaunas, Lithuania.
| |
Collapse
|
12
|
Eimonte M, Eimantas N, Daniuseviciute L, Paulauskas H, Vitkauskiene A, Dauksaite G, Brazaitis M. Recovering body temperature from acute cold stress is associated with delayed proinflammatory cytokine production in vivo. Cytokine 2021; 143:155510. [PMID: 33820701 DOI: 10.1016/j.cyto.2021.155510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/05/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022]
Abstract
A poor outcome of whole-body hypothermia often results from a late complication, rather than from acute effects of hypothermia. A low body (cell) temperature or the increase in the concentrations of the stress hormones cortisol, epinephrine, and norepinephrine in response to acute cold stress have been proposed as potent proinflammatory cytokine suppressant. In the current study, we tested the hypothesis that the recovery of body temperature from a whole-body intermittent cold-water immersion (CWI, at 13-14 °C for a total 170 min) is associated with a delayed response of proinflammatory cytokines in young healthy men. Our results revealed a delay in the increase in the proinflammatory interleukin 6 and interleukin 1β cytokines after the CWI, which paralleled the changes in cortisol, epinephrine, norepinephrine, and body temperature. CWI decreased tumor necrosis factor α (TNF-α) immediately and 1 h after the CWI. Although TNF-α had recovered to the pre-immersion level at 2 h after CWI, its natural circadian cycle kinetics was disrupted until 12 h after the CWI. Furthermore, we showed that CWI strongly modified the white blood cell counts, with changes reaching a peak between 1 and 2 h after the CWI.
Collapse
Affiliation(s)
- Milda Eimonte
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Nerijus Eimantas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Laura Daniuseviciute
- Faculty of Social Sciences, Arts and Humanities, Kaunas University of Technology, Kaunas, Lithuania
| | - Henrikas Paulauskas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintare Dauksaite
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.
| |
Collapse
|
13
|
Abramavicius S, Galaune V, Tunaityte A, Vitkauskiene A, Gumbrevicius G, Radzeviciene A, Maciulaitis R. The Glomerular Filtration Rate Estimators in the Pharmacokinetic Modelling in Acute Kidney Injury: An Observational Study. Antibiotics (Basel) 2021; 10:antibiotics10020158. [PMID: 33557261 PMCID: PMC7915939 DOI: 10.3390/antibiotics10020158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/29/2022] Open
Abstract
The glomerular filtration rate (GFR), according to which the drug dose for patients with chronic kidney disease (CKD) is adjusted, is computed with estimators (eGFR) that are developed specifically for CKD. These particular types of estimators are also used in population pharmacokinetic (pop PK) modelling in drug development. Similar approaches without scientific validation have been proposed for patients with acute kidney injury (AKI), yet it is uncertain which specific eGFR should be used for drug dosing or in pop PK models in patients with AKI. In our study, we included 34 patients with AKI and vancomycin (VCM) treatment, and we built both individual PK and pop PK (non-linear mixed-effects, one-compartment) models to see which eGFR estimator is the best covariate. In these models different eGFRs (Cockcroft-Gault, MDRD, CKD-EPI 2009, Jelliffe and Jelliffe, Chen et al., and Yashiro et al. 2013) were used. We included six additional patients to validate the final pop PK model. All eGFRs underrate the true renal clearance in the AKI, so we created pop PK models for VCM dosing in AKI with all eGFRs, to discover that the most accurate model was the one with the Cockcroft-Gault estimator. Since the eGFRs underestimate the true renal clearance in AKI, they are inaccurate for clinical drug dosing decisions, with the exception of the Cockcroft-Gault one, which is appropriate for the pop PK models intended for drug development purposes in AKI.
Collapse
Affiliation(s)
- Silvijus Abramavicius
- Laboratory of Preclinical Drug, Investigation Institute of Cardiology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania; (S.A.); (V.G.); (G.G.); (A.R.); (R.M.)
| | - Vaidotas Galaune
- Laboratory of Preclinical Drug, Investigation Institute of Cardiology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania; (S.A.); (V.G.); (G.G.); (A.R.); (R.M.)
| | - Agile Tunaityte
- Laboratory of Preclinical Drug, Investigation Institute of Cardiology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania; (S.A.); (V.G.); (G.G.); (A.R.); (R.M.)
- Correspondence:
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania;
| | - Gintautas Gumbrevicius
- Laboratory of Preclinical Drug, Investigation Institute of Cardiology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania; (S.A.); (V.G.); (G.G.); (A.R.); (R.M.)
| | - Aurelija Radzeviciene
- Laboratory of Preclinical Drug, Investigation Institute of Cardiology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania; (S.A.); (V.G.); (G.G.); (A.R.); (R.M.)
- Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Romaldas Maciulaitis
- Laboratory of Preclinical Drug, Investigation Institute of Cardiology, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania; (S.A.); (V.G.); (G.G.); (A.R.); (R.M.)
- Nephrology Department, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania
| |
Collapse
|
14
|
Smetanina N, Valickas R, Vitkauskiene A, Albertsson-Wikland K, Verkauskienė R. Prevalence of Metabolic Syndrome and Impaired Glucose Metabolism among 10- to 17-Year-Old Overweight and Obese Lithuanian Children and Adolescents. Obes Facts 2021; 14:271-282. [PMID: 33951670 PMCID: PMC8255643 DOI: 10.1159/000514720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 01/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Overweight (Ow) and obesity among adults and children increases the risk of metabolic consequences. Metabolic syndrome (MS) and impaired glucose metabolism are well-known risk factors for cardiovascular diseases and type 2 diabetes. The aim of this study was to evaluate the prevalence of MS and impaired glucose metabolism among Ow and obese (Ob) children and adolescents (aged 10-17 years) in Lithuania, and to evaluate the associations between insulin resistance (IR) indices and anthropometric parameters as well as metabolic disturbances. METHODS The study population consisted of 344 OwOb children and adolescents of all pubertal stages. Oral glucose tolerance tests (OGTTs), IR and β cell function indices, lipid profile, and anthropometric parameters of all subjects were analyzed. MS was defined according to the International Diabetes Federation consensus guidelines. RESULTS MS was found in 21.3% of the OwOb children and adolescents, and 12.1% had impaired glucose metabolism (6.9% with impaired fasting glucose, 4.5% with impaired glucose tolerance, and 0.6% with type 2 diabetes). IR was directly related to body mass index and waist circumference, waist-to-height and waist-to-hip ratios, and sum of skin-fold thicknesses. Children with MS were more insulin-resistant, had higher odds ratio for prediabetes and had a more disturbed lipid profile than subjects without MS. Moreover, total cholesterol and low-density lipoprotein cholesterol levels were significantly lower in the more mature OwOb adolescents. CONCLUSION MS and lipid profile disturbances are common in OwOb children and adolescents. MS is directly associated with IR. Therefore, OwOb children and adolescents should be carefully followed up for metabolic abnormalities during late childhood as these can persist into adulthood.
Collapse
Affiliation(s)
- Natalija Smetanina
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- *Natalija Smetanina,
| | - Raimondas Valickas
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Rasa Verkauskienė
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
15
|
Petraitiene B, Conejo PR, Jankauskaite L, Kevalas R, Trumpulyte G, Snipaitiene A, Vitkauskiene A, Gurskis V. Prevalence, clinical expression, invasiveness and outcome of Staphylococcus aureus containing Panton-Valentine leukocidin in children treated in a university hospital of Lithuania. Infect Dis (Lond) 2020; 52:464-472. [PMID: 32297537 DOI: 10.1080/23744235.2020.1752395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: There is a high prevalence of Staphylococcus aureus virulence factor Panton-Valentine leukocidin (PVL) in North-East parts of Europe. The aim was to evaluate data regarding the PVL occurrences in Lithuania, determine the relationship with Methicillin resistant Staphylococcus aureus (MRSA), association with demographic and clinical conditions, invasiveness and severity of the disease in children treated in hospital Kauno klinikos (KK).Methods: We performed a prospective case-cohort single-center study on paediatric patients hospitalized from 2012 to 2015 to KK. We compared characteristics in PVL positive [SA-PVL(+)] and PVL negative [SA-PVL(-)] groups among non-invasive and invasive infections. Logistic regression was performed to detect PVL predicting factors and Cox regression was presented to define factors associated with admission to intensive care unit (ICU).Results: PVL was detected in 51.5%, MRSA in 7.0% and MRSA-PVL(+) in 4.8% of cases. In general, PVL was associated with older age comparing with SA-PVL(-) (median 8.5 vs. 4.0 years, p < .001). Skin and soft tissue infections were presented in 87.9% of all SA-PVL(+) cases. Invasive infections (44.7% vs. 12.1%, p < .001) and co-morbidities (20.5% vs. 2.9%, p < .001) were associated with SA-PVL(-) infections compared to SA-PVL(+), but ICU admission number was higher in invasive SA-PVL(+) cases comparing to invasive SA-PVL(-) cases (41.2% vs. 10.2%, p = .007).Conclusions: There was a high prevalence of pvl gene in patients treated in KK. SA-PVL(+) infections were associated with SSTI and were not common in invasive infections, but the invasive infections caused by SA-PVL(+) were related to severe disease progression and admission to ICU.
