Acta medica Lituanica https://www.journals.vu.lt/AML <p>Acta Medica Lituanica is the peer-reviewed scholarly journal published by Vilnius University in collaboration with the Lithuanian Academy of Sciences and the National Cancer Institute. It publishes papers on high quality research, mostly from Lithuania, the Baltic countries, and Eastern Europe.</p> Vilniaus universiteto leidykla / Vilnius University Press en-US Acta medica Lituanica 1392-0138 Hemoptysis in Renal Transplant Recipients https://www.journals.vu.lt/AML/article/view/23790 <p><strong>Background</strong><em>:&nbsp;</em>Hemoptysis is the expectoration of blood from respiratory system. Clinical entities associated with hemoptysis in renal transplant recipients differ from those causing hemoptysis in common population. This review summarizes all reported clinical conditions related to hemoptysis in renal transplant patients, their causes, diagnostic approach and management.<br><strong>Methods and Materials:&nbsp;</strong>Primary literature was researched through MEDLINE/PubMed database and Google Scholar without restrictions. Relevant and current literatures related to hemoptysis in renal transplant recipients were used.<br><strong>Results:&nbsp;</strong>Overall 23 articles were included, since they report clinical conditions associated with hemoptysis in renal transplant recipients. Opportunistic lung infections, pulmonary hemorrhage associated with drugs and malignancies are usual causes of hemoptysis in these patients,&nbsp;sometimes with a fatal outcome.<br><strong>Conclusions:&nbsp;</strong>Hemoptysis is an important manifestation in renal transplant patients, caused frequently by rare clinical entities, different from those in common population.</p> Vasiliki Epameinondas Georgakopoulou Aikaterini Gkoufa Aikaterini Aravantinou Nikolaos Garmpis Konstantinos Mantzouranis Serafeim Chlapoutakis Pagona Sklapani Anna Garmpi Nikolaos Trakas Christos Damaskos Copyright (c) 2021 Vasiliki Epameinondas Georgakopoulou | Aikaterini Gkoufa | Aikaterini Aravantinou | Nikolaos Garmpis | Konstantinos Mantzouranis | Serafeim Chlapoutakis | Pagona Sklapani | Anna Garmpi | Nikolaos Trakas | Christos Damaskos https://creativecommons.org/licenses/by/4.0 2021-07-29 2021-07-29 28 2 4 4 10.15388/Amed.2021.28.2.4 Depression, Anxiety and Quality of Life in Greek Hospital Staff: A Study in the Aftermath of the Debt Crisis Era https://www.journals.vu.lt/AML/article/view/23040 <p class="western" align="justify"><strong>Background:</strong>&nbsp;Several studies investigated the mental health needs of hospital staff in Greece during the debt crisis era. Yet, no relevant data are available regarding the mental health of hospital staff after this period. The aims of this study are: 1) To investigate the prevalence of clinically significant depression and anxiety in healthcare workers in a general hospital in Athens, Greece; 2) to search for the association of quality of life with anxiety and depression in those workers; 3) to investigate the association of sociodemographic characteristics with those parameters.<br><strong>Methods:</strong><em>&nbsp;</em>The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, the Short-Form Survey-12, assessing quality of life, and sociodemographic assessments were administrated in 110 workers of a public hospital in Athens, Greece. The assessments were completed during January, 2020.<br><strong>Results</strong><em>:&nbsp;</em>Of the study participants, 38.2% had clinically significant anxiety and 6.4% had clinically significant depression. Males had lower scores of depression compared to females (p=0.003). As for the effects of educational level, differences were noted in psychological quality of life between secondary education participants when compared to tertiary education (Mean Difference -3.527, p=0.021), post-graduate (Mean Difference -3.937, p=0.012) and PhD participants (Mean Difference -5.100, p=0.007). Quality of life and its psychological and physical health subscales had strong inverse associations with depression and anxiety (p=0.000).<br><strong>Conclusions</strong><em>:</em>&nbsp;Relevant interventions are necessary to decrease anxiety in hospital staff, which is elevated in the aftermath of the debt crisis period. In addition, health policy makers have to reduce the gender gap in mental health between male and female workers, since the latter had higher levels of depression.