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PubMed2001

Socio-economic, demographic and obstetric risk factors for late fetal death of unknown etiology in Lithuania: a case--referent study.

BACKGROUND: The purpose of this study was to evaluate the association between third trimester unexplained prelabor fetal deaths and various socio-economic, demographic and obstetric factors in Lithuania. METHODS: A case-referent study on 58 women with third trimester fetal death and 116 women with live fetus at term was carried out. Inclusion criteria for women in the first group (cases) were: prelabor fetal death of unknown etiology, singleton pregnancy >26 weeks of gestation and intact fetal membranes. For each case two referent women were recruited, admitted during the same period in active phase of labor at term (>37 weeks of gestation) with intact fetal membranes and fetus alive. Data were obtained by interview, anthropometry and by reviewing the medical records. Several potential socio-economic, demographic and obstetrical risk factors for unexplained fetal death were investigated. RESULTS: Univariate analyses determined several factors that were associated with fetal death of unknown etiology: low educational level, single marital status, low income, etc. After secondary logistic regression analysis only three independent variables remained significantly associated with otherwise unexplained stillbirth: small for gestational age fetus (OR 29.6; 95% CI 6.2-141.6), low income (OR 7.4; 95% CI 3.1-17.6), and maternal white blood cell count more than 16,000/mm3 (OR 5.4; 95% CI 1.4-21.6). Body mass index, smoking, occupation of women and other evaluated parameters were not confirmed to be significant risk factors. CONCLUSION: Small for gestational age fetus, low income and elevated maternal white blood cell count are factors significantly associated with late prelabor fetal death in Lithuania.

Adult↗

PubMed2001

Child and adolescent mental health emergency services in Lithuania.

This paper describes the development of emergency mental health services for children and adolescents in Lithuania over the past decade. The dramatic changes in child and adolescent psychiatry which correspond to the move away from the Soviet school to democracy and the restoration of the independent Lithuanian state are outlined. The paper includes: the nature of child mental health emergencies in Lithuania, how they are evaluated, follow-up care, training and supervision, and societal emergencies. Recommendations for the future are made.

Adolescent↗

PubMed2002

[Cardiac pacing activities in Lithuania in the background of other European countries].

Survey of pacemaking activities of the three Lithuanian centers (located in Kaunas, Vilnius and Klaipeda) is presented. Results of the last eight years are analyzed and compared with the activities of the rest European countries. According to the index of number of primary implantations per 1 million of population/per year Lithuania has ranked in 19th position. Annual number of implantations of cardioverter-defibrillators is approximately 5-10. These results demonstrate that Lithuania lags behind the majority of European countries. There is a need to increase the activities both in implantation of pacemakers and cardioverter-defibrillators as well.

Cardiac Pacing, Artificial↗

PubMed2003

Validation of PAH genotype-based predictions of metabolic phenylalanine hydroxylase deficiency phenotype: investigation of PKU/MHP patients from Lithuania.

BACKGROUND: Phenylalanine hydroxylase (PheOH) deficiency is inherited as an autosomal recessive trait. The associated hyperphenylalaninemia phenotype is highly variable, primarily due to great allelic heterogeneity in the PAH locus. The goal of our study was to assess the relationship between individual PAH locus mutations and biochemical and metabolic phenotypes in phenylketonuria (PKU) and mild hyperphenylalaninemia (MHP) patients. MATERIAL/METHODS: In this study, a total of 184 independent PAH chromosomes (92 unrelated patients with PKU and MHP residing in Lithuania) were investigated. All 13 exons of the PAH gene of all PKU probands tested were scanned for DNA sequence alterations by denaturing gradient gel electrophoresis (DGGE); mutations were identified by direct fluorescent automated sequencing or by restriction enzyme digestion analysis of the relevant exons. PAH genotype-based prediction of metabolic PhOH deficiency phenotype in PKU/MHP patients form Lithuania was estimated by the assigned value (AV) and functional hemizygosity methods. RESULTS: Our data provide evidence that a simple genotype-phenotype correlation does exist in most patients with PheOH deficiency: we observed a perfect match between the expected and observed phenotypes in 96% of the cases investigated. CONCLUSIONS: The results obtained confirm that methods of functional hemizygosity and AV sum are applicable for the estimation of the genotype-phenotype correlation in the investigated group of PKU/MHP patients.

Female↗

PubMed2003

[Survival of patients with lung cancer in Lithuania (1995-1997)].

