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Žinoma, kad COVID-19 pandemijos laikotarpiu kai kurių operacijų skaičius sumažėjo apie 30 procentų. Klinikinėje praktikoje dažnai pastebima šiuo laikotarpiu užleisto, pažengusio, išplitusio vėžio atvejų. Šio tyrimo metu norėjome išsiaiškinti, kokią įtaką skydliaukės chirurgijai turėjo COVID-19 pandemijos laikotarpis. Nagrinėti pacientų, operuotų dėl skydliaukės patologijos, duomenys ikikovidiniu ir COVID-19 pandemijos laikotarpiu. Nustatyta, kad COVID-19 laikotarpiu dėl skydliaukės patologijos operuota 46 proc. mažiau pacientų. Operacijos laukimo laikas ir nustatyto skydliaukės vėžio atvejų skaičius šiuo laikotarpiu, lyginant su iki kovidiniu laikotarpiu, išliko labai panašus.

In this retrospective study we report the first experience of robotic cholecystectomies in Baltic countries. From Nov 2018 to Mar 2021, 72 robotic cholecystectomies were performed in Klaipėda University Hospital using the Senhance (TransEnterix) robotic system. Patients were diagnosed with symptomatic gallstone disease and had no life-threatening co-morbidities. We retrospectively investigated patient demographics and pre-, peri- and postoperative data. Eighteen male and fifty four female patients were included in this study (n = 72). Mean age was 53 years (range 21–85); mean BMI was 26.6 kg/ m² (range 21.1–43.7). Mean docking time was 10 min (range 1–55), and mean operative time was 80 min (range 50–138). There were no conversions to standard lapa­roscopy or open surgery. There were no intra-operative complications. There was one post-operative bleeding from the gallbladder bed and subhepatic hematoma, su­ccessfully treated by laparoscopy. This study demons­trates the feasibility of robotic surgery in performing minimally invasive cholecystectomies.

Mamografija − tai specialus radiologinis krūtų audinio diagnostinis tyrimas, padedantis diagnozuoti piktybinius ir gerybinius pakitimus krūtyse. Šis tyrimas naudojamas ne tik krūtyse apčiuopiamų darinių ar kitų pakitimų dia­gnostikai. Krūties vėžio atrankinių patikrų metu jis taiko­mas ir nesant simptomų. Mamografijos tyrimas turi ne tik privalumų, bet ir trūkumų. Vienas iš trūkumų – skausmas, kurį mamografijos metu sukelia krūties suspaudimas, būtinas sumažinti apšvitos dozę, užkirsti kelią judesio artefaktams ir gauti suplotą krūties audinio vaizdą. Tyrimo tikslas − atskleisti veiksnius, sukeliančius krūtų skausmą diagnostinės mamografijos tyrimo metu. Atlikta anoniminė apklausa Klaipėdos ligoninėje. Ap­klausoje dalyvavo 202 moterys, įtrauktos į prevencinę mamografijos programą. Tyrimo metu buvo siekiama išsiaiškinti veiksnius, sukeliančius skausmą mamogra­fijos tyrimo metu. Tyrimo duomenų apdorojimui ir re­zultatų skaičiavimui naudota statistinės analizės ir duo­menų apdorojimo programinė įranga Microsoft Office Excel 2016 ir SPSS (27 versijos) programa. Kintamųjų priklausomumui vertinti naudotas Chi kvadrato (χ2) tes­tas. Lyginant tiriamųjų grupių statistinį duomenų skir­tumą, patikimumas tikrintas pagal z kriterijų. Rezultatai laikyti statistiškai reikšmingi, kai p

