Prevalence of self-reported drug hypersensitivity reactions among Lithuanian children and adults.

INTRODUCTION AND OBJECTIVES: Drug hypersensitivity reactions (DHRs) are the adverse effects of drugs that, when taken at doses generally tolerated by normal subjects, clinically resemble allergy. We aimed to assess the prevalence of self-reported DHRs among Lithuanian children and adults and to identify possible risk factors. MATERIALS AND METHODS: A cross-sectional survey of a population visiting their general practitioners in Vilnius and Kaunas regions of Lithuania was performed. Thirty-five questions on drug allergy symptoms, in addition, food, pollen allergy and family history were included. RESULTS: 3222 (60.0%) children and 2148 (40.0%) adults were included in the study. 7.9% of children and 13.8% of adults reported a DHR for at least one drug (p<0.001). 69.8% of children and 47.3% of adults, who indicated DHRs, had skin symptoms. Rate of anaphylaxis was similar in both groups (about 10%). 4.5% of children and 7.3% of adults had DHRs induced by antibiotics and this was the most implicated group of drugs. Significant self-reported risk factors for DHRs were family history of DHRs (OR=6.007, 95%CI 4.756-7.587), pollen allergy (OR=2.0, 95%CI 1.573-2.544), food allergy (OR=1.92, 95%CI 1.505-2.448), female gender (OR=1.439, 95%CI 1.187-1.744) and age (OR=1.017 in favour of adults, 95%CI 1.013-1.021). CONCLUSIONS: The prevalence of self-reported DHRs in Lithuania is higher among adults than children. Drug-induced skin reactions were the predominant symptom in both groups. Besides female gender and age, a positive family history of DHR and presence of pollen or food allergy may be associated with DHR.

Does multimorbidity still remain a matter of the elderly: Lithuanian national data analysis.

INTRODUCTION: Multimorbidity - the coexistence of ≥2 chronic conditions in same individual is usually associated with older age. There is an increase in its prevalence at a much younger age, however with very limited research specifying that. OBJECTIVE: To identify age breaking points for the occurrence of multimorbidity. METHODS: The study included patients, who used any healthcare services between the 01/01/2012 and 30/06/2014. Patients were divided into two groups - with single chronic condition and with multimorbidity. Age-specific proportion of multimorbidity, rate of primary and outpatient visits, number of hospitalizations and prescribed reimbursed medications between these groups were analyzed. RESULTS: The study included 452578 patients, 94.63% of them had more than one chronic condition. The risk increase with every consecutive year for developing multimorbidity was between the age of 28 and 39 years. The age breaking point for the rapid increase in hospitalizations was about 29 years in multimorbidity group. The proportion of patients with multimorbidity using expensive medications starts to increase at the age of 41. CONCLUSIONS: The risk of acquiring an additional chronic condition rises exponentially from the age of 29 years and platos between the age of 51 and 57. Patients with multimorbidity require increasing amounts of primary healthcare resources, where patients with single chronic condition require decreasing primary care usage, possibly attributed to successful patient empowerment.

CNV analysis in the Lithuanian population.

BACKGROUND: Although copy number variation (CNV) has received much attention, knowledge about the characteristics of CNVs such as occurrence rate and distribution in the genome between populations and within the same population is still insufficient. In this study, Illumina 770 K HumanOmniExpress-12 v1.0 (and v1.1) arrays were used to examine the diversity and distribution of CNVs in 286 unrelated individuals from the two main ethnolinguistic groups of the Lithuanian population (Aukstaiciai and Zemaiciai) (see Additional file 3). For primary data analysis, the Illumina GenomeStudio™ Genotyping Module v1.9 and two algorithms, cnvPartition 3.2.0 and QuantiSNP 2.0, were used to identify high-confidence CNVs. RESULTS: A total of 478 autosomal CNVs were detected by both algorithms, and those were clustered in 87 copy number variation regions (CNVRs), spanning ~12.5 Mb of the genome (see Table 1). At least 8.6 % of the CNVRs were unique and had not been reported in the Database of Genomic Variants. Most CNVRs (57.5 %) were rare, with a frequency of <1 %, whereas common CNVRs with at least 5 % frequency made up only 1.1 % of all CNVRs identified. About 49 % of non-singleton CNVRs were shared between Aukstaiciai and Zemaiciai, and the remaining CNVRs were specific to each group. Many of the CNVs detected (66 %) overlapped with known UCSC gene regions. CONCLUSIONS: The ethnolinguistic groups of the Lithuanian population could not be differentiated based on CNV profiles, which may reflect their geographical proximity and suggest the homogeneity of the Lithuanian population. In addition, putative novel CNVs unique to the Lithuanian population were identified. The results of our study enhance the CNV map of the Lithuanian population.

Prevalence and structure of multiple chronic conditions in Lithuanian population and the distribution of the associated healthcare resources.

BACKGROUND: Chronic multiple conditions have become a major threat to the world's healthcare systems within the last years. OBJECTIVE: To estimate the prevalence and structure of chronic conditions in Lithuania and to analyse the utilisation of healthcare resources striving to manage patients with multimorbidity. METHODS: It was based on the National Health Insurance Fund (NHIF) database, that covered the period from January, 2012 to June, 2014 and included 452,769 subjects. The prevalence of multimorbidity in Lithuania, the structure of chronic diseases within the age and gender groups as well as the association between multimorbidity and facilities usage were analysed. RESULTS: The prevalence of chronic diseases in adult Lithuanian population was 17.2%, where 94.6% (N=428 430) of the chronically diseased subjects had >1 chronic condition. The number of chronic conditions increased with the age, especially at the age of 45-54 years, and male gender (p<0.001). 10% of patients had at least 2 chronic diseases at the age of 45 and over. Multimorbidity accounted for 258,761 additional bed days per year nationally and 61% increase in the 30-day readmission rate. Primary care and outpatient visits per 1000 population were 2.1 times more prevalent and home visits were 9.6 times more frequent in multimorbid patients compared to a single chronic disease. CONCLUSIONS: Multimorbidity and its increasing prevalence among the younger patients will put additional strain on healthcare resources at an earlier stage by increasing admission, readmission rates and vastly increasing primary care contacts.