Collapse
Affiliation(s)
- Birute Petraitiene
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | | | - Lina Jankauskaite
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | - Rimantas Kevalas
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | - Giedre Trumpulyte
- Department of Pediatric Surgery, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania
| | - Ausra Snipaitiene
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania.,Department of Laboratory Medicine, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania
| | - Vaidotas Gurskis
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| |
Collapse
|
16
|
Simkiene J, Pranskuniene Z, Vitkauskiene A, Pilvinis V, Boerma EC, Pranskunas A. Ocular microvascular changes in patients with sepsis: a prospective observational study. Ann Intensive Care 2020; 10:38. [PMID: 32266602 PMCID: PMC7138894 DOI: 10.1186/s13613-020-00655-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Background The aim of the study was to detect differences in the conjunctival microcirculation between septic patients and healthy subjects and to evaluate the course of conjunctival and retinal microvasculature in survivors and non-survivors over a 24-h period of time. Methods This single-center prospective observational study was performed in mixed ICU in a tertiary teaching hospital. We included patients with sepsis or septic shock within the first 24 h after ICU admission. Conjunctival imaging, using an IDF video microscope, and retinal imaging, using portable digital fundus camera, as well as systemic hemodynamic measurements, were performed at three time points: at baseline, 6 h and 24 h. Baseline conjunctival microcirculatory parameters were compared with healthy controls. Results A total of 48 patients were included in the final assessment and analysis. Median APACHE II and SOFA scores were 16[12–21] and 10[7–12], respectively. Forty-four (92%) patients were in septic shock, 48 (100%) required mechanical ventilation. 19 (40%) patients were discharged alive from the intensive care unit. We found significant reductions in all microcirculatory parameters in the conjunctiva when comparing septic and healthy subjects. In addition, we observed a significant lower microvascular flow index (MFI) of small conjunctival vessels during all three time points in non-survivors compared with survivors. However, retinal arteriolar vessels were not different between survivors and non-survivors. Conclusions Conjunctival microvascular blood flow was altered in septic patients. In the 24-h observation period conjunctival small vessels had a significantly higher MFI, but no difference in retinal arteriolar diameter in survivors in comparison with non-survivors. Trial registration NCT04214743, https://www.clinicaltrials.gov. Date of registration: 31 December 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04214743
Collapse
Affiliation(s)
- Jurate Simkiene
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - Zivile Pranskuniene
- Department of Drug Technology and Social Pharmacy, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania.,Institute of Pharmaceutical Technologies, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - Vidas Pilvinis
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - E Christiaan Boerma
- Department of Intensive Care Medicine, Medical Center Leeuwarden, Henri Dunantweg 2, 8901 BR, Leeuwarden, The Netherlands
| | - Andrius Pranskunas
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania.
| |
Collapse
|
17
|
Bösl K, Ianevski A, Than TT, Andersen PI, Kuivanen S, Teppor M, Zusinaite E, Dumpis U, Vitkauskiene A, Cox RJ, Kallio-Kokko H, Bergqvist A, Tenson T, Merits A, Oksenych V, Bjørås M, Anthonsen MW, Shum D, Kaarbø M, Vapalahti O, Windisch MP, Superti-Furga G, Snijder B, Kainov D, Kandasamy RK. Common Nodes of Virus-Host Interaction Revealed Through an Integrated Network Analysis. Front Immunol 2019; 10:2186. [PMID: 31636628 PMCID: PMC6787150 DOI: 10.3389/fimmu.2019.02186] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/29/2019] [Indexed: 12/22/2022] Open
Abstract
Viruses are one of the major causes of acute and chronic infectious diseases and thus a major contributor to the global burden of disease. Several studies have shown how viruses have evolved to hijack basic cellular pathways and evade innate immune response by modulating key host factors and signaling pathways. A collective view of these multiple studies could advance our understanding of virus-host interactions and provide new therapeutic perspectives for the treatment of viral diseases. Here, we performed an integrative meta-analysis to elucidate the 17 different host-virus interactomes. Network and bioinformatics analyses showed how viruses with small genomes efficiently achieve the maximal effect by targeting multifunctional and highly connected host proteins with a high occurrence of disordered regions. We also identified the core cellular process subnetworks that are targeted by all the viruses. Integration with functional RNA interference (RNAi) datasets showed that a large proportion of the targets are required for viral replication. Furthermore, we performed an interactome-informed drug re-purposing screen and identified novel activities for broad-spectrum antiviral agents against hepatitis C virus and human metapneumovirus. Altogether, these orthogonal datasets could serve as a platform for hypothesis generation and follow-up studies to broaden our understanding of the viral evasion landscape.
Collapse
Affiliation(s)
- Korbinian Bösl
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thoa T Than
- Institut Pasteur Korea, Seongnam, South Korea
| | - Petter I Andersen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Suvi Kuivanen
- Department of Virology, University of Helsinki, Helsinki, Finland
| | - Mona Teppor
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Eva Zusinaite
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Uga Dumpis
- Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Science, Kaunas, Lithuania
| | - Rebecca J Cox
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
| | - Hannimari Kallio-Kokko
- Department of Virology and Immunology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Tanel Tenson
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Andres Merits
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Valentyn Oksenych
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Magnar Bjørås
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit W Anthonsen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - David Shum
- Institut Pasteur Korea, Seongnam, South Korea
| | - Mari Kaarbø
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Olli Vapalahti
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
| | | | - Giulio Superti-Furga
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Berend Snijder
- Department of Biology, Institute of Molecular Systems Biology, ETH Zürich, Zurich, Switzerland
| | - Denis Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Technology, University of Tartu, Tartu, Estonia
| | - Richard K Kandasamy
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway.,Program in Innate Immunity, Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| |
Collapse
|
18
|
Brazaitis M, Eimantas N, Baranauskiene N, Kilikeviciene S, Vitkauskiene A, Daniuseviciute L. Effects of severe whole-body hyperthermia on ovarian hormone and extracellular Hsp72 responses in young adult women. Int J Hyperthermia 2019; 36:660-665. [DOI: 10.1080/02656736.2019.1627431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Marius Brazaitis
- Institute of Sports Science and Innovations Lithuanian Sports University, Kaunas, Lithuania
| | - Nerijus Eimantas
- Institute of Sports Science and Innovations Lithuanian Sports University, Kaunas, Lithuania
| | - Neringa Baranauskiene
- Institute of Sports Science and Innovations Lithuanian Sports University, Kaunas, Lithuania
| | - Sandra Kilikeviciene
- Institute of Sports Science and Innovations Lithuanian Sports University, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laura Daniuseviciute
- Department of Educational Studies, Kaunas University of Technology, Kaunas, Lithuania
| |
Collapse
|
19
|
Abstract
Objectives The aim of this study was to analyze drain fluid, blood, and urine simultaneously to follow the long-term release of vancomycin from a biphasic ceramic carrier in major hip surgery. Our hypothesis was that there would be high local vancomycin concentrations during the first week with safe low systemic trough levels and a complete antibiotic release during the first month. Methods Nine patients (six female, three male; mean age 75.3 years (sd 12.3; 44 to 84)) with trochanteric hip fractures had internal fixations. An injectable ceramic bone substitute, with hydroxyapatite in a calcium sulphate matrix, containing 66 mg of vancomycin per millilitre, was inserted to augment the fixation. The vancomycin elution was followed by simultaneously collecting drain fluid, blood, and urine. Results The antibiotic concentration in the drain reached a peak during the first six hours post-surgery (mean 966.1 mg/l), which decreased linearly to a mean value of 88.3 mg/l at 2.5 days. In the urine, the vancomycin concentration reached 99.8 mg/l during the first two days, followed by a logarithmic decrease over the next two weeks to reach 0 mg/l at 20 days. The systemic concentration of vancomycin measured in blood serum was low and decreased linearly from 2.17 mg/l at one hour post-surgery to 0 mg/l at four days postoperatively. Conclusion This is the first long-term pharmacokinetic study that reports vancomycin release from a biphasic injectable ceramic bone substitute. The study shows initial high targeted local vancomycin levels, sustained and complete release at three weeks, and systemic concentrations well below toxic levels. The plain ceramic bone substitute has been proven to regenerate bone but should also be useful in preventing bone infection. Cite this article: M. Stravinskas, M. Nilsson, A. Vitkauskiene, S. Tarasevicius, L. Lidgren. Vancomycin elution from a biphasic ceramic bone substitute. Bone Joint Res 2019;8:49–54. DOI: 10.1302/2046-3758.82.BJR-2018-0174.R2.
Collapse
Affiliation(s)
- M Stravinskas
- Orthopaedic Surgeon, Lithuanian University of Health, Kaunas, Lithuania
| | - M Nilsson
- Department of Orthopedics, Lund University Hospital, Lund, Sweden
| | - A Vitkauskiene
- Orthopaedic Surgeon, Lithuanian University of Health, Kaunas, Lithuania
| | - S Tarasevicius
- Orthopaedic Surgeon, Lithuanian University of Health, Kaunas, Lithuania
| | - L Lidgren
- Department of Orthopedics, Lund University Hospital, Lund, Sweden
| |
Collapse
|
20
|
Ianevski A, Zusinaite E, Shtaida N, Kallio-Kokko H, Valkonen M, Kantele A, Telling K, Lutsar I, Letjuka P, Metelitsa N, Oksenych V, Dumpis U, Vitkauskiene A, Stašaitis K, Öhrmalm C, Bondeson K, Bergqvist A, Cox RJ, Tenson T, Merits A, Kainov DE. Low Temperature and Low UV Indexes Correlated with Peaks of Influenza Virus Activity in Northern Europe during 2010⁻2018. Viruses 2019; 11:v11030207. [PMID: 30832226 PMCID: PMC6466003 DOI: 10.3390/v11030207] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/18/2019] [Accepted: 02/28/2019] [Indexed: 12/21/2022] Open
Abstract
With the increasing pace of global warming, it is important to understand the role of meteorological factors in influenza virus (IV) epidemics. In this study, we investigated the impact of temperature, UV index, humidity, wind speed, atmospheric pressure, and precipitation on IV activity in Norway, Sweden, Finland, Estonia, Latvia and Lithuania during 2010–2018. Both correlation and machine learning analyses revealed that low temperature and UV indexes were the most predictive meteorological factors for IV epidemics in Northern Europe. Our in vitro experiments confirmed that low temperature and UV radiation preserved IV infectivity. Associations between these meteorological factors and IV activity could improve surveillance and promote development of accurate predictive models for future influenza outbreaks in the region.
Collapse
Affiliation(s)
- Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7028 Trondheim, Norway.
| | - Eva Zusinaite
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | | | | | - Miia Valkonen
- Helsinki University Hospital (HUS) and University of Helsinki, 00290 Helsinki, Finland.
| | - Anu Kantele
- Helsinki University Hospital (HUS) and University of Helsinki, 00290 Helsinki, Finland.
| | - Kaidi Telling
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | - Irja Lutsar
- Institute of Medical Microbiology, University of Tartu, 50411 Tartu, Estonia.
| | | | | | - Valentyn Oksenych
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7028 Trondheim, Norway.
| | - Uga Dumpis
- Latvian Biomedical Research and Study Centre, 1067 Riga, Latvia.
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Science, 44307 Kaunas, Lithuania.
| | - Kestutis Stašaitis
- Department of Emergency Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
| | - Christina Öhrmalm
- Department of Medical Sciences, Uppsala University, 75309 Uppsala, Sweden.
| | - Kåre Bondeson
- Department of Medical Sciences, Uppsala University, 75309 Uppsala, Sweden.
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, 75309 Uppsala, Sweden.
| | - Rebecca J Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway.
| | - Tanel Tenson
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | - Andres Merits
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| | - Denis E Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7028 Trondheim, Norway.