OBJECTIVE: The study is aimed to evaluate the survival of lung cancer patients diagnosed in Lithuania 1995-1997. MATERIAL AND METHODS: Based on Cancer registry material, 4337 of 4746 new lung cancer cases were included into the study group. Only cases with primary lung cancer were included into the study; cases at autopsy and death certificate only cases were excluded from the study. The closing date of follow-up was June 30, 2002. At that time 3966 (91.4%) patients of the study group died, 339 (7.8%) survived and 32 (0.7%) were lost on follow-up. RESULTS: The relative five-year survival rate was estimated to be 9.0% for male and 18.3% for female. Cox proportional hazard modeling has indicated tha females had better survival than males (RH(female)=0.84, 0.76-0.92). Males living in large cities had better prognosis than other urban or rural patients (RH(towns)=1.18, 1.09-1.27, RH(rural)=1.27, 1.17-1.40). Elder patients (75 and older, both women and men) had worse survival than those at age of 64-74. Annual relative rates were improving on follow-up and exceeded 90% of population level for women at the third year (men at fifth year) and has dropped down at the sixth year of observation. CONCLUSION: Compared to European survival rates, one-year and five-year survival of patients with lung cancer in Lithuania is lower than European average for men, and alike for women. Recent high mortality/incidence ratio does not allow predict an increase of survival rates.

Age Factors↗

PubMed2003

[Irrational drug use in Siauliai, Panevezys and Utena counties of Lithuania].

UNLABELLED: In our study, we aimed to investigate the irrational use of the reimbursed drugs in some counties of Lithuania in 2001 by investigating the viewpoints of the physicians to the problems of the irrational pharmacotherapy, possible causes and solutions of them. This investigation was designed as a qualitative structured questionnaire. The study was composed of two stages. The personal health records of 2001 of Siauliai, Panevezys and Utena counties residents were analyzed and the cases of irrational drug use were selected, examined and verified during the first stage. There were 318 personal health records analyzed and 111 cases of irrational drug use verified. The 23 problems of irrational pharmacotherapy were distinguished and classified according to the responsibilities. The viewpoints of the physicians to the problems of the irrational pharmacotherapy were confirmed and analyzed during the second stage of the study. Thirty-one physicians were interviewed and responses summarized. CONCLUSIONS: 1. The irrational drug use took place in Siauliai, Panevezys and Utena counties of Lithuania in 2001. 2. Twenty-three types of problems of irrational pharmacotherapy can be distinguished. They can be classified into the 3 main levels according to the responsibility: the level of the administration (institution), the physician and the patient; other problems can be distinguished separately. 3. The most frequently specified by physicians possible reasons of the irrational drug use were the lack of information, the overcharge of the physician and the lack of the qualification. 4. The most frequently specified possible solutions of the irrational drug use by physicians were the growth of qualification, the establishment of the algorithms and the increase of the time spent per patient. 5. There was noticed particular tendency at the level of the physicians: physicians eliminated their responsibility at this level and related the problems with other levels--the levels of the administration (institution) and the patient.

Attitude of Health Personnel↗

PubMed2003

[Phytochemical research of hawthorn species introduced in Lithuania].

UNLABELLED: The natural vegetable resources of Republic of Lithuania can be supplied by imported hawthorn species, subspecies and varieties, not growing naturally in the territory of country, but well growing and able to produce the crude drug with local conditions of the climate. OBJECTIVE: Determinate amounts of phenolic substances (favonoid glycosides and phenolic acids) in the flowers and leaves of collected species of genus Crataegus and Crataegomespilus. MATERIALS AND METHODS: Different examples of crude drug from some Lithuanian regions were extracted with 96% of ethanol and flavonoids were detected spectroscopically and with HPLC (High performance liquid chromatography). RESULTS: In leaves and flowers were found different quantities of common amounts of flavonoids (1.07-2.53%) and different quantities of individual substances: flavonoids (hyperosid, vitexin-O-rhamnosid, rutin, quercitrin, quercetin, vitexin) and phenolic acids (chlorogenic and caffeic acids). CONCLUSION: Flowers and leaves of hawthorn species, introduced in Lithuania, can be used for preparation of crude drugs procurements; the marks of phytochemical compounds of phenotypes from different genetic lines are sufficient grounds for planning of production of crude drug with special phytotherapeutic influences.

