Evaluation of daily outpatient multidisciplinary rehabilitative treatment of patients with musculoskeletal, neurological and traumatic disorders in a municipality outpatient setting

Background and objective: Musculoskeletal, neurological, and traumatic injuries are a considerably increasing problem. There is a lack of studies evaluating the results of outpatient rehabilitative treatment of patients with the abovementioned diseases. The aim of this study was to determine the effectiveness of daily outpatient multidisciplinary rehabilitation. Materials and methods: This observational study enrolled 223 adult people undergoing outpatient rehabilitation performed in a municipality outpatient clinic during 14 days. The functional assessment of disability was performed by using the Barthel index (BI), functional performance was estimated by the modified Keitel functional test (MKFT), and pain perception was evaluated by the visual analogue scale (VAS). The mean scores of the tests were compared before and after outpatient multidisciplinary rehabilitation. Results: Significantly reduced disability and pain perception as well as increased functional performance were documented after outpatient rehabilitation. The mean scores of BI, MKFT, and VAS before and after rehabilitation did not differ significantly among patients ranked to each cluster of diseases. Increased functional performance of patients had a moderate-to-weak association with decreased disability and pain perception. The positive changes in health status considering disability, functional performance, and pain perception were documented after 14-day rehabilitation. Conclusions: Multidisciplinary outpatient rehabilitation can be considered as effective treatment. However, it is necessary to implement specific, well-adapted consuming assessment instruments in order to evaluate the outcomes of daily multidisciplinary outpatient rehabilitative treatment

Height, weight and body mass index of preterm very low birth weight infants at the preschool age

The aim of this study was to reveal trends in height, weight, and body mass index of preterm very low birth weight children from birth up to 5 years of age. Material and methods. The present study is based on cross-sectional growth study carried out in the Clinic of Neonatology of Kaunas University of Medicine. Total sample consisted of 735 children from birth up to 5 years of age: 379 preterm children with very low birth weight; and 356 term children with normal (appropriate for gestation age) birth weight. Height, weight, body mass index were measured. In order to verify if normal birth weight group corresponds to Lithuanian standards, the data of normal birth weight group children were compared with Lithuanian standard measures. Then data of very low birth weight group and normal birth weight group were compared. Results. We found that height and weight of very low birth weight girls and boys were significantly lower than height and weight of term normal birth weight infant from birth up to 5 years of age (p<0.01). The body mass index of very low birth weight girls was significantly lower than that of term normal birth weight girls at birth (p<0.01) and at age of 4 years (p<0.05). The body mass index of very low birth weight boys was significantly lower than that of term normal birth weight boys at birth and from age of 2 up to the age of 5 years (p<0.01). These data show that very low birth weight boys differently from girls were more slender than term normal birth weight infant of the same age. Conclusions. It has been shown that preterm very low birth weight infants have different patterns of growth than term normal birth weight infants. The very low birth weight infants have not caught up on their retardation at the age of 5 years

Breastfeeding and medications

Breastfeeding is the most healthful method of feeding neonates and infants. In 2001 about 98% of new mothers in Lithuania started breastfeeding their neonates. One-third of nursing women (34%) discontinued breastfeeding at the time when infant reached the age of 3 months. About 56% of women breastfed their infants longer than 4 months. Only 3–6% of nursing women discontinued breastfeeding after the fourth month. Discontinuation of breastfeeding in 21–23% of all cases was directly or indirectly associated with use of medications. Such data suggest that there is a lack of information often leading physicians to advise mothers to discontinue breastfeeding because of medication use. The aim of this article was to survey the situation about classification of drugs used during breastfeeding and factors influencing drug transfer into milk in order to give more information for physician concerning the use of medication during breastfeeding. In this review, a short description of main pharmacokinetic characteristics, influencing drug transfer into milk; information on the classification of drugs used during breastfeeding; some considerations on drug safety and possible adverse effects of medications on breastfed infant; the list of drugs preferred for nursing women are presented

Secondary prevention of ischemic heart disease: pharmacological treatment after myocardial infarction according to follow-up protocol

The aim of this work was to assess the quality of pharmacological treatment in patients within one year after acute myocardial infarction. Material and methods. We performed a prospective survey of 985 consecutive patients with acute myocardial infarction who were treated in the Clinic of Cardiology of Kaunas University of Medicine Hospital in 2004. About half of patients were hospitalized from different regions of Lithuania. According to the follow-up protocol, an information on 514 patients and their used treatment within 13.8±3.2 months after myocardial infarction were collected by letter with questionnaire. Results. Beta-adrenoblockers, angiotensin-converting enzyme inhibitors, and antithrombotic drugs were the most drug used (76%, 74%, and 76%, respectively) in patients following myocardial infarction. Most of the patients used a three-drug combination (36.8%), more rarely – two-drug (24.1%) or four-drug complex (19.8%). One drug was used only in 12.1% of cases; 7.2% of patients did not use any cardiac drugs. Betaadrenoblocker with angiotensin-converting enzyme inhibitor was the most common (40.3%) used drug combination in patients on two drug complex. The combination of beta-adrenoblocker, angiotensin-converting enzyme inhibitor, and antithrombotics was more frequently used in patients on three drug complex. The combination of two or three cardiac drugs with statin was used in several cases (1.6–10.3%). Conclusions. These findings underscore that the use of beta-adrenoblockers, angiotensin-converting enzyme inhibitors, and antithrombotics was high (about 75%) in patients during the first year after myocardial infarction, and the combination of these three drugs was used more commonly. The discordance between existing guidelines for statin use after myocardial infarction and current practice was determined in patients following myocardial infarction