Quality of life in children with asthma

Quality of life in children with asthma, behavioural problems and psychological adjustment is presented

Conception of quality of life and health-related quality-of-life investigations in children population

Assessment of the impact of diseases and their treatment on a patient with chronic disease is especially important. When there is no possibility to recover, patients and their closest relatives have to accept changes in lifestyle, which may vary with time. Health professionals assume that improvements in symptoms show better quality of life of patients. Quality-of-life assessments incorporate not only the impact of illness and treatment on physical functions, but also its effect on lifestyle and emotional well-being. Quality of life deals with a higher order of complexity: the impact of functional impairment on other aspects of life, e.g. the ability of children to go to school or play, and the emotional effect of these restrictions. The aim of this article is to present measurement tools and how to use them and the application of quality-of-life measurement in pediatric medicine. Every investigator has to raise the question to himself/herself, “What is health-related quality of life,” and before planning the investigation, answer this question correctly

Microcirculatory effects of L-arginine during acute anaerobic exercise in healthy men: A pilot study

Background/Objective We hypothesized that L-arginine supplementation increases sublingual capillary perfusion during acute anaerobic exercise. Methods In a double-blind randomized study, 20 healthy men were randomly assigned to an L-arginine group or a placebo group. Both groups performed a standard 60-second duration BOSCO jumping test. Before the exercise, immediately after, and 30 minutes after exercise, systemic hemodynamic parameters were recorded. Sublingual evaluation of microcirculation using sidestream dark field (SDF) videomicroscopy was also carried out. Results There were no differences in mean arterial blood pressure and cardiac output between the placebo and L-arginine groups immediately after exercise and at 30 minutes after exercise. Both groups had no changes in the microvascular flow index and proportion of perfused vessels of small vessels over the testing period. We observed significantly higher functional capillary density [14.1 (12.5 – 16.0) vs. 11.7 (10.9 – 12.9) 1/mm, p = 0.021] and total vessel density of small vessels [27.8 (24.4 – 29.2) vs. 23.0 (21.6 – 24.2) mm/mm2, p = 0.041] in the L-arginine group compared with the placebo group immediately after exercise, but after 30 minutes these differences had disappeared. Conclusion Our findings show that supplementation with L-arginine may cause additional effects on the acute anaerobic exercise-induced transient increase in capillary density in the sublingual mucosa of untrained men

Lietuvos greitosios medicinos pagalbos tarnybų galimybės teikti pagalbą traumą patyrusiems pacientams

Objective. To evaluate the ability of country ambulance services to provide first medical aid in trauma cases. Material and methods. A survey of chiefs of emergency medicine service was performed in October–November 2005, in which 34 of the 59 institutions (58%) were participating. The questionnaire presented questions concerning physical and human resources, performance values, and system configuration. The study has shown that emergency medicine service operates in radius of 23 km, each team providing service for about 40 000 inhabitants. Taking into consideration distance and average on-scene time values, emergency medicine service is capable to render the first medical aid within so-called “golden hour” in case the accident is reported immediately. The physical resources are not quite complete. Not all the cars are equipped with essential first aid measures. Among more rarely found resources are vacuum pumps, intubation sets, defibrillators, vacuum splints, back immobilization devices, and hammock immobilization devices. There are less mentioned resources than working teams and even more than two times less than emergency cars at all. Two-thirds of the operating emergency medicine services do not provide advanced life support procedures. The evaluation of theoretical/practical ability to provide some important medical procedures used in emergency medical care showed that medical staff quite often fails to perform defibrillation, intubation, and pleural cavity drainage. Conclusions. Country ambulance service network configuration according to area under service, number of people served, and response frequency comply with the requirement set. The ambulance vehicles lack complete set up as well as some important supplies. Only rarely the staff is skilled enough to perform such advanced life support procedures as intubation, defibrillation, and pleural drainage

Hospitalinės infekcijos ekonominis įvertinimas vaikų intensyviosios terapijos skyriuose Lietuvoje