Chromatography, High Pressure Liquid↗

PubMedDate not supplied

Environmental monitoring in Lithuania. Environmental distress signals: gastrointestinal epithelial barrier after exposure to chemical agents.

Lithuania's environment is heavily polluted as a result of domestic and transboundary contamination. The main ecological problems are related to atmospheric pollution; water contamination; soil, water, and forest acidification; nitrogen-compounds overload of soil, water, and food; and contamination with agricultural chemicals and heavy metals. The increased environmental distress is a menace to public health in Lithuania. Experimental studies need to be designed and used to ascertain the effects of environmental distress on the gastrointestinal tract epithelial barrier. Our electronmicroscopic and immunohistochemical study of human gastrointestinal endocrine cells revealed changes in the amount of secretory material and intracytoplasmic vacuolization after exposure to the environmental chemicals such as hexavalent chromium and the herbicide Saprol. The most affected were the EC (serotonin, motilin, substance P), D (somatostatin), A (glucagon), B (insulin), and mast (histamine, serotonin, heparin) cells. These results provide ultrastructural evidence of digestive tract epithelial barrier reaction as an expression of environmental distress signals of the organism.

Animals↗

PubMed2003

An evaluation of laryngeal cancer morbidity time trends in Lithuania.

PURPOSE: To make assessments of the rates of cases of larynx cancer in Lithuania in the years 1978-2001 as well as possible trends of changes in the future. MATERIAL AND METHODS: The data contained in the Lithuanian Cancer Register for the period 1978-2001 about new cases as well as the data compiled by the Lithuanian Department of Statistics on the average number of population of Lithuania within the same period in the same age groups have been used in the course of the study. The data have been standardized by age using direct method, in accordance with the European standard; a regression analysis of larynx cancer case rates was made. RESULTS: After standardization of data for the period 1978-2001, tendencies of increase have been registered both among men and women: in 1978 the case rate per 100,000 population was 10.73 among men and 0.26 among women, in 2001 the corresponding data were 11.6 among men and 0.7 among women. Throughout the period the investigated case rate for men was higher than for women. An increasing average age of men and women suffering from this disease has been noticed: average age for men is annually increasing by 0.1566 years and for women--0.0602 years. The forecast for men in the year 2006 is 13.88 cases per 100,000 population and 0.54 for women. CONCLUSIONS: The increase of larynx cancer case rates is growing more rapidly among women than among men, and also average age of the patients is increasing. The forecast is that in 2006 the case rate will be growing up, and both men and women will get ill at older age.

Female↗

PubMed2004

Epidemiology of HIV/AIDS in Lithuania in 1988-2001: review of present situation and prognosis of HIV transmission trends.

The aim of this study was to review epidemiological situation of HIV infection and AIDS in Lithuania during 1988-2001 and to try to forecast possible trends of further HIV transmission. The data were obtained from the database of Lithuanian AIDS Center, which is the only organization in Lithuania in charge of HIV epidemiological data sampling and analysis. First, the general overview of both development of the HIV/AIDS epidemics, reporting and surveillance system is presented that proves systematic and scientific approach to the problem, while taking into consideration recommendations and guidelines of key international organizations acting in the HIV/AIDS field. Secondly, HIV transmission trends are analyzed in the so-called target groups including intravenous drug users, sex workers and homosexuals. Lastly, cases of a full-blown HIV infection--AIDS are discussed allowing to track epidemics from the very beginning.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Maternal socio-economic factors and the risk of low birth weight in Lithuania.

AIM: To evaluate the importance of maternal socio-economic factors on the risk of low birth weight in Lithuania. MATERIAL AND METHODS: The case-control study involved 851 newborns with low birth weight (<2500 g) (cases) and 851 newborns with normal weight (controls). Study was accomplished from 1st February, 2001 until 31st October, 2002 in six main maternity hospitals in Lithuania. Mothers of infants were interviewed on the first day after delivery using the structured questionnaire. The database was processed by the application of statistical package "SPSS for Windows v.10.0". RESULTS: Young (<20 years) and older (35 years and older) maternal age, primary or basic education, being single, divorced or widowed, low income, living in rural area and unemployment before pregnancy and during pregnancy increased the risk to deliver low birth weight baby in univariate analysis. In logistic multivariable regression analysis, low education, low income and unemployment during pregnancy significantly increased risk of low birth weight--OR - 2.0, 1.7 and 1.6 respectively. Interaction between several unfavorable risk factors increased risk of low birth weight by 3.4-7.8 times, being the highest among mothers with low education, unstable marital status and low income. CONCLUSION: Maternal unfavorable socio-economic factors increased the risk to deliver low birth weight baby.

