Hansted, Edita

Background and Objectives: Assess the quality of life of children aged 2–10 with mild to moderate bronchial asthma. To evaluate the general health condition of children with mild and moderate severity bronchial asthma. To determine health changes in children with mild- and moderate-severity bronchial asthma as they grow older. To evaluate the impact of mild- and moderate-severity bronchial asthma on children’s daily and social activities, physical health, emotional state, and general well-being. Materials and Methods: A comparative cross-sectional study was conducted in March–June 2020. Parents or guardians of 2–10-year-old children without bronchial asthma and children with mild to moderate bronchial asthma were interviewed after receiving their written informed consent. The questionnaire was based on the standardized quality-of-life quiz SF-36. A total of 248 questionnaires were collected—106 from the parents or guardians of children with bronchial asthma and 142 from parents/guardians of children without bronchial asthma. For further analysis, 106 children without bronchial asthma and with no chronic conditions were selected. Quantitative variables were compared using the Mann–Whitney U test and qualitative data using the chi-square (χ2) criteria. Quantitative data were described by giving means, medians, and standard deviations (SD); qualitative features by giving relative frequencies. Statistical data were analyzed using SPSS and Excel 2020. Results: Children with mild and moderate asthma exhibit poorer health compared to their healthy counterparts. Only 20.7% of respondents with asthma reported excellent or very good health, contrasting with 64.1% of healthy children (p < 0.001). As children with asthma age, their general condition improves, with 46.2% showing improvement in the past year, while 42.5% of healthy children had a stable condition (p < 0.05). In various activities, children with asthma face more constraints than healthy children (p < 0.05), including energetic activities (sick—59.5%; healthy—10.3%), moderate activities (sick—24.5%; healthy—4.7%), climbing stairs (sick—22.7%; healthy—3.8%), and walking over 100 m (sick—9.4%; healthy—0%). Children with asthma are more likely to experience exhaustion, anxiety, tiredness, lack of energy, and restraint in public activities (p < 0.05). Conclusions: Parents/caregivers of children with mild to moderate bronchial asthma rate their health worse than those of healthy children do. As children with mild to moderate bronchial asthma grow, the disease impact on their overall well-being decreases. Children with mild to moderate bronchial asthma, compared to healthy children, experience more limitations in vigorous or moderate activities; face more difficulties climbing stairs or walking more than 100 m; frequently feel exhaustion, anxiety, fatigue, or lack of energy; and encounter restrictions in social activities.

Pediatric Post-COVID-Condition (PPCC) clinics treat children despite limited scientific substantiation. By exploring real-life management of children diagnosed with PPCC, the International Post-COVID-Condition in Children Collaboration (IP4C) aimed to provide guidance for future PPCC care.

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.

Background and aim. Since COVID pandemics, ~50% of children can have asymptomatic infection. However, they tend to have post-covid symptoms. Due to unexplained symptom origin (without confirmed COVID), they are referred to different paediatric specialists. Aims:to analyse SARS-CoV-2 antibody levels in children referred to our University Hospital ambulatory care with unexplained symptoms, to clarify percentage of asymptomatic covid cases and related post-covid symptoms. Methods:prospective study was conducted including children up to age of 18y without previous SARS-CoV-2 infection, were not breastfed during the last months, nor vaccinated against SARS-CoV-2. Parents were asked to fill-in the questionnaire about symptoms within one year before referral. Results:in total, 124 children were included into the study, 47.5% were female. Median age was 8.6y. 63.7% had different chronic diseases, e.g., asthma or arthritis and 56.4% were allergic. 41% noted that they have had symptoms of acute infection within one year, 24% had family member who tested positive for SARS-COV-2. 24.2% of children had antibodies against SARS-CoV-2 (Ab+). No correlation between positive test of family member and Ab+ child was found. No significant difference was observed between Ab+ versus Ab- within age groups, with or without chronic diseases. There were 57 children with unexplained symptoms and 26% of those children had Ab+. Most of those symptoms were respiratory (dyspnoea, cough), followed by neurological symptoms (insomnia, tiredness). Conclusions:we did find 24% of the Ab+ children who were defined as never ill with COVID. Majority of unexplained symptoms within the Ab+ group were respiratory and/or neurological.

Background and objective: Lithuania belongs to the group of countries with a high-incidence of tuberculosis (TB). Some scientific studies show that the interferon-gamma release assay is more accurate and correlates more highly with TB exposure as compared to the tuberculin skin test (TST). This study aimed at comparing the efficacy between the T SPOT TB and TST for diagnosing TB among Lithuanian adults. Materials and methods: Individuals with diagnosed TB, healthcare workers with known risk for TB and individuals without any known risk for TB underwent clinical examinations, interviews about their history of TB exposure and chest radiography. Then the TST and the T SPOT TB were performed on patients. Results: A positive T SPOT TB was more common in the group with diagnosed TB compared to healthcare workers and the low risk for TB groups (97.5%, 36.4%, and 0%, respectively, P < 0.01). Positive TST results did not differ between the groups with diagnosed TB and the healthcare workers (92.5% vs. 95.5%, P > 0.05). Agreement between TST and T SPOT TB was poor (kappa 0.14, P > 0.05). T SPOT TB had higher specificity and sensitivity compared to TST (area under the ROC 0.9 0.04, P < 0.01, vs. 0.5 0.06, P > 0.05). Conclusions: The T SPOT TB showed greater accuracy in diagnosing TB than TST did. Positive T SPOT TB result but not the TST was more common in patients with diagnosed TB.

