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PubMed2000

Incidence in young adulthood-onset Type 1 diabetes mellitus in Lithuania during 1991-1997. Lithuanian Epidemiology Diabetes Study Group.

Our aim was to determine the incidence of Type 1 diabetes mellitus (T1DM) in the 15-39-yr-old Lithuanian population from 1991 to 1997. A specifically developed communications system with all endocrinologists/diabetologists and general practitioners involved in diabetes care covering 100% of the sample Lithuanian population was the initial data source. Annual reports from regional endocrinologists/diabetologists, death certificates and patients' lists from Diabetes Societies remained as secondary sources for case ascertainment. The annual incidence was calculated per 100,000 persons/yr. The trend in incidence was estimated by fitting the linear regression model with the annual incidence data. The total of 769 new cases (496 males and 273 females) of T1DM were recorded among the 15-39-yr-old population during the period 1 January 1991-31 December 1997. The average age-standardised incidence rate was 7.78 per 100,000 persons/yr [95% Poisson distribution confidence interval (CI) 7.25-8.35] and was slightly higher among males (9.68 per 100,000 persons/yr, 95% CI 8.87-10.57) than among females (5.71 per 100,000, 95% CI 5.07-6.43). Male/female ratio was 1.82 (95% CI 1.69-1.95). Results of the linear regression model showed that the incidence of T1DM in the 15-39-yr-old population had a tendency to increase. The incidence data of T1DM in Lithuania are appropriate to those in Poland and lower than in other countries of the Baltic Sea region.

Adolescent↗

PubMed2001

Risk factors for coronary heart disease in different socioeconomic groups of Lithuania and Sweden--the LiVicordia Study.

AIMS: Lithuanian middle-aged men have a fourfold higher risk for coronary heart disease (CHD) mortality compared with Swedish men. In Sweden, CHD mortality is twice as high in blue- compared with white-collar workers. Whether the same risk factors that characterized Lithuanian men, compared with Swedish men, could be found in low socioeconomic groups within the cities was investigated. METHODS: The LiVicordia study compared both traditional and new possible risk factors for CHD among 150 50-year-old men in Linköping, Sweden and Vilnius, Lithuania. A comparison was made of the prevalence of these risk factors in high and low socioeconomic groups within the cities and, after controlling for the city, variations across socioeconomic groups in the total sample. RESULTS: Small differences were found in traditional risk factors between cities. However, Vilnius men were shorter, had lower serum levels of antioxidant vitamins, more psychosocial strain, and lower cortisol response to a standardized laboratory stress test. These characteristics were also found among men in low social classes in both cities. In linear regression models, short stature, low serum beta-carotene, low social integration, coping and self-esteem, high vital exhaustion, high baseline and low cortisol response to stress were related to low social class. CONCLUSIONS: The same set of risk factors, mainly relating to oxidative and psychosocial stress, that characterized Vilnius men was also found in men in low social classes within the cities. The results suggest that a common set of risk factors may help to explain health differences both between and within countries.

Antioxidants↗

PubMed2001

Water-quality control, monitoring and wastewater treatment in Lithuania 1950 to 1999.

The Lithuanian water-management system developed on the basis of Soviet regulations in 1950-1990. Surface-water quality monitoring started in the 1950s, and the system was improved in the 1960s. Today, 48 rivers are being monitored using up to 70 parameters. Statutory monitoring of discharges started in 1962, wastewater standards were issued in 1957 and 1966, and then revised in 1996. Wastewater-treatment plants were built first in rural areas, in factories since the 1950s, and later in towns. Since 1991, large capacity municipal plants have been constructed with foreign assistance. Water quality has improved in some rivers since 1970, but Lithuania's main river, Nemunas, remains moderately polluted. The lower Nemunas is especially affected by discharges of municipal and industrial wastewater from Sovietsk and Neman (Russia), which account for half of the total loading. Hydrobiological data of 1994-1998 indicated the eutrophication of the Curonian Lagoon, and bacteriological pollution and blue-green algae blooms in the Baltic Sea north of Klaipeda.

Environmental Monitoring↗

PubMed2002

Tackling social inequality through the development of health policy in Lithuania.