Adult↗

PubMed2004

Healthy life expectancy--an important indicator for health policy development in Lithuania.

UNLABELLED: The aim of the study was to assess the changes in healthy life expectancy of the Lithuanian population between the years 1997 and 2001 and to explore the differentials of this combined mortality and subjective health measure in males and females. MATERIAL AND METHODS: The data about the Lithuanian population and the deceased were available from the Lithuanian Department of Statistics, life tables for 1997 and 2001 were created and life expectancy estimated. The method presented first by D. F. Sullivan was applied for the assessment of healthy life expectancy. The data on self-perceived health of the Lithuanian population were acquired from the surveys of the health behavior of a randomly selected sample of the adult population of Lithuania, carried out by the Lithuanian Center for Health Education. RESULTS: Healthy life expectancy at birth increased from 52.7 in males and 52.6 in females in 1997 up to 53.7 in males and 55.3 in females in 2001. The proportion of healthy life expectancy in the total life expectancy at birth increased both in males and in females. Though the total life expectancy of males is 10-11 years shorter, females are expected to spend considerably more years in poor health, even though some positive changes were observed. CONCLUSION: Increasing healthy life expectancy reflects improving health of Lithuanian population. This integrated health indicator should be periodically assessed and used for development health strategies to promote health in Lithuania.

Adolescent↗

PubMed2004

[Methods of suicides in Lithuania and their associations with demographic factors].

Methods of completed suicides in relation to gender, age and place of residence and their changes in Lithuania during 1993-1997 and 1998-2002 were analyzed in this study. Data on completed suicides (n=16147) was compiled from the computerized database of the Lithuanian Department of Statistics. Hanging was the most common method of completed suicides in Lithuania. Proportion of hanging among the other methods of suicides increased from 87.3% during 1993-1997 till 90.1% during 1998-2002. Proportion of hanging increased most notably among girls aged 10-19. Hanging, as the method of suicide, was more prevalent among males in comparison to females and among rural residents in comparison to the urban population. Proportion of hanging had the increasing tendency with an increase of age. The next most prevalent method of suicide among males was firearm, while among females--poisoning, jumping from the height and drowning. Different types of poisoning were more prevalent among adolescents, particularly among girls, in comparison to the adult population. Poisoning and jumping from the height were more common among urban males and females if compared to the rural population.

Adolescent↗

PubMed2005

[Health resorts and development of the health resort medicine in Lithuania].

Lithuanian health resorts are national resources of this country. Body hardening, health promotion, disease prevention and rehabilitation by means of applying natural factors are linked for centuries with the names of health resorts such as Druskininkai and Birstonas. The effect of natural factors is multiplex and depends on many parameters the study of which in concrete health resorts is indispensable in order to individualize the treatment at the health resorts and avoid undesirable side effects. As the contingent of the patients being referred to the sanatoria is changing--the number of severe patients after acute disorders and traumas is increasing constantly--the need of such studies becomes relevant. However, after renewal of independence of Lithuania in 1990, the policy of health resort development on the national scale has not been carried out yet. Besides, the number of localities that aim for becoming health resorts is increasing, however, such localities often do not meet the required criteria. The article reviews the status of health resorts and their localities together with their regulations in Lithuania, their development, specificity, the effects of the health resort natural factors (climatotherapy, balneotherapy, pelotherapy) on the healthy body and patients. The data are presented on the development of research studies concerning health resorts and main trends of health resort medicine: health promotion, prevention of disorders, early health resort rehabilitation, health resort tourism, treatment and health resort etiology. Possibilities of revival of studies concerning the effects of health resort factors on the rehabilities are discussed.

Balneology↗

PubMed2006

Trends in the consumption of antidepressant drugs in Lithuania in 2002-2004.

