Publications by authors named "Kristina Jariene"

7 Publications

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Pre-existingmental health disorders affect pregnancy and neonatal outcomes: a retrospectivecohort study.

BMC Pregnancy Childbirth 2020 Jul 25;20(1):419. Epub 2020 Jul 25.

Faculty of Odontology, Clinic of Dental and Oral Pathology, Lithuanian University of Health Sciences, Medical Academy, Eivenių Street 2, LT-50161, Kaunas, Lithuania.

Background: This was a hospital registry-based retrospective age-matched cohort study that aimed to compare pregnancy and neonatal outcomes of women with pre-existing mental disorders with those of mentally healthy women.

Methods: A matched cohort retrospective study was carried out in the Department of Obstetrics and Gynecology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, a tertiary health care institution. Medical records of pregnant women who gave birth from 2006 to 2015 were used. The study group was comprised of 131 pregnant women with mental disorders matched to 228 mentally healthy controls. The primary outcomes assessed were antenatal care characteristics; secondary outcomes were neonatal complications.

Results: Pregnant women with pre-existing mental health disorders were significantly more likely to have low education, be unmarried and unemployed, have a disability that led to lower working capacity, smoke more frequently, have chronic concomitant diseases, attend fewer antenatal visits, gain less weight, be hospitalized during pregnancy, spend more time in hospital during the postpartum period, and were less likely to breastfeed their newborns. The newborns of women with pre-existing mental disorders were small for gestational age (SGA) more often than those of healthy controls (12.9% vs. 7.6%, p < 0.05). No difference was found comparing the methods of delivery.

Conclusions: Women with pre-existing mental health disorders had a worse course of pregnancy. Mental illness increased the risk to deliver a SGA newborn (RR 2.055, 95% CI 1.081-3.908).
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http://dx.doi.org/10.1186/s12884-020-03094-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382029PMC
July 2020

Circulating inflammatory markers in cervical cancer patients and healthy controls.

J Immunotoxicol 2020 12;17(1):105-109

Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

There is increasing evidence that host inflammatory responses play an important role in the development and progression of cancers. There are some data that cancer is associated not only with inflammation at the site of the lesion, but also with dysregulations of the host overall systemic immune response. In the case of cervical cancer, inflammation is an important factor associated with the development, progression, and potential metastasis of the disease. What is unclear still in the potential for modifications of host responses to human papillomaviruses (HPV) - a known causative agent of CC, that could be induced by cigarette smoking. In particular, it remains to be determined how the inflammation induced by HPV infection could impact on CC incidence/severity. In this prospective study, serum levels of 10 cytokines were evaluated using Multiplex and ELISA assays. The samples were the sera of 43 CC patients and 60 healthy (NILM) controls. All outcomes were evaluated in relation to host HPV and to their smoking status. The results in indicated that serum sTREM-1, TNFα, IFNβ, IL-1β, and IL-6 levels were significantly increased in CC (HPV+) patients compared to healthy NILM controls. A similar trend was observed for IL-10 and IL-2 levels. Within the two groups, differences in cytokine levels between smokers and never smokers were not remarkable. The findings here support the hypothesized role of systemic inflammation in the pathophysiology of CC.
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http://dx.doi.org/10.1080/1547691X.2020.1755397DOI Listing
December 2020

Sex Hormones, Gonad Size, and Metabolic Profile in Adolescent Girls Born Small for Gestational Age with Catch-up Growth.

J Pediatr Adolesc Gynecol 2020 Apr 7;33(2):125-132. Epub 2019 Nov 7.

Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Study Objective: To characterize and compare sex hormone concentrations, and uterine and ovarian volumes in adolescent girls born small for gestational age (SGA) who had experienced catch-up growth and girls born at a size appropriate for gestational age (AGA), and to investigate the association between these parameters and glucose metabolism, perinatal factors, and early growth.

Design: A prospective, longitudinal, observational study from birth until adolescence.

Setting: Mean age at final assessment was 12.7 ± 0.1 years.

Participants: We followed 55 girls (20 SGA, 35 AGA).

Interventions And Main Outcome Measures: Sex hormone concentrations (gonadotropins, estradiol, testosterone, and sex hormone binding globulin) were analyzed, and the oral glucose tolerance test conducted. Uterine and ovarian sizes were assessed using pelvic ultrasound.

Results: Uterine and ovarian volumes were smaller in SGA-born compared with AGA-born girls (P = .013 and P = .039, respectively). SGA girls had lower sex hormone binding globulin levels (P = .039) and higher testosterone levels (P = .003), free androgen index (P < .001), and glycemia 2 hours post glucose load (P = .005) compared with AGA-born girls. Birth weight and early infancy height velocity explained 37.4% of variation in ovarian volume (P = .004), and body mass index at birth, increase in peripheral skinfold thickness during second year of life, and early childhood height velocity explained 43.2% of variation in testosterone levels in adolescence (P = .006).

Conclusion: SGA-born girls who experienced catch-up growth remain at risk of biochemical hyperandrogenism in adolescence, and have reduced uterine and ovarian volumes, which might influence future reproductive function. Ovarian size and androgen levels in adolescence might be influenced by early growth and subcutaneous fat deposition.
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http://dx.doi.org/10.1016/j.jpag.2019.11.001DOI Listing
April 2020

Clinical and Microbiological Findings of Vulvovaginitis in Prepubertal Girls.

