Background Changes in the demographics and respective growth of life expectancy and social needs make informal caregiving crucial component of comprehensive health and social care network, which substantially contributes to the health and well-being of the elderly. The purpose of this paper is to understand the system of care of elderly patients with mental disorders from the perspective of informal caregivers in Lithuania. Methods We conducted five semi-structured focus group discussions with 31 informal caregivers attending to elderly patients with mental disorders. The data were audiotaped and transcribed verbatim. A thematic analysis was subsequently performed. Results Five thematic categories were established: (1) the current state of care-receivers: representation of the complexity of patients’ physical and mental condition. (2) The current state of caregivers: lack of formal caregivers’ integration as a team; inadequate formal involvement of informal caregivers. (3) Basic care needs: the reflection of the group needs relating directly to the patient, care organisation and the caretaker. (4) The (non-) Readiness of the existing system to respond to the needs for care: long-term care reliance on institutional services, lack of distinction between acute/immediate care and nursing, lack of integration between the medical sector and the social care sector. (5) Potential trends for further improvement of long-term care for the elderly with mental disorders. Conclusions Strengthening of the care network for elderly patients with mental disorders should cover more than a personalised and comprehensive assessment of the needs of patients and their caregivers. Comprehensive approaches, such as formalization of informal caregivers’ role in the patient care management and planning, a more extensive range of available services and programs supported by diverse sources of funding, systemic developments and better integration of health and social care systems are essential for making the system of care more balanced.

Background In many communities around the world, informal caregivers of older adults with dementia represent an essential, yet often underappreciated, source of long-term care. The present study aimed to determine the personal experiences of such caregivers, which could be instrumental for developing means of improving the quality of care for both care receivers and their informal caregivers. Methods Five semi-structured focus-group discussions were held. The participants (n = 31) were all informal caregivers of older adults with dementia. The focus-group discussions were audio-recorded and transcribed verbatim. An inductive approach was used, and thematic data analysis was applied. Results Four thematic categories were identified: learning caregiving through personal experience; implications of caregiving on social wellbeing; caregivers’ contradictory emotions regarding care delivery; and addressing challenges regarding care provision. Conclusions This study revealed, among the informal caregivers, a variety of experiences, contradicting feelings, and problem-solving strategies relating to the care of older adults with mental disorders. Becoming an effective caregiver involves professional and psychological development. Developing caregiving skills, supportive environment and positive attitude can help facilitate providing care. Caregiving largely impacts the emotional, physical, and social wellbeing of the person; thus, comprehensive approaches are needed to prevent burnout and associated social disadvantages.

Background and Objectives: The prospective study was conducted to evaluate humoral and cellular immune responses after two doses of BNT162b2 (Pfizer-BioNTech) vaccine and possible relation with other factors (medication, etc.) in kidney transplant patients. Materials and Methods: Out of 167 vaccinated patients, 136 agreed to a follow-up visit three to six weeks after vaccination. Results: Only 39 patients (29%) developed antibody response against SARS-CoV-2 (≥35.2 binding antibody units (BAU)/mL) after full vaccination. Multivariate binary logistic regression analysis showed that predictive factors for good antibody response to the COVID-19 vaccine were better kidney function, higher hemoglobin level, and no use of mycophenolate mofetil for immunosuppression. For seropositive kidney transplant patients there was a significant negative correlation between anti-SARS-CoV-2 antibody titer and CD4/CD8 ratio (Spearman’s correlation coefficient −0.4, p = 0.02), percentage of CD19+ cells (r = −0.37, p = 0.02), and a positive correlation with percentage of CD8+ cells (r = 0.4, p = 0.01). There was an increase of total leucocyte count after vaccination in the total studied population, and in the group of responders. Conclusions: Only one third of kidney transplant patients develop sufficient antibody responses after full COVID-19 vaccination with Pfizer-BioNTech. Better kidney function, higher hemoglobin level, and no use of mycophenolate mofetil for immunosuppression increases the adequacy of response. The antibody titers correlated positively with relative number of CD8+ cells and negatively with CD4/CD8 ratio in responders.

