Results of 1‑year follow‑up after umbilical hernia with rectus abdominis muscle diastasis repair using endoscopic subcutaneous onlay approach (SCOLA)

Introduction: Endoscopic subcutaneous onlay approach (SCOLA) mesh repair in combination with anterior plication of diastasis has recently become a commonly performed procedure. Aim: The aim of this study was to analyze the results of 1-year follow-up in patients after umbilical hernia with rectal abdominal muscle diastasis repair using endoscopic SCOLA. MateriaLs and methods: Our prospective cohort study included patients who underwent elective surgery for small- (<⁠2 cm) and medium- (2–4 cm) size primary umbilical hernia with diastasis recti. The follow-up period was 12 months. Hernia recurrence and postoperative seroma diagnosis were based on the patient’s physical examination and ultrasound assessment. The Carolinas Comfort Scale questionnaire was used to evaluate the quality of life after the surgery. Results: One hundred patients underwent surgery for umbilical hernia with rectal abdominal muscle diastasis repair. Their mean (SD) age was 39.6 (11.8) years. Most of the patients (n = 77) were women. We found no hernia or diastasis recurrence during 1-year follow-up. Seroma was found in 15 patients during the first month of follow-up. The rate of seroma was 11% after 3 months and 2% after 6 months of follow-up. Almost all the patients reported mild or moderate symptoms during daily activities after the surgery. Conclusions: SCOLA is a safe and effective technique for patients with small umbilical hernia with diastasis. It provides an acceptable cosmetic result for carefully selected patients, low postoperative pain, and good quality of life

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Guilt: a metaphysical given or a constructed feeling? The motives of Jewish guilt in Lithuanian periodicals from 1922 to 1940

Straipsnyje analizuojami 1922–1940 m. lietuvių periodikos straipsniai, nagrinėjantys lietuvių ir žydų santykių problematiką. Nuo pat reguliarios lietuvių periodikos leidybos pradžios šių dviejų grupių santykiai vaizduoti kaip probleminiai, tam įtakos turėjo ir susiklosčiusios istorinės, kultūrinės aplinkybės, greitai besikeičiantis ir besikuriantis modernusis pasaulis, kuriame lietuvių visuomenė gavo galimybę sukurti nepriklausomą valstybę. Tekste analizuojamas žydų kaltę grindžiantis diskursas, tam pasirinkus dvi kaltės sampratas: ar kaltė yra prigimtinė ir iš jos negalima išsivaduoti, ar kaltė yra socialiai konstruojamas jausmas, kai viena tautinė grupė gali sukurti veiklos lauką kitai tautinei grupei, o šiai nenorint ar nesugebant „įtilpti“ į nubrėžtą schemą pateikiami priekaištai ir paklydimų įrodymai. Pirmuoju atveju susilieja dvi tradicijos – antijudaistinė, teigianti, kad žydai nuo krikščionybės pradžios gyvena paklydime, stengiasi kenkti krikščionims ir juos nugalėti, antroji – žydai kaip „rasė“ pačios gamtos sukurta kaip netobula, nesugebanti gyventi darnioje aplinkoje ir dėl to užsiima destrukcija, kuri glūdi pačioje tautos prigimtyje: jie kelia sumaištį, bet tuo pačiu bando įrodyti, kad patys žydai yra labiausiai persekiojami. Kita šaltinių grupė siūlo kiek kitokį žydų egzistencijos traktavimą – neapleidžiant pagrindinio motyvo, kad lietuvių ir žydų santykiai yra problemiški, bet gali pakisti, jei žydai sutiktų priimti lietuvių reikalavimus. Tačiau straipsnių autoriai pateikia žydų nesupratingumo įrodymus – jie nenori vartoti lietuvių kalbos, propaguoja nepriimtinas ideologijas, siekia daugiau naudos sau ar net bando kurti pasaulio užvaldymo scenarijusThis article analyzes publications of Lithuanian periodicals from 1922 to 1940 that deal with Lithuanian – Jewish relations. Ever since Lithuanian periodicals started to be published regularly, the relations between Jews and Lithuanians were presented as problematic. This was due to historical and cultural traditions, as well as the opportunity Lithuanians got to become an independent country in a rapidly forming and changing modern world. Two concepts of guilt are discussed in the article: guilt as an inbuilt feature that could not be avoided; and guilt as a socially constructed feeling when one national group presumes to create a framework for the social and cultural activities of another national group and when, the latter group not fitting into the given scheme, it is reproached and presented with evidence of its failure. In the first case, two traditions may be identified. One is that of anti-Judaism, which alleges that Jews have been living in error since the dawn of Christianity and have therefore tried to harm Christians and to overcome them. The second tradition presents Jews as a “race” created with inborn defects by nature itself; hence they are unable to live in harmony but are led by their very nature to engage in destruction. Thus the Jews create confusion and at the same time claim that they themselves are the most discriminated against and troubled people. Another group of sources suggests a slightly different approach: the idea that Lithuanian – Jewish relations are problematic remains, yet the nature of these relations would change if Jews accepted Lithuanian requirements. However, the Jews are presented as purblind in this respect: they do not want to learn and use the Lithuanian language; but they advocate unacceptable ideologies and seek only their own benefit, or even create plans to take over the whole worldPolitikos mokslų ir diplomatijos fakult.Vytauto Didžiojo universiteta