J Pediatr Adolesc Gynecol 2019 Dec 21;32(6):574-578. Epub 2019 Aug 21.

Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Study Objective: To evaluate genital microbiological findings in prepubertal girls with vulvovaginitis and in healthy controls.

Design: Prospective case-control study.

Setting: Pediatric Outpatient unit of the Department of Pediatrics of the Hospital of the Lithuanian University of Health Sciences Kauno Klinikos from November 2014 to May 2017.

Participants: Fifty-two prepubertal girls aged 1-9 years diagnosed with vulvovaginitis, and 42 age-matched healthy controls.

Interventions And Main Outcome Measures: Samples for microbiological culture were collected using sterile cotton swabs from the introitus and the lower third of the vagina from all study participants. Microbiological findings were analyzed according to bacteria type and intensity of growth.

Results: Most of the vaginal microbiological swab results were positive for bacterial growth: 47 (90.4%) and 34 (80.9%) were similar in the study and control groups, respectively (P = .24). Sixteen (30.8%) and 9 (21.4%) of the microbiological traits results in the case and control groups, respectively, were regarded as potential causative agents (P = .27). Streptococcus pyogenes was the most frequent pathogen in the study group (P = .03); all other microorganisms detected as either a pure or dominant growth in the control group, were considered opportunistic.

Conclusions: Vaginal bacterial culture results were positive in prepubertal girls with vulvovaginitis and in healthy controls. Nonspecific vulvovaginitis without a dominant/isolated pathogen was seen to be more common than vulvovaginitis with a potential causative agent. Clinical symptoms were more frequent among girls when the potential infectious agent was identified.
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http://dx.doi.org/10.1016/j.jpag.2019.08.009DOI Listing
December 2019

Prevalence of human papillomavirus types 16, 18, and 45 in women with cervical intraepithelial changes: associations with colposcopic and histological findings.

Medicina (Kaunas) 2012 ;48(1):22-30

Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50028 Kaunas, Lithuania.

The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. MATERIAL AND METHODS. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. RESULTS. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). CONCLUSIONS. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions.
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May 2012

The Diagnostic Properties of Medical History in the Diagnosis of Tubal Pathology among Subfertile Patients.

ISRN Obstet Gynecol 2012 22;2012:436930. Epub 2012 Jan 22.

Department of Obstetrics and Gynecology, Lithuanian University of Health Sciences, Eiveniu 2, 50009 Kaunas, Lithuania.

Objectives. To evaluate the diagnostic performance of medical history in the diagnosis of tubal pathology among subfertile patients. Patients and Methods. Prospective cross-sectional study was performed. Prior to tubal evaluation, medical history data were collected. Sensitivity, specificity, and likelihood ratios (LRs) for predicting tubal pathology as determined by laparoscopy and dye test were calculated for each issue of medical history. Results. 39.6 % (59/149) were diagnosed with tubal pathology. The sensitivity for the different issues ranged between 1.7 and 54.2% and the specificity between 75.6 and 97.8%. The estimated highest value of positive LR is attributed to the history of ectopic pregnancy and lowest of negative LR to pelvic inflammatory disease (PID) and abdominal surgery. Conclusion. The positive history of PID, sexually transmitted diseases (STDs), abdominal and laparoscopic surgery, and ectopic pregnancy are satisfactory screening tests for ruling the tubal pathology in. The negative history of evaluated issues is inappropriate for ruling the tubal damage out.
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http://dx.doi.org/10.5402/2012/436930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302065PMC
August 2012

[Some aspects of diagnosis and treatment of cervical intraepithelial neoplasia (review of the literature)].

Medicina (Kaunas) 2002 ;38(9):876-87; quiz 956

Kauno medicinos universiteto kliniku Akuserijos ir ginekologijos klinika, Eiveniu 2, 3007 Kaunas.

Cervical cancer has remained close to the forefront of oncologic studies even in our days. The incidence of the disease has changed little, except in those countries with effective screening programs. The morbidity in Lithuania reached 23.9/100,000 in the 2000's, while in comparison the morbidity in the 1994's was 20.4/100,000. The mortality was 13.2 and 11.3/100,000, respectively. Over the last 50 years our understanding of the etiology and pathogenesis of lower genital tract squamous neoplasia has increased enormously and, particularly in the last 15 years, progress in our understanding of the molecular events associated with lower anogenital tract neoplasia has developed rapidly. Cervical cancer is the second most common type of cancer in women worldwide, after breast cancer. Since 1978 it is known that Human Papillomavirus is closely related to genital neoplasia--cervical, vulva, vagina, penis, anus intraepithelial neoplasia and invasive carcinoma. It is also known that cytologic smear is one of the most important way to diagnose cervical intraepithelial neoplasia and cancer as well, because we can not evaluate cervical lesion visually. Cytologic smear remains the main principle of cancer screening because of its simplicity and accessibility, while colposcopy remains the method of examination in choice, when pathologic cytologic findings are determined.
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January 2003