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Assessment of HIV transmission risks in clinical situations in health care students from Germany, Lithuania and Namibia.

Due to the increasing global HIV prevalence, comprehensive knowledge about clinical HIV transmission risks in health care professionals is essential. Mainly medical and nursing students are at risk, because they are working close to infected patients. By using an anonymous questionnaire, the study analysed the assessments of German medical/dental students (n = 182), Lithuanian medical students (n = 176) and Namibian student nurses (n = 135) on the risk of getting HIV infected in different clinical situations. It became obvious that the Namibian student nurses overestimated the risk of HIV transmission in several situations (eg changing dirty linen, physical examination). In comparison, the Lithuanian students showed the most realistic assessments, while the German students also tended to overestimate the risks of HIV transmission. The results indicate that assessments on the risk of HIV transmission in clinical situations are influenced by the national prevalence and daily contacts with HIV patients. Education of health care students should consider this and focus more on epidemiological aspects and infection control procedures, to avoid endangering students and patients.

Adolescent↗

Content of lead in human hair from people with various exposure levels in Lithuania.

A study has been performed to estimate if hair lead (Pb) can be used assessing environmental and occupational exposure to the metal. From 1994-1997, 622 ceramic plant employees, 520 randomly selected controls from Kaunas without occupational exposure to Pb aged 18-64 years, and 380 10-13 year old children living in Kaunas participated in this study. The concentration of Pb in the hair samples was measured by atomic absorption spectrometry. The geometric mean of Pb in the hair of workers occupationally exposed to Pb was significantly higher than that in persons not exposed to the metal (7.6 microg/g, 95% CI = 6.5-8.7 for exposed workers, 3.2 microg/g, 95% CI = 2.8-3.6 for not exposed workers and 2.6 microg/g, 95% CI = 2.4-2.9 for randomly selected controls, p < 0.05). Pb content in hair of boys and girls was 2.9 microg/g (95% CI = 2.6-3.3) and 3.1 microg/g (95% CI = 2.6-3.6), respectively. Lead in hair was not related to gender. Multiple regression analysis in adults with age as a continuous variable showed a positive relationship between Pb in hair and age. Also different exposure levels were significantly related to Pb in hair. In men, a positive association was found between Pb in hair and smoking. The data obtained suggest that human hair could be used to identify lead exposure in epidemiological surveys.

Adolescent↗

Menarche stories: reminiscences of college students from Lithuania, Malaysia, Sudan, and the United States.

Women college students in four countries were invited to write the story of their first menstruation in as much detail as memory allowed. Stories were received from 26 Lithuanians, 27 Americans, 20 Malaysians, and 23 Sudanese. The stories were read and their contents analyzed for the presence or absence of information on such topics as emotional reaction, preparedness, sources of information about menstruation, changes in body image, and celebrations of this rite of passage. Similarities and differences among the groups are discussed, and passages from particularly interesting stories are quoted.

Adolescent↗

Variation in size at birth in infants born small for gestational age in Lithuania.

UNLABELLED: The aim of this study was to describe the heterogeneity in body proportions of infants born small for gestational age (SGA), defined by birthweight, and to study the relationship of placental size with neonatal anthropometric measurements. Anthropometry was evaluated in 107 symmetrically and asymmetrically growth-retarded infants born SGA (birthweight <-2 SD) and compared with 181 appropriate-for-gestational age infants (AGA; birthweight and length +/- 2 SD). Study children were born at Kaunas University Hospital during the period from 1 January 1998 to 25 August 2000. Two-thirds of SGA children were light (SGA(W)) and one-third was both light and short (SGA(WL)) for gestational age. Infants in both SGA groups were significantly leaner than AGA children. SGA(WL) infants had significantly larger heads in relation to their length compared with SGA(W) and even AGA children, probably indicating a brain-sparing effect. SGA(WL) children had the lowest mean placental weight, but the highest placental weight to birthweight (PW/BW) ratio. The PW/BW ratio was inversely correlated with most infant measurements; the strongest negative relationship was observed with birthlength and lower leg length. CONCLUSION: There is heterogeneity in children born SGA, defined by birthweight. It is suggested that the two SGA groups represent the continuum of intrauterine growth retardation, with an initial reduction in trophic growth and a subsequent retardation of linear growth. The PW/BW ratio is a strong indicator for impaired prenatal linear growth.

Anthropometry↗

Marked differences in antibiotic use and resistance between university hospitals in Vilnius, Lithuania, and Huddinge, Sweden.