- Institute of Technology, University of Tartu, 50090 Tartu, Estonia.
| |
Collapse
|
21
|
Pranskunas A, Tamosuitis T, Balciuniene N, Damanskyte D, Sneider E, Vitkauskiene A, Sirvinskas E, Pilvinis V, Boerma EC. Alterations of conjunctival glycocalyx and microcirculation in non-septic critically ill patients. Microvasc Res 2018; 118:44-48. [DOI: 10.1016/j.mvr.2018.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/21/2017] [Accepted: 02/15/2018] [Indexed: 12/29/2022]
|
22
|
Ianevski A, Zusinaite E, Kuivanen S, Strand M, Lysvand H, Teppor M, Kakkola L, Paavilainen H, Laajala M, Kallio-Kokko H, Valkonen M, Kantele A, Telling K, Lutsar I, Letjuka P, Metelitsa N, Oksenych V, Bjørås M, Nordbø SA, Dumpis U, Vitkauskiene A, Öhrmalm C, Bondeson K, Bergqvist A, Aittokallio T, Cox RJ, Evander M, Hukkanen V, Marjomaki V, Julkunen I, Vapalahti O, Tenson T, Merits A, Kainov D. Novel activities of safe-in-human broad-spectrum antiviral agents. Antiviral Res 2018; 154:174-182. [PMID: 29698664 PMCID: PMC7113852 DOI: 10.1016/j.antiviral.2018.04.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/16/2018] [Accepted: 04/20/2018] [Indexed: 12/03/2022]
Abstract
According to the WHO, there is an urgent need for better control of viral diseases. Re-positioning existing safe-in-human antiviral agents from one viral disease to another could play a pivotal role in this process. Here, we reviewed all approved, investigational and experimental antiviral agents, which are safe in man, and identified 59 compounds that target at least three viral diseases. We tested 55 of these compounds against eight different RNA and DNA viruses. We found novel activities for dalbavancin against echovirus 1, ezetimibe against human immunodeficiency virus 1 and Zika virus, as well as azacitidine, cyclosporine, minocycline, oritavancin and ritonavir against Rift valley fever virus. Thus, the spectrum of antiviral activities of existing antiviral agents could be expanded towards other viral diseases. 339 approved, investigational and experimental safe-in-human antivirals were identified. 59 compounds, which target ≥3 viral diseases, were selected. 55 of the 59 compounds were tested against 8 RNA and DNA viruses. 7 compounds were found to possess novel antiviral activities.
Collapse
Affiliation(s)
- Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7028, Norway.
| | - Eva Zusinaite
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Suvi Kuivanen
- Department of Virology, University of Helsinki, Helsinki 00014, Finland.
| | - Mårten Strand
- Department of Clinical Microbiology, Umeå University, Umeå 90185, Sweden.
| | - Hilde Lysvand
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway.
| | - Mona Teppor
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Laura Kakkola
- Institute of Biomedicine, University of Turku, Turku 20520, Finland.
| | | | - Mira Laajala
- Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä 40500, Finland.
| | - Hannimari Kallio-Kokko
- Department of Virology and Immunology, University of Helsinki, Helsinki University Hospital, Helsinki 00014, Finland.
| | - Miia Valkonen
- Helsinki University Hospital, Helsinki 00014, Finland.
| | - Anu Kantele
- Helsinki University Hospital, Helsinki 00014, Finland.
| | - Kaidi Telling
- Institute of Medical Microbiology, University of Tartu, Tartu 50411, Estonia.
| | - Irja Lutsar
- Institute of Medical Microbiology, University of Tartu, Tartu 50411, Estonia.
| | | | | | - Valentyn Oksenych
- St. Olavs Hospital, Trondheim University Hospital, Clinic of Medicine, Trondheim 7006, Norway.
| | - Magnar Bjørås
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway.
| | - Svein Arne Nordbø
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway; Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim 7006, Norway.
| | - Uga Dumpis
- Pauls Stradins Clinical University Hospital, Riga 1002, Latvia.
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Science, Kaunas 44307, Lithuania.
| | - Christina Öhrmalm
- Department of Medical Sciences, Uppsala University, Uppsala 75309, Sweden.
| | - Kåre Bondeson
- Department of Medical Sciences, Uppsala University, Uppsala 75309, Sweden.
| | - Anders Bergqvist
- Department of Medical Sciences, Uppsala University, Uppsala 75309, Sweden.
| | - Tero Aittokallio
- Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Helsinki 00290, Finland; Department of Mathematics and Statistics, University of Turku, Turku 20014, Finland.
| | - Rebecca J Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen 5021, Norway.
| | - Magnus Evander
- Department of Clinical Microbiology, Umeå University, Umeå 90185, Sweden.
| | - Veijo Hukkanen
- Institute of Biomedicine, University of Turku, Turku 20520, Finland.
| | - Varpu Marjomaki
- Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä 40500, Finland.
| | - Ilkka Julkunen
- Institute of Biomedicine, University of Turku, Turku 20520, Finland.
| | - Olli Vapalahti
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki 00014, Finland; Department of Veterinary Biosciences, University of Helsinki, Helsinki 00014, Finland.
| | - Tanel Tenson
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Andres Merits
- Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| | - Denis Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7028, Norway; Institute of Technology, University of Tartu, Tartu 50090, Estonia.
| |
Collapse
|
23
|
Verkauskiene R, Danyte E, Dobrovolskiene R, Stankute I, Simoniene D, Razanskaite-Virbickiene D, Seibokaite A, Urbonaite B, Jurgeviciene N, Vitkauskiene A, Schwitzgebel V, Marciulionyte D. The course of diabetes in children, adolescents and young adults: does the autoimmunity status matter? BMC Endocr Disord 2016; 16:61. [PMID: 27842589 PMCID: PMC5109672 DOI: 10.1186/s12902-016-0145-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 11/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Initial classification of diabetes of young may require revision to improve diagnostic accuracy of different forms of diabetes. The aim of our study was to examine markers of beta-cell autoimmunity in a cohort of young (0-25 years) patients with type 1 diabetes and compare the presentation and course of the disease according to the presence of pancreatic antibodies. METHODS Cross-sectional population-based study was performed covering 100% of pediatric (n = 860) and 70% of 18-25 years old adult patients (n = 349) with type 1 diabetes in Lithuania. RESULTS No antibodies (GAD65, IA-2, IAA and ICA) were found in 87 (7.5%) cases. Familial history of diabetes was more frequent in those with antibodies-negative diabetes (24.1 vs. 9.4%, p < 0.001). Gestational age, birth weight and age at diagnosis was similar in both groups. Ketosis at presentation was more frequent in patients with autoimmune diabetes (88.1 vs. 73.5%, p < 0.05). HbA1c at the moment of investigation was 8.6 (3) vs. 8.7 (2.2)% in antibodies-negative and antibodies-positive diabetes groups, respectively, p > 0.05. In the whole cohort, neuropathy was found in 8.8% and nephropathy - in 8.1% of cases, not depending on autoimmunity status. Adjusted for age at onset, disease duration and HbA1c, retinopathy was more frequent in antibodies-negative subjects (13.8 vs. 7.8%, p < 0.05). CONCLUSION Antibodies-negative pediatric and young adult patients with type 1 diabetes in this study had higher incidence of family history of diabetes, higher frequency of retinopathy, less frequent ketosis at presentation, but similar age at onset, HbA1c, incidence of nephropathy and neuropathy compared to antibodies-positive patients.
Collapse
Affiliation(s)
- Rasa Verkauskiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| | - Evalda Danyte
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| | - Rimante Dobrovolskiene
- Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania
| | - Ingrida Stankute
- Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania
| | - Diana Simoniene
- Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania
| | - Dovile Razanskaite-Virbickiene
- Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania
| | - Audrone Seibokaite
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| | - Brone Urbonaite
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| | - Nijole Jurgeviciene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Endocrinology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania
| | - Valerie Schwitzgebel
- Department of Child and Adolescent, University Hospital of Geneva, 1211 Geneva, Switzerland
- Diabetes Center, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Dalia Marciulionyte
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| |
Collapse
|
24
|
Sakalauskiene J, Giedrimiene D, Gleiznys D, Gleiznys A, Gleizniene R, Vitkauskiene A. Peripheral Blood Leukocytes Interleukin-1 Beta (IL-1β) Cytokine Hyper-Reactivity in Chronic Periodontitis. Med Sci Monit 2016; 22:4323-4329. [PMID: 27847385 PMCID: PMC5115217 DOI: 10.12659/msm.898422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Levels of pro-inflammatory cytokine (IL-1β) released by peripheral blood leukocyte medium (PBLM), isolated from chronic periodontitis patients (P) before therapy and matched to controls, were determined in the presence or absence of non-opsonized Escherichia coli and Staphylococcus aureus. Material/Methods In this investigation, 26 patients with untreated, severe, generalized, chronic periodontitis and 26 healthy subjects (H) were enrolled. Periodontal status was assessed by measuring bleeding on probing (BOP), clinical attachment loss (CAL), probing pocket depth (PPD), and Ramfjord index (PDI). The levels of IL-1β (μg/ml) were assayed by a standard Immunoenzymetric Assay Diasource IL-1β ELISA kit in PBLM. Results Our study showed that the values of IL-1β levels in PBLM of the P group (stimulated with non-opsonized E. coli and S. aureus) were significantly higher than in the analogous medium of H group subjects (P<0.001). All correlations between the cytokine levels of IL-1β in the samples of PBLM (stimulated with non-opsonized E. coli and S. aureus) and clinical parameters such as BOP, PPD, CAL, and PDI were significantly higher in the group of patients with periodontitis. Conclusions Levels of IL-1β secreted by leukocytes may help measure severe, generalized, chronic periodontitis, and can be predictive of future detrimental clinical sequelae associated with chronic periodontitis.
