Kubiliūtė, Ugnė

This study aimed to demonstrate a novel sensor-based measuring stand for objective assessment of multi-directional lower limb muscle strength and to establish essential, age- and gender-stratified normative benchmarks. This cross-sectional study measured relative leg strength (N/kg) across six standing movements in 99 healthy, non-professional athletes (males and females aged 20–30, 40–50, and 60–70 years). Results confirmed that men exhibited significantly greater strength than women across all six directions (17% to 35% difference). Furthermore, a marked age-related decline was consistently observed in both sexes, with the largest and most clinically relevant differences (often exceeding 30%) concentrated in the transition to the 60–70-year range. Methodologically, these findings are limited to demonstrating age-related differences rather than longitudinal decline and are specific to an active, healthy cohort. This study demonstrates the sensor-based stand as an efficient, objective tool for comprehensive strength assessment, but its clinical utility is prospective and requires further validation against diverse and pathological patient populations.

Background and Aims: Blood cultures (BC) are regarded as the most effective approach to identifying bloodstream infections. Inaccurate positive results from BC can lead to adverse outcomes, e.g. prolonged hospital stays. Aim: to analyze factors associated with the decision to perform BC in febrile children referred to PED. Methods: Retrospective analysis from electronic record data system was conducted including randomly selected data of febrile children aged 0–5 y between June-December, 2019. We collected: demographics, triage category, physician's “sense”, chief complaints, clinical findings, investigations, diagnosis, and treatment. Data were divided according to age (<1y/≥1y),diagnosis (viral/bacterial), and physician's “sense” (looks sick/doesn’t look sick). Statistical analysis was done with SPSS 29.0; p< 0.05 was considered significant. Results: Data from 507 patients were collected; mean age-2.17y(1.03–3.16); 55.2% – male; 22.7% – <1y. According to a physician,66.3% of children looked sick. 484 patients were categorized as non-urgent. All children received CBC, and CRP; 37 children had urine tests. 80 (15.8%) children were diagnosed with bacterial infection; 68.8% of them had BCs. Younger age was linked to higher BC sampling (OR3.2, CI95% 1.5–6.9, p = 0.002). Gender, triage category, and physician's “sense” were unrelated to per-forming BCs. Only irritation/sluggishness was associated with BC among symptoms (OR6.5, CI95% 1.2–37.2, p = 0.033). All children who received BC were administered antibiotics and 10were hospitalized. Conclusions: Younger age was associated with increased BC sampling. This is significant because most younger children cannot verbalize their symptoms, present early, and require broad-spectrum antibiotics when SBI is suspected. Gender, triage category, and physician's judgment did not affect the procedure.

Background and Aims: Inappropriate use of antibiotics re-mains one of the most relevant problems in healthcare. Aim: to analyze factors linked to the decision to prescribe antibiotics (AB) in respiratory viral infections (RVI) in PED of our university hospital. Methods: Retrospective analysis was conducted including data of randomly selected patients aged 0-5y between June-December, 2019. We collected demographics, triage category, physician's “sense”; chief complaints, clinical findings; investigations, diagnosis and treatment. Data were divided according to age (<1y, ≥1y), diagnosis (viral/bacterial), physician's “sense”(looks/doesn’t look sick). Statistical analysis was done using SPSS 29.0; p < 0.05 was considered significant. Results: Data from 507 patients were collected; mean age-2.17y(1.03- 3.16); 55.2%-male; 22.7%-<1y. According to physician,66.3% of children looked sick. Older children were considered sicker (69.9%) as well as “higher” (red/orange) triage category (100% vs 60.6% respectively, p = 0.001). 159 children were pre-scribed AB, 52.8% were diagnosed with viral diseases (e.g. viral croup, etc.). Neither age, gender, physician's sense, vital signs, or duration of fever were associated with AB prescription. Only red throat and dyspnea were linked to AB prescription (OR-1.7,CI95% (1.0-2.9), p = 0.034; OR-5.6, CI95% (2.2-14.3), p < 0.001). If child received chest X-ray, he/she was prescribed AB more frequently (OR-3.7, CI95% (1.7-8.3), p = 0.001). Chest X-ray results were not associated with AB prescription. Conclusions: Based on our findings, principal AB prescription contributors in RVI were red throat, dyspnea and chest X-ray. AB prescription was neither linked to patient's age, gender, physician's perception, vital signs, duration of fever or chest X-ray results. We recommend promoting medical education and follow guidelines to reduce AB overuse.

