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PubMed2005

Optimisation of X-ray examinations in Lithuania: start of implementation in mammography.

Optimisation of medical X-ray examinations is very important for the enhancement of the reliability of the examination and for the reduction of the radiation dose to patients. Results of investigations of doses to patients during mammography using thermoluminescence dosemeters at different hospitals are presented together with a brief overview of the situation for mammography in Lithuania. It is shown that the entrance surface air kerma varies in a broad range and differed from hospital to hospital. Nevertheless the calculated values of average glandular dose (AGD) for a 'standard' breast being relatively high were comparable with those (3.2 mGy per exposure at net optical density 1.4) currently accepted by international authorities. Differences in AGD values evaluated at different hospitals demonstrate the existing potential for optimisation of the mammography screening procedures. The results of this investigation will be included in a database for patient doses in Lithuania and used for establishing a national reference dose level for mammography. Currently, reference levels recommended by international authorities are used in Lithuania.

Adult↗

PubMed1998

Potentially avoidable perinatal deaths in Denmark, Sweden and Lithuania as classified by the Nordic-Baltic classification.

OBJECTIVES: To analyse which subgroups of perinatal deaths contribute most to the perinatal mortality rate in Lithuania compared with Denmark/Sweden. DESIGN: Comparison of all perinatal deaths in Denmark/Sweden 1991 and Lithuania 1993-1994 by the common Nordic-Baltic perinatal death classification, based on information from the medical records. RESULTS: The doubled perinatal mortality in Lithuania compared with Denmark/Sweden is mainly explained by a threefold increase of intrapartum and two- to fivefold increase in neonatal deaths of nonmalformed infants. The higher rate of malformed infants is partly explained by a four times higher mortality from neural tube defects. CONCLUSIONS: The use of a common perinatal death classification has identified categories mainly responsible for the higher rate of perinatal mortality, but further investigation of potentially avoidable factors requires further study.

Adult↗

PubMed2003

Disease activity and health status in rheumatoid arthritis: a case-control comparison between Norway and Lithuania.

OBJECTIVE: To compare disease characteristics and health status in patients with rheumatoid arthritis (RA) from two countries, Norway and Lithuania. METHODS: Patients were recruited from the RA registers in Vilnius (Lithuania) and Oslo (Norway). For each patient from Vilnius, a patient matched for age and sex from the Oslo register was selected. Sociodemographic characteristics, disease process, and health status were compared between the patient groups. RESULTS: 201 Lithuanian patients and 201 Norwegian patients were included. Mean (SD) age in both groups was 55.9 (10.0) years, and 83% were women. Patients from Lithuania were less often employed (27% v 42%; p=0.001), had higher disease activity expressed by the disease activity score (DAS28; mean (SD) 5.3 (1.0) v 4.4 (1.4); p<0.001), had worse physical function by the modified Health Assessment Questionnaire (MHAQ; mean (SD) 2.3 (0.8) v 1.6 (0.5); p<0.001), had more often comorbidity (73% v 53%; p<0.001) and they reported worse general health measured by Short Form-36 Health Survey (SF-36; mean (SD) 23.2 (13.5) v 44.5 (21.3); p<0.001). The proportions of patients who had used disease modifying drugs were similar, but the pattern of use differed. CONCLUSION: Important differences in employment, disease activity, physical function, and self reported health status were observed in patients with RA from two northern European countries. Socioeconomic inequalities, differences in disease management, and access to specialised health care, as well as methodological issues regarding instruments and data collection are likely explanations. These data support the view that management of RA should be adapted to country-specific needs.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2006

Dealing with ethical problems in the healthcare system in Lithuania: achievements and challenges.

Ethical problems in healthcare in Lithuania are identified, existing mechanisms that deal with them are analysed and policy implications are discussed. At least three groups of ethical problems exist in the Lithuanian healthcare system: problems in the healthcare reform process, in interprofessional interaction and in doctor-patient relationships. During the past 15 years, several diverse legal, political and administrative mechanisms have been implemented in Lithuania to tackle these problems. Despite major achievements, numerous problems persist, implying that the focus should be shifted to different mechanisms and interventions. It is necessary to broaden the conceptual understanding of ethics in healthcare and focus on management ethics to tackle ethical problems in Lithuania or in other countries in transition.

