Gudavičiūtė, Gerda

Melatoninas – kankorėžinės liaukos išskiriamas hormonas, reikšmingas įvairiems organizmo neurologiniams ir endokrininiams procesams. Senstant ir sergant įvairiomis ligomis, stebimas melatonino koncentracijos mažėjimas, silpsta jo antioksidacinis poveikis, todėl ima trikti cirkadinis ritmas, pasireiškia psichikos sutrikimai, didėja onkologinių, neurodegeneracinių bei širdies ir kraujagyslių ligų rizika. Dėl plataus melatonino poveikio jis gali būti sėkmingai ir saugiai naudojamas įvairių ligų prevencijai ir gydymui. Pastaraisiais metais vis plačiau tiriamas melatonino antineoplastinis, priešuždegiminis ir analgezinis poveikis, taip pat galimas teigiamas melatonino efektas COVID-19 infekcijos adjuvantinei terapijai. Pritaikant natūralias melatonino savybes terapiniais tikslais, melatonino egzogeniniai preparatai gali būti potencialiai vartojami greta kitų šiuo metu vartojamų vaistų ar net juos pakeičiant. Vis dėlto svarbu pasverti naudos ir rizikos santykį. Nors esami tyrimai rodo reliatyvų saugumą, naudojant mažas egzogeninio melatonino dozes, svarbu toliau tirti ir analizuoti šių preparatų trumpalaikio ir ilgalaikio vartojimo saugumą bei veiksmingumą.

Background: Lithuania has the highest tick-borne encephalitis (TBE) rates in Europe. Although TBE incidence in children is lower, it may still cause long-term consequences. So far pediatric epidemiological and clinical characteristics of TBE in Lithuania were not described. Methods: We performed a retrospective analysis of 87 cases of children who were hospitalized for TBE in Kaunas Hospital of the Lithuanian University of Health Sciences from 2012 to 2019. Each case was identified with neurological symptoms and positive serological tests. Results: Around half of the children (50.6%) reported having a tick bite, whereas 6.9% stated having exposure to unpasteurized milk. Biphasic course of the disease occurred in 70.1% of the cases. The most common clinical symptoms were headache (100%), fever (100%), nausea (85.1%), vomiting (78.2%), drowsiness (67.8%) and general weakness (66.7%). Meningeal symptoms were present in 93.1% of the cases, and 93.1% of the children had at least one focal neurological sign (tremor 82.3%, impaired balance 73.6%). Isolated meningitis was diagnosed in 57.5%, meningoencephalitis in 41.4% and meningoencephalomyelitis in 1.1% of the cases. Majority of younger children (1–8 years old) had meningitis (77.3%), whereas 49.2% of older children (9–17 years old) had more severe forms of TBE. Cerebrospinal fluid pleocytosis was found in 94.3% of cases (average white blood cell count: 111.7 per μL, protein: 0.5 g/L). Higher levels of cerebrospinal fluid protein were associated with more severe forms of TBE and older age. Duration of the symptomatic disease lasted ≈11 days. Early residual signs were observed in 75.9% of all cases. Conclusions: The epidemiological and clinical characteristics of TBE in children in Lithuania are similar to those described in other countries. Only half of the subjects reported having a tick bite. Younger children tend to suffer from meningoencephalitis and meningoencephalomyelitis less frequently than elder ones. Focal neurological signs were commonly observed. Majority of children had lasting symptoms of TBE upon discharge from the hospital.

Introduction: Bronchiolitis is one of the most frequent causes of hospitalization in children under age of 2. Most evidence-based clinical bronchiolitis guidelines recommend minimal or no laboratory and instrumental tests and only supportive management. Aim: To evaluate treatment options and influencing factors of children referred to our university hospital pediatric emergency department (PED); to analyze hospitalization rate, and associated factors. Methods: Retrospective single center study was performed. Data of children < 2 years of age referred to PED from 2018 March to2019 June were included. Exclusion: lack of medical documentation, neonatal age. Demographic and clinical data, diagnostic and treatment options were evaluated. Results: In total, 268 children were included, 60% male. Majority were <6 months (n=181, 67.5%). 73 children had different risk factors, such as prematurity, cardiovascular diseases, etc. Most of the children complained of cough (n=240) without difference between the age or gender groups; wheezing was less frequent complaint on presentation (n=113). 50% of children had symptoms of RDS and younger children were more likely to present with RDS (39% from total; p<0.001). Obstruction was equally frequent in both age groups; however, crepitation was more commonly detected in younger children (121/181 versus 47/87; p=0.042). Most of the children were hospitalized and as expected, the majority were younger (138/181 as for <6 mo, 38/87 as for >6mo, p<0.001). None of the clinical factors except wheezing was associated with more frequent hospitalization rate (OR* 5.88, CI 95% 2.5-13.75 asfor wheezing; adjusted for age, gender, risk group, RDS). Most of the children received inhalations with salbutamol (n=182) and 63 of all were prescribed glucocorticoids on arrival. 32 received antibiotics. Younger children presenting with RDS were more likely to get salbutamol inhalations (p<0.001). Children less than 6mo of age were more likely to receive supplementary oxygen (81% versus 19% of >6mo; p<0.001). As expected, children receiving O2 were more likely to be hospitalized (OR 11.63, CI 95% 4.25-31.83). None of other treatment methods were associatedwith hospital admission. In a linear regression analysis, both supplementary O2 and antibiotics at ED were associated with longer LOS (OR 2.4 CI 95% 0.28-2.71 as for O2; OR 4.9 CI 95% 2.0-4.8 as for antibiotics). Conclusion: younger children with RDS were more likely to receive salbutamol inhalations. Children who presented with wheezing and those who received supplementary oxygen were more likely to be hospitalized. Receiving oxygen and antibiotics at ED was associated withlonger LOS.