Darbo tikslas. Apžvelgti vidutinės tikėtinos gyvenimo trukmės (toliau – VGT) raidą Lietuvoje, lyginant su kitomis šalimis, nustatyti gyventojų sveikatingumo, sveikatos apsaugos sistemos rodiklių svarbą VGT, prognozuoti tolesnę visuomenių sveikatingumo raidą. Duomenys ir metodai. Tyrime analizuoti 43 pasaulio šalių gyventojų VGT rodiklio sąsajos su kitais demografiniais, gyventojų sveikatingumo, sveikatos apsaugos sistemos rodikliais. Rodiklių duomenys yra 2016 m. arba artimiausi 2016 m. duomenims. Rezultatai. VGT ilgumas statistiškai labai reikšmingai tiesiogiai siejasi su Sveiko gyvenimo trukme (toliau – SGT). VGT atotrūkis nuo SGT vidutiniškai sudaro 9,3 metus. VGT ilgėjant, šis atotrūkis išlieka panašaus dydžio. Be to, VGT statistiškai labai reikšmingai ilgesnė šalyse, kuriose aukštesni Sveiko gyvenimo trukmės įsivertinimai, kuriose daugiau gyventojų pasižymi labai gera arba gera sveikata bei kuriose vyrų Sveiko gyvenimo metų rodikliai aukštesni. Atlikta analizė rodo, kad kuo šalyse ilgesnė VGT, tuo jose statistiškai labai reikšmingai mažesnė dalis asmenų, kuriems reikia pagalbos atliekant kasdienes ar kitokias namų ūkyje kiekvienam individui būtinas veiklas. Pacientų gydymo trukmė ligoninėse statistiškai nesusijusi su VGT: tiek demografiškai senesnėse, tiek jaunesnėse šalyse pacientai ligoninėse vidutiniškai išbūna 7,4 dienas. VGT statistiškai nesusijusi su gydytojų skaičiumi, tenkančiu 100 tūkst. gyv., tačiau statistiškai labai reikšmingai ilgesnė tose šalyse, kuriose išlaidų sveikatai santykinė dalis didesnė. VGT statistiškai labai trumpesnė šalyse, kuriose didesnis mirtingumas dėl kardiovaskulinių ligų bei savižudybių. Išvados. Ilgiausios VGT šalių vyresnio amžiaus gyventojai ilgiau išlieka sveiki ir savarankiški, jiems rečiau reikia pagalbos kasdienėse žmonėms įprastinėse veiklose. Šiame laikotarpyje VGT ilgėjmas sietinas su senatvės nutolinimu, didėjančia geros sveikatos būklės asmenų santykine dalimi, senų žmonių slaugos ir priežiūros poreikio mažėjimu. Jei Lietuvoje VGT toliau ilgės kaip pastaraisiais metais, tikėtinos panašios pozityvios perspektyvos jos gyventojų sveikatingumo srityje. Sparčiai tobulėjančios medicinos technologijos turėtų dar padidinti galimybes vyriausio amžiaus žmonėms anksčiau diagnozuoti ligas, jas sėkmingiau išgydyti, ilgiau išsaugoti jų savarankiškumą.

The aim - to analyze the parents’ awareness of rotavirus infection. Rotavirus infection (RVI) is prevalent worldwide and is the most common cause of diarrhea. RVI is a relevant public health problem due to the high incidence of young children. In the interest of effective prevention RVI need to provide information to parents’. A study used questionnaire survey method. The study involved parents (102 parents) raising children 3-5 years old with a history of RVI and treated in a hospital x, in gastroenterological section. The investigation has shown that parents are not adequately informed about RVI: more than one-third (36.7 percent.) parents have the wrong knowledge or do not know how RVI spreads. The majority (65 percent) of the parents' think, that the main risk factor that leads to disease RVI is communicating with sick children and one-third (30 percent.) of parents say, that RVI illness is caused by failure of personal (especially hand) hygiene. 60 percent of parents’ believe that recovering from the RVI does not acquire resistance to this illness. Parents lack knowledge about vaccines from RVI: only 20 percent of parents’ are convinced that in order to prevent the disease and it’s complications - the most effective means is vaccination, and only one-third of parents believe that children must be vaccinated against RVI. Survey data suggest that parents do not get enough qualified and necessary information from health care professionals. In case of doubt of child hygiene, parents tend not to seek advice from a nurse and the main source from which the parents are aware of RVI is the media and the Internet. Parental awareness of rotavirus infection is insufficient: 3.7 percent. parents do not know or is mistakenly aware of rotavirus infection and the ways infection spreads, 60 percent. - lack of knowledge about acquired immunity and 30 percent. – importance of hygiene. Parents does not evaluate enough the meaning of vaccination against rotavirus infection, but insufficient, 28.3 percent. of parents believe that vaccination is effective, but the other part of the parents does not evaluate the vaccine or do not know about it - 31.7 percent. Parents welcomes the educational and information tools, including nurses and doctors' efforts to provide information about rotavirus infection and hygiene skills. This points to 80 percent. parents.

