Andreikėnas, Jonas

This study aimed to provide the first comprehensive national assessment of early intervention services for children with developmental disorders in Lithuania. The primary goal was to identify key challenges related to accessibility, quality, diagnostic capabilities, professional training, and family involvement, and to offer evidence-based recommendations for systemic improvement. A multi-method approach was employed, including demographic data analysis, structured surveys of 46 early intervention institutions, 753 specialists, and 1,004 parents, as well as site visits to 11 representative institutions. Quantitative and qualitative data were collected and triangulated to assess service coverage, diagnostic practices, training access, and service quality across regions. The findings revealed significant regional disparities in service access, long waiting times, limited availability of validated diagnostic tools, and a shortage of qualified professionals. Only 24% of specialists expressed high satisfaction with available diagnostic and treatment methodologies. Although service coverage has expanded, systemic fragmentation persists. Parents identified gaps in communication, individualization of care, and access to home-based guidance. Institutions prioritized professional training as the top need, followed by updated methodologies and equipment. Conclusion: Despite notable efforts and committed professionals, Lithuania's early intervention system faces systemic barriers that limit its effectiveness. The study highlights the urgent need for national clinical guidelines, validated tools, expanded training opportunities, and greater family engagement. These findings offer a foundation for health policy reforms aimed at building a more accessible, equitable, and family-centred early intervention system.

Backgrounds: Children who have contracted COVID are at risk of experiencing a variety of long-lasting symptoms collectively known as prolonged COVID syndrome. According to world data, about 30% of children infected with SARS-CoV-2 will experience certain symptoms. In this study, we aimed to create a continuous follow-up program for children after COVID infection. Moreover, our aim was to improve longterm periodic communication with the patient's parents to discuss her/his condition and timely recognize the signs of prolonged COVID. In addition, provide individualized assistance, monitoring of the patient and symptoms, assessment of the persistence of symptoms, and provide specific treatment. Methods: Continuous follow-up program in the frame of a prospective observational study was created and is conducted in our hospital. The program started in March 2022. Criteria for the inclusion: 1 month up to 18 years of age, diagnosed with COVID-19, or have been diagnosed with MIS-C syndrome according to the clinical criteria. After the inclusion, in a period of one year, 5 medical assessments of the state of health are planned to be carried out. In case of specific symptoms, a patient is referred to a specialist. Results: Currently, ~40 children with their caregivers are included into the program. The median age for inclusion – 9y, 42%-female. Nine children required additional consultation with a pediatric neurologist with the most frequent complaint of headaches. 4 children have ongoing consultations with a psychiatrist and continuous visits are planned. Six children were referred to a pediatric rheumatologist complaining of prolonged joint aches and the assessment regarding autoimmune diseases is ongoing. Conclusions/Learning Points: Our further plans are to collect more data and analyze the symptoms and signs according to age and gender.

Introduction. Critical illness-associated weakness (CIAW) is a term used to describe a group of neuromuscular disorders including critical illness polyneuropathy (CIP), critical illness myopathy (CIM) and critical illness polyneuromyopathy (CIPNM) which are the most common causes of neuromuscular weakness in the intensive care unit (ICU) and is associated with adverse short-and long-term clinical outcomes. CIPN and/or CIM is a poorly characterized entity in children because of limited data. We report a case of 17 years old patient who was treated in the ICU due to polytrauma. He developed sepsis and multiple organ failure on the 10th ICU day. Multidisciplinary treatment was effective. He was weaned from a respirator on day 24 after the onset of sepsis, but was noted to have flaccid tetraplegia. Neurophysiological assessment showed motor response abnormalities (reduced/borderline amplitudes, mildly prolonged duration) and fibrillations/ positive sharp waves in all tested muscles consistent with motor axonopathy or myopathy, but differentiation could not be made due to absence of voluntary muscle activation. […].

Introduction. Human Parechovirus (HPeV) type 3 can cause a serious sepsis-like illness and meningoencephalitis in neonates and young infants which can be lethal or result in neurological sequelae. First case of HPeV 3 was reported in 2004. Since then clinical findings have accumulated and attracted considerable attention among pediatricians. The way to ensure that infection could be caused by HPeV is to detect RNR of the virus in blood or CSF by performing PCR, however some specific findings in imaging studies can yield the suspicion. White matter damage can be visualized with cranial ultrasonography (US), however MRI can provide more accurate information especially diffusion-weighted imaging. Case report. We present a case of neonate with presumably HPeV encephalitis suspected by radiologist. Sixteen days old female born after uneventful pregnancy and delivery developed fever, became "sluggish" and refused to eat. [...].

Įžanga Apatinės dalies nugaros skausmas yra aktuali šiuolaikinės visuomenės problema. Jį per savo gyvenimą patiria 4 iš penkių gyventojų.Dažnai nugaros skausmai atsinaujina net ir pašalinus priežastį operuojant [6]. Operuoto stuburo skausmo sindromas, tai paciento būklė, kuri apibrėžiama kaip išliekantis apatinės nugaros dalies ar kojos skausmas po stuburo operacijos[3]. Šis sindromas vis dar išlieka viena dažnesnių stuburo chirurginio gydymo komplikacijų. Skirtingais duomenimis po atliktų stuburo juosmens kryžmens srities operacijų po 6 mėnesių ar daugiau skausmas vėl atsinaujino iki 70% pacientų [2] . Be to, anksčiau atlikto tyrimo Kauno klinikose metu buvo nustatyta kad 27% operuotų pacientų, skausmas ne tik išliko, bet ir nesumažėjo [4]. Tikslas Įvertinti pacientų, patyrusių stuburo juosmens kryžmens operaciją, skausmo ypatumus. Uždaviniai 1. Nustatyti, kiek pacientų per mėnesį kreipėsi į KK skausmo gydymo poskyrį su nugaros apatinės dalies skausmu, ir kiek iš jų yra turėję stuburo kryžmens srities opereacijų. 2. Įvertinti operuoto stuburo skausmo pagrindines charakteristikas: lokalizaciją, intensyvumą, pobūdį, skausmą stiprinančius bei silpninačius veiksnius. 3. Prognozuoti, kiek pacientų, su operuoto stuburo sindromu, skausmas gali būt neuropatinis. Metodika Gavus LSMU bioetikos leidimą (Nr. BEC-MF-413) retrospektyviai buvo atrinktos 93 pacientų, kurie gydėsi ar konsultavosi dėl nugaros apatinės dalies skausmo LSMU KK Skausmo gydymo poskyryje 2015m. vasario mėn., ambulatorinės kortelės. Buvo vertinama, kiek pacientų kreipėsi dėl išlikusio skausmo po stuburo operacijų, šių pacientų skausmo anketos („pacientų skausmo priežiūros lapas“), kuriose atsižvelgta į skausmo lokalizaciją, skausmo intensyvumą pagal SAS, skausmo pobūdį, skausmo tąsą, nuo ko pradeda skaudėti, kas padeda numalšinti skausmą. Prognozuoti[...].