Psychosocial Aspects of Deliberate Physical Suicide Attempts by Children and Adolescents.

Suicide is the second most common cause of death among young people in Lithuania. This study aimed to evaluate circumstance, and conditions possibly related to suicide attempt in adolescents. Study was performed at the tertiary Children's Hospital. Medical documentation of the suicide attempts from January 2011 to April 2018 was analyzed. There were 102 cases included in the study: 83.8% female and 16.2% male patients (average age of 15.02 ± 1.9); 40.6% of patients lived in divorced families, 17.7% in orphanages, 4.2% in foster care; 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in close surroundings; 54.1% experienced bullying or violence (26.0%), and 85.4% showed signs of other types of self-harm, girls more often (P < .001). In 52.8% of cases, the attempt was spontaneous, and 34% relapsed. In summary female gender, living in orphanages, and signs of other self-harm were significantly related to suicide attempt.

COVID-19 in Hospitalised Children and Adolescents: Review of the First Pandemic Year at Vilnius University Hospital Santaros Klinikos.

Background: Since the start of the pandemic with SARS-CoV-2 virus, very little data was known about clinical features and outcomes of COVID-19 in children and adolescents not only in Lithuania, but also in other European countries. This study was started in collaboration with 82 participating healthcare institutions across 25 European countries, using a well-established research network-the Paediatric Tuberculosis Network European Trials Group (ptbnet). This multinational, multicentre cohort study was performed during the first wave of the pandemic, between April 1 and April 24, 2020. Each participating country was allowed to continue further research individually encompassing brighter time limits and using the same methodology. We present here data of children hospitalised at Vilnius University Hospital Santaros Klinikos (VUH SK) during the first year of the pandemic. Materials and methods: We included all paediatric patients with PCR confirmed SARS-CoV-2 infection who were hospitalised at VUH SK. The study was performed between March 12, 2020 and March 12, 2021. A standardised data collection spreadsheet was used to record epidemiological, clinical and treatment data. Results: A total of 104 patients were included in the study. The median age of participants was 5 years (IQR 1.0-11.0, range 0-17 years). Males accounted for 50 (48%) of all patients. The average duration of hospitalisation was 3 days. Ten (9.6%) patients had pre-existing medical conditions. Among all hospitalised patients 16 (15%) were asymptomatic, 5 (4.8%) were treated in intensive care unit (ICU). The most common symptoms among COVID-19 patients were pyrexia 71 (68%) followed by upper respiratory tract infection 49 (47%) and gastrointestinal symptoms 33 (32%). Among the entire cohort only 3 (3%) patients required oxygen support, but none of them was started on continuous positive airway pressure (CPAP), mechanical ventilation or extracorporeal membrane oxygenation (ECMO). None of the patients admitted to ICU needed inotropic support. There was no fatal outcome. Conclusions: Our data indicate that COVID-19 may affect children of any age. The COVID-19 disease was usually mild in hospitalized children and adolescents. The most common clinical findings of COVID-19 were pyrexia and symptoms of upper respiratory tract infection. Severe COVID-19 disease cases when oxygen support or treatment in ICU was required were very rare. No patient received antiviral drugs for Covid-19 treatment. There was no fatal outcome due to COVID-19 in our study population.

Pediatric Community-Acquired Bone and Joint Staphylococcus Aureus Infections In Europe: Severe Infections are Associated to Panton-Valentine Leucocidin Presence.

To analyze host and pathogen factors related to disease severity of community-acquired bone and joint infections in children, a cohort of pediatric patients was prospectively recruited from 13 centers in 7 European countries. A total of 85 children were included, 11 (13%) had a severe infection. Panton-Valentine leukocidin-positive isolates were 17%, and 6% of the isolates were methicillin-resistant Staphylococcus aureus. Multivariate analysis identified Panton-Valentine leukocidin presence (adjusted odds ratio, 12.6; P = 0.01) as the only factor independently associated with severe outcome, regardless of methicillin resistance.

Overview of caustic ingestion cases at the Children's Hospital of Vilnius University Hospital Santaros klinikos between 2011 and 2018.

BACKGROUND: Although not common, caustic ingestion can cause serious injury and sequelae. Clinical symptoms do not always represent the depth of lesions of the intestinal tract, which makes management of these patients difficult. MATERIALS AND METHODS: Between 2011 and 2018, we performed a retrospective one-centre study on ingestion of corrosive agents by children. We used ICD-10 codes of X49, X54.X, and T28.2. Cases of eye or skin burns were excluded. RESULTS: Sixty-five cases were found. Due to a lack of data, we analysed 56 cases. The majority of them were boys (64%); 41% of patients were between 12 and 24 months old. The median age was one year. In 68% of cases, the corrosive substance was alkali: laundry detergent pods and sodium hydroxide accounting for 25% and 14%, respectively. Of the  hospitalised patients and all those admitted to the paediatric intensive care unit (PICU), 78% had oesophagogastroduodenoscopy (EGD), 61% within 24 h after ingestion. The time of EGD was not known for 29% of patients. Nine (29%) had 2nd- or 3rd-degree burns of the oesophagus or the  stomach, one of them did not have any visible changes of the lips and oral mucosa or any symptoms. CONCLUSIONS: Physicians should be suspicious about potential lesions of the gastrointestinal tract when managing caustic ingestion cases. It is recommended to perform EGD for symptomatic children within 24 hours after the accident.

Sepsis epidemiology and outcome in the paediatric intensive care unit of Vilnius University Children's Hospital.

Research was carried out at the paediatric intensive care unit (paediatric ICU) of the Children's Hospital, affiliate of Vilnius University Hospital Santariskiu klinikos. BACKGROUND: Being the most common cause of children's death, sepsis is a challenge for most physicians. In order to improve the outcomes, it is important to know the aetiology and peculiarities of sepsis in a particular region and hospital. The aim of this study was to analyse the outcomes of sepsis in a paediatric intensive care unit and their relation with patients' characteristics and causative microorganisms. MATERIALS AND METHODS: A retrospective analysis of the Sepsis Registration System in Vilnius University Children's hospital was started in 2012. From 2012 to 2015, we found 529 sepsis cases in our hospital, 203 of which were found to be fulfilling all of the inclusion criteria (patient's age >28 days on admission, taken blood culture/positive PCR test, need for paediatric ICU hospitalization) and were included in the final analysis. Abbreviations: ICD - international disease classification PCR - polymerase chain reaction. RESULTS: Sepsis made 4% of all patients of the paediatric ICU in the period from 2012 to 2015 and caused 32% of deaths in the unit. Paediatric mortality reached 14% of all sepsis cases in our analysis, the majority of them due to hospital-acquired sepsis that occurred in patients suffering from oncologic or hematologic diseases. Another significant part of the patients that did not survive were previously healthy with no co-morbidities. The most common microorganism in lethal community-acquired cases was N. meningitidis and in hospital-acquired sepsis - Staphylococcus spp. Multi-drug resistance was observed, especially in the cases of hospital-acquired sepsis. CONCLUSIONS: A large percentage of lethal outcomes that occur in the paediatric ICU are due to sepsis. The majority of lethal cases of sepsis occur in patients suffering from chronic co-morbidities, such as oncologic, hematologic, neurologic, and others.