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PubMed1997

Peptic ulcer haemorrhage in Tartu County, Estonia: epidemiology and mortality risk factors.

BACKGROUND: The aim of the study was to assess the epidemiology and mortality risk factors of peptic ulcer haemorrhage (PUH) in Tartu County, Estonia. METHODS: In a prospective unselected defined area study, data for 144 patients aged > or = 15 years with new cases of PUH were analysed during a 2-year period. RESULTS: The incidence of PUH was 57 per 100,000 adult population per year, increasing from 12 in patients aged 20-29 years to more than 135 in those > or = 70 years. The incidence was 2.3-fold higher for men. The incidence of gastric ulcer haemorrhage was 26 (men, 33; women, 20) and that of duodenal ulcer 22 (men, 39; women, 9). Of the women 72% and of the men 37% were > or = 60 years. Nonsteroidal anti-inflammatory drugs (NSAIDs) were used by 45% of the patients (64% of women, 36% of men). Helicobacter pylori infection was present in 93% of the duodenal ulcer patients and in 81% of the gastric ulcer patients. Mortality (8%) was related to age, shock, haemoglobin < 80 g/l, cardiac comorbidity, and recurrence of haemorrhage. CONCLUSIONS: The incidence of PUH is relatively high owing to a high incidence among the younger population in Tartu County. Women with PUH are older, have consumed more NSAIDs, and have mainly gastric ulcer; men are younger, have consumed less NSAIDs, and are prone to duodenal ulcer haemorrhage. H. pylori infection is common in PUH patients. Mortality risk factors coincide with those reported by other researchers.

Adult↗

PubMed1997

Bladder cancer in Estonia, 1968-1992: incidence, mortality, prevalence and survival.

This paper summarizes what is known about the occurrence and survival of bladder cancer in Estonia from 1968 to 1992. In 1988-92 the age standardized (world standard) incidence rate of bladder cancer was 11.1 per 100,000 person-years in males and 2.0 in females, and the age standardized mortality rate was 8.2 and 2.7, respectively; by July 1, 1990 the age standardized prevalence rate was 41.5 and 14.7, respectively. Between 1968-72 and 1988-92, incidence increased by 1.26 times (95% confidence interval 1.09 to 1.46) among males; incidence rates for females did not show a consistent trend. The time trends in mortality generally paralleled the trends in incidence. Higher rates of bladder cancer were found among males in five large towns. For patients diagnosed in 1983-87, the five-year relative survival was 32.4% (95% confidence interval 27.0 to 37.8) for males and 32.5% (23.8 to 41.2) for females; throughout the 20 years there was no improvement in survival. As the survival rates are less favorable than those in the Nordic countries, further hospital-based studies are needed to investigate the relation between survival and clinical characteristics.

Adult↗

PubMed1997

Prevalence of scleroderma spectrum disorders in the general population of Estonia.

The purpose of this study was to estimate the prevalence of scleroderma spectrum disorders (SDS) in the general population of Estonia while taking into account environmental and ethnic factors. A random sample of 14,467 subjects from the general population were surveyed by mail questionnaire to detect those with suspected Raynaud phenomenon (RP) and SDS. A subsample of 2,154 participants was then seen during the field study to confirm the RP diagnosis and to perform a short clinical examination. Of 581 subjects with RP, 13 cases (all women) were diagnosed as having SDS; based on these findings, the estimated prevalence of SDS in the adult population is 228 per 100,000 (95% CL 121; 391), while in women alone it is 354 per 100,000 (95% CL 188; 605). The best estimate of SD (systemic scleroderma), based on ACR criteria, is 35 per 100,000 (95% CL 4; 127). No significant difference in SDS prevalence was found between the two environmentally different regions we studied. Although statistically not significant, the prevalence of SDS, especially of SD and CREST syndrome, among Russians was higher than among Estonians, as we had hypothesized. The distribution of SDS subtypes also suggests an ethnic difference. The overall prevalence of SD/CREST that we found is higher than that reported in studies not based on a random sample of the general population.

Adult↗

PubMed1993

Differentiation of two rabies strains in Estonia with reference to recent Finnish isolates.

