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PubMed1998

Could long-term alimentary iron overload have an impact on the parameters of oxidative stress? A study on the basis of a village in southern Estonia.

The effects of long-term alimentary (drinking water) iron overload on the parameters of oxidative stress were evaluated. The study group (n = 35) from a village in southern Estonia was 37.1 +/- 13.3 years old, and the mean period of drinking water iron overload was 20.6 +/- 9.3 years. The serum iron content was significantly higher than normal. The total iron-binding capacity of serum tended to be lowered. There was no change in the transferrin content. The parameters of lipid peroxidation like conjugated dienes and thiobarbituric acid reactive substances showed also significant differences. In addition, the red blood cell glutathione content was also decreased. The total antioxidant capacity of serum was not changed. It can be concluded from our results that a long-term alimentary iron overload results in a positive serum iron balance, which, in turn, yields an increased oxidative stress.

Adult↗

PubMed2002

Drugs in the postsocialist transitions of Estonia, Latvia, Lithuania and Poland.

The article discusses problems related to illicit drugs in Poland, Lithuania, Latvia and Estonia against the background of the postsocialist transitions of the 1990s. Besides the drug problem, the political and market reforms of the 1990s were accompanied by a surfacing of a variety of social problems, some of which had already been present during the authoritarian socialist regimes. Gaining reliable and comparable statistics on drug-related harm has become very difficult due to changes in treatment system and health statistics. Nevertheless, all available evidence suggests that the use of illicit drugs has grown rapidly in all four countries, it now being close to the Western European level. As a result of international impulses rather than domestic interest, strictly restrictive drug policies have been adopted. Drug problems are aggravated by a marginalisation of a large part of the populations. Accordingly, their reduction may require a more general revision of the four countries' economic and social policies.

Estonia↗

PubMed2003

Parents' satisfaction with medical and social assistance provided to children with Down syndrome: experience in Estonia.

OBJECTIVE: Parents of children with mental or physical disabilities have been assumed to live more stressful lives than other parents, and people with Down syndrome (DS) may get second-rate care because of their diagnosis. The aim of this work is to investigate the extent of parents' satisfaction with medical and social services in Estonia provided for the DS individuals and their families. METHODS: From 1999 to 2001, fifty-nine DS families answered questionnaires in which we inquired about their satisfaction with medical and social assistance. RESULTS: We found that satisfaction with the quality of the information about DS is low, and most of the parents are not satisfied with the social benefits and rehabilitation options. CONCLUSIONS: The DS families need more medical information about this syndrome. The medical staff has to learn more about how to deliver bad news and how to support parents. More work needs to be done in the area of rehabilitation options and social assistance.

Down Syndrome↗

PubMed2004

First-year results of the third stroke registry in Tartu, Estonia.

BACKGROUND: The main goal of the Third Stroke Registry in Tartu was to determine the incidence and 28-day case-fatality rates for first-ever stroke in an Estonian population. METHODS: The data collection started on 01.12.2001. All patients with first-ever stroke living in Tartu were registered. RESULTS: During the first year, 234 first-ever stroke cases were registered. The incidence rate of first-ever stroke age-standardised to the European population was 195/100,000, 214 (95% CI, 185-243) for men and 181 (95% CI, 155-208) per 100,000 for women. Sixty-eight patients (29%) died within 28 days of stroke onset. CONCLUSIONS: The incidence and 28-day case-fatality rate of stroke in Estonia are high compared to other countries. It might be related to higher risk factor prevalence, stress and socioeconomic status.

Adolescent↗

PubMed2005

Remediation of an oily leachate pond in Estonia.

Until recent years, waste oil and oil-contaminated waters commonly ended up in landfills. At some dump sites, ponds of oily liquids and leachate were formed. To remediate such ponds, an interdisciplinary approach is now required, keeping costs at an affordable level, particularly in countries with changing economies. From 1974 to 1993, liquid oily wastes taken to the Laguja landfill, in Estonia, were disposed of in a pond with a surface area of 9800 m2. It was estimated that the pond contained 4500-6000 m3 of oily water and 3500 m3 of oil-containing bottom sediments. This study aimed at developing an environmentally sound and cost-effective method for remediation of the oily liquids, leachate and contaminated underlying sediment material, to meet the existing legal demands. It was concluded that treatment of contaminated water is well established and the procedures carried out to meet the regulatory demands achieved satisfactory results. However, regarding treatment of sediments it was concluded that legal and technological aspects, as well as monitoring procedures are not fully established and are usually underestimated. Laboratory investigations can provide valuable information in decision-making, and contribute to effective full-scale remediation planning.