Collapse
Affiliation(s)
- Jurgina Sakalauskiene
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Giedrimiene
- School of Health and Natural Sciences and School of Pharmacy, University of Saint Joseph, West Hartford, CT, USA
| | - Darius Gleiznys
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alvydas Gleiznys
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rymante Gleizniene
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
25
|
Kucinskiene V, Russetti L, Stoniene D, Vitkauskiene A, Valiukeviciene S, Tameliene R. A Case Report and Review of Early Symptomatic Congenital Syphilis Clinical Variations. Clin Pediatr (Phila) 2016; 55:693-7. [PMID: 26976805 DOI: 10.1177/0009922816638666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | - Laura Russetti
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Stoniene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | - Rasa Tameliene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
26
|
Gijón M, Bellusci M, Petraitiene B, Noguera-Julian A, Zilinskaite V, Sanchez Moreno P, Saavedra-Lozano J, Glikman D, Daskalaki M, Kaiser-Labusch P, Falup-Pecurariu O, Montagnani C, Prieto L, Gené A, Trumpulyte G, Kulecnikova I, Lepe JA, Cercenado E, Kudinsky R, Makri A, Huppertz HI, Bleotu L, Cocchi P, García-Hierro P, Vitkauskiene A, Fortuny C, Zukovskaja V, Neth O, Santos M, Rokney A, Petra M, Lixandru R, Galli L, Guillén S, Chaves F, Rojo Conejo P. Factors associated with severity in invasive community-acquired Staphylococcus aureus infections in children: a prospective European multicentre study. Clin Microbiol Infect 2016; 22:643.e1-6. [PMID: 27107685 DOI: 10.1016/j.cmi.2016.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/17/2016] [Accepted: 04/05/2016] [Indexed: 11/30/2022]
Abstract
Staphylococcus aureus is the main pathogen responsible for bone and joint infections worldwide and is also capable of causing pneumonia and other invasive severe diseases. Panton-Valentine leukocidin (PVL) and methicillin-resistant S. aureus (MRSA) have been studied as factors related with severity in these infections. The aims of this study were to describe invasive community-acquired S. aureus (CA-SA) infections and to analyse factors related to severity of disease. Paediatric patients (aged 0-16 years) who had a CA-SA invasive infection were prospectively recruited from 13 centres in 7 European countries. Demographic, clinical and microbiological data were collected. Severe infection was defined as invasive infection leading to death or admission to intensive care due to haemodynamic instability or respiratory failure. A total of 152 children (88 boys) were included. The median age was 7.2 years (interquartile range, 1.3-11.9). Twenty-six (17%) of the 152 patients had a severe infection, including 3 deaths (2%). Prevalence of PVL-positive CA-SA infections was 18.6%, and 7.8% of the isolates were MRSA. The multivariate analysis identified pneumonia (adjusted odds ratio (aOR) 13.39 (95% confidence interval (CI) 4.11-43.56); p 0.008), leukopenia at admission (<3000/mm(3)) (aOR 18.3 (95% CI 1.3-259.9); p 0.03) and PVL-positive infections (aOR 4.69 (95% CI 1.39-15.81); p 0.01) as the only factors independently associated with severe outcome. There were no differences in MRSA prevalence between severe and nonsevere cases (aOR 4.30 (95% CI 0.68- 28.95); p 0.13). Our results show that in European children, PVL is associated with more severe infections, regardless of methicillin resistance.
Collapse
Affiliation(s)
- M Gijón
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Bellusci
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - B Petraitiene
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Noguera-Julian
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - V Zilinskaite
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Sanchez Moreno
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Saavedra-Lozano
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - D Glikman
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Daskalaki
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Kaiser-Labusch
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - O Falup-Pecurariu
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Montagnani
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - L Prieto
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Gené
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - G Trumpulyte
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Kulecnikova
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J A Lepe
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - E Cercenado
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - R Kudinsky
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Makri
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - H I Huppertz
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - L Bleotu
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Cocchi
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P García-Hierro
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Vitkauskiene
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Fortuny
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - V Zukovskaja
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - O Neth
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Santos
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Rokney
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Petra
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - R Lixandru
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - L Galli
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Guillén
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Chaves
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Rojo Conejo
- Pediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain.
| |
Collapse
|
27
|
Vaznaisiene D, Sulcaite R, Vitkauskiene A, Spucis A, Reingardas A, Kymantas V, Balanaska K, Sleivys R, Velicka L, Belickas J, Rysevaite-Kyguoliene K, Pauza DH, Mickiene A, Senneville E. Section's osseous slice biopsy during major amputation of lower extremity: preliminary results of prospective cohort study. BMC Infect Dis 2015; 15:247. [PMID: 26123296 PMCID: PMC4485639 DOI: 10.1186/s12879-015-0993-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 06/22/2015] [Indexed: 11/12/2022] Open
Abstract
Background The purpose of this cohort study was to assess the incidence of positive cultures in section’s osseous slice biopsy (SOB) taken at the level of major limb amputation. In case of positive cultures we sought whether the microorganisms present in SOB could take origin from the primary infection site necessitating the amputation. The impact of diabetes on culture results was also investigated. Methods This prospective cohort study, which aimed to confirm the results of the pilot study, analysed patients who underwent major limb amputation between 2012 and 2013 in three Lithuanian hospitals. SOBs at the amputation site (surgical bone biopsies) and percutaneous bone biopsies of the distal site were performed simultaneously during limb amputation. Tissue cultures were analysed by microbiologists, and species along with antibiograms were reported. Histopathological assessment and bacterial typing were also evaluated. A positive culture was defined as the identification of at least 1 bacteria not belonging to the skin flora, at least 2 bacteria belonging to the skin flora with the same antibiotic susceptibility profiles or the same bacteria belonging to the skin flora in two different sites. Fisher’s exact test and Student’s test were used to compare the populations and the microbiological results. The statistical significance level was set at P < 0.05. Results Sixty-nine patients (35 males/34 females), mean age 68.7 (S = 13.6) years, including 21 (30.4 %) with diabetes underwent the major limb amputation. Forty-five amputations (65.2 %) were done above the knee. In total, 207 SOBs and 207 percutaneous distal site biopsies were studied. SOB cultures were positive in 11 (15.9 %) cases. In 5 (45.5 %) cases the same microorganisms were identified in both SOB and distal biopsy cultures. No association between culture results and presence of diabetes was identified. Conclusions Our results suggest that, independently of the diabetes status, foot infection may silently spread along the bone and can achieve the site of major limb amputation. Additional investigations aiming to confirm this hypothesis and to evaluate a prognostic value are in progress.
Collapse
Affiliation(s)
- Danguole Vaznaisiene
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Rita Sulcaite
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Arturas Spucis
- Department of Surgical Infection, Republican Hospital of Kaunas, Kaunas, Lithuania.
| | | | - Vytautas Kymantas
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | | | - Rolandas Sleivys
- Department of Surgery, Kaunas Clinical Hospital, Kaunas, Lithuania.
| | - Linas Velicka
- Department of Cardiothoracic and Vascular Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Juozas Belickas
- Department of Orthopedics and Traumatology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | | | - Dainius H Pauza
- Institute of Anatomy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Aukse Mickiene
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Eric Senneville
- Infectious Diseases Department, Dron Hospital, Tourcoing, France.
| |
Collapse
|
28
|
Brazaitis M, Eimantas N, Daniuseviciute L, Vitkauskiene A, Paulauskas H, Skurvydas A. Two strategies for the acute response to cold exposure but one strategy for the response to heat stress. Int J Hyperthermia 2015; 31:325-35. [DOI: 10.3109/02656736.2015.1004135] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
|
29
|
Zemeckiene Z, Sitkauskiene B, Gasiuniene E, Paramonova N, Tamasauskiene L, Vitkauskiene A, Sjakste T, Sakalauskas R. Evaluation of proteasomal gene polymorphisms in Lithuanian patients with asthma. J Asthma 2014; 52:447-52. [PMID: 25375907 DOI: 10.3109/02770903.2014.982761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate polymorphisms of proteasomal genes PSMA6 (rs1048990 and rs2277460), PSMC6 (rs2295826 and rs2295827) and PSMA3 (rs2348071) in Lithuanian patients with asthma. METHODS One-hundred forty-six asthma patients and 150 control subjects were studied. DNA was extracted from peripheral blood samples. Five single nucleotide polymorphisms (SNP's) of the three proteasomal genes were analyzed using allele-specific amplification or the cleaved amplified polymorphic sequence method. RESULTS While certain alleles and genotypes of PSMA6 rs2277460 and rs1048990 and PSMA3 rs2348071 SNP's occurred more frequently in asthma patients than in controls, no statistically significant differences in alleles or genotypes of PSMA6, PSMC6 or PSMA3 were observed between asthma patients and control subjects. However, when male and female study subjects were considered separately, we found that the CG genotype of PSMA6 rs1048990 is significantly more frequent in male asthma patients compared to male control subjects. CONCLUSIONS We found no significant differences in frequencies of selected five proteasomal gene PSMA6, PSMC6 and PSMA3 SNP's between asthma patients and control subjects overall. Among male subjects, however, the CG PSMA6 rs1048990 genotype was significantly more frequent in asthma patients compared with control subjects.
Collapse
Affiliation(s)
- Zivile Zemeckiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences , Kaunas , Lithuania
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Sakalauskiene J, Kubilius R, Gleiznys A, Vitkauskiene A, Ivanauskiene E, Šaferis V. Relationship of clinical and microbiological variables in patients with type 1 diabetes mellitus and periodontitis. Med Sci Monit 2014; 20:1871-7. [PMID: 25294115 PMCID: PMC4199460 DOI: 10.12659/msm.890879] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of the study was to analyze how metabolic control of type 1 diabetes is related to clinical and microbiological periodontal parameters. MATERIAL AND METHODS The study involved 56 subjects aged from 19 to 50 years divided into 2 groups: healthy subjects (the H group), and diabetic (type 1 diabetes) patients with chronic untreated generalized periodontitis (the DM group). The glycosylated hemoglobin value (HbA1c) was determined using the UniCel DxC 800 SYNCHRON System (Beckman Coulter, USA), and the concentration in blood was measured by the turbidimetric immunoinhibition method. A molecular genetic assay (Micro-IDent plus, Germany) was used to detect periodontopathogenic bacteria in plaque samples. Periodontitis was confirmed by clinical and radiological examination. RESULTS Fusobacterium nucleatum, Capnocytophaga species, and Eikenella corrodens were the most frequently found bacteria in dental plaque samples (77.8%, 66.7%, and 33.4%, respectively), whereas Aggregatibacter actinomycetemcomitans was identified 40.7% less frequently in the DM group than in the H group. The strongest relationship was observed between the presence of 2 periodontal pathogens - F. nucleatum and Capnocytophaga spp. - and poorer metabolic control in type 1 diabetes patients (HbA1c) and all clinical parameters of periodontal pathology. CONCLUSIONS Periodontal disease was more evident in type 1 diabetic patients, and the prevalence of periodontitis was greatly increased in subjects with poorer metabolic control.