We compared 24 rabies samples collected in Estonia in 1989 to 1992, to identify the kinds of rabies strains circulating in this country. Eleven of the strains came from the islands of Saaremaa, Hiiumaa and Muhu, off the Baltic coast; 13 came from the mainland. The mainland strains, like those from the 1988 to 1989 epizootic in Finland, were antigenically different from the 11 island isolates. The island isolates reacted negatively with monoclonal antibody W-187.5 as does the SAD B19 rabies vaccine strain, currently spread as baits to wildlife in Finland and other parts of Europe. In order to unambiguously distinguish the island isolates from the SAD B19 vaccine, we developed a polymerase chain reaction (PCR) protocol for rabies, followed by a single restriction enzyme digestion. This method enabled the island isolates to be differentiated with ease from the vaccine strain SAD B19 at the level of the nucleoprotein-coding region. Additionally, this method had the ability to distinguish other polar field isolates examined, as well as the laboratory challenge virus strain CVS, from SAD B19 vaccine. Modifications of the above PCR method may be used for epidemiological investigations of new outbreaks or of outbreaks involving different species.

Animals↗

PubMed1998

Health services for seafarers in Estonia, plans for future, and possible improvements.

Estonian National Maritime Board has reported about 16,000 seafarers in Estonia. According to Estonian new national regulations concerning medical examination of employees on board ships issued on 9 April 1998 seafarers are examined only at Estonian Seamen's Hospital by experienced physicians of expertise commission. The validity of the certificates of fitness is 2 years, for persons younger than 21 and older than 50 years of age the validity is 1 year. The medical training of seafrers is carried out according to IMO Model Courses at special training ships and Estonian Disaster Medicine Centre. The International Medical Guide for Ships is used on sea-going vessels which fly Estonian flag.

Adult↗

PubMedDate not supplied

Epidemiology of permanent childhood hearing impairment in Estonia, 1985-1990.

This paper describes a retrospective study of permanent childhood hearing impairment (PCHI) > or = 40 dB HL in the better ear in children born between 1985 and 1990 and resident in Estonia. The prevalence rate of all permanent hearing impairment for the birth cohort 1985-1990 was 172 (95 per cent (CI 151-194) per 100,000 live births and that of congenital impairment was 152 (CI 134-170) per 100,000. For the congenitally-impaired children, 11 per cent had stayed in a neonatal intensive care unit for 48 hours or more, 2 per cent had a craniofacial abnormality, and 31 per cent had a family history of PCHI. As for aetiology, hereditary causes were stated most frequently in 36 per cent of all of the cases of PCHI. The aetiology remained unknown in 34 per cent of cases. Additional disabilities were found in 23 per cent of all cases. Specific syndromes were recognized in 2 per cent of hereditary cases. The mean age at the confirmation of hearing impairment was 46.4 months and at hearing aid fitting 57.0 months. The results were compared with other European studies, particularly the Trent study.

Child↗

PubMedDate not supplied

Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C in northern Estonia.

Distribution of hepatitis C virus (HCV) genotypes among 30 patients with chronic liver diseases and antibodies to HCV (anti-HCV) was investigated. Sera of these patients were analyzed for HCV genotype by reverse transcription-polymerase chain reaction (RT-PCR) and restriction fragment length polymorphism (RFLP) analysis of the 5'-non-coding region (5'-NCR) of the virus genome and for HCV serotype by detecting antibodies to HCV NS4 peptides by enzyme-linked immunosorbent assay (ELISA). The following distribution of genotypes was found: genotypes 1b in 32.0%, 3a in 20.0%, 2a in 12.0% and 1a/b (double infection) in 28.0%. The results of serotyping were interpretable in 92.0% and concordant with those of genotyping in 80.0% of the patients. In Northern Estonia, the genotypes 1b and 3a seem to be most common in chronically infected patients. Serotyping is an generally available and cheap assay and can be performed in most diagnostic laboratories in comparison to genotyping. However, genotyping is a more sensitive and more specific assay.

5' Untranslated Regions↗

PubMed2001

Tuberculosis as an occupational hazard for health care workers in Estonia.

