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PubMed1998

Autoantibodies in Estonia and Sweden, populations with different responses to allergens.

BACKGROUND: There are substantial differences in immune-mediated disease prevalence between different countries and populations which cannot be explained by genetic variability. AIMS: To compare the prevalence of antinuclear (ANA), antimitochondrial, antireticulin, liver-kidney microsomal, parietal cell, thyroid microsomal and double-stranded DNA (dsDNA) antibodies among adults aged 20-44 years in two towns, i.e. in Tartu, Estonia (n = 448) and in Uppsala, Sweden (n = 532) with a low and a high prevalence of allergy. METHODS: For autoantibody detection, standard indirect immunofluorescence tests on tissue and Chritidia lucilia antigenic preparations were used (sera were diluted starting from 1:10). RESULTS: The prevalence of ANA was lower in Tartu than in Uppsala (3 vs. 10% among males and 11 vs. 16% among females; p<0.01 and p<0.1, respectively). Furthermore, dsDNA antibody-positive cases were only identified in Uppsala. The largest difference between the two populations was revealed for IgM type ANA, both among males (1 vs. 6%; p<0.02) and females (5 vs. 11%; p<0.01). In addition, the antibody titers were lower in Tartu than in Uppsala (p<0.05). The prevalence of other autoantibodies was similar in the two towns. CONCLUSIONS: The findings could support that Th2-like immune responses are commoner in Sweden than in Estonia, as previously suggested by the higher prevalence of allergy.

Adult↗

PubMedDate not supplied

Epidemiology of primary central nervous system tumors in Estonia.

During the period from 1986 to 1996, 1,665 cases of primary central nervous system (CNS) tumors were identified in the resident population of Estonia. Histological verification was available in 81% of the cases. Gliomas were more common in men, while meningiomas and neurinomas were more common in women. No significant difference was observed between the sexes for all primary CNS tumors. The age-specific incidence increased from the age of 30, reached a maximum in the age range of 50-69 years and declined in the elderly which may reflect under-diagnosis. The age-adjusted incidence rate for CNS tumors was 8.5/100,000 population. A comparison of our results with those of a previous study carried out in Estonia revealed a significant histology-specific increase in incidence in all age groups.

Adolescent↗

PubMedDate not supplied

Incidence of Parkinson's disease in estonia.

The incidence of Parkinson's disease (PD) was studied over a 9-year period (1990-1998) in Tartu county, Estonia, with a mean population of 156,417. Based on 264 patients, the average crude incidence rate of PD was 18.8 per 100,000 person-years. The age-adjusted incidence was 16.8/100,000; 18.3 for the urban group and 14.0 for the rural group; 16.6 for men and 17.1 for women. The age-specific incidence was 1.0/100,000 in the age range 30-39 years, reached a maximum of 117.2/100,000 in the age range 70-79 years and declined in the elderly. The incidence of PD was comparable with that found in developed countries, except for a slightly higher (not significant) incidence rate in the urban compared with the rural population in Estonia.

Adult↗

PubMed1996

Changed incidence and case-fatality rates of first-ever stroke between 1970 and 1993 in Tartu, Estonia.

BACKGROUND AND PURPOSE: The incidence of stroke has stabilized or increased in several developed countries recently, but few data about the trends are available from Eastern Europe. The study was designed to evaluate the possible changes of stroke incidence in Estonia. METHODS: A population-based stroke registry was conducted in Tartu during 1991 through 1993 (mean population, 110,631) to compare it with the study of 1970 through 1973 (population, 90,459). The majority of stroke patients were recorded prospectively, and most were hospitalized and evaluated by a neurologist. All available medical records were reviewed. Only first-ever stroke cases were registered. RESULTS: A total of 667 patients in 1970 through 1973 and 829 patients in 1991 through 1993 were recorded. The total annual incidence per 100,000 rose from 221 to 250 (P = .0173). The total rate for men increased nonsignificantly from 183 to 209 and for women from 258 to 284. Significant increases were observed for men aged 50 to 59 years and for women aged 50 to 69 years; for persons over 70 years, the rates slightly declined. The case-fatality rate at 1 month declined significantly, from 49% to 30%. CONCLUSIONS: A remarkable increase in the incidence and decline in the case-fatality rate of first-ever stroke was observed in Tartu, Estonia. The increase of incidence for those younger than 70 years could be due to the increased prevalence of risk factors. The decline in case fatality could theoretically be related to better management of secondary complications.

Adult↗

PubMed2005

Lessons from European population genetic databases: comparing the law in Estonia, Iceland, Sweden and the United Kingdom.