Background In many communities around the world, informal caregivers of older adults with mental disorders (such as dementia) represent an essential, yet often underappreciated, source of long-term care. The present study aimed to determine the personal experiences of such caregivers, which could be instrumental for developing means of improving the quality of care for both care receivers and their informal caregivers.Methods Five semi-structured focus-group discussions were held. The participants (n = 31) were all informal caregivers of older adults with mental disorders. The focus-group discussions were audio-recorded and transcribed verbatim. An inductive approach was used, and thematic data analysis was applied.Results Four thematic categories were identified: learning caregiving through personal experience; implications of caregiving on social wellbeing; caregivers’ contradictory emotions regarding care delivery; and addressing challenges regarding care provision.Conclusions This study revealed, among the informal caregivers, a variety of experiences, contradicting feelings, and problem-solving strategies relating to the care of older adults with mental disorders. Becoming an effective caregiver involves professional and psychological development, but also requires a relevant educational background, a positive attitude, and a supportive environment. Caregiving largely impacts the emotional, physical, and social wellbeing of the person; thus, comprehensive approaches are needed to prevent burnout and associated social disadvantages.

Background and Objectives: The safety and effectiveness of vaccines are among the key priorities in COVID-19 pandemic management. Moreover, evidence-based data regarding vaccine safety and immunogenicity can play an important role in building the trust of the community regarding vaccination. The aim of this study was to investigate the safety and immunogenicity of Pfizer-BioNTech vaccine among healthcare workers in one hospital, 21 days after first dose. Materials and Methods: This study was conducted in the Hospital of the Lithuanian University of Health Sciences between February and March 2021. Hospital employees who arrived to receive the second dose of the Pfizer-BioNTech vaccine 21 days after the first one were invited to participate in the study: they were asked to complete an anonymous adverse events questionnaire and were offered a SARS-CoV-2 IgG/IgM rapid test. The study was performed at a single point, 21 days after the first dose of the vaccine. Results: Data of 4181 vaccine recipients were analysed. The first vaccine dose was associated with a 53.6% incidence of adverse events, mainly local reactions. Adverse events occurred more frequently in younger participants and women. Moderate adverse events were experienced by 1.4% of the vaccine recipients; 6.2% were incapacitated. Of the 3439 participants who performed a rapid IgG test, 94.5% were positive for IgG antibodies after the first vaccine dose. Seroconversion rates were lower in participants older than 47 years. Conclusions: Despite 1.4% moderate adverse events, no safety concerns or anaphylaxis were identified. The Pfizer-BioNTech vaccine induced an immune response in the overwhelming majority of recipients after a single dose. Younger participants experienced adverse events and were positive for IgG antibodies more frequently than older counterparts. It is important to mention that this study specifically considered short-term safety and reactions following vaccination and that long-term adverse effects were not investigated in the study. Thus, future research into both long-term adverse reactions and immune system programming is essential.

Skiepo nuo COVID–19 sukūrimo greitis tapo precedento neturinčiu reiškiniu medicinos istorijoje [7, 8]. Tiek klinikinių tyrimų metu, tiek pradėjus rizikos grupių asmenų skiepijimą, labai daug diskusijų kelia nepageidaujamos reakcijos, jų dažnis ir sunkumas. Žiniasklaidoje analizuojami sunkių sveikatos sutrikimų atvejai, siejami su skiepais, didina visuomenės baimę skiepytis, o oficiali Lietuvoje registruojamų nepageidaujamų reakcijų į skiepus statistika, galimai netiksli. Šiomis aplinkybėmis šeimos gydytojams labai svarbūs klinikinės praktikos mokslinių tyrimų duomenys, kurie leistų numatyti nepageidaujamas reakcijas pacientams bei veiksmingai jas valdyti. Tyrimo tikslas. Nustatyti nepageidaujamas reakcijas, jų pasireiškimo aplinkybes po COVID–19 skiepų. Tyrimo uždaviniai. 1. Nustatyti nepageidaujamų reakcijų į COVID–19 vakciną pasireiškimo laiką ir intensyvumą. 2. Įvertinti nepageidaujamų reakcijų įtaką darbingumui. Metodika. Tyrimas vykdytas Lietuvos sveikatos mokslų universiteto ligoninėje Kauno klinikų (toliau – Kauno klinikos) laikinai įkurtame vakcinavimo nuo COVID–19 centre 2021 m. vasario–kovo mėn. Tyrimo dalyviai: antrajai vakcinos dozei atvykę suaugusieji, informuoti apie tyrimo tikslą bei eigą, savanoriškai užpildę anoniminę anketą apie patirtas nepageidaujamas reakcijas po pirmosios vakcinos dozės. Anketą sudarė 20 įvairaus tipo klausimų, pateiktos pasireiškusių nepageidaujamų reakcijų vertinimo skalės su įverčiais nuo 1 (pasireiškė nežymiai) iki 5 (pasireiškė labai stipriai). Statistinė analizė atlikta naudojant „SPSS 26.0 for Windows“ duomenų apdorojimo paketą. Rezultatai ir išvados. 1. Iš 4344 apklaustųjų simptomai po skiepo pasireiškė 2305 (53,1 proc.) (19,2 proc. vyrų ir 80,8 proc. moterų). 2. Daugiausia nepageidaujamų reiškinių po skiepo teigė jautę 25–34 metų amžiaus asmenys, iš jų – 46,3 proc. vyrų. Mažiausiai nepageidaujamų reiškinių patyrė vyresni nei 65 metų asmenys. 3. Po pirmosios vakcinos nebuvo nė vienos ūminės alerginės reakcijos į skiepą, į gydymo įstaigą, dėl tam tikrų simptomų po skiepo pasireiškimo, kreipėsi 4,8 proc. asmenų. 4. Dažniausias simptomas – skausmas injekcijos vietoje, pasireiškė 94,4 proc. asmenų, jautusių nepageidaujamą poveikį. Rečiausiai (≤1 proc.) pasireiškė kosulys, dusulys, viduriavimas, skonio ir uoslės praradimas. 5. Nedarbingi jautėsi 265 iš 2305 tiriamųjų, kuriems pasireiškė nepageidaujamos reakcijos po skiepo, moterys statistiškai reikšmingai dažniau jautėsi nedarbingos. Šis Lietuvoje pirmasis didelės imties tyrimas apie nepageidaujamas reakcijas į vakciną nuo COVID–19 parodė, kad nepageidaujamos reakcijos yra dažnos, tačiau dažniausiai lengvos, greitai praeinančios, tik retais atvejais trumpam sutrikdančios darbingumą arba reikalaujančios trumpalaikio nepageidaujamų simptomų slopinimo vaistais.