Environmental Pollution↗

PubMed2004

Syphilis as a social disease: experience from the post-communist transition period in Estonia.

Increased incidence of sexually transmitted diseases (STD) and radical social changes have taken place at the same time in Estonia. Our aim was to study the trends in syphilis incidence, selected sociodemographic factors and health status indicators during the economic transition. Associations were estimated by the ordinary least square regression method for change in and actual values of syphilis and tuberculosis incidence rate (IR), percentage of non-ethnic Estonians and urban population, homicides rate, unemployment rate and, birth rate. The analysis was performed by counties at three different time periods. Syphilis IR significantly correlated with the proportion of non-ethnic Estonians, urban population, tuberculosis IR and birth rate. Change of syphilis IR correlated significantly with concurrent changes in unemployment rate and tuberculosis IR. Our findings support the theory that syphilis is a social disease, thus emphasizing the importance of social factors in the occurrence of STDs.

Adult↗

PubMed1993

Morbidity and mortality in Estonia, Latvia and Lithuania in the 1980's.

The purpose of the present study was to examine the general morbidity and mortality rates in the three Baltic republics--Estonia, Latvia and Lithuania during a decade before the collapse of the Soviet Union. Official statistical data were used to compare morbidity and mortality rates. A method of standardization and life table functions were employed. Soviet morbidity statistics were predominantly descriptive, and based mainly on crude rates registered cases of illness during a year per 100,000 population. The death rates during the Soviet period are a better indicator of the health of the populations than more specific health indicators. A general deterioration of the ecological, social and economic situation in the Baltic republics at the end of the 1980s and early 1990s may have resulted in the mortality rising and aborted any trends to increasing life expectancy in the next few years thus requiring more radical reforms in health and social policy. The study demonstrates a noticeable difference in mortality rates between demographic and socio-economic groups in the Baltic states.

Absenteeism↗

PubMed2004

Family doctors' involvement with families in Estonia.

BACKGROUND: Family doctors should care for individuals in the context of their family. Family has a powerful influence on health and illness and family interventions have been shown to improve health outcomes for a variety of health problems. The aim of the study was to investigate the Estonian family doctors' (FD) attitudes to the patients' family-related issues in their work: to explore the degree of FDs involvement in family matters, their preparedness for management of family-related issues and their self-assessment of the ability to manage different family-related problems. METHODS: A random sample (n = 236) of all FDs in Estonia was investigated using a postal questionnaire. Altogether 151 FDs responded to the questionnaire (response rate 64%), while five of them were excluded as they did not actually work as FDs. RESULTS: Of the respondents, 90% thought that in managing the health problems of patients FDs should communicate and cooperate with family members. Although most of the family doctors agreed that modifying of the health damaging risk factors (smoking, alcohol and drug abuse) of their patients and families is their task, one third of them felt that dealing with these problems is ineffective, or perceived themselves as poorly prepared or having too little time for such activities. Of the respondents, 58% (n = 83) were of the opinion that they could modify also relationship problems. CONCLUSIONS: Estonian family doctors are favourably disposed to involvement in family-related problems, however, they need some additional training, especially in the field of relationship management.

Adult↗

PubMed2006

Gastrointestinal failure in intensive care: a retrospective clinical study in three different intensive care units in Germany and Estonia.

BACKGROUND: While gastrointestinal problems are common in ICU patients with multiple organ failure, gastrointestinal failure has not been given the consideration other organ systems receive. The aim of this study was to evaluate the incidence of gastrointestinal failure (GIF), to identify its risk factors, and to determine its association with ICU mortality. METHODS: A retrospective analysis of adult patients (n = 2588) admitted to three different ICUs (two ICUs at the university hospital Charité-Universitätsmedizin Berlin, Germany and one at Tartu University Clinics, Estonia) during the year 2002 was performed. Data recorded in a computerized database were used in Berlin. In Tartu, the data documented in the patients' charts was retrospectively transferred into a similar database. GIF was defined as documented gastrointestinal problems (food intolerance, gastrointestinal haemorrhage, and/or ileus) in the patient data at any period of their ICU stay. ICU mortality, length of stay, and duration of mechanical ventilation were assessed as outcome parameters. RESULTS: GIF was identified in 252 patients (9.7% of all patients). Only 20% of GIF patients were identifiable at admission. GIF was related to significantly higher mortality (43.7% vs. 5.3% in patients without GIF), as well as prolonged length of ICU stay (10 vs. 2 days) and mechanical ventilation (8 vs. 1 day), p < 0.001, respectively. Patients' profile (emergency surgical or medical), APACHE II and SOFA scores and the use of catecholamines at admission were identified as independent risk factors for the development of GIF. Development of GIF during ICU stay was an independent predictor for death. CONCLUSION: Gastrointestinal failure represents a relevant clinical problem accompanied by an increased mortality, longer ICU stay and mechanical ventilation.