Delivery of Health Care↗

PubMed2005

Case-control study of sudden infant death syndrome in Lithuania, 1997-2000.

BACKGROUND: To identify risk factors for sudden infant death syndrome relevant in Lithuania. METHODS: A nationwide case-control study surveying parents of 35 infants who died from sudden infant death syndrome during the period of 1997-2000 and parents of 145 control infants matched with SIDS infants for date of birth and for region of birth was carried out. RESULTS: Deaths incidence was greater in the warm period (60%) vs. cold period (40%). Prone and side sleeping positions both carried no increased risk of sudden infant death syndrome compared with supine because of a rare prone sleeping (4.1% of controls vs. 0% of dead infants) and more prevalent side than supine sleeping (84.8% of controls vs. 94.3% of dead infants) in the controls as well as the cases. Bed sharing for the whole night as a risk factor for sudden infant death syndrome has not been confirmed, either, as bed sharing was common only for the controls (13.8% of controls vs. 0% of dead infants). Routine sleeping environment factors such as heavy wrapping (> or =4 togs) of an infant (odds ratio 8.49; 95% confidence interval 2.38 to 30.32), sleeping in a bassinet (4.22; 1.16 to 15.38) and maternal factors such as maternal education < or =12 years (4.48; 1.34 to 14.94), unplanned pregnancy (5.22; 1.49 to 18.18) and > or =2 previous live births (3.90; 1.00 to 15.10) were significantly associated with sudden infant death syndrome on multivariate analysis. CONCLUSION: The results of this first population-based case-control study have shed some light on the epidemiology of the syndrome in Lithuania. Although the mortality of sudden infant death syndrome in Lithuania is not high, it might be lowered moreover by public informing about sudden infant death syndrome and related risk factors. Special attention must be paid to mothers with low education on potentially modifiable risk factors such as routine heavy wrapping of an infant during sleep, routine sleeping in a bassinet and unplanned pregnancy.

Analysis of Variance↗

PubMed2006

Duration of unemployment and depression: a cross-sectional survey in Lithuania.

BACKGROUND: In spite of a growing economy, unemployment is still a severe socio-economic problem in Lithuania. Nonetheless, no studies have been performed about the associations between unemployment and mental health in Lithuania. The aim of this study was to evaluate the associations between unemployment duration and depression in Lithuania. METHODS: The data was collected in a cross-sectional study in 2005. There were 429 filled-in questionnaires received (53.6% response rate) from unemployed persons registered with the Kaunas Labour Market Office. The severity of depression symptoms was evaluated using the Beck Depression Inventory (BDI). Logistic regression was used to estimate the risk factors for occurrence of depression. Sex, age, place of residence, marital status, education, income and practiced religion were the independent variables. Long-term unemployment was defined as lasting a duration of 12 months or more. RESULTS: The findings showed that long-term unemployed persons had more episodes of a depressive mood in the past 12 months in comparison with the group of the short-term unemployed. In addition, the BDI score mean was higher among the long-term unemployed compared with the short-term unemployed (10.1 +/- 8.8 and 14.2 +/- 9.5 respectively, p < 0.001). It was estimated that the duration of unemployment and BDI score had a positive correlation (r = 0.1968, p < 0.001). Among the short-term unemployed, the risk of depression increased significantly when the person was female, had an older age and had experienced more episodes of unemployment. Among the long-term unemployed, an older age was the risk factor for development of depression. However, higher education and income were the factors that significantly decreased the risk of developing depression for-short term as well as for long-term unemployed. CONCLUSION: The results indicated that depression is a severe problem in the unemployed population. Depression is more elevated among the long-term unemployed. This leads to arguing for common efforts in providing needed social support and health care to reduce the effects of unemployment on mental health.

Adolescent↗

PubMed2001

Occupational exposure to carcinogens in Estonia, Latvia, Lithuania and the Czech Republic in 1997.