SETTING: Tuberculosis incidence has been increasing in the Baltic states since the 1990s, accompanied by the emergence of drug resistance, including multidrug resistance (MDR). In this changing situation, the potential threat of nosocomial spread of tuberculosis to other patients and health care workers (HCW) has remained unrecognised. OBJECTIVE: To investigate the risk of tuberculosis in health care workers in Estonia. DESIGN: Cases of tuberculosis registered among HCWs from 1994 to 1998 were evaluated. The case records were analysed retrospectively and combined with bacteriological data including data on drug resistance. RESULTS: Sixty-seven HCWs (23 physicians, 23 nurses and seven laboratory technicians, 12 assistant nurses and two cleaners), all of whom tested negative for human immunodeficiency virus, were diagnosed as having active tuberculosis. The incidence of tuberculosis among HCWs (mean 91/100,000/year) was 1.5 to three times higher than in the general population. In a chest hospital in charge of regional tuberculosis care, the incidence was 30 to 90 times higher, and was highest among physicians. In 49 HCWs tuberculosis was confirmed by culture. Among these, drug resistance was detected in 23 (49%), 18 (38%) of whom had MDR tuberculosis. CONCLUSIONS: Health care workers, especially those working in a chest hospital where tuberculosis patients were treated, were found to be at an elevated risk of tuberculosis. MDR tuberculosis poses a particular threat which is difficult to combat.

Adolescent↗

PubMed2001

Attitudes towards war, killing, and punishment of children among young people in Estonia, Finland, Romania, the Russian Federation, and the USA.

OBJECTIVE: To study the cultural differences in moral disengagement, which lends support to attitudes used to justify violence. METHODS: We carried out classroom surveys of a total of 3122 students in the USA (Houston, TX, and Washington, DC) and in four European countries--Estonia (Tartu), Finland (Helsinki), Romania (Satu Mare) and the Russian Federation (St Petersburg). Data were also taken from a random sample telephone survey of 341 young adults (aged 18-35 years) in Texas, USA. Ten distinct groups were studied. Seven questions were common to all the surveys, using identical statements about the participants' agreement with attitudes relating to war, diplomacy, killing, and the punishment of children. FINDINGS: The US students were more likely than those in Europe to agree with the following statements: "War is necessary" (20% vs 9%), "A person has the right to kill to defend property" (54% vs 17%), and "Physical punishment is necessary for children" (27% vs 10%). Justification of war and killing was less common among females than males in all groups; other differences within the US groups and the European groups were smaller than the differences between the US and European groups. CONCLUSION: The results confirm the gap between the US and European groups in moral disengagement attitudes and tendencies that could lead to deadly violence.

Adolescent↗

PubMed2001

Health status of the older population in Estonia.

AIM: To assess the prevalence of physical, depressive, and cognitive disorders in the elderly population in Estonia. METHODS: The prevalence of various common morbidities was determined by a questionnaire sent to 200 general practitioners (GP). GPs were asked to collect data, use medical records, and interview five randomly selected patients (a total of 1,000 people aged 65 years or older). Physical morbidities of older persons were assessed according to their self-reports and reports of their general practitioners. Depressive symptoms and cognitive status were determined by 15-item Geriatric Depression Scale and Mini Mental State Examination, respectively. Response rate was 81%. RESULTS: The prevalences of diseases were as follows: hypertension 63.2%, arthritis 61.3%, ischemic heart disease 56.5% (history of myocardial infarction, 9.8%), heart failure 41.4%, heart rhythm disorders 37.5%, hypercholesterolemia 25.4%, kidney and/or urinary disorders 20.5%, osteoporosis 15.5%, diabetes mellitus 14.9%, chronic airway diseases 13.8% (emphysema 5.8%, asthma 5.5%), hypotension 11.1%, gastroduodenal peptic ulcers 10.6%, thyroid diseases 8.9%, malignant tumors 8.1%, psychiatric disorders 5.7%, and stroke 5.3%. Depressive symptoms were found in 40.3% and cognitive impairment in 22.5% of the elderly persons. CONCLUSIONS: The general structure of diseases in the Estonian elderly population is similar to that of other European countries, but the prevalence of cardiovascular, depressive, and cognitive disorders is much higher.

