Hospitalisation of late preterm infants due to lower respiratory tract infections in Lithuania, Latvia, and Estonia: incidence, disease severity, and risk factors.

BACKGROUND: By two years of age, almost all children experience at least one episode of respiratory syncytial virus (RSV) infection, the most common viral cause of hospitalisation due to lower respiratory tract infection (LRTI). We present data on LRTI hospitalisations (with a special focus on RSV), the course of illness, and LRTI hospitalisation risk factors in Lithuania, Latvia, and Estonia. MATERIALS AND METHODS: The analysed data were part of a large multinational study conducted in 23 countries (PONI). LRTI-related hospitalisations were observed during one RSV season for late premature infants (born between 33 weeks and 0 days and 35 weeks and 6 days of gestation) ≤6 months of age, who did not receive RSV prophylaxis. The potential risk factors and demographics were recorded at study enrolment and at the end of the RSV season. The primary endpoint was hospitalisation due to RSV LRTI; the secondary endpoints included severity, the course and the outcome of LRTI hospitalisations. RESULTS: Out of the 291 infants enrolled in three Baltic states, 19 were hospitalised due to LRTI (6.5%). RSV testing was performed for 14 hospitalised infants; five infants had a positive test for RSV (1.7%). The majority of the hospitalised infants (94.7%) had mild or moderate respiratory illness. Male sex, O2 dependency after birth, younger maternal age, and furred pets at home were significantly associated with an increased risk for LRTI hospitalisation. CONCLUSIONS: During one RSV season, the incidence of LRTI hospitalisations among late preterm infants was 6.5% and the incidence of RSV LRTI hospitalisations was 1.7%.

The impact of anti-cyclic citrullinated peptide antibody status on the management of patients with early rheumatoid arthritis: observational study results from Lithuania.

BACKGROUND: To provide data on the use of anti-cyclic citrullinated peptide antibody (anti-CCP) and other routinely used clinical parameters and to assess the impact of anti-CCP status on therapeutic decisions, an observational study was conducted in patients with rheumatoid arthritis (RA). METHODS: Sixty-seven adult patients with a recent diagnosis of RA were recruited from four rheumatology centres in Lithuania and were prospectively observed for 12 months. Data collection was based on the review of medical records and routine examination of patients. Patients completed the Health Assessment Questionnaire - Disability Index and Patient Global Assessment of disease activity using a visual analogue scale. Physicians were asked about the importance of the anti-CCP results and other factors important for therapeutic decisions. RESULTS: Of the 67 patients enrolled, 54 (80.6%) completed the study. At the beginning of the study, physicians considered anti-CCP results to be important for decision-making in 87.0% of patients. The perceived importance of anti-CCP results did not change significantly throughout the study. After one year of treatment, factors that were considered more important than the anti-CCP results included the presence of erosions, significantly increased C-reactive protein, duration of morning stiffness, multi-articular expanding, and rheumatoid factor status. For nearly half of the patients (n = 26; 48.1%), physicians would not change the treatment strategy if the patient had the opposite anti-CCP results at baseline. CONCLUSIONS: The study revealed that decision-making in the management of RA was based on multifactorial data. The role of anti-CCP as a single test in treatment decisions needs further investigation.

Respiratory syncytial virus infection in a selected sample of infants hospitalized for lower respiratory tract infection in Lithuania and Estonia.

BACKGROUND: The study presents data on a sample of children under one year of age hospitalized with lower respiratory tract infections (LRTIs) in Lithuania and Estonia. SUBJECTS AND METHODS: This large, retrospective, cross-sectional, observational epidemiologic survey was conducted in 12 countries in Central and Eastern Europe. Eligible subjects were under one year of age, hospitalized for LRTIs, for whom RDT (Rapid Diagnostic Test) was performed. Physicians completed questionnaires at discharge or on the first check-up visit after hospitalization. To test for RSV, the immunochromatographic method was used in Lithuania, and immunofluorescense or the PCR methods were applied in Estonia. RESULTS: In two countries, 482 patients fulfilling the definition of a LRTI case (i.e., children below one year of age hospitalized with a diagnosis of bronchiolitis and/or pneumonia) were enrolled during two consecutive RSV seasons. Bronchiolitis was the most common diagnosis (84%). In Lithuania and Estonia, 36.6% and 83.3% of cases were conscious at admission. RSV was confirmed in 87.3% and 54.2% of tested LRTI cases in Estonia and Lithuania, respectively. Intensive care unit hospitalization was required for 9.1% of LRTI cases in Lithuania and for 3.1% of cases in Estonia. Supplemental oxygen was required for 23.2% and 31.6% in cases in Lithuania and Estonia, respectively. In Lithuania, complete recovery at discharge was assessed for 35.8% of LRTI cases and improvement in 62.2% of cases. In Estonia, all LRTI cases were improved at discharge and there were no complete recoveries. CONCLUSION: RSV was prevalent among children hospitalized for LRTI in Lithuania and Estonia; bronchiolitis was the most common diagnosis in hospitalized patients.

[Ischemic heart disease: structural changes of the atria in preinfarction and postinfarction stages]. / Isemine sirdies liga: priesirdziu strukturos pokyciai ikiinfarktiniu ir poinfarktiniu laikotarpiais.

OBJECTIVE: The aim of this study was to determine atrial structural remodeling during the development of ischemic heart disease. MATERIAL AND METHODS: Quantitative histomorphometric parameters of interstitial collagen network (the percentage volume, perimeter, number of fibers per field and collagen-cardiomyocyte volume ratio) of the atria of 132 autopsied men (mean age 49.7+/-8.9 years) who had died suddenly (within 6 hours since the onset of terminal heart attack symptoms) due to the first (no postinfarction scars) and repeated (postinfarction scars present) acute "pure" ischemic heart disease were investigated. RESULTS: The main remodeling feature of the wall of the both atria among ischemic heart disease subjects is hypertrophy of cardiomyocytes and hyperplasia of interstitial fibrillar collagen network with the maintenance of the same proportion of contractile myocardium and fibrillar collagen network volume. This proportion in the case of the left atrium persists in both pre- and postinfarction ischemic heart disease groups, while myocardium of the right atrium in preinfarction group subjects is characterized by an excess increase of collagen network as compared to cardiomyocyte hypertrophy, which levels again with that of the control in postinfarction group. CONCLUSIONS: At preinfarction stage of ischemic heart disease, remodeling of both atria develops and progresses in the left atrium at postinfarction stage in the relationship with increase of left ventricular dysfunction.