OBJECTIVES: The aim of the study was to estimate the numbers of workers exposed to carcinogens in Estonia, Latvia, Lithuania, and the Czech Republic. METHODS: CAREX is an international information system on occupational exposure to 139 known and suspected carcinogens. It provides exposure data and estimates of the numbers of exposed workers by country, carcinogen, and industry. The CAREX method, which has been previously applied in the member states of the European Union, was applied in the present study to the exposure situation in Estonia, Latvia, Lithuania, and the Czech Republic in 1997. The preliminary estimates generated by CAREX were reviewed and revised by national experts mainly for asbestos, benzene, and lead, which were of special interest for this project. RESULTS: The numbers of workers exposed to carcinogens covered by CAREX in 1997 were about 180,000 (29% of employed persons) in Estonia, 260,000 (28% of employed persons) in Latvia, 470,000 (28% of employed persons) in Lithuania, and 1,400,000 (28% of employed persons) in the Czech Republic. The most common exposures were solar radiation (7-13% exposed at least 75% of the worktime), environmental tobacco smoke (4-5% exposed at least 75% of the worktime), wood dust (3-5% exposed), crystalline silica (2-3% exposed), diesel exhaust (2-3% exposed), radon and its decay products (2% exposed), benzene (0.9-1.7% exposed), and lead and inorganic lead compounds (0.8-1.4% exposed). Exposure to asbestos was slightly less prevalent (0.3-1.1% exposed). CONCLUSIONS: These preliminary results indicate that a substantial proportion of the workers in the studied countries were exposed to carcinogens.

Carcinogens, Environmental↗

PubMed2002

Occupational health care system and its effectiveness in Lithuania.

The Ministry of Labor and Social Affairs in collaboration with the Ministry of Health Care carries out the activities aimed at solving occupational health and safety problems in Lithuania. Occupational health care system in Lithuania consists of three levels: 1) primary occupational health centers in the industry; 2) general practitioners taking care of employees' health; and 3) the State Labor Inspectorate. The second level includes regional occupational medicine centers that are located in the three major cities of Lithuania: Vilnius, Kaunas and Klaipeda. Hygiene investigations of workplaces and prophylaxis of occupational diseases are performed by regional Public Health Center Departments of Occupational Medicine. The third level is provided by the Lithuanian Center of Occupational Medicine in Vilnius and the State Commission of Medical and Social Examination. The complicated cases of occupational diseases are treated in specialized departments of the University clinics. The real situation of work safety is not good. About 600 cases of occupational diseases and over 2500 accidents, including 60 fatal causalities are registered annually.

Accidents, Occupational↗

PubMed2002

[The prevalence of type I diabetes mellitus among adult population of towns and regions of Lithuania].

UNLABELLED: OBJECTIVE, MATERIAL AND METHODS: The goal of study was to analyze the prevalence rates in > 15-year-aged patients with Type 1 (insulin-dependent) diabetes mellitus in different provinces, cites, and regions of Lithuania. The data on > 16-year-aged patients were collected with the help of endocrinologists and physicians-internists working in the diabetes care in all towns and regions in Lithuania. The data on > 14 and < 16-year-aged patients we have received from the National children Insulin-dependent diabetes mellitus Register. RESULTS: On 31 December 1998 there were 1, 744 > or = 15-year-aged and adult Type 1 diabetic patients or 140.97 per 100,000 (95% uneven Poisson confidence interval was 134.97-143.43) living in 12 cities of national jurisdiction and 1,609 or 112.22 (107.10-117.57) living in 44 country-side regions, p > 0.05. Male/female ratio of prevalence rates in cities was 1.48, and in country-side regions--1.44. The prevalence rates of Type 1 diabetes mellitus in cities with > or = 100,000 inhabitants vary from 123.70 (107.73-142.04) in Klaipeda city to 173.34 (159.85-187.97) (p > 0.05) in Kaunas city. The prevalence rate of Type 1 diabetes mellitus in localities with < 70,000 inhabitants vary from 61.31 (37.56-100.08) in Lazdijai region to 184.25 (130.30-260.55) in Druskininkai health-resort or 228.53 (109.09-480.00) in Birstonas health-resort. The prevalence rate of Type 1 diabetes mellitus was 118.47 (102.73-136.62) in Alytus province, 152.95 (143.39-163.215) in Kaunas province, 121.04 (109.66-133.60) in Klaipeda province, 115.07 (96.00-137.93) in Marijampole province, 125.30 (112.28-139.83) in Panevezys province, 114.46 (105.10-129.04) in Siauliai province, 115.12 (95.89-138.21) in Taurage province, 137.01 (118.85-157.95) in Telsiai province, 98.23 (84.05-114.81) in Utena province and 117.75 (110.10-125.93) in Vilnius province. The male/female ratios of rates were 1.71, 1.35, 1.39, 1.14, 1.87, 1.67, 1.72, 1.12, 1.31 and 1.51. CONCLUSION: There were no statistical significant differences between Type 1 diabetes mellitus prevalence rates in different localities in Lithuania.