Study objective: to evaluate the impact of new origin high salinity geothermal water for reinforcing the comprehensive health of seamen and explore the safety profile of water. Methods. 180 seamen were randomized into three groups: geothermal (65) which has got 108 g/l salinity geothermal water bath for 2 weeks daily five times a week, music group (50) which has received music therapy at home, 65 participants have got no treatment. Outcomes measures: systolic and diastolic blood pressure, heart and breathing rate, skin temperature, fingertip-floor distance, joint mobility failures, mood scale, VAS pain scale, 5-point Likert‘s well-being scale and cognitive failures questionnaire (CFQ). Safety was assessed for effects on the cardiopulmonary system and the side effects. The statistical analysis of the data was performed by using the SPSS21 software package. Results: after the 2 weeks in geothermal group reduced blood pressure, heart and breathing rate (p0.001); pain (p0.001), skin temperature (p0.05), improved spine (p 0.05) and joint mobility (p 0.001), general well-being (p0.001), mood (p0.001) and cognitive functions (p=0.001) were observed. In the music therapy group reduced breathing rate (p0.01), pain (p0.05) and improved general well-being (p0.01) were observed. Adverse events were rare in both groups. No significant changes were observed in the control group. Conclusions: the balneotherapy using very high salinity geothermal waters has multiple health-enhancing effects and is safe for seamen.

The aim of the study: to evaluate multi-morbidity dynamics, and needs of out-patient health care services in rural and urban areas in Klaipeda region during years 2009-2011.An observational retrospective study was performed using non-personalized population data from the Klaipeda TerritorialSickness Fund database. The research population included approximately 410 000 patients, enlisted to 44 primary health care institutions in Klaipeda region during the years 2009-2011. Johns Hopkins ACG system was used to group the population into six Resource Utilization Bands (RUB) which range from non-users (RUB 0) to a very high co-morbidity group (RUB 5). The study revealed that during the investigation period (2009-2011) prevalence of multi-morbidity (RUB 5) increased from 9.5/1000 to 9.6/1000 patients (statistically insignificant). In year 2009 and 2010 more multi-morbid patients were in urban population (p