Collapse
Affiliation(s)
- Jurgina Sakalauskiene
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ricardas Kubilius
- Department of Maxillofacial Surgery and Surgical Stomatology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alvydas Gleiznys
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Egle Ivanauskiene
- Department of Dental and Maxillofacial Orthopedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Viktoras Šaferis
- Department of Physics, Mathematics, and Biophysics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
31
|
Pranskunas A, Pranskuniene Z, Milieskaite E, Daniuseviciute L, Kudreviciene A, Vitkauskiene A, Skurvydas A, Brazaitis M. Effects of whole body heat stress on sublingual microcirculation in healthy humans. Eur J Appl Physiol 2014; 115:157-65. [DOI: 10.1007/s00421-014-2999-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 09/14/2014] [Indexed: 01/17/2023]
|
32
|
Jelen MM, Chen Z, Kocjan BJ, Burt FJ, Chan PKS, Chouhy D, Combrinck CE, Coutlée F, Estrade C, Ferenczy A, Fiander A, Franco EL, Garland SM, Giri AA, González JV, Gröning A, Heidrich K, Hibbitts S, Hošnjak L, Luk TNM, Marinic K, Matsukura T, Neumann A, Oštrbenk A, Picconi MA, Richardson H, Sagadin M, Sahli R, Seedat RY, Seme K, Severini A, Sinchi JL, Smahelova J, Tabrizi SN, Tachezy R, Tohme S, Uloza V, Vitkauskiene A, Wong YW, Zidovec Lepej S, Burk RD, Poljak M. Global genomic diversity of human papillomavirus 6 based on 724 isolates and 190 complete genome sequences. J Virol 2014; 88:7307-16. [PMID: 24741079 PMCID: PMC4054425 DOI: 10.1128/jvi.00621-14] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 04/08/2014] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Human papillomavirus type 6 (HPV6) is the major etiological agent of anogenital warts and laryngeal papillomas and has been included in both the quadrivalent and nonavalent prophylactic HPV vaccines. This study investigated the global genomic diversity of HPV6, using 724 isolates and 190 complete genomes from six continents, and the association of HPV6 genomic variants with geographical location, anatomical site of infection/disease, and gender. Initially, a 2,800-bp E5a-E5b-L1-LCR fragment was sequenced from 492/530 (92.8%) HPV6-positive samples collected for this study. Among them, 130 exhibited at least one single nucleotide polymorphism (SNP), indel, or amino acid change in the E5a-E5b-L1-LCR fragment and were sequenced in full. A global alignment and maximum likelihood tree of 190 complete HPV6 genomes (130 fully sequenced in this study and 60 obtained from sequence repositories) revealed two variant lineages, A and B, and five B sublineages: B1, B2, B3, B4, and B5. HPV6 (sub)lineage-specific SNPs and a 960-bp representative region for whole-genome-based phylogenetic clustering within the L2 open reading frame were identified. Multivariate logistic regression analysis revealed that lineage B predominated globally. Sublineage B3 was more common in Africa and North and South America, and lineage A was more common in Asia. Sublineages B1 and B3 were associated with anogenital infections, indicating a potential lesion-specific predilection of some HPV6 sublineages. Females had higher odds for infection with sublineage B3 than males. In conclusion, a global HPV6 phylogenetic analysis revealed the existence of two variant lineages and five sublineages, showing some degree of ethnogeographic, gender, and/or disease predilection in their distribution. IMPORTANCE This study established the largest database of globally circulating HPV6 genomic variants and contributed a total of 130 new, complete HPV6 genome sequences to available sequence repositories. Two HPV6 variant lineages and five sublineages were identified and showed some degree of association with geographical location, anatomical site of infection/disease, and/or gender. We additionally identified several HPV6 lineage- and sublineage-specific SNPs to facilitate the identification of HPV6 variants and determined a representative region within the L2 gene that is suitable for HPV6 whole-genome-based phylogenetic analysis. This study complements and significantly expands the current knowledge of HPV6 genetic diversity and forms a comprehensive basis for future epidemiological, evolutionary, functional, pathogenicity, vaccination, and molecular assay development studies.
Collapse
Affiliation(s)
- Mateja M Jelen
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Zigui Chen
- Department of Pediatrics, Albert Einstein College of Medicine, New York, New York, USA
| | - Boštjan J Kocjan
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Felicity J Burt
- Department of Medical Microbiology and Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Paul K S Chan
- Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Diego Chouhy
- Human Virology Group, National Council of Scientific and Technical Research, Institute of Molecular and Cell Biology of Rosario, Rosario, Argentina
| | - Catharina E Combrinck
- Department of Medical Microbiology and Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - François Coutlée
- Laboratoire de Virologie Moléculaire, Centre de Recherche, Centre Hospitalier de L'Université de Montréal, Hôpital Notre-Dame-Pavillon Deschamps, Montréal, Québec, Canada
| | - Christine Estrade
- Lausanne University Hospital (CHUV), Institute of Microbiology, Lausanne, Switzerland
| | - Alex Ferenczy
- Department of Pathology, McGill University and Jewish General Hospital, Montréal, Québec, Canada
| | - Alison Fiander
- Department of Obstetrics and Gynaecology, Cardiff University School of Medicine, Institute of Cancer and Genetics, Cardiff, United Kingdom
| | - Eduardo L Franco
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada
| | - Suzanne M Garland
- Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Adriana A Giri
- Human Virology Group, National Council of Scientific and Technical Research, Institute of Molecular and Cell Biology of Rosario, Rosario, Argentina
| | - Joaquín Víctor González
- Oncogenic Viruses Service, National Institute of Infectious Diseases-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Arndt Gröning
- Medizinisches Versorgungszentrum wagnerstibbe für Laboratoriumsmedizin und Pathologie GmbH, Hannover, Germany
| | - Kerstin Heidrich
- Medizinisches Versorgungszentrum wagnerstibbe für Laboratoriumsmedizin und Pathologie GmbH, Hannover, Germany
| | - Sam Hibbitts
- Department of Obstetrics and Gynaecology, Cardiff University School of Medicine, Institute of Cancer and Genetics, Cardiff, United Kingdom
| | - Lea Hošnjak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tommy N M Luk
- Dermatology Research Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China Department of Health, Social Hygiene Service, Centre for Health Protection, Hong Kong Special Administrative Region, China
| | - Karina Marinic
- Histocompatibility and Molecular Genetics Laboratory, Dr. Julio C. Perrando Hospital, Resistencia, Chaco, Argentina
| | - Toshihiko Matsukura
- Ganshintetsu Memorial Laboratory, Department of Virology II, National Institute of Health, Tokyo, Japan
| | - Anna Neumann
- Medizinisches Versorgungszentrum wagnerstibbe für Laboratoriumsmedizin und Pathologie GmbH, Hannover, Germany
| | - Anja Oštrbenk
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maria Alejandra Picconi
- Oncogenic Viruses Service, National Institute of Infectious Diseases-ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Harriet Richardson
- Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Martin Sagadin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Roland Sahli
- Lausanne University Hospital (CHUV), Institute of Microbiology, Lausanne, Switzerland
| | - Riaz Y Seedat
- Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alberto Severini
- Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jessica L Sinchi
- Histocompatibility and Molecular Genetics Laboratory, Dr. Julio C. Perrando Hospital, Resistencia, Chaco, Argentina
| | - Jana Smahelova
- Department of Experimental Virology, National Reference Laboratory for Papillomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Sepehr N Tabrizi
- Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Ruth Tachezy
- Department of Experimental Virology, National Reference Laboratory for Papillomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Sarah Tohme
- Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Virgilijus Uloza
- Department of Otolaryngology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Yong Wee Wong
- DNA Laboratories Sdn. Bhd., UKM-MTDC Technology Centre, Universti Kebangsaan Malaysia, Bangi, Malaysia
| | - Snježana Zidovec Lepej
- Department of Molecular Diagnostics, University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia
| | - Robert D Burk
- Departments of Microbiology and Immunology, Epidemiology and Population Health, Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, New York, New York, USA Department of Pediatrics, Albert Einstein College of Medicine, New York, New York, USA
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
33
|
Balnyte R, Rastenyte D, Vaitkus A, Mickeviciene D, Skrodeniene E, Vitkauskiene A, Uloziene I. The importance of HLA DRB1 gene allele to clinical features and disability in patients with multiple sclerosis in Lithuania. BMC Neurol 2013; 13:77. [PMID: 23837503 PMCID: PMC3716946 DOI: 10.1186/1471-2377-13-77] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 06/24/2013] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The association of HLA DRB1 alleles with susceptibility to multiple sclerosis (MS) has been consistently reported although its effect on the clinical features and disability is still unclear probably due to diversity in ethnicity and geographic location of the studied populations. The aim of the present study was to investigate the influence of HLA DRB1 alleles on the clinical features and disability of the patients with MS in Lithuania. METHODS This was a prospective study of 120 patients with MS. HLA DRB1 alleles were genotyped using the polymerase chain reaction. RESULTS The first symptoms of MS in patients with HLA DRB1*15 allele manifested at younger age than in those without this allele (28.32 +/- 5.49 yrs vs. 30.94 +/- 8.43 yrs, respectively, p = 0.043). HLA DRB1*08 allele was more prevalent among relapsing-remitting (RR) MS patients than among patients with progressive course of MS (25.0% vs. 8.3%, respectively, chi^2 = 6.000, p = 0.05). MS patients with this allele had lower relapse rate than those without this allele (1.00 +/- 0.97 and 1.44 +/- 0.85, respectively, p = 0.043). Degree of disability during the last visit was lower among the patients with HLA DRB1*08 allele (EDSS score 3.15 +/- 1.95 vs. 4.49 +/- 1.96, p = 0.006), and higher among those with HLA DRB1*15 allele (EDSS score 4.60 +/- 2.10 vs.4.05 +/- 1.94, p = 0.047) compared to patients without these alleles but there were no significant associations between these alleles and the duration of the disease to disability. HLA DRB1*08 allele (OR = 0.18, 95% CI 0,039-0,8, p = 0.029) was demonstradet to be independent factor to take a longer time to reach an EDSS of 6, while HLA DRB1*01 allele (OR = 5.92, 95% CI 1,30-26,8, p = 0.021) was related in a shorter time to reach and EDSS of 6. Patients with HLA DRB1*08 allele had lower IgG index compared to patients without this allele (0.58 +/- 0.17 and 0.73 +/- 0.31, respectively, p = 0.04), and HLA DRB1*15 allele was more often found among MS patients with oligoclonal bands (OCBs) in cerebrospinal fluid than among those without OCBs (OR 2.3, CI 95% 1.017-5.301; p = 0.043). CONCLUSIONS HLA DRB1*15 allele was related with an earlier manifestation of the first MS symptoms, progressive course of the disease and higher degree of disability. HLA DRB1*08 allele was more prevalent among the RR MS patients and was associated with the lower rate of relapse, degree of disability and IgG index.