The advent of large-scale, population genetic databases (PGDs) in several countries around the world marks a significant development in human DNA banking and genetic research. The European countries that have led the way in the development of PGDs are Iceland, Sweden, Estonia and the U.K. In legal terms, the emergence of PGDs has been far from straightforward as such projects pose a range of difficult and complex issues for the law to address. This article canvasses the current law in Iceland, Estonia, Sweden and the U.K. on four fundamental issues of principle pertaining to PGDs, in order to illustrate the difficulties that have emerged around PGDs, highlight key areas of legal concern, and shed light on possible ways forward. It compares and contrasts the differing legal positions and lawmakers' responses to date in these four European countries that have established PGDs or are seeking to do so. The four fundamental issues examined are: (1) consent, especially for secondary research purposes; (2) ownership of biological samples, data and databases; (3) the rights of certain third parties to gain access to, and to use, PGD biological samples and data; and (4) benefit sharing, including the provision of feedback and genetic counselling to participants. This analysis may offer some guidance for policymakers in other jurisdictions where PGDs have been proposed or are being established.

Databases, Genetic↗

PubMed1999

Sexually transmitted infections in Estonia.

Estonia, one of the Baltic countries, regained its independence in 1991, after the collapse of the USSR. This process led to great changes in every sphere of life--in politics, in the economy and in medicine. The service providing care for sexually transmitted infections (STIs) was involved in the process of these changes, too. However, freedom was followed not only by great happiness, but also by social destabilization and transformation of the old moral norms, the most evident features of which were the dramatic rise in crime, a sexual revolution and public prostitution. These 2 great simultaneous transformations in the STI care system and public mores led to the rapid increase of STIs in Estonia in the first half of the 1990s. Now some stabilization, and even a fall in incidence has occurred.

Delivery of Health Care↗

PubMed1996

The historical background of the control of enzootic bovine leukosis in Estonia.

The authors describe the history of enzootic bovine leukosis (EBL) in Estonia, including the occurrence and distribution of disease within the cattle population, and the factors which have influenced disease spread since the 1950s. The principles of various control schemes which were applied from 1960 to 1994 are also surveyed. Considerable progress in eradicating EBL has been achieved during recent years, as a result of systematic serological herd testing, and the slaughter of cattle infected with bovine leukaemia virus (BLV). The decrease in the numbers of EBL-affected cattle may be expressed by the reduction in the number of leukotic tumour cases recorded annually: from an average of 180 cases per 100,000 cows in the 1980s to four cases in 1994; and by the decrease in the average prevalence of BLV-infected animals in the cattle population, from 31.4% in 1989 to 0% in 1994. The national EBL control programme will be continued. It is hoped that Estonia can be declared EBL-free within the coming years.

Animals↗

PubMed2004

Comparison of management and 30-day mortality of acute myocardial infarction in men versus women in Estonia.

OBJECTIVE: There is conflicting information about gender differences in clinical features, management and outcome after acute myocardial infarction (AMI). The objective of the study was to compare the baseline characteristics, management and 30-day mortality of AMI in men and women in Estonia. METHODS: This study included consecutive unselected patients from the Myocardial Infarction Registry (MIR) in Estonia, who were admitted to a university hospital between January 2001 and February 2002. Logistic regression analysis was used to estimate crude and adjusted odds ratios (OR) with 95 percent confidence intervals (95% CI). RESULTS: The study included 228 men and 167 women. Women were older than men (73.49 +/- 10.95 vs. 65.63 +/- 12.60, p < 0.000), and had more comorbidities. After age-adjustment, the higher prevalence of comorbidities, like diabetes (age-adjusted odds ratio [OR] 2.48, 95% confidence intervals [CI] 1.45-4.24), hypertension (OR 1.78, 95% CI 1.15-2.76) and history of congestive heart failure (OR 2.14, 95% CI 1.32-3.46) in women was preserved. Women were more frequently treated with diuretics (OR 2.68, 95% CI 1.69-4.25) and less frequently with statins (OR 0.61, 95% CI 0.39-0.96), after age-adjustment. Although thrombolytic therapy, coronary angiography and angioplasty were performed less frequently in women, these differences disappeared after age-adjustment. Female gender was not an independent predictor of 30-day mortality after AMI, crude OR was 1.39, 95% CI 0.80 to 2.41, adjustment for age and other covariates reduced OR to 0.98, 95% CI 0.44 to 2.20. CONCLUSIONS: Among AMI-patients, age but not gender is an important determinant of care and early mortality.

Acute Disease↗

PubMed2002

A study of intelligence in Estonia.

The Standard Progressive Matrices was standardised in Estonia in 2001 on a sample of 2,689 12- to 18-yr.-olds. The mean IQ of the Estonian sample was approximately 5 points higher than British IQ norms of 1979. Adjustment for the estimated secular increase of intelligence in Britain reduces the mean IQ of the Estonian sample to 100.2, in relation to a British mean of 100. A particular interest of the result from Estonia is that the intelligence of a European population is apparently not impaired by decades of low living standards.