Tyrimo tikslas. Įvertinti trijų Lietuvos vaikų intensyviosios terapijos skyrių tiesiogines išlaidas, susijusias su hospitalinių infekcijų atvejais bei apžvelgti hospitalinių infekcijų prevencijos programos (intervencijos) ekonominį efektyvumą. Metodika. Perspektyvusis stebėsenos tyrimas atliktas trijuose Lietuvos vaikų intensyviosios terapijos skyriuose 2005 m. sausio – 2007 m. gruodžio mėn. Tikslinės atrankos būdu į tyrimą įtraukti visi 1 mėn. – 18 metų vaikai, kurie gydyti vaikų intensyviosios terapijos skyriuose ilgiau nei 48 val. Tiesioginės vaikų intensyviosios terapijos skyrių hospitalinių infekcijų sąlygotos išlaidos apskaičiuotos vienam hospitaline infekcija susirgusiam ligoniui ir vienam hospitalinės infekcijos atvejui. Vidutiniam vieno lovadienio įkainiui apskaičiuoti panaudoti hospitalinių infekcijų registro duomenys, taip pat remtasi ligoninių gaunamų lėšų už suteiktas vaikų reanimacijos paslaugas analize pagal 2005 m. spalio 27 d. Lietuvos Respublikos sveikatos apsaugos ministro įsakymu Nr. V-802 patvirtintus stacionarinių sveikatos priežiūros paslaugų įkainius. Pagal gydymo trukmę reanimacijos paslaugų įkainius ir hospitalinių infekcijų sąlygotas išlaidas visi ligoniai suskirstyti į dvi grupes – įgiję ir neįgiję hospitalinių infekcijų. Vertinant intervencijos ekonominį efektyvumą, ligoniai suskirstyti į kitas dvi grupes – prieš ir po intervencijos. Ekonominis įvertinimas apskaičiuotas nacionaline šalies valiuta – litais. Rezultatai. Tyrime dalyvavo 755 pacientai. Pagal daugialypės tiesinės regresijos modelį (r2=0,47), vienam ligoniui įgijus hospitalinę(-es) infekciją(-as), vaikų intensyviosios terapijos skyriaus gydymo trukmės pailgėjimas sudarė vidutiniškai 6,32 (95 proc. PI: 4,32–8,33; p=0,003) lovadienio. Vieno ligonio įgytos(-ų) hospitalinės(-ių) infekcijos(ų) sąlygotos vidutinės išlaidos sudarė 5215,47 litų (95 proc. PI: 3565,00–6874,19). Vieno hospitalinės infekcijos atvejo sąlygotos vidutinės išlaidos sudarė 4070,61 litų (95 proc. PI: 2782,44–5365,22). Hospitalinių infekcijų profilaktikos programos (intervencijos) bendrasis ekonominis efektas buvo 20046,14 litų. Apsaugojus vieną ligonį nuo hospitalinės(-ių) infekcijos(-ų), išlaidų sumažėjimas sudarė 1336,41 litų, pavykus išvengti vieno hospitalinės infekcijos atvejo, išlaidų sumažėjimas sudarė 1113,67 litų, o sąnaudų ir naudos santykis – 1:4. Išvados. Vaikų intensyviosios terapijos skyrių hospitalinių infekcijų sąlygotos išlaidos buvo pakankamai didelės. Įdiegus hospitalinių infekcijų profilaktikos programoje numatytas priemones, užfiksuotas teigiamas ekonominis efektyvumas – hospitalinių infekcijų profilaktikai panaudojus 1 litą, sutaupyti 4 litai lėšų

Magical manoeuvre : a 5-s instructor’s intervention helps lightweight female rescuers achieve the required chest compression depth

BACKGROUND: Adequate chest compression (CC) depth is crucial for resuscitation outcomes. Lightweight rescuers, particularly women, are often unable to achieve the required 5-6 cm CC depth. This nonrandomized cohort study investigated new strategies to improve CC performance. OBJECTIVE: To evaluate the effects of a 5-s instructor's intervention on the depth of CCs performed by female rescuers during standard video self-instruction basic life support training. METHODS: Data were prospectively collected from January 2011 to January 2012 from 336 female medical and pharmacy students undergoing cardiopulmonary resuscitation (CPR) training at the Lithuanian University of Health Sciences. During the training process, the instructors performed a simple 5-s intervention (Andrew's manoeuvre) with all of the rescuers in the study group. The instructor pushed 10 times on the shoulders of each trainee while she performed CCs to achieve the maximal required compression depth. Immediately after training, the participants were asked to perform a 6-min basic life support test on a manikin that was connected to a PC with Skill Reporter System software; the quality of the participants' CPR skills was then evaluated. RESULTS: The CC depth in the study group increased by 6.4 mm (P<0.001) compared with the control group (52.9 vs. 46.6 mm). A regression analysis showed that Andrew's manoeuvre increased the depth of the CCs among women by 14.87×(1-0.01×weight) mm. CONCLUSION: A simple 5-s instructor's intervention during the CPR training significantly improved the performance of the female rescuers and helped them achieve the CC depth required by 2010 resuscitation guidelines. Andrew's manoeuvre is most effective among the women with the lowest body weightAplinkotyros katedraLietuvos sveikatos mokslų universitetasLietuvos sveikatos mokslų universiteto ligoninė viešoji įstaiga Kauno klinikosVytauto Didžiojo universiteta

Survival after out of hospital cardiac arrest in Kaunas (Lithuania) in 2016–2018

Web of Science patekęs visas leidinys "RESUSCITATION 2020-Abstracts of the Virtual Congress Abstracts"Purpose of the study: EuReCa TWO study1 has recently reported outcomes from out-of-hospital cardiac arrest (OHCA) from 28 European countries. Unfortunately, there is no data from Lithuania In EuReCa Two study.Wesought to fill the gap and report the outcomes from OHCA in Kaunas, the second largest Lithuanian city with a population of 0.29 million (9.7% of all population in Lithuania). Materials and methods: The incidence, demographics and outcomes of patients who were treated for an OHCA between 1st January 2016 and 31st December 2018 in Kaunas Emergency Medical Service (EMS), were collected and are reported in accordance with 2014 Utstein recommendations. Results: In total, 842 OHCA cases of EMS treated cardiac arrests were analysed. Return of spontaneous circulation (ROSC) at hospital transfer was 26.8% in 2016, 27.7% in 2017, and 30.7% in 2018. Survival to hospital discharge was 8.6% in 2016, 11.9% in 2017, and 12.7% in 2018. Survival to hospital discharge in Utstein comparator group (defined as bystander-witnessed OHCA with an initial shockable rhythm) was 27% in 2016, 31.7% in 2017, and 45.8% in 2018. Conclusions: Survival to hospital discharge in Kaunas (Lithuania) in 2016–2018 were slightly better to those reported as median in EuReCa TWO studyAplinkotyros katedraLietuvos sveikatos mokslų universitetasVytauto Didžiojo universiteta