Collapse
Affiliation(s)
- Renata Balnyte
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Daiva Rastenyte
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Antanas Vaitkus
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Dalia Mickeviciene
- Department of Neurology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Erika Skrodeniene
- Department of Laboratory Medicine, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| | - Ingrida Uloziene
- Department of Otorinolaryngology, Academy of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus street 9, Kaunas LT 44307, Lithuania
| |
Collapse
|
34
|
Kucinskiene V, Valiukeviciene S, Vitkauskiene A, Domeika M. P5.110 Multiprofessional Approach For the Development of the National STIS Management Guidelines in Lithuania. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
35
|
Vitkauskiene A, Dambrauskiene A, Cerniauskiene K, Rimdeika R, Sakalauskas R. Risk factors and outcomes in patients with carbapenem-resistant Acinetobacter infection. ACTA ACUST UNITED AC 2012; 45:213-8. [PMID: 23113773 DOI: 10.3109/00365548.2012.724178] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Acinetobacter spp. are important pathogens increasingly reported as the cause of outbreaks of nosocomial infections. The aim of our study was to identify the risk factors and assess their influence on outcomes in patients with infections caused by carbapenem-resistant Acinetobacter spp. METHODS A retrospective data analysis was performed to evaluate risk factors and mortality in patients with Acinetobacter spp. infections. Methods used for the statistical analysis were the Student's t-test, Chi-square test, and multivariate analysis; p < 0.05 was considered statistically significant. RESULTS A total of 99 patients with an Acinetobacter spp. infection were identified. Comparing patients with carbapenem-sensitive and carbapenem-resistant Acinetobacter spp. infection, significant differences were found in the mean length of intensive care unit stay (4.17 ± 3.61 vs 7.92 ± 6.74 days, p = 0.038) and mechanical ventilation (3.25 ± 2.61 and 7.07 ± 5.79 days, p = 0.009). The previous use of carbapenems (odds ratio (OR) 10.1, 95% confidence interval (CI) 1.16-87.20) and fluoroquinolones (OR 3.6, 95% CI 1.13-11.51) was independently associated with resistance to carbapenems. Of the Acinetobacter spp. strains, 94.9% (n = 94) were resistant to piperacillin-tazobactam, 88.9% (n = 88) to ceftazidime, 85.9% (n = 85) to ciprofloxacin, 83.8% (n = 83) to gentamicin, 79.8 (n = 79) to amikacin, and 48.5% (n = 48) to cefepime. CONCLUSIONS Intensive care unit stay before infection and source of infection in the respiratory tract were independently associated with patient mortality. Resistance to carbapenems had no impact on mortality rates. Carbapenem-resistant Acinetobacter spp. isolates had high resistance rates to other antimicrobial drugs.
Collapse
Affiliation(s)
- Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | | | | | | | | |
Collapse
|
36
|
Bajoriuniene I, Malakauskas K, Lavinskiene S, Jeroch J, Gasiuniene E, Vitkauskiene A, Sakalauskas R. Response of peripheral blood Th17 cells to inhaled Dermatophagoides pteronyssinus in patients with allergic rhinitis and asthma. Lung 2012; 190:487-95. [PMID: 22990520 DOI: 10.1007/s00408-012-9411-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 07/09/2012] [Indexed: 01/05/2023]
Abstract
BACKGROUND Recent studies have shown the importance of Th17 cells in the development of allergic airway diseases. We examined Dermatophagoides pteronyssinus-induced changes in peripheral blood Th17 cells to establish the importance of these cells in late-phase allergic inflammation in patients with allergic rhinitis (AR) and allergic asthma (AA). METHODS Eighteen patients with mild-to-moderate/severe persistent AR, 14 patients with intermittent- or mild-to-moderate persistent AA, and 15 healthy subjects (HS) were examined. All patients had positive skin test to D. pteronyssinus. Study subjects underwent bronchial challenge with D. pteronyssinus. The peripheral blood Th1, Th2, and Th17 cells were determined by flow cytometry 24 h before and 7 and 24 h after challenge. The serum IL-17 levels were determined by ELISA. RESULTS The percentage of Th17 cells and IL-17 levels was significantly higher in patients with AR and AA compared with HS before and after challenge. Twenty-four hours after challenge, the percentage of Th17 cells increased significantly in patients with AA compared with baseline values. The IL-17 levels rose markedly in patients with AR and AA after challenge. Moreover, 24 h after challenge, the percentage of Th17 cells and IL-17 levels were significantly higher in patients with AA than those with AR. CONCLUSIONS Percentages of peripheral blood Th17 cells and serum IL-17 levels were found to be higher in patients with AR and AA. An increase in the percentage of Th17 cells following challenge shows that Th17 cells may have an important role in the development of late-phase allergen-induced inflammation.
Collapse
Affiliation(s)
- Ieva Bajoriuniene
- Department of Pulmonology and Immunology, Lithuanian University of Health Sciences, Eiveniu Str. 2, 50009, Kaunas, Lithuania.
| | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
OBJECTIVES The use of prophylactic antibiotics in severe acute pancreatitis (SAP) is controversial. The aim of this study was to compare the effects of antibiotics administered as prophylaxis and as treatment on demand, respectively, in two prospective, non-randomized cohorts of patients. METHODS The study population consisted of 210 patients treated for SAP. In Group 1 (n= 103), patients received prophylactic antibiotics (ciprofloxacin, metronidazole). In Group 2 (n= 107), patients were treated on demand. Ultrasound-guided drainage and/or surgical debridement of infected necrosis were performed when the presence of infected pancreatic necrosis was demonstrated. The primary endpoints were infectious complication rate, need for and timing of surgical interventions, incidence of nosocomial infections and mortality rate. RESULTS Ultrasound-guided fine needle aspiration [in 18 (16.8%) vs. 13 (12.6%) patients; P= 0.714], ultrasound-guided drainage [in 15 (14.0%) vs. six (5.8%) patients; P= 0.065] and open surgical necrosectomy [in 10 (9.3%) vs. five (4.9%) patients; P= 0.206] were performed more frequently and earlier [at 16.6 ± 7.8 days vs. 17.2 ± 6.7 days (P= 0.723); at 19.5 ± 9.4 days vs. 24.5 ± 14.2 days (P= 0.498), and at 22.6 ± 13.5 days vs. 26.7 ± 18.1 days (P= 0.826), respectively] in Group 2 compared with Group 1. There were no significant differences between groups in mortality and duration of stay in the surgical ward or intensive care unit. CONCLUSIONS The results of this study support the suggestion that the use of prophylactic antibiotics does not affect mortality rate, but may decrease the need for interventional and surgical management, and lower the number of reoperations.
Collapse
Affiliation(s)
- Povilas Ignatavicius
- Department of Surgery, Institute for Digestive System Research, Lithuanian University of Health SciencesKaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Institute for Digestive System Research, Lithuanian University of Health SciencesKaunas, Lithuania
| | - Juozas Pundzius
- Department of Surgery, Institute for Digestive System Research, Lithuanian University of Health SciencesKaunas, Lithuania
| | - Zilvinas Dambrauskas
- Department of Surgery, Institute for Digestive System Research, Lithuanian University of Health SciencesKaunas, Lithuania,Department of Laboratory of Surgical Gastroenterology, Institute for Digestive System Research, Lithuanian University of Health SciencesKaunas, Lithuania
| | - Giedrius Barauskas
- Department of Surgery, Institute for Digestive System Research, Lithuanian University of Health SciencesKaunas, Lithuania
| |
Collapse
|
38
|
Pranskunas A, Rasimaviciute R, Milieskaite E, Vitkauskiene A, Dobozinskas P, Veikutis V, Dambrauskas Z, Vaitkaitis D, Pilvinis V. Early course of microcirculatory perfusion in the eye and digestive tract during experimental sepsis. Crit Care 2012. [PMCID: PMC3363621 DOI: 10.1186/cc10810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
39
|
Barcaite E, Bartusevicius A, Tameliene R, Maleckiene L, Vitkauskiene A, Nadisauskiene R. Group B streptococcus and Escherichia coli colonization in pregnant women and neonates in Lithuania. Int J Gynaecol Obstet 2012; 117:69-73. [PMID: 22265188 DOI: 10.1016/j.ijgo.2011.11.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 11/05/2011] [Accepted: 12/21/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the prevalence of maternal and neonatal colonization with group B streptococcus (GBS) and Escherichia coli, and examine GBS serotypes and susceptibility to antibiotics. METHODS A prospective cross-sectional study was carried out in Lithuania between October 2006 and June 2007. Lower vaginal/rectal swabs were obtained from pregnant women (n=998) and ear canal/throat swabs were obtained from their newborns (n=827) for culture. RESULTS Overall, maternal and neonatal GBS colonization rates were 15.3% and 6.4%, respectively. Serotypes III (34.5%) and Ia (29.7%) were most common. All GBS isolates were susceptible to penicillin and 4.1% were resistant to erythromycin. Overall, maternal and neonatal E. coli colonization rates were 19.9% and 14.4%, respectively. In total, 71.4% of newborns with E. coli colonization were born to E. coli-negative mothers. E. coli was resistant to ampicillin and piperacillin in 25.9% and 16.6% of cases, respectively. The majority of E. coli-colonized newborns were contaminated with maternal fecal, but not vaginal, E. coli strains. CONCLUSION Maternal and neonatal GBS colonization rates, serotypes, and susceptibility to antibiotics were comparable to those reported in previous studies. Population-based data regarding early-onset neonatal infection rates will enable the formulation of a prevention program for early-onset GBS disease in Lithuania.
Collapse
Affiliation(s)
- Egle Barcaite
- Department of Obstetrics and Gynecology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | | | | | | | | | | |
Collapse
|
40
|
Kucinskas L, Juzenas S, Sventoraityte J, Cedaviciute R, Vitkauskiene A, Kalibatas V, Kondrackiene J, Kupcinskas L. Prevalence of C282Y, H63D, and S65C mutations in hereditary HFE-hemochromatosis gene in Lithuanian population. Ann Hematol 2011; 91:491-5. [PMID: 21947086 DOI: 10.1007/s00277-011-1338-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 09/02/2011] [Indexed: 10/17/2022]
Abstract
HFE-hemochromatosis is a common autosomal recessive disease caused by HFE gene mutations and characterized as iron overload and failure of different organs. The aim of this study was to determine the prevalence of C282Y (c.845 G>A), H63D (c.187 C>G), and S65C (c.193A>T) alleles of HFE gene in the Lithuanian population. One thousand and eleven healthy blood donors of Lithuanian nationality were examined in four different ethnic Lithuanian regions to determine HFE gene alleles and genotype frequencies. The samples of DNA were analyzed for the presence of restriction fragment length polymorphism and validated by DNA sequencing. Among 1,011 blood donors tested, the frequency of C282Y, H63D, and S65C alleles were 2.6%, 15.9%, and 1.9%, respectively. One third of the tested subjects (n = 336) had at least one of the C282Y or H63D HFE gene mutations. The screening of Lithuanian blood donors has detected 13 (1.3%) subjects with a genotype C282Y/C282Y or C282Y/H63D responsible for the development of HFE-hemochromatosis. The prevalence of C282Y mutation was significantly higher among the inhabitants of Zemaitija (Somogitia) at the Baltic Sea area (5.9%) in comparison to the regions of continental part of Lithuania (2.4% in Dzukija, 2.3% in Aukstaitija, and 2% in Suvalkija, p < 0.05). These data support the hypothesis that the p.C282Y mutation originated from Scandinavia and spread with the Vikings along the Baltic Sea coast. The first epidemiological investigation of HFE gene mutations in ethnic Lithuanians showed that the frequencies of H63D, C282Y, and S65C of HFE gene alleles are similar to the other North-Eastern Europeans, especially in the Baltic region (Estonia, Latvia), Poland, and part of Russia (Moscow region).