Between tolerance and hatred: the rhetoric of modern Lithuanian anti-semitism

Vytauto Didžiojo universiteta

Considérations de Jean-Jacques Rousseau sur le gouvernement de la République polono-lituanienne

L’historiographie lituanienne, au sens plein du terme, s’est formée après la Première guerre mondiale. La communauté lituanienne en avait grandement besoin. Après de longues années d’occupation, il fallait créer une société et un état modernes, et mettre en valeur les spécificités de l’identité lituanienne. Toutefois, cette nécessité s’accompagna d’une limitation du champ des études historiques, dans la mesure où la majorité des sujets étaient traités dans une perspective nationaliste. L’infl..

Valstybės saugumo departamento pranešimai apie antisemitines apraiškas Lietuvoje 1939–1940 metais: pobūdis, intensyvumas, turinys

ISSN 2335-8769 (internetinis)Straipsnyje analizuojami Valstybės saugumo departamento (VSD) pranešimai, susiję su antisemitiniais išpuoliais Lietuvoje 1939–1940 m. Šis laikotarpis nebuvo ramus nei Europoje, nei Lietuvoje. Straipsnyje svarstoma, kaip šios aplinkybės darė įtaką antisemitizmo augimui paskutiniaisiais Lietuvos nepriklausomybės metais. Straipsnį sudaro trys dalys. Pirmoje analizuojama valdžios politika ir požiūris į žydų tautinę mažumą, antroje apariami didesni antisemitiniai ekscesai, trečioje aprašomi kasdieniniai antisemitizmo reiškiniai, užfiksuoti VSD dokumentuose. Išvados leidžia teigti, jog Lietuvos Respublikos valdžia visuomet reaguodavo į antisemitizmo apraiškas, stengėsi jas suvaldyti, o kaltininkus nubausti. 1939–1940 m., dar prieš prasidedant sovietinei okupacijai, didesnių antisemitinių išpuolių, palyginti su ankstesniais metais, nebuvo užfiksuota. Kasdieninių antisemitinių išpuolių nefiksuota daugiau nei ankstesniais metais (jų padaugėjo tik 1940 m. vasarą, kai Lietuva buvo okupuota Raudonosios armijos ir vyko aktyvūs sovietizacijos procesai), o išpuolių scenarijus išliko tas pats – žydams priklausiusių pastatų langų daužymas, antisemitinių plakatų bei atsišaukimų platinimas. Nors ir retai, bet pasitaikydavo užpuolimų – muštynių ir kitų bandymų fiziškai susidoroti su žydais – tautine mažuma, kuri buvo tapusi lietuvių ir kitų tautų atstovų neapykantos ir smurto taikiniuThe article is based on the analysis of the reports of State Security Department (SSD) concerning antisemitism in Lithuania in 1939‒1940. This section of Lithuanian and world history is known as a turbulent time, so was this period anyhow different in respect with the dissemination of anti-Semitic ideas and actions in Lithuania? Anti-Semitism emerged in Lithuania (as well as in other countries) as one of the results of modernization but the question arises whether the geopolitical tensions in the world had any impact on the relationship between Jews and Lithuanians, not to mention the country’s internal situation, worsened by the increasing social and economic problems, the loss of Klaipėda Region, the attempts to incorporate Vilnius Region into Lithuania, etc. The analysis, which is based on SSD reports, is structured in three parts that analyse the following topics: Lithuanian authorities’ position toward Jewish minority, major anti-Semitic attacks in 1939‒1940, and day-to-day anti-Semitic incidents. It was clear that authorities by all means tried to avoid and suppress any anti-Semitic actions, and if attacks on Jews occurred, the perpetrators were punished. During this period, there were no major anti-Semitic attacks, which leads to the assumptions that Antisemitism was not intensifying over the last years of independent Lithuania, and that daily anti-Semitic actions did not reduce the average of Lithuanian – Jewish conflicts, in comparison with other periods. The source of the conflicts remained the same: distribution of anti-Semitic pamphlets and posters, destruction of Jewish property breaking windows, and occasional physical attacksIstorijos katedraVytauto Didžiojo universiteta

Girnius' Tauta ir Tautinė Ištikimybė as a diaspora handbook

The article focuses on Juozas Girnius and his work “The Nation and National Liability” (Tauta ir tautinė ištikimybė). Juozas Girnius was extremely concerned about the future of Lithuanism in the world and actively offered various ways of its protection. Models offered by him are approached as attempts to create a diaspora. Nevertheless, he does not discuss more general issues related to features of Lithuanian diaspora, their manifestation and identification, since contemporary processes do not completely match models offered by Girnius that might be hold the elements of diaspora’s creation. The article presents Girnius attitude towards Lithuanism, Lithuanian exiles, and the destiny of exiles. The author of the article aims to understand intelligent initial positions of Juozas Girnius: why a nation is unquestioned value to him? Why the individual should depend on a nation? How functions Girnius value system? What priorities does it state