OBJECTIVE: To evaluate trends in the use of antidepressant drugs in Lithuania between 2002 and 2004 and to perform cost-minimization and reference price analysis enabling more rational use of financial resources of national health system. MATERIAL AND METHODS: The data on sales of antidepressant drugs in Lithuanian over a 3-year period (2002-2004) were obtained from IMS Health Inc. database. Data were calculated by defined daily dose (DDD) methodology and expressed in DDDs per 1000 inhabitants per day. DU90% was used as the quality indicator of the drug prescribing. The pharmacoeconomic analysis of antidepressant drugs was performed by cost-minimization and reference price methodology. RESULTS: The consumption of antidepressants in Lithuanian increased by 30.55% over a 3-year period (2002-2004) reaching the value of 10.00 DDDs/1000 inhabitants/day. Since 2002, the proportion of use of selective serotonin reuptake inhibitors has increased by 27.82%, and the use of tricyclic antidepressants has declined by 10.78%, while the use of other (newer) antidepressant drugs expanded almost three times. The expenditures of antidepressant drugs have reached 26 million Lt in 2004, of which 68.15% were costs for selective serotonin reuptake inhibitors. Choosing the second lowest price in different antidepressant drug class, it is estimated the possible savings of 4.34 million Lt lowering the total expenses by 16.5% (1 euro=3.4528 Lt). CONCLUSIONS: The findings suggest that the use of total antidepressant drugs continues to increase because of the increased use of selective serotonin reuptake inhibitors and other (newer) antidepressant drugs. In comparison with the data in other countries, the consumption of antidepressant drugs in Lithuania is low.

Adult↗

PubMed1995

Simultaneous introduction of distinct HIV-1 subtypes into different risk groups in Russia, Byelorussia and Lithuania.

OBJECTIVE: To investigate genotypes and serotypes of HIV-1 variants in Russia, Byelorussia and Lithuania. PATIENTS AND METHODS: Sera from 20 HIV-1-infected individuals were tested in an enzyme-linked immunosorbent assay (ELISA) with 19 V3 synthetic peptides, and serum HIV-1 V3 RNA was amplified and sequenced. RESULTS: Sequence comparison of the envelope V3 region among specimens tested revealed a 2-29% range nucleotide divergence, with a mean of 19%. Phylogenetic analysis from the homosexual men were shown to belong to subtype B, and all of the heterosexually infected individuals to subtype C. Sequences from the parenterally infected individuals were more heterogeneous. IOn the peptide ELISA three reactivity patterns were found. Serum samples from six out of seven homosexual men showed reactivity to peptides p108 or p110 representing V3 amino-acid sequences found in US/West European HIV-1 isolates. Serum samples from six of seven individuals who had acquired HIV-1 through heterosexual contacts were reactive to peptide p169. Four out of six parenterally infected patients had peak reactivity to p168. CONCLUSION: Distinct HIV-1 variants were found in Russia, Byelorussia and Lithuania, which were introduced simultaneously in the mid-1980s. This diversity was shown to be associated with the route of transmission. Homosexual men appeared to be infected with subtype B and heterosexually infected individuals with subtype C HIV-1 variants. HIV-1 subtypes A, C, D and G were found among parenterally infected individuals.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Tick-borne encephalitis virus in Lithuania.

Tick-borne encephalitis (TBE) is a severe problem in Lithuania, indicated by the 171 to 645 serologically confirmed cases that occurred each year between 1993 and 1999. In the present report, the first isolation and partial genetic analysis of a Lithuanian TBE virus (TBEV) strain isolated from a patient's serum sample is described. The patient was bitten by a tick while visiting the Lazdijai district (Veisiejai forest) in the southernmost part of Lithuania, a geographical area where Ixodes ricinus but not Ixodes persulcatus ticks are known to be present. The E protein-encoding viral gene sequence (nt 74-1273) recovered from the TBEV isolate showed the closest similarity to previously characterized European strains of the Western TBEV subtype, including the prototype TBEV strain Neudoerfl and those from neighbouring Latvia. Accordingly, the Lithuanian isolate was placed within the Western genetic lineage of TBEV in phylogenetic trees.

Adult↗

PubMed2000

Changes in women's health in the Baltic republics of Lithuania, Latvia and Estonia during 1970-1997.

The rapid political, economic and social changes occurring in the Baltic republics of Estonia, Latvia and Lithuania fundamentally affect female health. Demographic trends, morbidity and mortality indicators point to a general decline in the status of women's health in the three Baltic republics since their independence from the Soviet Union. The transition period from socialist to market economy has clearly taken a toll in women's health. These have to be taken into consideration by health authorities in Lithuania, Latvia, Estonia as well as the European Union during the undergoing reforms being planned for healthcare systems in all EU countries in accession.

Adolescent↗