Įvadas. Fizinis aktyvumas - vienas efektyviausių fizinės ir protinės sveikatos palaikymo būdų. Tinkama protinė veikla ir geri akademiniai pasiekimai ypač svarbūs studentams, todėl aktualu išsiaiškinti, ar reguliari fizinė veikla teigiamai veikia studentų akademinius pasiekimus. Tyrimo tikslas. Įvertinti medicinos studentų fizinį aktyvumą ir išsiaiškinti sporto įtaką jų akademiniams rezultatams. Metodika. 2018 m. spalio 10-18 dienomis atlikta anoniminė anketinė apklausa. Anketa buvo pateikta 300 Lietuvos sveikatos mokslų universiteto (LSMU) Medicinos akademijos studentų, anketą užpildė 170 studentų. Atsako dažnis – 57%. Skirtumai tarp lyginamų grupių laikyti statistiškai reikšmingais, kai p<0,05. Statistinė duomenų analizė atlikta naudojant programinį paketą „IBM SPSS Statistics 22”. Rezultatai. 31,5% studentų užsiima reguliaria sportine veikla, 25,0% studentų teigia, kad išvis nesportuoja. 27,1% studentų reguliaria sportine veikla užsiima jau ilgiau nei metus. Iš sporto šakų studentai dažniausiai renkasi sporto klubą, pratimus namuose ir bėgimą. 41,2% studentų pastebėjo, kad pradėjus sportuoti pagerėjo jų mokymosi efektyvumas. 50,0% studentų pradėję sportuoti didelių studijų vidurkio pokyčių nepastebėjo, tačiau palyginus sportuojančių ir nesportuojančių studentų pažymių vidurkius, matyti, kad sportuojančių studentų vidurkis yra statistiškai reikšmingai (p<0,05) didesnis nei nesportuojančių. Išvados. Trečdalis tirtų studentų užsiima reguliaria fizine veikla, likusieji sportuoja nereguliariai, retai ar nesportuoja. Sportuojančių studentų studijų vidurkis yra statistiškai reikšmingai (p<0,05) didesnis nei nesportuojančių.

Background. Lithuania has the highest tick-borne encephalitis (TBE) rate in Europe. Even though TBE incidence in children is lower, it may still cause long-term consequences. Therefore, it is essential to further investigate its clinical and epidemiological characteristics in children. Aim. To evaluate epidemiological and clinical characteristics of children with TBE. Methods. We performed a retrospective analysis of 87 cases of children with confirmed TBE who were hospitalized in Kaunas Hospital of the Lithuanian University of Health Sciences from 2012 to 2019. Each case of TBE was identified with neurological symptoms and positive serological tests. Results. 87 children (55.2% male, 44.8% female) aged from 1 to 17 years old were involved in this study. Around half of them (50.6%) reported having a tick bite, while 6.9% stated having exposure to unpasteurized milk. Incubation period varied between 1 to 60 days (19 days on average) in case of a known tick bite. Biphasic course of the disease occurred in 70.1% of the cases with an average of 13 days (5 to 25 days) between the two phases. The most common clinical symptoms were headache (100%, N=87), nausea (85.1%, N=74), vomiting (78.2%, N=68), drowsiness (67.8%, N=59) and general weakness (66.7%, N=58). Meningeal symptoms were present in 93.1% of the cases and 93.1% of the children had at least one focal neurological sign (tremor 82.3%, impaired balance 73.6%). Isolated meningitis was diagnosed in 57.5%, meningoencephalitis – in 41.4% and meningoencephalomyelitis in 1.1% of the cases. Majority of younger children (1–8 years old) had meningitis (77.3%) while 49.2% of older children (9–17 years old) had more severe forms of TBE. Pleocytosis was found in 94.3% of cases (average WBC count – 111.7 per μL, protein – 0.5 g/l). Duration of the symptomatic disease lasted for approximately 12 days. Early residual signs were observed in 75.9% of all cases. Most[...].

Background. Bronchiolitis is most frequent cause of hospitalization in children <2years. Most evidence-based clinical bronchiolitis guidelines recommend minimal/ no laboratory/instrumental tests and only supportive management. Aims To evaluate treatment of children referred to pediatric emergency department (PED) with bronchiolitis and hospitalized into Pediatric Department (PD); to compare dominant diagnostic and treatment practices in our hospital. Methods. Retrospective single-center study. Data of children<2y hospitalized to PD 2018 March-2019 June were included. Exclusion:lack of medical documentation, neonatal age. Diagnostics, treatment use were evaluated. Results. 115 patients referred to PED due to bronchiolitis were later hospitalized. Only 99 (86.1%) met inclusion criteria and were analyzed. Median age–3mo (min 1mo, max 12mo);59.6% (n=59) were male. Most frequent symptoms in PED–subfebrile T°C(n=69, 69.7%), cough (n=89, 89.9%), dyspnea (n=57, 57.6%), ARDS (n=70, 70.7%). Mean SpO2–92.4±5.72%; RR–45.2±13.2bpm, auscultation findings–crackles (75.8%), wheezing (81.2%). Routine blood test performed for 29.3%(n=29) in PED and for 41.4%(n=41) in PD, eight–tested twice (in PED and PD).59 (59.6%) received chest X-ray.69 children required oxygen therapy.57.6% of patients received salbutamol in PED and 79.8%(n=79) in PD(average duration 4.7±3.5d). Glucocorticoids (GC) were administered in 20.2%(n=20) in PED vs 31.3%(n=31) in PD.11 patients were prescribed antibiotics. Mean length of stay (LOS)–4.9±3.9d. LOS was longer when children received oxygen or GC(5.67±4.4d and 7.1±5.8d respectively).