Background and Aims: Medical over testing and overtreatment are common in pediatric population as children are de-fined as fragile population with nonspecific symptoms that can change rapidly. Aim: to clarify the factors linked to decision to perform urine cultures in the PED of our university hospital. Methods: Retrospective analysis was conducted including data of randomly selected patients aged 0–5y between June-December, 2019. We collected demographics, triage category, physician's “sense”; chief complaints, clinical findings; investigations, diagnosis, treatment. Data were divided according to age (<1y, ≥1y), diagnosis (viral/bacterial), physician's “sense”(looks/doesn’t look sick). Statistical analysis was done using SPSS 29.0; p < 0.05 was considered significant. Results: Data from 507 patients were collected; mean age-2.17y(1.03–3.16); 55.2%-male; 22.7%-<1y. According to physician,66.3% of children looked sick. Older children (69.9%) and “higher” (red/orange) triage category (100% vs 60.6% respectively, p = 0.001) were considered sicker. In total, 254 urine tests and 37 urine cultures were performed with only 8 children complaining of urination changes. 62% of urine cultures were positive. Age, gender, triage category, symptoms were not as-sociated with urine culture performance but physician's sense (OR- 4.06, CI95% (2.0–8.2), p < 0.001). In total, 159 children were prescribed antibiotics, from whom 23.3% received urine culture sampling. 21 patients received ceftriaxone, followed by cefuroxime (16).Conclusions: Our analysis showed that in total 254 urine tests were performed and 37 children received urine cultures. None of the factors except physicians' “sense” were associated with decision to perform urine culture. There should be continuous discussions and reviews of protocols regarding distinguishing when to perform urine culture, emphasizing principle of choosing wisely.

Sportininkų traumos yra neišvengiama sporto dalis, jos veikia ne tik pacientų fizinę, bet ir emocinę savijautą. Reabilitacijos procese didžiausias dėmesys skiriamas sužalojimo gydymui ir funkcijos grąžinimui, o psichologinei paciento būklei dažnai skiriama mažai laiko arba visai neteikiama dėmesio. Daugelyje tyrimų pastebėta, kad tokie veiksniai kaip pasitikėjimas savimi ir aplinkinių palaikymas gerina reabilitacijos rezultatus [1,2]. O pakartotinos traumos baimė, nerimas dėl gebėjimo grįžti sportuoti ir patiriamas stresas rezultatus veikia neigiamai. Siekiant užtikrinti visapusišką ir efektyvią sportininkų reabilitaciją, būtina formuoti tarpdalykinę komandą.

Telemedicina yra sparčiai populiarėjantis nuotolinių medicininių paslaugų teikimo būdas, naudojant informacijos ir ryšių technologijas. Pasaulyje ir Lietuvoje atlikti tyrimai rodo, kad papildomai naudojant telemediciną kardiologinei reabilitacijai, pasiekiami geresni rezultatai, atsižvelgiant į pacientų fizinį pasirengimą, gyvenimo kokybę, psichinę sveikatą, mirštamumo mažėjimą bei hospitalizacijos dažnį. Kiti pasaulyje atlikti tyrimai patvirtina, kad telemedicinos būdu atlikta kardiologinė reabilitacija gali būti lygiavertė atliekamai reabilitacijos centruose. Svarbu atsižvelgti į pacientų individualius poreikius ir leisti jiems rinktis tarp namų ir centro reabilitacijos, užtikrinant efektyvų ir patogų gydymą.

Introduction Various methods are being adapted to assess which patients require hospitalization from the pediatric emergency department (PED), especially in settings without the possibility of short observation. Therefore, clear pathways should exist in PEDs to avoid patient overload and unnecessary hospitalization. Our study aim: to analyze factors linked to the decision to hospitalize patients between 2019 June 29th and 2019 December 9th in the PED of Lithuanian University of Health Sciences Hospital Kauno Klinikos.

Method & Materials Retrospective analysis from an electronic record data system was conducted including randomly selected data of children aged 0-5y. The following data were collected: demographics, triage category, physician’s sense (looks sick/doesn't look sick); chief complaints, clinical findings; investigations, diagnosis, and treatment. Data were divided according to age (<1y/>1y), diagnosis (viral/bacterial), and physician's sense (looks sick/doesn't look sick). Statistical analysis was done with SPSS 29.0; p<0.05 was considered significant.

