Raminta Lukšaitė-Lukštė: When You Share Your Concerns with Your Colleagues, You Can See That You Are Not an Exception

“Sometimes when faced with challenges we get lost and confused, and the problems seem to snowball or gain more weight. Yet when you share your concerns with your community or colleagues, who are travelling along a similar path, you can see that, unfortunately, you are not that different – everyone has similar worries. I have come across many kind-hearted and helpful people at Vilnius University, provided you take the time to build relationships with them,” said Raminta Lukšaitė-Lukštė, physician ultrasound radiologist.

Raminta agreed to talk to us about her completed doctoral dissertation, its significance for society and what changes her journey toward a doctoral degree has made in her life.

At the end of June, you defended your doctoral dissertation on “Optimizing the Diagnosis of Acute Appendicitis – A Prospective Clinical Study”. Tell me briefly what it is about?

Acute appendicitis is inflammation of the appendix, a small rudimentary worm-shaped organ connected to the cecum. This condition mostly affects children and young people. It is treated by surgically removing the appendix. A surgery during which an intact “healthy” appendix is detected is called a negative appendectomy. The main problem related to the diagnosis today is to ensure the lowest possible incidence of negative appendectomies by making an accurate diagnosis.

The most accurate method of diagnosis of acute appendicitis is to carry out a CT scan. The main disadvantage of this test is that the patient is subject to ionizing radiation, which has a detrimental effect on the human body, increasing the risk of developing oncological diseases in the course of a lifetime. Unfortunately, children and younger patients are particularly sensitive to the effects of ionizing radiation. So the aim of our research was to look for ways to improve the diagnosis of acute appendicitis, to reduce the number of negative appendectomies, and the reliance on CT scans.

During our research, our main chosen alternative was observation and repeated ultrasound examination. The main advantage of this strategy is that in patients with acute appendicitis, we can monitor the fairly rapid dynamics of the condition, like changes in blood tests and ultrasound images. Although ultrasound is less sensitive and specific than a CT scan, it does not produce the harmful effects of ionizing radiation, and when obtained results are assessed in conjunction with the results of laboratory and clinical tests, we can achieve good results.

What did your study reveal?

The main outcome of this study is our alternative, monitoring-based, diagnostic protocol for acute appendicitis. It reduces the number of CT scans by up to 65% while ensuring that there is no increase in the frequency of complications or negative appendectomies. If we compare the previous results of patient testing and the monitoring-based strategy, there is no statistically significant difference in the diagnostic accuracy of these two algorithms. This means they are equivalent.

How is this topic relevant to the general public?

With the modernization of medical diagnosis, we have become accustomed to more diagnostic procedures to help us make a more accurate diagnosis. However, as everywhere in life, every stick has two ends: procedures for an accurate diagnosis may have other adverse, long-term effects on our health.

I remember the words of one of my teachers, who said when I was a student: “Everything in life has its price.” They emphasized it when talking about the use of medicines – after all, they all have the potential to be harmful. This may also be the case with diagnostic methods, e.g. CT scans, during which the patient receives additional ionizing radiation. Given that most often this pathology affects children and young adults, especially young women, it is necessary to ensure the safest and most effective diagnostic procedure.

What do you wish you had known before you started your doctoral studies? What would you recommend to a student who is starting a PhD?

They say that sometimes it is easier to choose a path without knowing exactly what is in store for you, because had you known, you may have hesitated to start it in the first place (smiling). I would probably advise future doctoral students to worry less about it and enjoy the process more. Most of the things that seem scary become simpler when you start dealing with them. It is also important to have a good team. Although the work of a doctoral student sounds like a process and result of one person’s work, it is really difficult to complete this journey on your own.

I am therefore grateful to all the colleagues I have worked with. Our objective was achieved with the help of persistent work by a very large, united team. We could not have succeeded without team cooperation. Of course, personal discipline and the pre-planning of one’s time and work significantly facilitate the process. I would also advise anyone not to be afraid, to communicate openly and ask if you do not understand, know something, or wish to get advice. Sometimes when faced with challenges we get lost and confused, and the problems seem to snowball or gain more weight. Yet when you share your concerns with the community or colleagues travelling along a similar path, you can see that, unfortunately, you are not an exception – everyone has similar worries. I have come across many kind-hearted and helpful people at Vilnius University, provided you take the time to build relationships with them.

How has your journey toward achieving your doctoral degree changed you? What did you learn?

Professionally, it improved my knowledge of the preparation and evaluation of research papers and publications. It expanded my horizons in academic fields. It is said that doctoral studies are a process of learning to become an independent researcher. I can’t say that after completing my PhD I feel I’ve become a very strong scientist, but I can say that I am moving in that direction.

When it comes to personal change, the journey toward a doctoral degree has mostly taught me to be patient and to accept that very often in life many things cannot be controlled. Usually, it’s not even worth worrying about. You just need to learn to accept it and try to focus on things that you can change.

What has changed since earning your doctoral degree? What are your future plans?

It’s hard to say what has changed. Some internal changes have probably taken place throughout the process, but it’s quite difficult to pinpoint any specifically. I think that the successfully defended doctoral dissertation gave me a sense of personal maturity and a feeling of being more firmly grounded.

In the future, I would like to continue both scientific and academic activities, perhaps exploring broader horizons. I will also encourage younger colleagues to take this path. The specifics of the medical profession demand that we combine routine clinical work, duties and high-quality academic activities, which isn’t easy, especially if you want to have some time for your personal life. So it’s a constant search for the right balance (smiling).