The aim of the study was to investigate the combined association of adherence to a Mediterranean diet (MedDiet) and muscular fitness (MF) with cardiometabolic health in collegiate students. The present cross-sectional analysis consisted of 1248 (714 females) healthy collegiate students (20.1 ± 2.7 years old). Adherence to a MedDiet was assessed by a KIDMED (Mediterranean Diet Quality Index) questionnaire. Standing broad jump, standing vertical jump, and isometric handgrip dynamometry were used as indicators of MF. The cardiometabolic profile was assessed using the following components: triglycerides, blood pressure, triglycerides, high-density lipoprotein (HDL)-cholesterol, glucose, and waist circumference. Analysis of covariance shows a significant difference in the cardiometabolic profile of both genders between the high MF/low MedDiet and high MF/optimal MedDiet groups, and the low MF/low MedDiet and low MF/optimal MedDiet groups (p < 0.001). No difference was found on cardiometabolic profile between high MF/optimal MedDiet and high MF/low MedDiet, both in males and females. Additionally, logistic regression shows that both female (odds ratio (OR) = 2.01; 95% confidence interval (CI): (1.8–3.7); p = 0.02) and male (OR = 3.38; 95% CI: (1.9–5.8); p < 0.001) participants in the optimal MedDiet/high MF group had the highest odds of expressing a healthier cardiometabolic profile as compared to those in the low MF/low MedDiet group. In conclusion, a combination of high MF levels and optimal adherence to a MedDiet is associated with a healthier cardiometabolic profile; however, high MF levels seem to circumvent the deleterious effects of having a low adherence to a MedDiet. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Objective. To investigate the influence of high-salinity geothermal mineral water on stress and fatigue.Method. 180 seamen were randomized into three groups: geothermal (65), music (50), and control (65). The geothermal group was administered 108 g/L salinity geothermal water bath for 2 weeks five times a week. Primary outcome was effect on stress and fatigue. Secondary outcomes were the effect on cognitive function, mood, and pain.Results. The improvements after balneotherapy were a reduction in the number and intensity of stress-related symptoms, a reduction in pain and general, physical, and mental fatigue, and an improvement in stress-related symptoms management, mood, activation, motivation, and cognitive functions with effect size from 0.8 to 2.3. In the music therapy group, there were significant positive changes in the number of stress symptoms, intensity, mood, pain, and activity with the effect size of 0.4 to 1.1. The researchers did not observe any significant positive changes in the control group. The comparison between the groups showed that balneotherapy was superior to music therapy and no treatment group.Conclusions. Balneotherapy is beneficial for stress and fatigue reduction in comparison with music or no therapy group. Geothermal water baths have a potential as an efficient approach to diminish stress caused by working or living conditions.

A medical-meteorological weather assessment using hybrid spatial classification of synoptic and meteorological data was done. Empirical models for assessment as well as for forecast of medical-meteorological weather type at the seaside climatic zone in Palanga were developed. It was based on the data of meteofactors (atmospheric pressure, relative humidity, temperature, oxygen density in atmosphere, cyclone fronts, etc.) as well as on the occurrence of meteotropical reactions of cardiovascular function collected during 8-year period. The empirical models allow objectively assess and forecast 3 types of medical-meteorological weather types: favourable, unfavourable and very unfavourable weather. Classification model assessed favourable weather type in 56.1%, unfavourable in 31.7% and very unfavourable in 12.2%, while forecast was of favourable weather type in 52.4%, unfavourable in 46% and very unfavourable in 1.6% of days. Developed model enables more precise weather estimation and forecast meteotropical reactions promoting development of preventive measures of cardiovascular complications for reduction of negative weather impact on health in coronary artery diseases patients.

Research in the area of workplace health promotion from a salutogenic perspective is lacking in Eastern Europe.To evaluate the relationship between psychosocial work environment and health from a salutogenic perspective among Lithuanian hospital workers.Using a cross-sectional design a questionnaire was distributed to staff in a large hospital in Lithuania. Out of 811 employees, 714 completed the survey: 151 physicians, 449 nurses and 114 other staff members (e.g., psychologists, technicians, therapists). A response rate of 88.0% was achieved. The Work Experience Measurement Scale (WEMS) and the Salutogenic Health Indicator Scale (SHIS) were linguistically adapted and used for the first time in a Lithuanian context. Logistic and multiple linear regression models were used for the analyses.Supportive working conditions, positive internal work experiences and time experience contributed the most to good health, defined as a high SHIS index. Having an executive post was significantly related to good work experiences, i.e. a high WEMS score, while being at the age of 40-54 years was associated with a low WEMS score. Physicians had the highest score on supportive working conditions; while nurses had the lowest scores on autonomy.A salutogenic approach enables an organisation to identify how to improve working conditions for the employees by focusing on possibilities and resources. Individual activities for workplace health promotion among different work groups seem necessary.