COVID-19 pandemija pareikalavo milijonų gyvybių ir tapo vienu didžiausių XXI a. iššūkių sveikatos sistemai. Vakcinacija yra viena veiksmingiausių priemonių infekcinių ligų valdyme, tačiau dalis žmonių abejoja COVID-19 vakcinų saugumu bei veiksmingumu, todėl nusprendžia nesiskiepyti. Neigiamas medikų požiūris į COVID-19 vakcinaciją taip pat gali turėti įtakos visuomenės atsisakymui skiepytis. Tyrimo tikslas. Įvertinti gydytojų bei slaugytojų požiūrį į vakcinaciją nuo COVID-19 ligos. Tyrimo metodai. 2021 m. rugsėjo–gruodžio mėn. buvo vykdyta Lietuvoje dirbančių gydytojų ir slaugytojų internetinė, anoniminė apklausa apie požiūrį į vakcinaciją nuo COVID-19 ligos. Anketą sudarė 16 originalių įvairaus tipo klausimų. Rezultatai. 91,4 proc. respondentų pasiskiepijo šia vakcina, o 2,2 proc. skiepysis ateityje, gydytojai (95,6 proc.) statistiškai reikšmingai labiau linkę skiepytis, lyginant su slaugytojais (87,2 proc.) (p < 0,05). Gydytojai reikšmingai dažniau nurodė norą apsaugoti save ir aplinkinius, o slaugytojai – spaudimą darbovietėje kaip priežastį, skatinusią pasiskiepyti (p < 0,001). Šalutinis poveikis (63,6 proc.) bei abejojimas vakcinos veiksmingumu (58,2 proc.) buvo pagrindinės nesiskiepijimo priežastys. 83,2 proc. tiriamųjų rekomenduotų skiepytis COVID-19 vakcina pacientams ir artimiesiems, pasiskiepijusieji bei gydytojai tai daryti linkę statistiškai reikšmingai dažniau (p < 0,001). Išvados. Gydytojų ir slaugytojų požiūris į vakcinaciją nuo COVID-19 ligos yra teigiamas, dauguma jų rekomenduoja skiepytis artimiesiems ir pacientams. Lyginant gydytojų ir slaugytojų grupes, slaugytojai mažiau linkę skiepytis COVID-19 vakcina ir tai rekomenduoti pacientams bei artimiesiems.

Psoriasis is a chronic skin condition that affects almost 3% of world’s population and is associated with potential adverse effects on mental health. Patients with psoriasis have a higher risk of depression, anxiety and suicide than the general population. The aim is to review articles published in 2010–2019 based on relations of psoriasis and suicide and to provide recommendations for physicians most frequently confronted with psoriasis.