APACHE↗

PubMed2004

The value of the qualitative method for adaptation of a disease-specific quality of life assessment instrument: the case of the Rheumatoid Arthritis Quality of Life Scale (RAQoL) in Estonia.

BACKGROUND: Due to differences in current socio-economical situation and historically shaped values, different societies have their own concepts of high-quality life. This diversity of concepts interferes with quality of life (Qol) research in health sciences. Before deciding to apply a Qol assessment tool designed in and for another society, a researcher should answer the question: how will this instrument work under the specific circumstances of my research. Our study represents an example of the utilization of qualitative research methods to investigate the appropriateness of the Rheumatoid Arthritis Quality of Life Scale (RAQol) for the assessment of Qol in Estonian patients. METHODS: Semi-structured interviews were conducted with the rheumatoid arthritis (RA) patients of Tartu University Hospital and these were analyzed using the principles of the grounded theory. RESULTS: We described the significance of the questionnaire's items for our patients and also identified topics that were important for the Qol of Estonian RA patients, but that were not assessed by the RAQol. We concluded that the RAQol can be successfully adapted for Estonia; the aspects of Qol not captured by the questionnaire but revealed during our study should be taken into account in future research. CONCLUSIONS: Our results show that qualitative research can successfully be used for pre-adaptation assessment of a Qol instrument's appropriateness.

Activities of Daily Living↗

PubMed1999

Passive smoking among adolescents in Estonia.

1. The objective of this study was to assess prevalence and patterns of passive smoking in Estonia and to describe how environmental tobacco smoke is likely to initiate the desire in adolescents to start active smoking. 2. A population sample of 2170 students within the age groups of 13-14, 15-16 and 17-18 of school grades 8, 10 and 12, respectively, at Tallinn High Schools participated in this study. The data were collected using questionnaires which mainly consisted of structured multiple-choice and a few open questions. 3. Every fourth adolescent in Tallinn was either an occasional or a habitual smoker. 4. Nearly half (48%) of the respondents had no daily exposure to cigarette smoke. Almost one third (31%) was exposed daily for less than 1 h, 15% for 1-5 h and 6% for over 5 h a day. 5. The number of adolescent smokers was higher than non-smokers among those daily inhaling tobacco sidestream smoke. 6. In conclusion, environment gives considerable impact to the development of smoking habits among adolescents. Passive smoking as an inducing factor is associated with higher prevalence of smoking among the adolescents studied.

Adolescent↗

PubMed1996

Early traumatic stress reactions among Swedish survivors of the m/s Estonia disaster.

BACKGROUND: This study is a three-month follow-up study in order to assess the short-term impact of traumatic stress among 53 Swedish survivors of the Estonia disaster. METHOD: A questionnaire consisting of general questions about conditions during and after the disaster and self-assessment by Post Traumatic Symptom Scale (PTSS-10), Impact of Event Scale (IES), Sense of Coherence-short version (SoC-12), and the DSM-IV list of dissociative symptoms of Acute Stress Disorder formulated as questions regarding individual reactions was distributed. RESULTS: The response rate was 79.2% (n = 42). The participants scored an average of 3.9 on PTSS-10, 28.5 on IES ('intrusion' and 'avoidance' subscales) and 62.8 on SoC-12, which shows elevated levels of post-traumatic stress reactions but a normal level of sense of coherence. The reported occurrence of dissociative symptoms during the disaster was as follows: emotional numbing in 43% of the survivors, reduction of awareness in 55%, derealisation in 67%, depersonalisation in 33%, and dissociative amnesia in 29%. Survivors scoring low in SoC scored significantly higher in both PTSS-10 and IES than those with high scores in SoC. All dissociative symptoms were predictive of post-traumatic reactions. CONCLUSIONS: This study substantiates the importance of assessing dissociative symptoms during a life-threatening event as a possible for later post-traumatic reactions and possible PTSD. The Sense of Coherence Scale may be useful as an instrument to sort out survivors at risk.

Adaptation, Psychological↗

PubMed2001

Sexually transmitted infections in Estonia--syndromic management of urethritis in a European country?

Sexually transmitted infections (STIs) are considered a major public health problem, globally. In particular, increasing STI rates have been documented throughout eastern Europe and central Asia. The Russian Federation and adjacent countries have, traditionally, managed STIs on an aetiological basis. This approach is expensive in terms of laboratory costs and it may lead to delayed diagnosis and treatment. To overcome the limitations of the aetiological management of STIs, the World Health Organization (WHO) has placed an increased emphasis on integrated care using syndromic management at the primary care level, especially in developing countries. This article reviews the current aetiology of STIs in Estonia, an eastern European country bordering the Baltic Sea and formerly a part of the Soviet Union, with the aim of defining whether infection with Trichomonas vaginalis is common enough to include its management in a syndromic management protocol. The use of syndromic management, in general, is also discussed.