Collapse
Affiliation(s)
- Laimutis Kucinskas
- Institute of Biological System and Genetic Research, Lithuanian University of Health Sciences, Mickeviciaus 9, Kaunas, LT 44307, Lithuania.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Skucaite N, Peciuliene V, Vitkauskiene A, Machiulskiene V. Susceptibility of endodontic pathogens to antibiotics in patients with symptomatic apical periodontitis. J Endod 2010; 36:1611-6. [PMID: 20850663 DOI: 10.1016/j.joen.2010.04.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2010] [Revised: 04/22/2010] [Accepted: 04/29/2010] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate susceptibility of predominant endodontic pathogens isolated from teeth with symptomatic apical periodontitis to most commonly prescribed antibiotics. METHODS Among 58 patients with symptomatic apical periodontitis, 47 and 11 cases were caused by primary and secondary root canal infection, respectively. The microbial samples were taken either from the root canals (35 cases) or by aspiration from apical abscesses (23 cases). Culture methods were used to identify the microorganisms present in the samples. Antibiotic susceptibilities of all isolates were evaluated by using the E-test method. RESULTS Microorganisms were isolated from 49 of the 58 samples studied and included facultative and obligate anaerobes. Streptococci and obligate anaerobes were the predominant microorganisms in cases of primary infection. Enterococcus faecalis dominated in cases of secondary infection. All tested microorganisms were highly sensitive to penicillin G, amoxicillin, and ampicillin. Susceptibilities to clindamycin and erythromycin were 73.8% and 54.7%, respectively. About 40% of the isolates were resistant to tetracycline. More than 50% of all anaerobes were resistant to metronidazole. All E. faecalis isolates were resistant to clindamycin. CONCLUSIONS Based on the study results, penicillin and amoxicillin are suitable antibiotics for treatment of endodontic infection when conventional root canal treatment alone is insufficient. Clindamycin could be advised for penicillin-allergic patients with primary endodontic infections.
Collapse
Affiliation(s)
- Neringa Skucaite
- Clinic of Dental and Oral Pathology, Kaunas University of Medicine, Kaunas, Lithuania.
| | | | | | | |
Collapse
|
42
|
Malakauskas K, Jankauskiene L, Gasiuniene E, Vitkauskiene A, Sarauskas V, Vaguliene N, Sirvinskas E, Bolys R, Benetis R, Sakalauskas R. 414: Lung Transplantation in Lithuania: Two Years Experience. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
43
|
Kavaliauskiene S, Povilionyte R, Jakubovskiene J, Jasaitiene D, Valiukeviciene S, Petrauskiene R, Zarankiene RP, Skrodeniene E, Vitkauskiene A. [Relationships between the incidence of onychomycosis and nail psoriasis]. Medicina (Kaunas) 2010; 46:180-184. [PMID: 20516757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
UNLABELLED The aim of the study was to determine the incidence of onychomycosis in affected nails among psoriatic and nonpsoriatic patients. MATERIAL AND METHODS The study included 559 patients (168 males and 391 females) examined for fungal infection of nails using direct microscopy and culture tests. RESULTS Of the 559 patients, 30 (5.3%) (9 males and 21 females) had psoriasis. The incidence of onychomycosis (determined according to positive results of culture tests) among psoriatic patients was 23.3% (7/30) as compared to 23.6% (125/529) among nonpsoriatic patients (P>0.05). Among psoriatic patients, dermatophytes were detected in 5 (71.4%) of the 7 cases, and in the remaining 2 cases, yeast and yeast-like fungi were found. Among nonpsoriatic patients, dermatophytes, yeast, and mould were detected in 66, 43, and 16 cases of the 125 positive cultures, respectively. The sensitivity of the microscopic examination versus culture for the identified dermatophytes and yeasts was 87.3% and 18.6%, accordingly. CONCLUSIONS There was no difference in the incidence of onychomycosis and distribution of fungal infections among psoriatic and nonpsoriatic patients. Onychomycosis was detected in less than one-third of the patients with clinically affected nails. The culture test is an important tool in diagnosing onychomycosis and selecting systemic treatment.
Collapse
|
44
|
Surna A, Kubilius R, Sakalauskiene J, Vitkauskiene A, Jonaitis J, Saferis V, Gleiznys A. Lysozyme and microbiota in relation to gingivitis and periodontitis. Med Sci Monit 2009; 15:CR66-CR73. [PMID: 19179970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate associations between the immune component of the oral cavity, lysozyme, in gingival crevicular fluid and unstimulated saliva, and colonization dynamics of periodontopathogenic bacteria from supra- and subgingival plaque samples in patients with gingivitis or periodontitis. MATERIAL/METHODS Lysozyme in crevicular fluid and unstimulated saliva, and bacteria in supra- and subgingival plaque samples were assessed in 84 samples from 28 patients with gingivitis, 96 samples from 32 patients with periodontitis, and 72 samples from 24 donors with intact periodontium and free of internal disease. Lysozyme activity was determined spectrophotometrically. The micro-IDent plus assay was used to detect 6 periodontopathogenic bacteria plaque samples. RESULTS Lysozyme activity in crevicular fluid in the gingivitis and periodontitis groups was significantly greater than that in the donor group, but lysozyme activity in unstimulated saliva was less than that in the donor group. Peptostreptococcus micros, Fusobacterium periodontium and Campylobacter rectus were predominant in subgingival plaque samples in the periodontitis group compared to the donor group (P<0.001), and Eubacterium nodatum and Eikenella corrodens were predominant in the gingivitis group compared to the donor group (P<0.001). CONCLUSIONS Lysozyme activity in crevicular fluid and in unstimulated saliva correlated with periodontal pocket depth in donors and in patients with gingivitis or periodontitis (specificity and sensitivity were both 100%). These findings indicate that infection with P. micros, F. periodontium, E. nodatum, E. corrodens, and C. rectus may be an important indicator of inflammatory periodontal disease development.
Collapse
Affiliation(s)
- Algimantas Surna
- Department of Dental and Maxillofacial Orthopedics, Kaunas University of Medicine, Lithuania.
| | | | | | | | | | | | | |
Collapse
|
45
|
Dambrauskiene A, Adukauskiene D, Jeroch J, Vitkauskiene A. [Pseudomonas aeruginosa bacteremia: associations with a source of infection and antibiotic resistance]. Medicina (Kaunas) 2009; 45:1-7. [PMID: 19223699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM OF THE STUDY To determine the associations between the source of infection and antibiotic resistance in patients with Pseudomonas aeruginosa bacteremia. MATERIAL AND METHODS A retrospective analysis of 50 patients with Pseudomonas aeruginosa bacteremia was carried out. If sepsis was suspected, blood culture was incubated in an automatic system BACTEC 9240. Then bacteria were identified, and their antibiotic resistance was estimated by disc diffusion method. If Pseudomonas aeruginosa strains were resistant to three or more antibiotics, they were considered as multidrug-resistant. RESULTS The origin of bacteremia was confirmed in 33 (66%) patients. Lower respiratory tract was the predominant source of Pseudomonas aeruginosa bacteremia (81.8%, n=27) as compared with infection of wound (39.4%, n=13), urinary tract (15.2%, n=5), and drain or cerebrospinal fluid (9.1%, n=3) (P<0.05). Eighteen percent (n=9) of strains, which caused bacteremia, were resistant to ceftazidime; 38% (n=19), to piperacillin; 22% (n=11), to imipenem; 26% (n=13), to meropenem; 24% (n=12), to ciprofloxacin; 40% (n=20), to gentamicin; and only 8% (n=4), to amikacin. Multidrug-resistant Pseudomonas aeruginosa strains were more frequently isolated if a source of infection was wound comparing to a source of other localization (61.5%, n=8 and 20.0%, n=4, respectively; P<0.05). Resistance of Pseudomonas aeruginosa strains to imipenem was associated with resistance to ciprofloxacin (13.2%, n=5 and 50.0%, n=6, retrospectively; P<0.05), but resistance to meropenem--both to ciprofloxacin and amikacin. CONCLUSIONS The predominant source of Pseudomonas aeruginosa bacteremia was lower respiratory tract, and multidrug-resistant strains caused bacteremia more frequently if a source infection was wound. Pseudomonas aeruginosa resistance to carbapenems was associated with resistance to ciprofloxacin and resistance to meropenem--also to amikacin. Resistance of strains to ceftazidime and piperacillin was associated with resistance to gentamicin.
Collapse
Affiliation(s)
- Asta Dambrauskiene
- Laboratory of Microbiology, Kaunas University of Medicine, Eiveniu 2, Kaunas, Lithuania
| | | | | | | |
Collapse
|
46
|
Adukauskiene D, Kinderyte A, Dambrauskiene A, Vitkauskiene A. [Candidemia in an intensive care unit]. Medicina (Kaunas) 2009; 45:351-356. [PMID: 19535880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Candidemia is becoming more actual because of better survival of even critically ill patients, wide use of antimicrobials, and increased numbers of invasive procedures and manipulations. Diagnosis of candidemia remains complicated, and costs of treatment and mortality rates are increasing. OBJECTIVE. To evaluate the pathogens of candidemia, risk factors and their influence on outcome. MATERIAL AND METHODS. Data of 41 patients with positive blood culture for Candida spp., who were treated in the intensive care units at the Hospital of Kaunas University of Medicine, were analyzed retrospectively. RESULTS. Candidemia was caused by Candida albicans (C. albicans) in 48.8% (n=20) of patients and by non-albicans Candida in 51.2% (n=21) of patients. The main cause of candidemia was C. albicans in 2004 (83.3%, n=5), but in 2005 (63.6%, n=7), in 2006 (57.1%, n=4), and in 2007 (52.9%, n=9), the main cause was non-albicans Candida spp. The number of candidemia cases caused by C. albicans was decreased in 2005, 2006, and 2007 as compared with 2004, and the number of candidemia caused by non-albicans Candida spp. was decreased, respectively (P<0.05). More than 65% (n=34) of patients had severe disease (P<0.05). Lethal outcome was recorded in 58.5% of patients with candidemia. Mechanical ventilation was used in 76.9% (n=20) and urinary bladder catheter in 72.1% (n=19) of non-survivors and in 23.1% (n=6) and 26.9% (n=7) of survivors, respectively (P<0.05). CONCLUSIONS. There is an increase in the prevalence of candidemia in the intensive care units during the 4-year period; half of candidemia cases were caused by non-albicans Candida spp., and patients with candidemia caused by non-albicans Candida spp. are at higher risk of mortality. Therefore, for the empirical treatment of septic conditions in an intensive care unit, when invasive fungal infection is suspected, we recommend using an antifungal agent of non-azole class until a pathogen of candidemia is determined. Severe disease is evaluated as a risk factor for candidemia. Patients with oncological diseases are at significantly higher risk for candidemia caused by non-albicans Candida spp. Use of mechanical ventilation and urinary bladder catheter is a risk factor for lethal outcome.
