The first case of invasive S. suis infection in a human in Lithuania: Case report and literature review.

Streptococcus suis is an emerging zoonotic pathogen that can cause infections in pigs and humans, usually after ingestion of raw pork meat or wound contamination. We report the first S. suis meningitis and sepsis case in a human in Lithuania. 51 y.o. man with no relevant comorbidities, but with a history of alcohol abuse was admitted to the emergency department due to new-onset tonic-clonic seizures. The patient became agitated, aggressive and hypotensive, later sensible contact was lost (GCS of 8 points). Blood tests and cerebrospinal fluid (CSF) analysis were consistent with bacterial meningitis, thus ceftriaxone and ampicillin were empirically started. S. suis, susceptible to penicillin and ceftriaxone, was identified in blood and CSF cultures. The patient recovered without any immediate significant sequels, but later developed cognitive impairment. The route of infection for our patient was not clear because he had no contact with pigs or raw pork, although he lived in the countryside, helped farmers with non-pig related work, had some scabs on his shins and ate home-cooked pork. The paper presents the case report and review of the literature.

Electronic field protocols for prehospital care quality improvement in Lithuania: a randomized simulation-based study.

BACKGROUND: Prehospital emergency care is complex and influenced by various factors, leading to the need for decision-support tools. Studies suggest that cognitive aids improve provider performance and patient outcomes in clinical emergencies. Electronic cognitive aids have rarely been investigated in prehospital care. Therefore, this study aimed to evaluate the effects of the electronic field protocol (eFP) module on performance, adherence to the standard of care, and satisfaction of prehospital care providers in a simulated environment. METHODS: This randomised simulation-based study was conducted at the Lithuanian University of Health Sciences in Kaunas, Lithuania. The simulation scenarios were developed to test 12 eFPs: adult resuscitation, pediatric resuscitation, delivery and postpartum care, seizures in pregnancy, stroke, anaphylaxis, acute chest pain, acute abdominal pain, respiratory distress in children, severe trauma, severe infection and sepsis, and initial neonatal evaluation and resuscitation. Sixteen prehospital practitioners with at least 3 years of clinical experience were randomly assigned to either use the eFP module or perform without it in each of the 12 simulated scenarios. Participant scores and adherence to standardised checklists were compared between the two performance modes. Participant satisfaction was measured through a post-simulation survey. RESULTS: A total of 190 simulation sessions were conducted. Compared to the use of memory alone, the use of the eFP module significantly improved participants' performance in 10 out of the 12 simulation scenarios. Adherence to the standardised checklist increased from 60 to 85% (p < 0.001). Post-simulation survey results indicate that participants found the eFP module easy to use and relevant to prehospital clinical practice. CONCLUSIONS: The study findings suggest that the eFP module as a cognitive aid can enhance prehospital practitioners' performance and adherence to the standard of care in simulated scenarios. These results highlight the potential of standardised eFPs as a quality improvement step in prehospital care in Lithuania.

Interrater agreement between student and teacher assessments of endotracheal intubation skills in a self-directed simulation learning environment.

BACKGROUND: Practical skill assessment is an important part of the learning process to confirm competencies in acquired medical knowledge. OBJECTIVE: This study aimed to compare the assessments of endotracheal intubation skills using the HybridLab® methodology between students and teacher in terms of interobserver reliability. METHODS: Reliability analysis was performed with observational data (data are reported according to STROBE guidelines). The study was conducted in two countries, the Lithuanian University of Health Science (LUHS) and Pennsylvania State University (PSU) in the US, between 1 January and 30 June 2020. A total of 92 students (60 from LUHS and 32 from PSU) were trained in endotracheal intubation using an algorithm-driven hybrid learning method. At the end of the training session, the participants had to complete the evaluation scenario, which was assessed by one of the students and evaluated remotely by a single teacher. The student assessment of the endotracheal intubation procedure was compared with the teacher's assessment using correlation and estimation of the intraclass correlation coefficient. RESULTS: Overall, the medians of the student and teacher assessments were both 100% (0%). Spearman's correlation coefficient between the student and teacher assessments was 0.879 (p = 0.001). The intraclass correlation coefficient used for interobserver variations between the students and teacher was 0.883 (95% confidence interval from 0.824 to 0.923). CONCLUSIONS: The algorithm-driven hybrid learning method allows students to reliably assess endotracheal intubation skills to a level comparable with that of the teacher's evaluation. This learning method has the potential to be a cost-effective and efficient way to provide high-quality education while also saving human resources.

[Vaccine for human immunodeficiency virus (HIV)--relevance of these days]. / Skiepai nuo zmogaus imunodeficito viruso (ZIV)--siu dienu aktualija.

Since 1980 more than 25 million people have died from acquired immunodeficiency syndrome (AIDS), which results from infection with human immunodeficiency virus (HIV). Number of new cases increases very threateningly. One and the most effective method to stop the progress of epidemic is the development of the vaccine for HIV. There is the presentation of the first stage of the vaccine for HIV testing (structure, methodology), which is now on trial in St. Pierre hospital, Brussels University. HIV characteristics which inflame the process of the vaccine development, historical facts and facts about vaccines on trial in these days are reviewed in this article. More than 10,000 volunteers have been participating in various clinical trials since 1987. The development of the vaccine is a very difficult, long-terming (about 8-10 years) and costly process. The process of the vaccine testing is very difficult in developing countries where the infection spreads the most rapidly. Available data confirm that the vaccine must be multi-componential, inducing cellular, humoral immunity against various subtypes of HIV. The vaccine cannot protect fully but the changes of the natural infection course could decrease virulence, distance the stage of AIDS, and retard the spread of the epidemic.