Adolescent↗

PubMed2002

[Trends in health care expenditures in Lithuania].

The aim of the study was to analyze the tendencies of public and private health care expenditure in Lithuania during 1994-1999. Crude examination of statistical data show, that the growth rate of health care spending per capital is largely determined by growth of national gross domestic product (GDP). We have estimated that health care spending in Lithuania have risen twice faster than GDP during 1994-1999. (Percentage of rise in health care spending, divided by percentage rise of GDP, is +2.26). The introduction of compulsory health insurance in 1997, and the development of private health care sector in Lithuania, led to increase health care expenditure in total, and has influenced changes in public-private spending proportions. A source of private spending in national health account has increased from 15 per cent in 1994-1995 to 24 percent in 1996-1999. The tendency of increasing private spending shows, the evidence, that households are facing more financial risk of purchasing health care. This should be an implication for health care policy makers. Further decisions to increase private payments have to be based on evidence after detailed analysis of impact of consequences on health care access for various social economic groups of population.

Financing, Government↗

PubMed2002

[Professional associations of pharmacists in Lithuania: history and directions of activity].

UNLABELLED: The aim of this study was to describe the historical development of pharmaceutical organisations, their tasks and ability to fulfill them. In the XIXth century a rapid development of the science of pharmacy influenced a need for scientific collaboration. Thus, in 1819 Department of Pharmacy of Vilnius Medical Society was founded by Vilnius chemists. The main directions of the activity of the members of this department were the following: scientific investigations, solution of practical tasks, spreading of pharmaceutical information, popularization of the knowledge of pharmaceutical science. However, a progressive dynamic development of pharmacy was hindered by unfavorable political and economic factors. In 1917, Lithuanians working in Russia united in a "Society of Lithuanian Pharmacists". The operation of the society was concerned with nationality, which was the main and the only direction of activity. There were four pharmaceutical organizations acting in the Independent Republic of Lithuania (1918-1940). In 1940, after Lithuania's annexation to the USSR, all pharmaceutical professional associations were eliminated. In 1948, Lithuanian Scientific Society of Pharmacists was founded. Despite its professional tasks it had also to proclaim ideological aims. CONCLUSION: Professional activity was influenced by unfavorable political conditions in the country. Independence of social professional associations was limited by czarist Russia, as well as by Soviet authorities. Department of Pharmacy of Vilnius Medical Society had a great influence upon the progress of pharmacy of that time. Associations acting in the Independent Republic of Lithuania were able to defend their business interests, participate in international activity, deal with the affairs of science, the heritage of the pharmacy, and representation of their profession.

Education, Pharmacy↗

PubMed2003

[Water treatment systems of hemodialysis centers in Lithuania and trace metals in purified water in 2002].

The objective of this survey was to obtain information on hemodialysis chemical water quality and on water treatment systems of hemodialysis centers in Lithuania. Five trace metals (Al, Pb, Cd, Zn, Cu) were examined in the purified water (sample from a point after the water treatment system) of 28 hemodialysis centers. Atomic absorption spectrophotometry was applied to measure water trace metals levels. All hemodialysis centers in Lithuania used treated water. Softeners were used by 100%, reverse osmosis by 86.2% of the centers. Concomitant use of sand filter, softeners, activated carbon, reverse osmosis was found in 72.4% of the centers. The age of the water treatment system varied from 1 to 117 months (mean=39.7+/-30.4). Concentrations of Al, Pb, Cd, Zn, Cu in the purified water of 28 hemodialysis centers did not exceed standards of the European Pharmacopoeia. There was significant decrease in the mean levels of investigated trace elements in the treated water in Lithuania in 2002 compared with examined in 1998.