AIMS: The major aim of this study was to assess existing inequalities in health of Lithuanian population and to present the process of health policy development as a major tool for reducing inequalities. The objectives were: to present life expectancy and mortality trend analysis in comparison with other European countries; to demonstrate risk profile of Lithuanian population to major noncommunicable diseases related to social inequalities and inequities in health; and to present the process of National health policy development as potential for effective reduction of inequalities in health of Lithuanian population. METHODS: Information about demographic, general health situation and inequalities in health was obtained from Lithuanian Department of Statistics, National Health Information Centre and research studies performed at Kaunas University of Medicine. RESULTS: Considerable demographic, social and territorial inequalities in health were disclosed in Lithuania. Large proportion of them might be related to social inequalities in the society. Substantial improvements in health status of Lithuanian population could be expected if due attention was paid to social determinants of health. CONCLUSION: Implementation of balanced national health policy involving all sectors of the society is the solution.

Adolescent↗

PubMed2002

[Prevalence of health affecting behavior factors among the population of Northern Lithuania].

The paper presents data on the prevalence of health affecting behavior factors--tobacco smoking and alcohol consumption in the region of Northern Lithuania (the districts of Birzai, Pasvalys and Pakruojis). In 1997-98, 1580 residents of this region were surveyed using the questionnaire prepared according to the recommendations of the WHO experts. Analysis of the study--patterns in tobacco smoking and consumption of alcoholic beverages--showed that 51.3% of males and 12.5% of females smoked every day. More male smokers were found in the countryside, while more female smokers--in towns. Most smokers were found in 30-39 year--old group (14.6% and 6.1%, respectively). Single women smoked more often than married ones or widows (p < 0.05). Irrespective of the marital status, the greatest proportion was of those who consumed alcohol at least once a month. There were 3.6 times more married women who never consumed alcoholic beverages compared to married men (p < 0.05). The prevalence rate of risk factors depended on education: men with higher education smoked more seldom than those with lower education; there were no men consuming alcohol every day among those with higher education; women with higher education smoked more often than those with lower education; with education getting higher, the number of women who never consumed alcohol was decreasing. In all age groups the highest proportion was of those who consumed alcohol once a month; somewhat lower was the proportion of those who consumed alcohol once a week.

Adolescent↗

PubMed2002

[Cervical cancer: recent trends of incidence and mortality in Lithuania].

Time trends of the cervical cancer in Lithuanian population were analysed. Changes in age standardised cancer incidence rates (World standard) in Lithuania were analysed between 1978 and 1999. Incidence rates were calculated by periods--1978-1982, 1983-1987, 1988-1992, 1993-1997 and 1998-1999. Incidence was analysed among 15-34, 35-49, 50-64, 65-74 and 75+ age groups. From 1978-1982 cervical cancer incidence decreased from 15.4 to 12.9 per 100,000 in 1993-1997. Increase was observed from 1993-1997 up to 17.4 per 100,000 in 1998-1999. In 1998-1999 only 49.2 of all cervical cancer cases were diagnosed at stages I and II. During 1978-1992 cervical cancer mortality rates were not decreasing despite the reduction of incidence (6.8, 7.0 and 6.8 cases per 100,000 in 1978-1982, 1983-1987 and 1988-1992 respectively). Starting from 1993 the increasing number of new incidence cases is being registered, but mortality rates are not subjected to changes (7.6 and 7.7 cases per 100,000 in 1993-1997 and 1998-1999 metais respectively). The higher increasing rates in incidence and mortality were observed among women below 50 years. The causes of increase of cervical cancer incidence are demanding detailed studies. The incidence and mortality of cervical cancer can be reduced by the implementation of national-wide screening program for cervical cancer.

Adolescent↗

PubMed2002

[Development of child mental health services in Lithuania: achievements and obstacles].