Animals↗

PubMed1997

Sexually transmitted diseases in Estonia: past and present.

The present survey covers historical events in Estonia during the era of the USSR regime and the era after independence as regards incidence of sexually transmitted diseases (STDs). The diagnostical methods used as the reporting system are presented. Reasons for the increased incidence of traditional venereal diseases such as gonorrhoea and syphilis are discussed. The importance of migration of prostitutes from Russia is also considered.

Estonia↗

PubMed2006

Distribution of Toxocara infection in the environment and in definitive and paratenic hosts in Estonia.

The aim of the study was to elucidate the distribution and possible transmission routes of Toxocara spp. infection in Estonia. Out of 454 faecal and sand samples collected from park lawns and sandpits in the town of Tartu, 19 were Toxocara positive (4.2%). Out of the 45 sandpit samples 17.8% were Toxocara positive. Cat faeces was found in 21 sandpit samples. Parasitological necropsies were performed on 41 euthanised stray dogs and 27 cats in the Tallinn Dog Home. Additionally, 13 wild free-roaming brown rats (Rattus norvegicus) were captured from the Tallinn Dog Home territory, necropsied and studied for the presence of Toxocara larvae. Toxocara canis adults were found in 14.6% of the dogs and Toxocara cati (syn. mystax) adults in the small intestines of 48.2% of the cats examined. Larval infection was detected in the kidney and liver in 5 dogs (12.2%). Our study demonstrated only low-level larval Toxocara infections in adult dogs. Toxocara larvae were not found in cats and brown rats. According to the results of this study, cats more often carry Toxocara infection than dogs. Under our conditions, stray and free-roaming cats are the main contaminators of the environment with Toxocara eggs. Children playing in sandpits are the main risk group for larval toxocarosis.

Animals↗

PubMed2003

A new estimate of the IQ in Estonia.

The Standard Progressive Matrices was standardized in Estonia in 2001 on a sample of 1,835 7- to 11-yr.-olds. The mean IQ of the Estonian sample was estimated at 98 in relation to a British IQ of 100 and 99 based on the combined results for two studies.

Adolescent↗

PubMed2006

Sectoral network on occupational health and safety in agriculture to support enterprises and family farms in Estonia.

A sectoral network on occupational health and safety in agriculture has been established in Estonia as part of a project that provided support for Estonian accession into European Union. Participating organizations represent farmers' unions at county level, agricultural enterprises, workers' representatives, universities and agricultural expert institutions, and government agencies. The purpose is to provide a shared infrastructure that combines information and other capacities of several organizations and provides a platform for dialogue and co-operation in order to make a greater impact with available resources. The network has a decentralized architecture and is technically managed by an institutionalized secretariat. The network's task forces have compiled a network directory, summarised the capacities and interests of member organizations, made an inventory of existing information and training materials, developed an overall strategy for information management, established an information repository on the Internet, prepared promotional materials, and devised a protocol for agricultural walk-though assessment. A profile on occupational health and safety in Estonian agriculture has been compiled with a rapid assessment approach that collected both quantitative and qualitative information from secondary sources (statistics, documents) and from focus group discussions. The profile is used as an instrument for taking occupational health and safety needs in agriculture into discussion on political arena.

Agriculture↗

PubMed1991

Helicobacter pylori: histological and serological study on gastric and duodenal ulcer patients in Estonia.

We have examined the occurrence of Helicobacter pylori (HP) infection in 86 Estonian gastric ulcer (GU) and 25 duodenal ulcer (DU) patients. Diagnosis of the HP infection was made histologically (modified Giemsa) from gastric biopsy specimens, and serologically by parallel use of two enzyme-linked immunosorbent assays for IgG antibodies to HP in patient sera. The infection was diagnosed simultaneously by all three methods in 84% of the GU and 84% of the DU patients. The infection was revealed histologically in 88% of the GU and 92% of the DU patients, and serologically by either of the two methods in 94% and 92% of the GU and DU patients, respectively. HP infection was absent by all three methods in one GU patient only, this patient being the only subject who showed normal gastric mucosa in conventional histology. These observations show that HP infection is very common in patients with peptic ulcer in Estonia. In addition, the findings suggest that the serological assays will find a small proportion (15%) of ulcer patients with antibodies against HP but no histologically detectable bacteria.

Adult↗