Aluminum↗

PubMed1992

[Studies of AIDS in Lithuania].

The seroepidemiological survey of 400,000 persons aged 20-40 years and belonging to different AIDS risk groups, as well as blood donors, for the presence of antibodies to HIV has been carried out on the territory of Lithuania. This investigation has been made with the use of the assay systems "Antigen", "Peptoscreen" and "Vector" manufactured in the USSR, as well as commercial assay systems from foreign manufacturers, such as Du Pont de Nemours Inc., Organon N. V., Abbott Laboratories, Serodia. The comparison of the results thus obtained has revealed that high frequency of false positive results is characteristic of all assay systems under study, including immunoblotting. These data indicate that test systems based on different acting principles should be used for the detection of anti-HIV antibodies. For the first time a HIV-infected resident of Lithuania has been detected. The investigation carried out in Lithuania has shown that HIV infection is not widely spread in this region, but due to some objective reasons this does not preclude the necessity of the constant epidemiological surveillance of this infection throughout this territory in order to bar the way to this infection.

Acquired Immunodeficiency Syndrome↗

PubMed2005

High prevalence of drug-resistant tuberculosis, Republic of Lithuania, 2002.

BACKGROUND: Nations of the former Soviet Union have the world's highest reported levels of resistance to anti-tuberculosis drugs. We conducted the first national survey of anti-tuberculosis drug resistance in the Republic of Lithuania. METHODS: We tested Mycobacterium tuberculosis isolates from all incident culture-positive pulmonary TB patients registered in 2002. New patients were those treated for <1 month with any first-line anti-tuberculosis drug (isoniazid [INH], rifampin [RMP], ethambutol, or streptomycin); previously treated patients were those treated for > or =1 month. RESULTS: Of 1163 isolates, 475 (41%) were resistant to at least one first-line drug, and 263 (23%) were resistant to at least INH and RMP (MDR); this included 76/818 (9.3%) from new patients and 187/345 (54%) from previously treated patients. Of 52 MDR isolates randomly selected for extended testing at an international reference laboratory, 27 (51%, 95%CI 38-66) had resistance to pyrazinamide, 21 (40%, 95%CI 27-55) to kanamycin, and 9 (17%, 95%CI 8-30) to ofloxacin. CONCLUSIONS: The prevalence of MDR-TB in Lithuania is among the world's highest. Among MDR-TB isolates, aminoglycoside and fluoroquinolone resistance were common. To combat drug-resistant TB, Lithuania has implemented the WHO global TB control strategy (DOTS), and is developing an MDR-TB treatment program (DOTS-Plus).

Adolescent↗

PubMed2005

[Development of nephrology in Lithuania].

This article reviews the development of nephrology in the different regions of Lithuania. History of Lithuanian nephrology started in Vilnius in 1969 when the first hemodialysis was performed in the oldest hospital of Lithuania. In 1969 the clinics of Kaunas Medical University started hemodialysis service, in 1977-Panevezys hospital, in 1991-Siauliai hospital and in 1993-Klaipeda hospital. In 1965 Assoc. Prof. S. Markovicius began to give a course in nephrology at the Faculty of Medicine of Vilnius University. In 1967 the first department of nephrology in Lithuania was opened at Vilnius City Hospital.

Adult↗

PubMed2006

Health behavior among Lithuania's adolescents in context of European Union.