Adolescent↗

PubMed1996

Induced abortions and childbirths: trends in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine during 1970 to 1994.

BACKGROUND: To analyse trends in childbirth, induced abortions and maternal morbidity from 1970 to 1994 in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine. METHODS: Official health statistics from the six countries were compiled and analysed. RESULTS: High abortion rates (up to 142 per 1000 women of fertile ages and years) were seen in all countries analysed, but since 1980 a continuing decrease is noted for Estonia, Latvia and Kalimingrad with a lowest rate of 50 abortions/1000 women/year in Latvia in 1994. Teenage abortions and childbirths are increasing. Maternal mortality, including complications of abortions, is still a reality in all the countries studied. CONCLUSION: The high abortion frequencies in all countries studied here indicate that national abortion prevention programs are needed. Such programs should focus on education, both of medical professionals, teenagers, fertile women and males. Concomitantly, the availability of cheap and modern contraceptives must increase, especially to defined risk groups.

Abortion, Induced↗

PubMed1995

Primary biliary cirrhosis in Estonia. With special reference to incidence, prevalence, clinical features, and outcome.

BACKGROUND: Primary biliary cirrhosis (PBC) is a liver disease of unknown etiology, whose occurrence varies greatly between different regions. For a long time there have been no published data about the incidence and prevalence of PBC from Eastern Europe countries. METHODS: The incidence and prevalence of PBC have been investigated in the Estonian population during the period 1973-92. Two sources of information were used: an information circular/questionnaire was sent to all district hospitals and gastroenterologists, and the case histories of all patients with a positive antimitochondrial antibody titer of 1:40 or more were reexamined. RESULTS: During this period 69 cases of PBC were diagnosed. The male to female ratio was 1:22; 13% of the patients were asymptomatic. The mean annual incidence was 2.27 per million, and on 31 December 1992 the point prevalence was 26.9 per million. There were differences in prevalence among the various districts of Estonia. Associated autoimmune conditions were reported in 32% of the patients. Mean survival from the time of diagnosis was 52.5 months. CONCLUSIONS: The incidence of PBC in Estonia is at the lower end of the range reported in the world literature. This has probably partly been caused by a low percentage of asymptomatic and male patients.

Adult↗

PubMed1997

Prevalence of Raynaud phenomenon in Tartu and Tartumaa, southern Estonia.

The aim of the present study was to estimate the prevalence of Raynaud phenomenon (RP) among Estonians in the general population of Southern Estonia. A random sample of 2626 Estonian subjects from the general population was asked about their fingers' sensitivity to cold and color changes by a mail survey. A subsample of 457 subjects was examined to confirm the diagnosis of RP, using a standard interview assisted by color charts (a color scale and hand photographs). In addition to a short clinical examination, the nailfold capillaries were examined by in vivo microscopy and a blood sample was drawn for ANA testing. The prevalence of RP, based on the presence of blanching, alone or with cyanosis, was 8.3% +/- 0.91% (SE) for women and 7.9% +/- 1.62% for men. The prevalence increased with age and, in men, was related to occupation. Smoking was also associated with RP among men but the effect was difficult to separate from that of the occupational influences because of the high proportion (84.2%) of current and past smokers among male manual workers. RP among the Estonians in Southern Estonia has a lower prevalence than in other countries with comparable climate, its female to male ratio is low, and it is related to occupation and smoking in men.

Absenteeism↗

PubMed2006

Lactase non-persistence and milk consumption in Estonia.

AIM: To define the frequency of the C/T-13910 variant associated with lactase persistence/non-persistence trait and to analyze the milk consumption of lactase non-persistent subjects in Estonia. METHODS: We genotyped 355 Estonians by polymerase chain reaction and direct sequencing. Milk consumption was analyzed by a questionnaire, specially developed to analyze milk consumption and abdominal complaints. RESULTS: The frequency of the genotype of the C/C-13910 (lactase non-persistence) was found to be 24.8% in native Estonians. No other single nucleotide polymorphisms covering the region of 400 bp adjacent to the C/T-13910 variant were found. Lactase non-persistence subjects were found to consume less milk than lactase persistence subjects. CONCLUSION: The frequency of lactase non-persistence defined by the C/C-13910 genotype confirms the results of the previous studies based on indirect methods of determining hypolactasia. Milk consumption of lactase non-persistence subjects is consistent with previously reported figures of adult-type hypolactasia in Estonia. However, lactase non-persistence does not prevent the intake of milk in many adults.

Adult↗

PubMed2004

Helminth fauna of Eurasian lynx (Lynx lynx) in Estonia.

