Blood donations and donors' profile in Lithuania: Trends for coming back after the COVID-19 outbreak.

The coronavirus disease (COVID-19) pandemic has significantly affected blood donors worldwide. It is important for the blood service to return to its pre-pandemic level as soon as possible and to perform its functions fully. This study compared the donation and demographic profiles of blood and its component donors one year before and during three pandemic years in Lithuania. All blood and blood component donations (n = 413,358) and demographic characteristics of all donors from April 1, 2019, to March 31, 2023, were analyzed. All data were obtained from annual publications, and statistics were obtained from the Blood Donor Register. Data were analyzed using descriptive statistics. Following a 9.41 percent decrease in the first year of the pandemic, the quantity of blood and blood component donations increased by 3.49 percent in the third year compared to the pre-pandemic year. Throughout the three years of the pandemic, a statistically significant decrease in the proportion of first-time blood and blood component donations was observed. Both the number and proportion of donations by donors under 25 years old decreased during the pandemic. The proportion of pre-donation deferrals for all attempts to donate significantly decreased during the pandemic. There was a statistically significant lower prevalence of all positive transfusion-transmitted infectious (TTI) markers among all donations compared to the pre-pandemic year for all three pandemic years. The odds for hepatitis B virus, hepatitis C virus, and all TTI markers during the second and third pandemic years were significantly lower than those in the pre-pandemic year. In conclusion, most dimensions of blood and its component donations and donor characteristics have returned to pre-pandemic levels or show positive trends. However, the major concern is the remaining decrease in donations from first-time and donors under 25 years old.

Reducing the risk of transfusion-transmitted infectious disease markers in blood and blood component donations: Movement from remunerated to voluntary, non-remunerated donations in Lithuania from 2013 to 2020.

Lithuania has a long history of remunerated donations. The first steps towards voluntary, non-remunerated blood and blood component donations started in 2004. Lithuania achieved 99.98% voluntary non-remunerated donations (VNRDs) in 2020. This study aimed to assess the risk of transfusion-transmitted infectious (TTI) disease markers for remunerated donations in comparison with VNRDs in Lithuania from 2013 to 2020. Data were obtained from the Lithuanian Blood Donor Register. The prevalence was calculated as the rate between the number of confirmed positive results for all TTI disease markers (serological anti-HCV, HBsAg, Ag/anti-HIV 1 and 2, and syphilis, and/or HCV, HBV, and HIV-1 NAT) per 100 donations. The relative risk of infectious disease markers for remunerated donations was then estimated. In total, 796310 donations were made. Altogether, 2743 donations were positive for TTI markers as follows: HCV, 1318; HBV, 768; syphilis, 583; and HIV 1 and 2, 74. The prevalence of confirmed TTI markers were 2.86, 0.97, 0.18, and 0.04 per 100 first-time remunerated donations, first-time VNRDs, repeat remunerated donations, and repeat VNRDs, respectively. Remunerated first-time and repeat donations had a statistically higher prevalence of TTI disease markers than VNRDs. First-time and repeat remunerated donations had statistically significantly higher relative risks of confirmed TTI disease markers than VNRD. In conclusion, the risks of TTI disease markers for remunerated first-time and repeat blood and its component donations are significantly higher than those for VNRDs.

An evaluation of the effectiveness and safety of midazolam in children undergoing dental surgery.

OBJECTIVE: The aim of this study was to evaluate the effectiveness and safety of oral midazolam in children undergoing dental surgery. MATERIALS AND METHODS: A prospective, randomized, controlled trial was conducted to assess the effectiveness and safety of midazolam in children. Patients aged 2-9 years who underwent dental surgery under general anesthesia were randomly allocated into one of the four groups: midazolam 0.2mg/kg dose group (n=30); midazolam 0.21-0.4mg/kg dose group (n=15); midazolam more than 0.41mg/kg dose group (n=15) or the placebo group (n=31). The effectiveness of midazolam on sedation was assessed by the evaluation of vital signs, such as the respiratory and heart rate, oxygen saturation and the patients' reactive behaviors, in comparison with the placebo. RESULTS: The scores of the ratings for sleep, movement and crying, as well as patients' reactions at the moment of separation from their parents and their collaboration with the staff were statistically significantly better among patients who received oral midazolam compared with the placebo. There were statistically significant direct correlations between the doses of midazolam and higher sleep, movement, crying and reaction scores 30min after premedication as well as higher scores of patients upon separation from their parents. There were only a few clinically insignificant side effects. CONCLUSIONS: Oral midazolam, at a single dose from 0.2 to 0.6mg/kg, is effective and safe, and provides the expected sedative effects in children required by premedication for dental surgery.