Aged↗

PubMed2000

Financing Estonia's unemployment insurance system: problems and prospects.

In recent years, favorable media coverage of the glowing employment situation in the United States has been the norm. History, for one, won't permit us, however, to become complacent with what appears on the books to be a rosy economic picture for the nation. Moreover, the mounting recognition that the U.S. economy is inextricably tied to those of other nations--large and small--serves to keep us vigilant. This paper allows us a comparative exploration of the employment conditions in Estonia and the problems and prospects of financing its unemployment insurance program.

Cross-Cultural Comparison↗

PubMed1991

[Population dynamics of ethnic groups in Estonia in the twentieth century].

The author describes and analyzes changes in the ethnic composition of Estonia during the twentieth century. "The paper points out that ethnic composition of the urban population was changing in the period under consideration much more rapidly than the ethnic structure of the rural population." Data are from censuses conducted between 1897 and 1989. (SUMMARY IN ENG)

Culture↗

PubMed2003

[Using CAREX data base system for occupational exposure to carcinogens in Estonia].

CAREX (CARcinogen EXposure) is international information system on occupational exposure to know and suspected carcinogens. The CAREX database provides selected exposure data and documented estimates of the number of exposed by workers by country, carcinogen, and industry. CAREX includes data on 139 agents evaluated by the International Agency for Research on Cancer, displayed across the 55 industrial classes of the United Nations system (ISIC Revision 2). In 1999-2000, CAREX approach was applied to Estonian, Latvian, Lithuanian and Czech exposure situation in 1997. According to the preliminary estimates, there were about 180,000 workers (29% of the employed) exposed to the agents covered by CAREX in Estonia in 1997. The number of the exposures was approximately 240,000. The most common exposure were solar radiation (62,000 workers), wood dust (34,000 exposed), environmental tobacco smoke (31,000), diesel engine exhaust (21,000 exposed), crystalline silica (19,000), radon and its decay products (14,000), formaldehyde (9000) benzene (7000), ethylene dibromide (6400), lead and inorganic compounds (6200), and glasswool (4300).

Carcinogens↗

PubMedDate not supplied

[The isolation and identification of the Sindbis virus from migratory birds in Estonia].

The data on isolation from birds and identification of two strains of alphaviruses in Estonia in the territory of Vilsandy natural reserve are presented. Electron microscopy of purified virions allowed the isolates to be classified into the family of togaviruses, and serological identification (neutralization test, CFT) using polyvalent sera and monoclonal antibody showed them to belong to Sindbis virus.

Animals↗

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↗

PubMed2004

Family medicine as a model of transition from academic medicine to academic health care: Estonia's experience.

This paper presents the development of academic family medicine in an environment of traditional academic medicine at the Tartu University, Estonia. The introduction of university family medicine teachers to everyday practice and practitioners to academic teaching and research helps bridge the gap between theory and practice, and it shows changed approach to academic medicine.

Academic Medical Centers↗

PubMed2004

Apolipoprotein E and A-IV polymorphisms in ethnic Russians living in Estonia.

137 Russians living in Estonia was screened by isoelectric focusing and immunoblotting procedures to determine the distribution of genetic variations in apolipoprotein E (apoE) and apolipoprotein A-IV (apoA-IV) genes. The apoA-IV-2 allele and epsilon4 allele frequency of the Russians tended to be lower than in most other European populations.

Apolipoproteins A↗

PubMed1992

[Position on the publication of S. Ehrhardt (1990): Setukesen. A population group between Estonians and Russians in southeast Estonia. Homo 40, 159-175. Reflections on responsibility in anthropological works].

The uncommented publication of data on Setukesen people (SE Estonia), which were collected in 1942, by the scientific journal Homo (40, 159-175, 1990) is remarkably unreceptive to discussions within the scientific community at large. Therefore some basic considerations on scientific ethics in anthropology are outlined. Unfortunately Homo has refused to publish this statement which was written on appointment of the advisory board of the German Society of Anthropology and Human Genetics.

Anthropology↗