Nepaisant visuotinio skiepijimo BCG vakcina Lietuvoje tuberkuliozės (TB) paplitimas yra dažnas. Iki šiol vienintelis metodas, taikytas TB infekcijai nustatyti, buvo įodinis tuberkulino mėginys, tačiau jis nėra pakankamai jautrus dėl galimų kryžminių reakcijų su BSG vakcina bei aplinkos mikobakterijomis, dėl įvairių kitų veiksnių, darančių įtaką klaidingai teigiamiems ar neigiamiems šio mėginio rezultatams. Siekiant efektyvesnės TB infekcijos diagnostikos, buvo sukurti nauji diagnostiniai metodai, pagrįsti M. tuberculosis sukelto stimuliuotų T-limfocitų išskiriamo interferono gama (IFN-γ) nustatymu. [...].

Darbo tikslas – įvertinti socialinius veiksnius, galinčius turėti reikšmės vaikų sergamumui tuberkulioze. Tuo tikslu Kauno medicinos universiteto klinikose buvo ištirti 35 vaikai, kurie gyvena Kaune ar Kauno apskrityje. Tiriamųjų vidutinis amžius 14,1±1,7 metų. Tyrime dalyvavo 15 (42,9 proc.) berniukų ir 20 (57,1 proc.) mergaičių. Visi tiriamieji buvo suskirstyti į tris grupes: 1) vaikai, sergantys bakteriologiškai patvirtinta tuberkulioze (n=13), t. y. jų skrepliuose rasta tuberkuliozės mikobakterijų mikroskopuojant ar pasėliuose, plaučiuose buvo tuberkuliozei būdingų rentgeninių pakitimų; 2) tuberkuliozine infekcija užsikrėtę vaikai (n=8), t. y. jų įodinis tuberkulino mėginys ir testas gama interferonui nustatyti buvo teigiami, tačiau nebuvo pakitimų plaučių rentgenogramoje, bakteriologiškai nerasta tuberkuliozės mikobakterijų; 3) sveikų vaikų grupė (n=14), t. y. jie neturėjo nusiskundimų, būdingų tuberkuliozei, žinomo sąlyčio su baciliaria tuberkulioze sergančiais asmenimis, jų įodinis tuberkulino mėginys ir testas gama interferonui nustatyti buvo neigiami, nebuvo pakitimų plaučių rentgenogramose. Bandomuoju tyrimu nustatyta, kad vaikams susirgti ar užsikrėsti tuberkulioze reikšmingą įtaką turėjo šie veiksniai: artimas sąlytis su sergančiuoju tuberkulioze, nėra ventiliacijos namuose. Nustatyta tendencija vaikui susirgti tuberkulioze, jei maitinasi nereguliariai. Šeimos sudėtis (pilna ar nepilna šeima) neturėjo reikšmės vaikams užsikrėsti/sirgti tuberkulioze. Remiantis daugiaveiksnės logistinės regresinės analizės duomenimis nustatyta, kad jei namuose nėra ventiliacijos, galimybė susirgti tuberkulioze padidėja 5,5 karto, o jei vaikas turi sąlytį su tuberkulioze sergančiu asmeniu, tai ši galimybė padidėja net 24,3 karto.

Background: Lithuania is a country with a high incidence of tuberculosis (TB), despite a high coverage with bacille Calmette-Guerin (BCG) vaccination. Until now the only method used to detect latent TB infection was the tuberculin skin test (TST). However, TST may have a cross reactivity to the BCG vaccine and to environmental mycobacteria. The aim of this study was to conduct assessments of the diagnostic accuracy of the T-cell based test (T SPOT TB) for TB in children who had previously been BCG vaccinated and compare these with the results of the TST. Methods: Between January 2005 and February 2007, children with bacteriologically confirmed TB, children having contacts with a case of infectious pulmonary TB and children without any known risk for TB were tested with both the TST and T SPOT TB. Results: The TST and T SPOT TB tests were positive for all patients in the „culture-confirmed TB“ group. Whereas, in the „high risk for TB“ group, the TST was positive for 60%, but the T SPOT TB test, only for 17.8%. Meanwhile the results for the „low risk for TB“ group were 65.4% and 9.6%, respectively. A correlation between the TST and T SPOT TB was obtained in the "cultureconfirmed TB" group where the TST ≥15 mm (r = 0.35, p < 0.001). Conclusion: The T-cell based method is more objective than the TST for identifying latent TB infection in children who had been previously BCG vaccinated. This method could be useful in countries like Lithuania where there is a high incidence of TB despite a high coverage with BCG vaccination. It may also help to avoid unnecessary chemoprophylaxis when TST reactions are falsepositive.