Thirty-seven carcasses of Eurasian lynx (Lynx lynx) collected and examined in Estonia during 1999-2001 had helminths. Parasites identified and their prevalence included Diphyllobothrium latum (5%), Taenia pisiformis (100%), Taenia laticollis (41%), Taenia hydatigena (3%), Taenia taeniaeformis (3%), Toxocara cati (68%), and Trichinella spp. (22%). The only significant relationships (P < or = 0.05) between occurrence of helminths and host age and sex were a greater number of T. pisiformis and T. laticollis in older than in youger male lynx, and older males had a greater number of species of helminth than did younger lynx. Sixty-one fecal samples collected during snow tracking of nine lynx were examined; eggs of T. cati were identified in 38 samples, and Capillaria spp were found in eight samples. This is the first systematic investigation of parasites of lynx in Estonia.

Age Factors↗

PubMed2006

Helminthologic survey of the wolf (Canis lupus) in Estonia, with an emphasis on Echinococcus granulosus.

Carcasses of 26 wolves were collected during the 2000/2001 and 2003/2004 hunting seasons and examined for helminths. Thirteen helminth species were recorded: one trematode (Alaria alata), seven cestodes (Diphyllobothrium latum, Mesocestoides lineatus, Taenia hydatigena, Taenia multiceps, Taenia ovis, Taenia pisiformis, and Echinococcus granulosus), and five nematode species (Uncinaria stenocephala, Toxascaris leonina, Toxocara canis, Trichinella nativa, and Trichinella britovi). The most common species were A. alata and U. stenocephala. Mature Echinococcus granulosus was found and described for the first time in Estonia, and its identity verified using PCR-RFLP analysis. Sequencing a fragment of the mitochondrial DNA NADH dehydrogenase 1 (mtND1) gene showed that the E. granulosus strain from Estonia was identical to strain G10, recently characterized in reindeer and moose in Finland.

Animals↗

PubMed2000

Epidemiological data sources in Estonia: a survey of registries and databases.

BACKGROUND: Central and Eastern European countries offer opportunities for studying the health effects of historical and present exposures, as well as the transition to a market economy. A prerequisite for research is the availability of good-quality information. This study was undertaken to describe sources of individual data that are available for epidemiological research in Estonia. Particular attention was paid to the methods of operation of health registries. METHODS: Information was collected during site visits, interviews with registry personnel and from published reports. For health registries, information was specifically requested on data collection, scope of recorded data, quality control, electronic linkage capability and use of data in research. RESULTS: The authors describe 35 data sources containing individual information on vital status, mortality, morbidity, natality and women's health, health and health care, and occupation. The most important health registries are the cancer registry, with data from 1968, and the medical birth registry, with data from 1992. Computerised cause-of-death information is available from 1983. Electronic linkage can be done with most of the data sources, the main matching variable being the eleven-digit personal identification number. Factors potentially affecting data-quality in health registries are undefined legal basis, scarcity of funding and staff, poor acknowledgement of problems, and rare scientific use of registry DISCUSSION: Various data sources are available for epidemiological research in Estonia. Thus far, collected data have largely been an under-used scientific resource. In health registries, more attention should be paid to quality control and continuous involvement of researchers.

Birth Certificates↗

PubMed2001

Emergency child mental health services in Estonia.

This paper describes emergency child mental health services in Estonia. The paper defines what is an emergency in Estonia, who provides services to children and adolescents, the process of evaluation, follow-up care and societal emergencies. Centers for care in Tartu and Tallin are described. The need for ongoing training and the expansion of services into the countryside is noted.

Adolescent↗

PubMedDate not supplied

[Hepatitis A in Estonia (1990-1999)].

During recent 10 years (1990-1999) essential changes occurred the epidemiology of viral hepatitis A (VHA) in Estonia: simultaneously with a decreased level of morbidity (morbidity rate per 100,000 of the population was 78.4 in 1990 and 7.7 in 1996, or 1,241 and 112 cases, respectively), a shift in the age structure of patients from children of preschool age to older age groups took place. Everyday contacts were the main established route of VHA transmission in recent years, but in more than 80% of cases the risk factors of the virus transmission remained obscure. During the regional outbreak of VHA in North Estonia in 1998 (937 out of 989 cases registered in the country) a rise in morbidity was observed among young people aged 15-29 years, when a wide spread of parenteral viral hepatitides B and C and drug addiction were registered in this region. During this outbreak VHA was transmitted mainly through everyday contacts. Still the considerable prevalence of injection drug users who practiced the group use of syringes and needles and took drugs from common containers, a sufficiently high level of the mixed forms of the disease (more than 18% of all registered cases of VHA), detected for the first time, make it possible to suggest that the parenteral transmission route could appear among persons belonging to the above mentioned group. Vaccination is regarded as the most effective measure for the prophylaxis of VHA.

Adolescent↗