The aim of the study was to investigate depressive mood in association with sociodemographic, behavioral, self-perceived health, and coronary artery disease (CAD) risk factors and sleep complaints among 35–74-year-old citizens of Palanga. Material and Methods. A representative sample of randomly selected 1602 persons, 600 men and 1002 women, was studied. Depressive mood was assessed by the WHO-5 Well-being Index. Sleep complaints, self-perceived health, and behavioral factors were evaluated by the Basic Nordic Sleep Quality questionnaire and questionnaires on self-perceived health and health behavior. Risk factors for CAD were assessed according to WHO recommendations. Results. The highest prevalence of depressive mood (34.7%) was identified in the age group of 45–54 years in the men and in the age group of 55–64 years in the women (30.0%). The highest odds ratios demonstrating a strong association between depressive mood and health behavior were established for the use of antidepressants (OR=26.0) in the men and for the use of sedatives (OR=3.09) in the women. The highest odds ratios demonstrating an association between depressive mood and self-perceived health were established for chronic pyelonephritis (OR=3.13) in the men and diabetic foot pain (OR=4.46) in the women. The highest odds ratios reflecting an association between depressive mood and sleep quality were established for the inability to work due to disturbed sleep (OR=1.93) in the men and self-perceived sleep quality (OR=1.55) in the women. Conclusions. Depressive mood, which was significantly associated with risky health behavior, poor self-perceived health, and disturbed sleep, was observed more often in the women than the men; however, significant associations between depressive mood and risk factors for CAD were not established.

Background / objective Evaluations of the health care quality of patients after abdominal operations are significant for the improvement of health care quality in all hospitals. However, there are a lot of discussions how to evaluate the patient’s opinion and attitudes. The aim of the present study was to analyze patients’ evaluations of the quality of abdominal surgical nursing care. Methods A multicenter, cross-sectional, analytical study was performed. The study was conducted in 11 abdominal surgical wards at Lithuanian hospitals. The data were collected in June 2007 and January 2008. Patients (n = 1208) after abdominal operations participated in the study. A GNCS-P with the response rates of 74 % was used. The data were analyzed statistically. Results The co-operation with significant others and the progress of the nursing and health care process were evaluated lowest by patients. The patient age and satisfaction were the factors related to the quality of nursing care. Conclusions The abdominal surgical nursing and health care is a specific surgical area in which different patients are involved; however, all of them expect the good quality of health care before, during, and after abdominal surgery. The process of nursing care in abdominal surgery is specific because of the limited time of patient hospitalization, usually multiple patients’ diagnosis, as well as multiple contacts and relationships with many different staff. Surgical patient participation in the process of health care should be based on the effective relationship and co-operation among patients, medical specialists, and significant others, which is necessary and imperative for increasing the quality of abdominal surgical nursing care. Key words: health and the quality of nursing care, surgical health care, abdominal surgery, patient evaluations. Pacientų po pilvo operacijų sveikatos priežiūros ir slaugos kokybės vertinimai Įvadas / tikslas Pacientų po pilvo operacijų sveikatos priežiūros kokybės vertinimai yra reiksmingi siekiant gerinti ligoninės paslaugų kokybe. Taciau daug diskutuojama, kaip būtų galima vertinti pacientų nuomone ir požiūrį į kokybe. Tyrimo tikslas – isanalizuoti pacientų sveikatos priežiūros ir slaugos kokybės vertinimus. Metodai Tyrimui atlikti buvo pasirinktas daugiacentris aprasomasis tyrimo metodas. Pacientų apklausa vyko 2007 m. birželio–2008 m. sausio mėn. septynių Lietuvos ligoninių 11-oje pilvo chirurgijos skyrių. Pacientai (n=1208), kuriems atlikta pilvo operacija, apklausti paskutine hospitalizacijos dieną. Klausimynų grįžtamumas 74 proc. Atlikta statistinė duomenų analizė. Rezultatai Bendradarbiavimą su paciento artimaisiais ir sveikatos priežiūros pažangą pacientai įvertino blogiausiai. Pacientų amžius ir pasitenkinimas sveikatos priežiūra turėjo koreliacinį rysį su sveikatos priežiūros kokybe. Isvados Pacientų po pilvo operacijų sveikatos priežiūra ir slauga yra specifinė chirurgijos sritis. Visi jie tikisi gauti kokybiskas paslaugas pries operaciją, jos metu ir po jos. Slaugos procesas pilvo chirurgijoje yra savitas ir todėl, kad pacientų hospitalizacijos laikas yra ribotas, jie dažnai serga gretutinėmis ligomis, turi daug kontaktų ir santykių su personalu. Pacientų dalyvavimas sveikatos priežiūros procese turi būti grindžiamas efektyviais jų santykiais ir bendradarbiavimu su medikais ir savo artimaisiais, nes nuo to priklauso paslaugos kokybės tobulinimas. Reiksminiai žodžiai: sveikatos priežiūros ir slaugos kokybė, chirurginė sveikatos priežiūra, pilvo operacija, pacientų vertinimai

