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PubMed2001

Copper, zinc, tin and lead in canned evaporated milk, produced in Lithuania: the initial content and its change at storage.

The study has been carried out to elucidate what contents of heavy metals were typical for canned milk products--evaporated (TS 25.5-28.5%) sterilized milk and condensed sweetened milk, produced in Lithuania in the period 1983-1997. The influence of storage time upon the level of Sn, Pb, Cu and Zn in the products has also been determined. The results show that the most considerable changes occurred in Cu concentration, which gradually decreased from the maximum level in 1983-1985 (2.23 +/- 0.18 mg/kg) to the minimum level in the latest years (0.44 +/- 0.01 mg/kg). Such variation of copper content in canned milks can be closely connected with its changes in raw milk. Zinc content in canned milk products also was in good agreement with raw milk. The content of tin and lead in the canned products many times exceeded their concentration in raw milk and ranged from 28 +/- 2 and 0.093 +/- 0.005 to 114 +/- 4 and 0.29 +/- 0.01 mg/kg, respectively. It has been determined that the dependence of the concentration of tin and lead on the storage time of concentrated (or evaporated) sterilized milk is nearest to the parabolic, and in sweetened condensed milk to the exponential function, whereas the small increase of copper and zinc concentrations can be described by straight-line function. The functional dependence obtained enables one to predict the Sn and Pb level in canned evaporated milk products after storage and to foresee the safe initial concentration of these metals in freshly produced evaporated milk, assigned for storage.

Animals↗

PubMedDate not supplied

Lithuania mental health country profile.

As a part of international mental health policy, programmes and services project, the 'country profile' instrument was used for assessment of mental health policy and services in the Republic of Lithuania. Analysis of contextual factors revealed high levels of social pathology (including violence, suicide and other self-destructive behaviour) with stigmatizing approaches by the general population to mentally disturbed persons and other vulnerable groups. Analysis of existing data about resources invested in the mental health care system raises questions for policymakers about the effectiveness of this traditional way of investment. The largest proportion of physical and human capital is concentrated in psychiatric institutions, with large numbers of beds, psychiatrists and increasing funding for medications, while other components of care--such as housing, psychosocial and vocational rehabilitation, community-based child mental health services--are not being developed. Statistical accounts keep the tradition of presenting processes as outcomes, while modern assessment of outcomes of services, programmes and policies are lacking. The findings from this country profile may be very useful in the development of modern mental health policies in the countries of Eastern and Central Europe, which have been deprived for decades from the opportunity to introduce evidence-based mental health policies and services.

Culture↗

PubMed2006

Factors affecting attitudes towards medical abortion in Lithuania.

OBJECTIVE: Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal. METHODS: A random sample of the adult population was asked if they supported medical abortion. The dependent variable of attitude towards medical abortion was tested against the eight independent variables reported for each respondent using Chi-square tests and odds ratios. The effects of the variables upon each other were tested with two logistic regression models. RESULTS: Among the respondents, 62.6% supported access to medical abortion. The independent variables of urban/rural residence, employment status and educational level significantly affected opinion. Overall, education level provided the strongest odds ratio for support of medical abortion. CONCLUSION: The majority of the Lithuanian population supports the legalisation of medical abortion. There is somewhat less support for it in rural areas, among those who are least educated and in certain nonworking population groups. Lithuanian policy-makers should consider responding to popular sentiment and legalising medical abortion.

Abortion, Legal↗

PubMed2004

Mortality from external causes in Lithuania: looking for critical points in time and place.

AIM: A study was undertaken to analyse trends in mortality from major external causes of death, and to detect urban/rural differences by cut points over the period of socioeconomic transition. METHODS: Information on deaths from major external causes (traffic accidents, suicides, and homicides) for the 1990-2000 period was obtained from Lithuanian Department of Statistics. Mortality rates were age standardized, using the European standard, and analysed, according to (urban/rural) residence and sex. The Jointpoint analysis was used to identify the best-fitting points, wherever a statistically significant change in mortality occurred. RESULTS: The most critical point for external causes of mortality during the period of transition was the year 1994, when an increasing mortality trend reversed to a decreasing one. Mortality from suicides primarily caused these positive changes. Changes in mortality from traffic accidents were not significantly associated with the period under analysis. Numerous less favourable trends in rural areas, including suicide rates, traffic accidents, and homicides, are likely to stratify urban/rural health outcomes in the future. CONCLUSION: Despite a recent decline, mortality from external causes remains at an extremely high level in Lithuania. Future progress requires sustained improvements in prevention, and serious attention to external causes of death in health policy development.

Cause of Death↗

PubMed2005

Prognosis of risk factors and trends in mortality from external causes among middle-aged men in Lithuania.

AIMS: The aims of this study were to investigate the risk of death and time trends from external causes, and to evaluate the significance of the effects of age, period and birth cohort on suicide mortality among middle-aged men during the period 1971-2000 in Lithuania. METHODS: Random samples of men aged 45-59 years from the Kaunas Rotterdam Intervention Study (conducted in 1972-74) and Study of Multifactorial Prevention of CHD (conducted in 1977-80) were examined (n?=?6,480). The participants of the two surveys were observed until 1 January 2001. Over this time 2,841 men had died, 230 of these from external causes. The Cox proportional hazards model was used to evaluate the risk of death from external causes. Trends in mortality from external causes and average annual changes were based on logarithmic regression analysis. For assessment of the effects of age, period, and birth cohort the Poisson regression model was applied. RESULTS: The risk of mortality from external causes among men was positively related to smoking habits and arterial hypertension and negatively related to education level and total serum cholesterol concentration but there was no association with consumption of alcohol. The risk of suicide mortality was associated with family status and occupation only. Trends in mortality from all external causes showed no significant changes during the period 1971-2000. After adjusting for age and cohort effects, the period effect was statistically significant. CONCLUSION: Prognosis of risk factors for mortality from external causes and period effect on suicide mortality rates will form important parts of future research agendas.