In 1990, political, economic and social changes in Lithuania introduced the possibility to develop for the first time in nations's history an effective and modern system of child mental health services. During the period between 1990 and 1995 a new model of services was developed in the Department of Social pediatrics and child psychiatry of Vilnius University. The model included development of child and adolescent psychiatric services, as well as early intervention services for infants and preschool children with developmental disabilities. The emphasis, following recommendations of WHO and existing international standards, was made on deinstitutionalization and development of family-oriented and community-based services, which have been ignored by previous system. In the first half of 90's of 20th century, new training programs for professionals were introduced, more than 50 methods of assessment, treatment and rehabilitation, new for Lithuanian clinical practice, were implemented, and a new model of services, including primary, secondary and tertiary level of prevention, was introduced in demonstration sites. However, during next phase of development, in 1997-2001, serious obstacles for replicating new approaches across the country, have been identified, which threatened successful implementation of the new model of services into everyday clinical practice. Analysis of obstacles, which are blocking development of new approaches in the field of child mental health, is presented in the article. The main obstacles, identified during analysis of socioeconomic context, planning and utilization of resources, running of the system of services and evaluation of outcomes, are as follows: lack of intersectorial cooperation between health, education and social welfare systems; strong tradition of discrimination of psychosocial interventions in funding schemes of health services; societal attitudes, which tend to discriminate and stigmatize marginal groups, including disabled children and dysfunctional families; lack of evidence-based decision making in the process of health care reform and reform of social infrastructure.

Age Factors↗

PubMedDate not supplied

[Characterization of thermophilic spore-forming bacteria from a geothermal spring in Lithuania based on 16S rDNA and 16S-23S rDNA intergenic spacers analyses].

Forty-two strains of gram-positive, aerobic, heterotrophic, obligately thermophilic, spore-forming bacteria were isolated from a geothermal site near the Baltic Sea in Lithuania. All of the strains were able to hydrolyze collagen and/or casein. Since characteristics of proteolytic activity are correlated with taxonomic positions of bacteria, the strains were grouped on the basis of molecular biological analyses. On the basis of RFLP patterns of 16S rDNA and 16S-23S rDNA ITS-PCR analysis, the strains were subdivided into nine groups.

Caseins↗

PubMed2003

[The indications of renal biopsies and spectrum of renal diseases in five nephrological centers of Lithuania (a five-year study)].

A retrospective study of 316 patients, who underwent renal biopsy, during the period of 1995-1999 in five nephrological centers of Lithuania. All renal biopsy materials were investigated in the State Center of Pathology. Male:female ratio was 204:112, the mean age 41.4 (SD 16.7) yrs., range 15-80. The main indications for renal biopsy were nephrotic syndrome (29.1%), hematuria and nonnephrotic proteinuria (27.8%). The leading type of kidney damage was primary glomerulonephritis--194 (69.3%), which was 2.4 times more frequent in males than in females. The dominant types of primary glomerulonephritis were IgA nephropathy--30.4%, membranoproliferative glomerulonephritis--26.8%, membranous nephropathy--10.3% and focal segmental glomerulosclerosis--9.8%. Renal amyloidosis was found even in 8.6% of all renal biopsies.

Acute Kidney Injury↗

PubMed2003

[Potential causes of antigenemia in the patients with an immune complex-mediated membranoproliferative glomerulonephritis in Lithuania].

UNLABELLED: The pathogenesis of an immune complex-mediated membranoproliferative glomerulonephritis (IMPGN) involves persistent deposition of circulating immune complexes in the glomeruli caused by persistent antigenemia. We have previously reported relatively high incidence of IMPGN in Lithuania. The objective of our study was to evaluate potential causes of persistent antigenemia in the patients with IMPGN. MATERIAL AND METHODS: Forty-five patients with IMPGN diagnosed on renal biopsy during 2000-2002 were retrospectively evaluated for the presence of persistent bacterial or viral infections, autoimmune diseases and other associated medical conditions. Patients with established diagnosis of systemic lupus erythematosus (SLE) before the biopsy were not included in the study. RESULTS: A great majority (20; 44%) of the patients were found to have persistent bacterial infections of various localization. Four patients (9%) were infected with hepatitis B virus (HBV). Three (7%) patients were eventually diagnosed with SLE and another 3 (7%) had other associated pathology. In the remaining 15 (33%) patients, IMPGN remained idiopathic. Testing for hepatitis C virus (HCV) antibody was performed in 36 patients (12 of them with idiopathic IMPGN) and was negative in all patients. Testing for HCV RNA was not performed. Patients with bacterial infections were significantly younger compared to the group of idiopathic IMPGN (36.5+/-19.1 and 53.8+/-16.4, respectively, p=0.01). We conclude that persistent bacterial infection was a major potential source of antigenemia in our patients with IMPGN, particularly in the younger patients, while HBV and HCV infection was rarely detected.