Single shot intercostal block for pain management in pediatric patients undergoing the Nuss procedure: a double-blind, randomized, controlled study.

PURPOSE: The aim of this study was to investigate the efficacy of a single shot intercostal block for pain control in pediatric patients undergoing the Nuss procedure. METHODS: A double-blind, randomized, controlled study was performed. Thirty patients received a single shot bilateral intercostal block with levobupivacaine (L group) and 30 patients with 0.9 % saline (S group). Standardized baseline analgesia was applied for all patients. Morphine consumption, pain scores, respiratory depression, nausea and vomiting, and urinary retention were recorded every 3h for 48h after surgery. RESULTS: The loading dose of morphine was lower (p<0.00001) in the L group. There were significantly lower morphine doses up to 6h after surgery and VAS scores up to 3h after surgery in the L group (p<0.001 and p=0.0003, respectively). The incidence of nausea and vomiting was lower in the L group (<0.00001). The incidence of urinary retention was lower in the L group (p=0.019). CONCLUSIONS: A single shot IB is an effective additional treatment for pediatric patients undergoing the Nuss procedure and results in the reduced consumption of morphine, less postoperative pain, and fewer opioid-related adverse effects.

The results of nucleic acid testing in remunerated and non-remunerated blood donors in Lithuania.

BACKGROUND: In Lithuania, governmentally covered remuneration for whole blood donations prevails. Donors may choose to accept or reject the remuneration. The purpose of this study was to compare the rate of nucleic acid testing (NAT) discriminatory-positive markers for human immunodeficiency virus-1 (HIV-1), hepatitis B virus (HBV) and hepatitis C virus (HCV) in seronegative, first-time and repeat, remunerated and non-remunerated donations at the National Blood Centre in Lithuania during the period from 2005 to 2010. MATERIALS AND METHODS: All seronegative whole blood and blood component donations were individually analysed by NAT for HIV-1, HBV and HCV. Only discriminatory-positive NAT were classified. The prevalence of discriminatory-positive NAT per 100,000 donations in the donor groups and the odds ratios comparing the remunerated and non-remunerated donations were determined. RESULTS: Significant differences were observed for HBV NAT results: 47.42 and 26.29 per 100,000 remunerated first-time and repeat donations, respectively, compared to 10.6 and 3.58 per 100,000 non-remunerated first-time and repeat, seronegative donations, respectively. The differences were also significant for HCV NAT results: 47.42 and 51.99 for remunerated first-time and repeat donations, respectively, compared to 2.12 and 0 per 100,000 non-remunerated first-time and repeat, seronegative donations, respectively. No seronegative, discriminatory-positive NAT HIV case was found. The odds of discriminatory HBV and HCV NAT positive results were statistically significantly higher for both first-time and repeat remunerated donations compared to first-time and repeat non-remunerated donations. DISCUSSION: First-time and repeat remunerated seronegative donations were associated with a statistically significantly higher prevalence and odds for discriminatory-positive HBV and HCV NAT results compared to first-time and repeat non-remunerated donations at the National Blood Centre in Lithuania.

Postoperative pain management in pediatric patients undergoing minimally invasive repair of pectus excavatum: the role of intercostal block.

PURPOSE: There are no published data regarding value of intercostal block following pectus excavatum repair. Our aim was to evaluate the efficacy of intercostal block in children following minimally invasive repair of pectus excavatum (MIRPE). METHODS: Forty-five patients given patient-controlled analgesia (PCA) with morphine postoperatively were studied. Twenty-six patients were given bilateral intercostal blocks after induction of anesthesia (PCA-IB group), and nineteen patients were retrospective controls without regional blockade (PCA group). All patients were followed up 24 h postoperatively. RESULTS: A loading dose of morphine (0,1±0,49 mg/kg) before starting PCA was used in seventeen patients in PCA group vs. no patient in PCA-IB group. Cumulative used morphine doses were lower up to 12 h after surgery in PCA-IB group (0,29±0,08 µg/kg) than in the PCA group (0,46±0,18 µg/kg), p<0,01. There were no differences in pain scores, oxygen saturation values, sedation scores, and the incidence of pulmonary adverse events between the two groups. There was a tendency towards less morphine-related adverse effects in PCA-IB group compared to PCA group (p<0,05). No complications related to the intercostal blocks were observed. CONCLUSION: Bilateral intercostal blocks following MIRPE are safe and easy to perform and can diminish postoperative opioid requirement. Double-blind randomized study is required to confirm the potential to diminish opioid related side effects.