AIM: To compare health behavior patterns of adolescents in Lithuania with health behavior of adolescents in European Union (EU) in 2001/2002. METHODS: The study was carried out in conformity with the methodology of Health Behavior in School-aged Children: a World Health Organization cross-national study. Three country representative samples of schoolchildren, aged 11, 13, and 15, were surveyed in 25 EU countries and regions in 2001/2002 school year. The study instrument was a standardized questionnaire that included questions on alcohol consumption, smoking, illegal drugs use, physical activity, and other patterns of health behavior. The rate or mean values of the targeted health behavior of Lithuanian students were assessed and compared to those calculated as an average for the EU countries and regions. RESULTS: We found an early onset of alcohol consumption among Lithuanian boys. Lithuanian boys and girls across all age groups reported being drunk two and more times more often than their peers from other EU member states. Lithuanian 15-year-old boys smoked more often that did their European peers, while girls smoke more rarely. The prevalence of drugs (marihuana group) use among Lithuanian students is relatively low: the prevalence of drug use among 15-year-olds in Lithuania is two times lower than the prevalence in other EU countries and regions (11.2% vs 24.5% for boys and 4.5% vs 18.3% for girls, respectively). Physical activity of Lithuanian adolescents is rather high in comparison with their EU peers, although many students watch television for > or =4 hours a day. Lithuanian students did not eat sweets often, or drank soft drinks (Coca Cola and other), and they ate fruits and had breakfast every school day. With respect to hygienic habits, approximately only one in 3 boys and every second girl brushed their teeth more than once a day. CONCLUSIONS: There are health behavior differences between adolescents in Lithuania and those in other EU countries. The disparities among health behavior of young people in EU countries and regions require Lithuanian and EU health policy to develop initiatives aimed at decreasing health behavior inequalities.

Adolescent↗

PubMed2006

[Survey on drug-related problems in Lithuania's pharmacies].

OBJECTIVE: to survey the most common and the most important drug-related problems in Lithuania, to explore their solution and factors influencing it, to formulate recommendations for solving drug-related problems. MATERIAL AND METHODS: Pharmacists from community pharmacies participated in a random survey. They filled in questionnaires about drug-related problems and their solutions. It was the first survey on drug-related problems ever carried out in Lithuania. RESULTS: For the first time, it was found out that in Lithuania pharmacists most commonly encountered drug-related problem--additional drug therapy (52.03% of respondents)--and most rarely encountered drug-related problem--dosage too high (3% of respondents). Pharmacists stated that all categories of drug-related problems were of equal importance. It was established that pharmacists commonly solved drug-related problems associated with noncompliance with instructions (72.5% of respondents) and rarely met the problem when improper drug was selected (39.56% of respondents). CONCLUSION: Patients taking prescription medicines commonly encounter additional drug therapy problem, and patients taking nonprescription medications commonly encounter problems related to noncompliance with instructions.

Community Pharmacy Services↗

PubMed1995

Hepatitis C in Lithuania: incidence, prevalence, risk factors and viral genotypes.

BACKGROUND: The epidemiology of hepatitis C virus (HCV) infection has been studied in many countries. However, little is known about HCV infection in Lithuania, a Baltic country, that was part of the former Soviet Union. OBJECTIVES: The aim of this study was to determine and evaluate the etiology of acute viral hepatitis, the risk factors for acquiring HCV in comparison to hepatitis B virus (HBV), seroprevalence of anti-HCV among blood donors and risk groups of the population in Lithuania. The distribution of HCV genotypes from Lithuanian first-time blood donors was also assessed. STUDY DESIGN: Sera taken from clinical viral hepatitis patients, blood donors, risk groups of population were investigated serologically. Patients with acute viral hepatitis were interviewed to determine their risk factors for HCV and HBV. HCV genotyping was done by PCR using type specific primers. RESULTS: Acute hepatitis C accounted for 5.0-8.5% of reported viral hepatitis cases in adults in Vilnius. Of the acute hepatitis C cases, 37.0% was associated with blood transfusions before the implementation of screening of blood donors for anti-HCV and only 15.4% (2/13) after the screening was started. Anti-HCV was found in 2.2% of first-time blood donors, in 7.9% of commercial blood donors, in 13.9% of commercial blood plasma donors, in 48.3% of hemodialysis patients, in 29.4% of prisoners, in 9.4% of elderly nursing home residents, and in 7.9% of hemodialysis staff. The following distribution in genotypes were found: genotype 1b (54.3%), 3a (23.9%), 2a (10.9%) 2b (4.3%), 1a (0%), and double infection (6.5%). CONCLUSIONS: Lithuania is a country with a considerable hepatitis C problem.

Journal Article↗