Adolescent↗

PubMed2003

Prof. Eber Landau, the very first chief of Histology and Embryology Department at the University of Lithuania.

The article deals with the scientific activities of professor Eber Landau carried out in Estonia, Lithuania and Switzerland. Professor E. Landau was born November 8, 1878, in a merchant's family in Rezekne, Latvia. On leaving a classical high school in Riga, E. Landau studied at the Medical Faculty of Tartu University, graduating it in 1902. Later he improved his qualification in histology and anatomy at Villafrenk Zoology station, at the Histology Laboratory in Munich, and in St. Petersburg under the guidance of professor P. Leshaft. In 1906-1912 Landau worked as a prosector assistant at the Anatomy Institute, headed by professor A. Rauber, Tartu University. In 1912 he was elected a director of the Anthropology Institute, Tartu. On the outbreak of the First World War, E. Landau, as a Russian citizen, was called to the army and served as a neurologist and psychiatrist in Paris military hospitals. In 1918, E. Landau returned to Bern and for 5 years worked at the Anatomy Institute headed by prof. H. Strasner. In December 1, 1923, E. Landau moved to Kaunas University. Here he established the Department of Histology and Embryology and headed the Department till 1932. From 1932 till 1950 Eber Landau worked as a professor at the University of Lausanne. Professor E. Landau retired in 1950, but he still continued his research work in the field of neurohistology. Professor E. Landau died October 30, 1959. He left behind him an ample scientific heritage: 175 scientific publications and 12 doctoral theses done under his guidance.

Embryology↗

PubMedDate not supplied

[The provision of vitamins to school children in rural regions of Lithuania].

Providing with vitamins of schoolchildren was studied in some regions of Lithuania during the winter-spring period. The biochemical blood count has revealed insufficient providing of schoolchildren with ascorbic acid, beta-carotene, vitamins B1, B2 and B6. Decreased levels of ascorbic acid in urine, as well as micro-symptoms of hypovitaminosis (ascorbic acid, thiamine and riboflavine deficiencies) have been recorded.

Adolescent↗

PubMed2004

[Evaluation of patient needs and quality of outpatient health care services in large cities, district centers, villages and townships of Lithuania].

Opinion of patients concerning some aspects of patient needs and quality of ambulatory care services was investigated by survey, performed in ambulatory health care institutions of Lithuania in May, 2002. Results of survey included comparison of patient opinion in cities, regional centers, villages and townships. Representative number of 1003 inhabitants was selected as a study sample. Inhabitants were interviewed by means of standardized questionnaire developed by study team. According to the results of survey, patients evaluate changes in quality of the health care services more negatively that positively. Positive changes, by opinion of respondents, were in physician attitudes towards patient, this opinion was supported by 27% of respondents. Most negative changes, reported by patients, were changes in management of health care institutions, including functioning of registration office. Forty percent of inhabitants, participating in the study, expressed the opinion that accessibility of consultant services became more complicated, 35% did not notice any changes, 15% thought that procedure became easier; 38% of respondents thought that accessibility to ambulatory health care services worsened. Respondents also had different opinions concerning development of institution of family physician; 45% evaluated it as a positive change in health care system, and 42% expressed negative opinion. Main problems in functioning of ambulatory care institutions, by opinion of respondents, are long queues at the physician office, difficulties in registration in advance and out-of-pocket payments to physicians.

Adolescent↗

PubMed2003

Socioeconomic differences in myocardial infarction risk among 35-64 year old women in Kaunas, Lithuania.

AIM: To investigate the risk of a first myocardial infarction among different occupational categories in 35-64 year old women in Kaunas, Lithuania, a country in a transition market economy. METHODS: We carried out a case-control study among women aged 35-64 who were residents in Kaunas between 1997-2000. We identified first nonfatal myocardial infarction cases (n = 191) from the hospital register (International Classification of Diseases, 10-th revision, code 121). Controls (N = 482) were selected on the basis of age and city district of residence. We obtained information on occupation, smoking, hypertension, psychosocial and behavioral factors. We used the International Standard Classification of Occupations (ISCO) to code for occupational categories and conducted logistic regression analysis to evaluate the relationship between a number of selected risk factors and myocardial infarction risk. RESULTS: We found that legislators, senior officials and managers (1-st ISCO category) had a 2.64-fold increased risk for myocardial infarction and and service, shop and market sales workers (5-th ISCO category) 2-fold increased myocardial infarction risk as compared to technicians and associate professionals (3-rd ISCO category). CONCLUSIONS: Our results on the role of socioeconomic gradient on myocardial infarction risk differ from findings in industrialized countries.