Results Data from 507 patients were collected; mean age-2.17y (1.03-3.16). Majority (55.2%) were male; 22.7%-younger than 1y. According to the physician, 66.3% of children looked sick. Older patients were considered sick (69.9%). Higher (red/orange) triaged were assigned as sicker compared to those in the green/blue category (100% vs. 60.6% respectively, p=0.001). 86 children were hospitalized. Hospitalization did not differ between age groups, triage category or time of referral. Initial evaluation looking sick, as well as none of the complaints or clinical signs were associated with hospitalization. More children received CBC (89.5% for hospitalized vs. 78.6% for discharged, p=0.02). CBC results nor CRP levels were linked to hospitalization, and neither did blood or urine cultures. Children who received chest X-rays were 2.3 times more likely to be hospitalized (OR 2.3, CI95% (1.2-4.3), p=0.014). X-ray result was not associated with the hospitalization rate.

Conclusion We found that higher rates of hospitalization were not related to the triage category, patient's age, time of referral, complaints, clinical signs, physician's sense or blood or urine cultures performed. Children who received CBC or Chest X-rays were admitted to the hospital more frequently. We suspect other factors, such as socioeconomic (lack of further safe-guarding, suspicion of not using antibiotics or other medicine), and parental (fair) to play significant roles in the decision to hospitalize.

Objectives (oral/poster only) Worldwide, pediatric trauma is the main cause of concern, regarding the frequency of admissions to the Pediatric Emergency Department (PED), and is the leading cause of death in this age group, especially when it comes to polytrauma. The aim of this investigation was to analyze all pediatric multiple trauma cases between 2018 and 2019 in the PED of Lithuanian University of Health Sciences Hospital Kauno Klinikos (LSMU KK). Materials and methods (oral/poster only) A retrospective analysis from the electronic record data system was conducted including all polytrauma cases of children aged 0-18 years from 2018 to 2019 referred to LSMU KK PED. The polytrauma categorization covered codes T00-T14 from the ICD-10-AM. In total, we investigated 349 patient records by analyzing and comparing cases between 2018 and 2019, seasonality, types, locations, and demographics (age and gender). Results (oral/poster only) In 2018, 165 pediatric polytrauma cases were recorded, and in 2019 - 184 (52.7%). Regarding the location of the injury, in both times unspecified injuries 136 (39.0%) had the biggest number of cases. The most common polytrauma type among both genders, was superficial injuries, in 2018 (125; 75.8%) and 2019 (138; 75.0%). The arm traumas were chiefly in groups of 1-6 year-olds, in all other age groups unspecified injuries were the most frequent. However, in all groups of age, the main polytrauma type was the same - superficial injuries. Summer was the most often season for PED visits due to multiple trauma 132 (37.8%) but the biggest peak was seen in May, 56 (16.0%).Conclusions The most common polytrauma type among all groups of age was superficial injuries. The unspecified injuries (39.0%) were recorded as the most frequent location. However, in the group ages of 1-6y, arm injuries were the most often. A significant increase in the number of pediatric polytrauma was observed in the summer.

Background Superficial head injuries are the most common type of injuries of head trauma. Therefore, our aim was to clarify the pediatric head traumas of 2018-2019 recorded in the PED of Lithuanian University of Health Sciences Hospital Kauno Klinikos (LSMU KK) and additionally investigate age group 0-3 month-old, to analyze its demographics and compare between those time frames. Methods A retrospective analysis from our hospital’s electronic record data system was conducted from all trauma cases of children aged 0-18 years from 2018 1st of January to 2019 31st of December referred to LSMU KK PED. The trauma categorization included all codes of S0-S99 from the ICD-10-AM classification with a more thorough analysis of the codes S00-S09 in the 0-3 month-old group. The analysis and comparison of data from 2018-2019y were made, including the seasonal distribution and demographics. Results We reviewed a total of 19,813 pediatric trauma patient records, including 6,210 head injuries. 57 head trauma cases further analyzed in the 0-3 month age group. Spring was the most frequent season of PED visits for head injuries – 1742 (28,1%), The additional analysis of all injury sites in the age group of 0-3 months old revealed that head injuries accounted for the majority of all injuries – 87,7% (57). 57,9% of all those traumas were boys. To clarify the location of head injuries, 31 (54,4%) happened in the hairy parts of the head. Knowing that children up to 3 months do not have fully developed motor activity to change the location or position, it is suspicious that 13 (22,8%) of head injuries were identified as concussions, 7 (12,3%) had head fractures. Discussion & Conclusions According to the analysis, it was found that the most significant incidence of PED visits with head trauma was during spring. Moreover, head injuries were the main trauma location in 0-3 month-old, especially concussions. Further analysis is necessary to clarify trauma mechanisms, environmental pecularities and social aspects of those head traumas in this specific age group.

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.