</p> Despoina Melemeni Konstantinos Mantzouranis Vasiliki Epameinondas Georgakopoulou Kyriakos Tarantinos Nikolaos Garmpis Christos Damaskos Pagona Sklapani Serafeim Chlapoutakis Nikolaos Trakas Xanthi Tsiafaki Ioanna V Papathanasiou Copyright (c) 2021 Despoina Melemeni | Konstantinos Mantzouranis | Vasiliki Epameinondas Georgakopoulou | Kyriakos Tarantinos | Nikolaos Garmpis | Christos Damaskos | Pagona Sklapani | Serafeim Chlapoutakis | Nikolaos Trakas | Xanthi Tsiafaki | Ioanna V Papathanasiou https://creativecommons.org/licenses/by/4.0 2021-07-29 2021-07-29 28 2 3 3 10.15388/Amed.2021.28.2.3 Paraneoplastic Phenomena of Disseminated Intravascular Coagulopathy in Hepatic Angiosarcoma – Rare, Challenging and Fatal. Case Report and Literature Review https://www.journals.vu.lt/AML/article/view/23976 <p><strong>Background.</strong> Hepatic angiosarcoma is an uncommon, malignant, primary liver tumor, comprising 2% of liver cancers and accounting for &lt; 1% of all sarcomas. Patients usually present with nonspecific symptoms, such as fatigue, weight loss, right upper quadrant pain, anemia, which leads to late diagnosis of an advanced stage tumor. The median life expectancy after the diagnosis of hepatic angiosarcoma is about 6 months, with only 3% of patients surviving more than 2 years. Liver failure and hemoperitoneum are the leading causes of death in patients with liver angiosarcoma. In rarer cases, it might cause paraneoplastic syndromes such as disseminated intravascular coagulopathy. The treatment of angiosarcomas is complicated as there are no established and effective treatment guidelines due to the tumor’s low frequency and aggressive nature.<br><strong>Case summary.</strong> We present the case of a 68-year old woman who was admitted to the hospital due to fatigue<br>and severe anemia (hemoglobin 65 g/l). Laboratory results also revealed high-grade thrombocytopenia<br>(8 × 109/l). The abdominal ultrasound and computed tomography scan showed multiple lesions throughout with hepatic angiosarcoma. The treatment with first-line chemotherapy (doxorubicin) was initiated despite<br>ongoing paraneoplastic syndrome – disseminative intravascular coagulopathy. However, the disease was terminal, and the patient died 2 months since diagnosed.<br><strong>Conclusions</strong>. Hepatic angiosarcoma is a rare and terminal tumor. Therefore, knowledge about its manifestations and effective treatment methods is lacking. Disseminative intravascular coagulopathy is a unique clinical characteristic of angiosarcoma seen in a subset of patients.</p> Sandra Strainienė Kipras Jauniškis Ilona Savlan Justinas Pamedys Ieva Stundienė Valentina Liakina Jonas Valantinas Copyright (c) 2021 Sandra Strainienė | Kipras Jauniškis | Ilona Savlan | Justinas Pamedys | Ieva Stundienė | Valentina Liakina | Jonas Valantinas https://creativecommons.org/licenses/by/4.0 2021-07-29 2021-07-29 28 2 1 1 10.15388/Amed.2021.28.2.1 Uterine Didelphys with Transverse Vaginal Septum – A Complex rare Müllerian Anomaly https://www.journals.vu.lt/AML/article/view/22500 <p>During the development of the female genital tract, any insult to the normal development process results in a set of intriguing abnormalities known as Müllerian duct abnormalities. The uterine didelphys is the second least common type of anomaly among these, which may commonly be associated with a longitudinal vaginal septum (lateral fusion defect). However uterine didelphys along with a transverse vaginal septum (lateral fusion plus resorption defect) is a very rare finding and to the best of our knowledge, thecase that we hereby report is the second one in literature.<br>A 16-year-old unmarried girl presented with primary amenorrhoea and cyclical pain for 18months.On clinical examination and imaging, a case of uterine didelphys and transverse vaginal septum was found. Her urinary tract was normalon USG and MRI evaluation. Excision of the septum was done by abdomino-vaginal approach. The patient was discharged well.<br>We conclude that a patient presenting with primary amenorrhea especially with cyclical dysmenorrhea with a transverse vaginal septum on examination should be thoroughly investigated for associated upper genital tract abnormalities as the treatment strategy and prognosis is largely dependent on the correct classification of the anomaly.</p> Dina Aisha Khan Nalini Sharma Anusmita Saha Rituparna Das Subrat Panda Copyright (c) 2021 Dina Aisha Khan | Nalini Sharma | Anusmita Saha | Rituparna Das | Subrat Panda https://creativecommons.org/licenses/by/4.0 2021-07-29 2021-07-29 28 2 2 2 10.15388/Amed.2021.28.2.2