The North Estonia Medical Centre belongs to the one percent that not only uses fruits of research, but also contributes and creates new knowledge in science. On October 28, we had our third annual in-house research and development conference. The aim of the conference is to highlight the important research work we do within the hospital walls and share the knowledge about the outcomes. To highlight some of the topics we will concentrate on the topics of drugs and markers in our overview, dwelling further in the use of benzodiazepines and Z-drugs in Estonia, the beta-lactam antibiotics plasma concentration testing, and amyloid-β pathology.
Every year the North Estonia Medical Centre (NEMC) nominates the best investigating article in Estonian Physician. Last year the recognition was given to Katrin Kurvits from the article “Benzodiazepine and Z-drug use in ambulatory care in Estonia”. The author points out that also in Estonia the usage of these drugs is very widespread – every tenth person is using those drugs and twenty percent, more commonly elderly patients, are long-term users. The trend is worrying as the long-term usage causes tolerance and addiction, plus the elderly are more susceptible to the adverse effects. The overall conclusion is that the regulations for prescribing benzodiazepines and Z-drugs should be revised.
Clinical Pharmacist Laura Orav introduced the successful cooperation with Tallinn University of Technology on developing a methodology for determining the concentration of beta-lactam antibiotics in plasma concentrate. There are many risks involved in using antibiotics in the intensive care unit (ICU), because the patients present many pathophysiological features that cause pharmacokinetic and pharmacodynamic specificities, which lead to the risk of under dosage. Today we can measure the plasma concentration of 7 beta-lactam antibiotics and all our ICUs use continuous or prolonged infusion when administering beta-lactam antibiotics.
Radiologist Juhan Reimand, M.D., introduced his PhD theses on the discordance between amyloid-PET and CSF biomarkers. The methods are considered equal but about 10-20% of the cases, they produce a contradictory result, where one tests positive for amyloid pathology while the other one does not. In two thirds of contradictory cases the amyloid-β pathology in evident only in CSF. The latter may be evidence of early stage amyloid-β accumulation in the brain, which is why the prognosis for patients with discordant results is significantly better than with unanimous results on the existence of amyloid-β pathology. The finding is of importance from the research perspective and more in the field of clinical trials and finding new drugs to battle Alzheimer’s disease, because the effect of the drug can be greater the earlier the stage of the disease.
The overall programme however included topics about the need for early intervention for young people with psychosis; the lessons from the stroke patient pathway pilot project. A lot of attention was given to personalised medicine in the introduction of the results from the “Clinical pilot projects of personalised medicine in the precise prevention of breast cancer and cardiovascular diseases and patient centred care”.
This year we celebrate the fact that despite the pandemic we have the strength to carry out investigative work and research projects, to publish and to share the findings with our colleagues.
The North Estonia Medical Centre Foundation (NEMC) is one of the top healthcare providers in the country established by the Republic of Estonia. As a tertiary level regional hospital, we have the highest-level competence to provide specialised medical care and ambulance services, to be the learning base of training that precedes and follows the acquiring of health care professionals’ qualifications and does health care related study and research work. Our Case mix index is 1.68.
We are a patient-centred institution committed to professionalism, innovation and teamwork. We have over 5000 people – doctors, nurses, caregivers and specialists – working for the good of patients. The hospital consists of seven clinics and 32 specialist centres. In a year, the Medical Centre gives specialised medical care to ca 144 000 patients. NEMC offers medical care in all specialist fields other than obstetrics.