Objective. Nurse competence became a relevant topic for discussion among nurse practitioners and nurse researchers. However, the factors connected with nurse competence need deeper exploring. The aim of this study was to explore nurse competence and factors associated with it from the perspective of nurses for predicting the possible ways for upgrading the nursing practice. Materials and Methods. A multicenter, descriptive study was performed in 11 surgical wards of 7 Lithuanian hospitals. Data were collected from November 2007 to January 2008. Lithuanian nurses (n=218) who were working with patients after abdominal surgery participated in this study. The response rate was 91%. Two instruments, both originally developed in Finland, were used: the Nurse Competence Scale and the Good Nursing Care Scale for Nurses. Results. The overall level of nurse competence and the frequency of using the competencies in practice as perceived by nurses were high. Nurses assessed the competencies in managing situations and work role the highest and in teaching-coaching and ensuring quality the lowest. Sociodemographic factors such as nurse education, experience, professional development, independence, and work satisfaction as well as the evaluation of quality of nursing care were identified as factors associated with nurse competence. Conclusions. The findings of study allow us to make the assumption that nurse education, nurse experience, and nurse professional development play a significant role in the evaluation of nurse competence as well as the evaluation of quality of nursing care. It is necessary to upgrade nursing education programs at all levels of nursing education in Lithuania: university, non-university, and professional development courses. The qualities of preconditions for nursing care, cooperation with relatives, caring and supporting initiative are related to nurse competence.

Objective. The aim of the study was to establish factors associated with poor sleep and to assess the relationship between self-evaluated sleep quality and health-related quality of life. Material and methods. Sleep complaints were evaluated using Basic Nordic Sleep Questionnaire, and health-related quality of life was assessed by SF-36. Subjective data about sleep quality were obtained from 1602 randomly selected persons: 600 males and 1002 females, aged 35–74 years. SF-36 was filled in by 1016 persons: 379 males and 637 females. Health status was evaluated by Perceived Health Questionnaire. The odds ratios of poor sleep were calculated using binary logistic regression analysis. Results. Among males poor self-evaluated health, frequent stress events, regular nighttime awakenings, and sleep latency period longer than 15 min in workdays were significant predictors of poor sleep. Among females, duration of sleep shorter than 7 h, frequent stress events, poor self-evaluated health, sleep latency period longer than 15 min in workdays, and regular nighttime awakenings predicted poor sleep. Poor sleepers, as compared with good ones, had poorer healthrelated quality of life. Conclusions. Poor perceived health, frequent stress events, regular nighttime awakenings, and sleep latency period longer than 15 min were indicated as significant predictors of poor sleep. Poor sleep worsened health-related quality of life in all domains of SF-36.