Adult↗

PubMed2004

[First clinical experience with nonreamed intramedullary nailing in Lithuania].

Long bone diaphyseal fractures are very common. Limited choice of implants for treatment of these fractures in Lithuania often leads to unsatisfactory treatment results and complications. Unreamed intramedullary nailing is relatively simple and effective method for treatment of severely injured patients. Using this method early stabilization and rehabilitation, decreased number of complications, and shortened stay in hospital can be ensured. Indications, technique and early results of first fifty intramedullary fixations with unreamed nails performed in the Clinic of Orthopedics and Traumatology, Kaunas University of Medicine are presented.

Adolescent↗

PubMed2004

Self-reported food hypersensitivity in Sweden, Denmark, Estonia, Lithuania, and Russia.

AIM: The main aim of the study was to describe the differences between some Northern countries regarding what foods, according to the patients, elicit hypersensitivity symptoms. METHODS: At the participating clinics, patients with a history of food hypersensitivity (n = 1139) were asked to fill in a questionnaire in which 86 different foodstuffs were listed. Skin-prick tests (SPT) were performed with common inhalant allergens. RESULTS: The foods that were reported as eliciting symptoms differed between countries. In Russia, Estonia, and Lithuania; citrus fruits, chocolate, honey, apple, hazelnut, strawberry, fish, tomato, egg, and milk were most often reported as causes of hypersensitivity. In Sweden and Denmark; birch pollen (BP) related foods, such as nuts, apple, pear, kiwi, stone fruits, and carrot were the most common causes. In all countries, children, more often than adults, had symptoms of allergic reaction to citrus fruits, tomato, strawberry, milk, egg, and fish. Most patients (95%) reported hypersensitivity to several foodstuffs (median: eight foods). The most common symptoms were oral allergy syndrome and urticaria. Severe symptoms were most common with fish, shellfish, nuts, and milk. Slight symptoms were most common with rice, coriander, poppy seed, lingonberry, corn, caraway red currant, and fig. Earlier well-known correlations, such as that between BP sensitization and some fruits and vegetables, as well as that between mugwort and some spices, were conoborated. Positive correlations were found between self-reported hypersensitivity to crustaceans and SPT with horse. A negative correlation was seen between hypersensitivity to crustaceans and SPT with BP. CONCLUSIONS: The foodstuffs that often are reported to cause food hypersensitivity, differ between Sweden/Denmark on one side and the Baltic States and Russia on the other. BP-related foods dominate in Scandinavia, whereas some mugwort-related foods are of more importance in Russia and the Baltic States.

Adolescent↗

PubMed2003

[Surgeons in the army of the Grand Duchy of Lithuania in the 18th century].

The paper presents profiles about 120 surgeons in the army of the Grand Duchy of Lithuania in the 18th century. It is based on unpublished archival sources form the Central Archives of Historical Records, of Radziwillien Archives, 7th section: Military Acts. Both, the acts and the era, that are concerned haven't been researched by any historian of medicine so far.

History, 18th Century↗

PubMed2004

[Distribution and growing possibilities of the medicinal woody plants in Lithuania].

The objective of the work was to collect and to publicize data about distribution and growing possibilities of native, introduced and suitable for introduction woody plants, containing some established medicinal properties, as a resource of material for medicinal preparations. It was established that 748 species of medicinal woody plants could be grown under Lithuanian climatic conditions: there are 65 native species of medicinal trees and shrubs, 421 introduced species and in addition 262 species of woody plants can be introduced. Out of all these plants, 368 species (49%) can be easily propagated and grown and are winter-hardy. The growing of 285 species (38%) is more difficult to some degree because of their more complicated propagation or care or less hardiness. Ninety-five species (13%) can be grown only in specialized collections. Thus, there are 262 species of woody medicinal plants, which can be introduced into Lithuania. In total 368 species of woody plants are promising as the resources of medicinal preparations in a broad scale and 285 species have medium perspectives.

Climate↗