Collapse
Affiliation(s)
- Dalia Adukauskiene
- Department of Intensive Care, Kaunas University of Medicine, Kaunas, Lithuania.
| | | | | | | |
Collapse
|
47
|
Kucinskas L, Jeroch J, Vitkauskiene A, Sakalauskas R, Petrenkiene V, Kucinskas V, Naginiene R, Schmidt H, Kupcinskas L. High frequency of the c.3207C>A (p.H1069Q) mutation in ATP7B gene of Lithuanian patients with hepatic presentation of Wilson's disease. World J Gastroenterol 2008; 14:5876-9. [PMID: 18855987 PMCID: PMC2751898 DOI: 10.3748/wjg.14.5876] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prevalence of the ATP7B gene mutation in patients with hepatic presentation of Wilson's disease (WD) in Lithuania. METHODS Eleven unrelated Lithuanian families, including 13 WD patients were tested. Clinically WD diagnosis was established in accordance to the Leipzig scoring system. Genomic DNA was extracted from whole venous blood using a salt precipitation method. Firstly, the semi-nested polymerase chain reaction (PCR) technique was used to detect the c.3207C>A (p.H1069Q) mutation. Patients not homozygous for the c.3207C>A (p.H1069Q) mutation were further analyzed. The 21 exons of the WD gene were amplified in a thermal cycler (Biometra T3 Thermocycler, Gottingen, Germany). Direct sequencing of the amplified PCR products was performed by cycle sequencing using fluorescent dye terminators in an automatic sequencer (Applied Biosystems, Darmstadt, Germany). RESULTS Total of 13 WD patients (mean age 26.4 years; range 17-40; male/female 3/10) presented with hepatic disorders and 16 their first degree relatives (including 12 siblings) were studied. Some of WD patients, in addition to hepatic symptoms, have had extrahepatic disorders (hemolytic anemia 3; Fanconi syndrome 1; neurophsychiatric and behavioural disorder 2). Liver biopsy specimens were available in all of 13 WD patients (8 had cirrhosis; 1-chronic hepatitis; 3-acute liver failure, 1-liver steatosis). Twelve of 13 (92.3%) WD patients had the c.3207C>A (p.H1069Q) mutation, 6 of them in both chromosomes, 6 were presented as compound heterozygotes with additional c.3472-82delGGTTTAACCAT, c.3402delC, c.3121C>T (p.R1041W) or unknown mutations. For one patient with liver cirrhosis and psychiatric disorder (Leipzig score 6), no mutations were found. Out of 16 first degree WD relatives, 11 (68.7%) were heterozygous for the c.3207C>A (p.H1069Q) mutation. Two patients with fulminant WD died from acute liver failure and 11 are in full remission under penicillamine or zinc acetate treatment. Three women with WD successfully delivered healthy babies. CONCLUSION The c.3207C>A (p.H1069Q) missense mutation is the most characteristic mutation for Lithuanian patients with WD. Even 92.3% of WD patients with hepatic presentation of the disease are homozygous or compound heterozygotes for the p.H1069Q mutation.
Collapse
Affiliation(s)
- Laimutis Kucinskas
- Department of Gastroenterology, Kaunas University of Medicine, Eiveniu 2, Kaunas LT-50009, Lithuania
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Surna A, Sakalauskiene J, Vitkauskiene A, Saferis V. [Microbiological and biochemical characteristics of inflammatory tissues in the periodontium]. Medicina (Kaunas) 2008; 44:201-210. [PMID: 18413987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To investigate bacterial populations in subgingival and supragingival plaque samples of patients with inflammatory periodontal diseases and activities of the lysosomal enzymes--lysozyme, alkaline phosphatase, and beta-glucuronidase--in peripheral venous blood, in gingival crevicular fluid, and mixed nonstimulated saliva. METHODS AND MATERIALS The study included 60 patients with inflammatory periodontal diseases without any internal pathology and 24 periodontally healthy subjects. Molecular genetic assay (Micro-IDent plus, Germany) for complex identification of additional six periodontopathic bacteria was applied. The activity of lysozyme was determined turbidimetrically, the activity of alkaline phosphatase--spectrophotometrically with a "Monarch" biochemical analyzer, the activity beta-glucuronidase--according to the method described by Mead et al. and modified by Strachunskii. RESULTS A statistically significant association between clinical and bacteriological data was found in the following cases: gingival bleeding in the presence of Eubacterium nodatum, Eikenella corrodens, Capnocytophaga spp. (P<0.01); pathological periodontal pockets in the presence of Peptostreptococcus micros (alpha< or =0.05 and beta< or =0.2), Fusobacterium nucleatum (alpha< or =0.05 and beta< or =0.2), Campylobacter rectus (alpha< or =0.05 and beta< or =0.2), and Capnocytophaga spp. (P<0.05); and satisfactory oral hygiene in the presence of all microorganisms investigated (P<0.05). The activity of lysozyme in gingival crevicular fluid and mixed nonstimulated saliva indicates the severity of periodontal inflammation. Based on clinical data, in assessing the amount of lysozyme in mixed nonstimulated saliva, sensitivity and specificity of 100% was found. Increased activities of lysozyme, alkaline phosphatase, and beta-glucuronidase were found in peripheral venous blood of patients with inflammatory periodontal disease as compared to control group. CONCLUSIONS The main principles of the treatment of periodontal inflammatory diseases should be based on microorganism elimination, creation of individual treatment means affecting microflora in the mouth and immune system of macroorganisms.
Collapse
Affiliation(s)
- Algimantas Surna
- Kauno medicinos universiteto Dantu ir zandikauliu ortopedijos klinika.
| | | | | | | |
Collapse
|
49
|
Galinyte D, Maciulaitis R, Budnikas V, Kubilius D, Varanaviciene B, Vitkauskiene A, Jokimas J, Jodkonis L. [Analysis of antibiotic consumption and microorganism resistance changes]. Medicina (Kaunas) 2008; 44:751-767. [PMID: 19001833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
SUMMARY OBJECTIVE The main goal of this study was to evaluate the variation of antibiotic consumption and relation between antibiotic consumption and microorganism resistance. MATERIAL AND METHODS This analysis was performed in one of Lithuanian tertiary hospitals. The defined daily dose (DDD) analysis was performed to express drug consumption per every 100 occupied bed days (OBDs) for single units in clinical departments. Average of DDD/100 OBDs was estimated for 2004-2007, and mean values were compared among all four years. The relation between the number of surgical operations and antibiotic consumption in surgery departments was analysed. E. coli and K. pneumoniae resistance for four years (2004-2007) was determined. Moreover, the relation between microorganism resistance and variation of antibiotic consumption was determined. Data were analysed by descriptive and comparative statistics (by Mann-Whitney test for nonparametric criteria and Spearman correlation). RESULTS Comparing the DDD/100 OBD data during 2004-2007 revealed a statistically significant increase in piperacillin and tazobactam (877.50%), metronidazole (114.00%), cefuroxime (77.31%), meropenem (47.55%), cefoperazone and sulbactam (173.11%) consumption. The increased usage of these antibiotics was determined in surgery department too. However, the increased number of surgical operations cannot be the only reason of the growing antibiotic consumption. Results revealed a statistically significant decrease in ofloxacin use from 2006 to 2007 (93.94%). E. coli resistance to ampicillin (from 49.80% to 56.60%), ampicillin and sulbactam (from 25.50% to 39.20%), cefuroxime (from 7.40% to 10.10%), ciprofloxacin (from 4.20% to 12.50%), gentamicin (from 11.40% to 13.20%) and K. pneumoniae resistance to ampicillin and sulbactam (from 45.40% to 56.40%), cefuroxime (from 34.00% to 39.10%), ciprofloxacin (from 5.50% to 10.50%), gentamicin (from 32.00% to 35.80%) increased. A statistically significant positive correlation between quinolone consumption and K. pneumoniae resistance to ciprofloxacin was determined (r=1, P<0.05). CONCLUSIONS In 2004-2007, the usage of piperacillin and tazobactam, metronidazole, cefuroxime, meropenem, cefoperazone, and sulbactam increased. In 2006-2007, ofloxacin consumption decreased. The changes in other antibiotic usage were statistically insignificant. In 2004-2007, E. coli and K. pneumoniae resistance to ampicillin and sulbactam, cefuroxime, ciprofloxacin, gentamicin and E. coli resistance to ampicillin increased. A statistically significant positive correlation between quinolone consumption and K. pneumoniae resistance to ciprofloxacin was determined.
Collapse
Affiliation(s)
- Daiva Galinyte
- Department of Theoretical and Clinical Pharmacology, Kaunas University of Medicine, Kaunas, Lithuania
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Nadisauskiene RJ, Kliucinskas M, Vitkauskiene A, Minkauskiene M, Vaitkiene D. Puerperal Clostridium perfringens Sepsis in a Patient with Granulocytopenia. Gynecol Obstet Invest 2007; 65:32-4. [PMID: 17675887 DOI: 10.1159/000106763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Accepted: 12/18/2006] [Indexed: 11/19/2022]
Abstract
We present a lethal case of fulminant puerperal sepsis with massive hemolysis after cesarean section in a patient with intermittent granulocytopenia.
Collapse
Affiliation(s)
- Ruta J Nadisauskiene
- Department of Obstetrics and Gynecology, Kaunas University of Medicine Hospital, Kaunas, Lithuania
| | | | | | | | | |
Collapse
|