Antibiotic use and antimicrobial resistance was compared between Vilnius and Huddinge University hospitals. Drug use data were expressed in number of defined daily doses/100 bed-days; antimicrobial resistance were given as percentages of resistant isolates. Thirty-five and 48 different antibiotic drugs were used in Vilnius and Huddinge, respectively. The overall consumption of antibiotics was 15 DDD/100 bed-days in Vilnius and 43 DDD/100 bed-days in Huddinge. Benzylpenicillin, ampicillin, and aminoglycosides were the major antibiotics in Vilnius; beta-lactamase-resistant penicillins, cefalosporins, and quinolones in Huddinge. In Vilnius, gentamicin made up one-quarter of the use. Staphylococcus aureus and Gram-negative isolates from wounds and blood were more resistant to gentamicin in Vilnius. S. aureus was more often methicillin resistant in Vilnius than in Huddinge. There was no S. aureus-resistant to vancomycin in either hospital. The vancomycin-resistant enterococci made up from 4% to 10% in Vilnius hospital, but they were not detected in Huddinge hospital (0%). The majority of Streptococcus pneumoniae isolates were sensitive to benzylpenicillin in both hospitals. The higher resistance of microorganisms to some antibiotics in Vilnius may be explained by heavy use of few antibiotics. Lower level of hygiene procedures, sampling bias, and other methodological issues may also have contributed. Guidelines for antibiotic use and hygienic procedures are now under development in Vilnius.

Anti-Bacterial Agents↗

Molecular basis of cystic fibrosis in Lithuania: incomplete CFTR mutation detection by PCR-based screening protocols.

Mutational analysis of the cystic fibrosis transmembrane regulator (CFTR) gene was performed in 98 unrelated CF chromosomes from 49 Lithuanian CF patients through a combined approach in which the p.F508del mutation was first screened by allele-specific PCR while CFTR mutations in nonp.F508del chromosomes have been screened for by denaturing gradient gel electrophoresis analysis. A CFTR mutation was characterized in 62.2% of CF chromosomes, two of which (2.0%) have been previously shown to carry a large gene deletion CFTRdele2,3(21 kb). The most frequent Lithuanian CF mutation is p.F508del (52.0%). Seven CFTR mutations, p.N1303K (2.0%), p.R75Q (1.0%), p.G314R (1.0%), p.R553X (4.2%), p.W1282X (1.0%), and g.3944delGT (1.0%), accounted for 10.1% of Lithuanian CF chromosomes. It was not possible to characterize 35.8% of the CF Lithuanian chromosomes. Analysis of intron 8 (TG)mTn and M470V polymorphic loci did not permit the characterization of the CFTR dysfunction underlying the CF phenotype in the patients for which no CFTR mutation was identified. Thus, screening of the eight CFTR mutations identified in this study and of the large deletion CFTRdele2,3(21 kb) allows the implementation of an early molecular or confirmatory CF diagnosis for 65% of Lithuanian CF chromosomes.

Amino Acid Substitution↗

Current status of personal dosimetry in industry, research and medicine in Lithuania.

The personal dosimetry service of the Radiation Protection Centre performs individual monitoring for all the industrial, medical and research radiation workers. The RADOS and DTU TLD systems are used for monitoring of doses. The DTU TLD system is used for measurements of doses to extremities and for measurements of public external exposure. Finger ring TLDs are used in therapy which uses radiopharmaceuticals. The RADOS system is also used for evaluation of patients' doses in selected hospitals. The dosimetry service recently provided individual monitoring of approximately 3000 workers. The average occupational dose was about 1.06 mSv for medical workers and 3.2 mSv for industrial radiography workers in 1999. Detailed analysis of doses received by different categories of workers is performed. A system for the urgent review of work conditions in the case of increased dose has been set up.

Dose-Response Relationship, Radiation↗

Results of a patient dose survey on diagnostic radiology in Lithuania.

One of the most effective means towards optimisation of radiation protection for patients undergoing radiodiagnostic examinations are the diagnostic reference levels. In order to ensure the effective use of these levels, they have to be set properly. National characteristics, such as the conditions of the radiological equipments, the training of the staff, the availability of quality assurance systems, etc., have to be taken into account when these levels are established. Measurements under real conditions were considered as the best tools to achieve these reference levels. With an aim to establish the Lithuanian national diagnostic reference levels, the nationwide survey of entrance surface doses received by the patients during the most typical X-ray examinations has been performed. The most common types of examinations, such as chest PA, skull PA and LAT, abdomen AP, lumbar spine AP and LAT, thorax spine AP and LAT, and hip joint AP, were included in the list of procedures under consideration. Hospitals of different size and levels using different X-ray machines were represented in the survey. The standard thermoluminescence dosemeter techniques with pellets attached to the skin of the patient in the centre of radiation field were applied. The data were analysed statistically, and the averages and 75th percentile were calculated. The results show that the Lithuanian diagnostic reference levels might be rather close to the ones promoted by the International Atomic Energy Agency and the European Commission.

Body Weight↗

Assessment of external dose indoors in Lithuania.

The aim of this paper was an assessment of external exposure indoors and its dependence on construction materials and indoor radon concentrations in Lithuanian living houses. Relationship of absorbed dose rate in air indoors and activity indexes of the most commonly used construction materials (wood, concrete and bricks) have been studied using results received in measurements done in >4700 rooms in 1995-2005. Possible connections of dose rate indoors with indoor radon concentrations are also discussed. Findings of this study helped to make an assessment of the mean value of effective dose of Lithuanian population due to external exposure indoors which is equal to 0.58 mSv y-1. The received data might also be used in improvement of quality of personal dosimetric measurements done in premises constructed of different construction materials.

Air Pollutants, Radioactive↗