Accidents↗

PubMed2006

Diverging trends in the incidence and mortality of stroke during the period 1986-2002: a study from the stroke register in Kaunas, Lithuania.

AIMS: The aim of the present study was to explore the longitudinal stroke trends in the middle-aged Lithuanian population. METHODS: All stroke events in the studied population were ascertained and validated according to the standardized criteria outlined by the WHO MONICA Project. The study included all patients aged 25 to 64 years who experienced a stroke between 1986 and 2002. RESULTS: A flat trend was observed in both the incidence and the attack rates of stroke among men during the 17-year study period, while among women, the incidence of stroke increased by 1.7%/year, and the attack rates by 2.3%/year. The 28-day case fatality and mortality rates of stroke decreased significantly in both sexes. The decline in case fatality explained 100% of the decline in mortality. Among the types of stroke, cerebral infarction contributed most to the decline in the mortality in men. In women, the mortality from cerebral infarction and intracerebral haemorrhage declined similarly to that from all types of strokes. CONCLUSIONS: Findings from our study indicating no positive changes in the incidence of stroke but instead an increase among middle-aged women in Kaunas are disturbing. These results suggest a need for the intensification of appropriate strategies for stroke prevention by the public health officials in Lithuania.

Adult↗

PubMed2005

Pollutant removal by horizontal subsurface flow constructed wetlands in Lithuania.

Horizontal subsurface flow constructed wetlands recently have been developed in Lithuania. They ensure the efficient removal of nutrients and organic matter. This article analyses BOD5 and N and P removal efficiency with respect to filter loads. To achieve a normative wastewater treatment level according to BOD5 (25 mg O2 l(-1), loads of filters should not exceed 5.8 g m(-2) day(-1), that is, the treatment of wastewater produced by population equivalent requires a filter area of 10.5 m2. After treatment in filters total N of wastewater contains 55-85% of mineral N. Nitrite-N and nitrate-N make up 0.1% and 3.0% on average; the other part is composed of ammonia-N. Increasing total N concentrations contained in water outflow predetermine higher ammonia-N amounts. If water outflow contains 10 mg l(-1) of total N, ammonia-N makes up 51.5%; if it contains 40 mg l(-1), then ammonia-N makes up 81.0%. The average total nitrogen removal efficiency is 37-44%. P removal is affected by the physico-chemical characteristics of sand and qualitative composition of phosphorus contained in wastewater. P removal up to 2 mg l(-1) from domestic and other wastewater of similar composition requires no higher than 0.15 g m(-2)/day(-1) load of filters according to total P.

Ammonia↗

PubMed2000

Diphtheria in Lithuania, 1986-1996.

Diphtheria reappeared in Lithuania in 1986 and rose to epidemic levels by 1992. Between 1991 and 1996, 110 cases of diphtheria were registered, with an incidence of 0.03-1.15/100,000 population. Most cases (84%) and all 17 deaths occurred among persons >/=15 years, most of whom had never been vaccinated. Persons 40-49 years old had the highest average annual age-specific morbidity (1.70/100,000) and mortality (0.53/100,000) rates. Low levels of immunity among individuals 40-49 years old and migration to epidemic areas in Russia and Belarus contributed to the epidemic's occurrence. Between 1991 and 1995, toxigenic Corynebacterium diphtheriae strains were isolated from 84 of all registered patients (76%), and nontoxigenic strains were isolated from 13 (12%). By 1996, two mass vaccination campaigns, which provided one dose of vaccine to individuals 25-30 years old and three doses of vaccine to persons 31-60 years old, helped reduce the number of cases. The first campaign achieved 69% coverage; the second achieved 48% coverage.

Adult↗

PubMed2002

Tickborne encephalitis in an area of high endemicity in lithuania: disease severity and long-term prognosis.

Of 250 consecutively admitted patients with central nervous system (CNS) infections who were treated during a 1-year period, all 133 patients with tickborne encephalitis (TBE) were included in a prospective follow-up study. TBE presented as mild (meningeal) in 43.6% of patients and as moderate or severe (encephalitic) in 43.6% and 12.8% of patients, respectively. Paralytic disease was observed in 3.8% of the subjects, and cranial nerve injury was observed in 5.3%. One patient died of TBE. Permanent CNS dysfunction after 1 year was found in 30.8% of patients; in 8.5% of all TBE cases, severe disabilities required adjustment of daily activities. Corticosteroid treatment did not seem to improve outcome. A progressive course of TBE was noted in 2 patients. The risk of incomplete recovery was significantly higher among patients with the encephalitic form of TBE (odds ratio, 4.066; 95% confidence interval, 1.848-8.947). In conclusion, TBE is an important pathogen in CNS infection in the Kaunas region of Lithuania, and it causes long-lasting morbidity in one-third of cases.

Adolescent↗

PubMed2004

Association between health behaviour and self-reported health in Estonia, Finland, Latvia and Lithuania.

BACKGROUND: The aim of the present study is to examine the associations of the selected health behaviours (daily smoking, frequent strong alcohol use, consumption of fresh vegetables less than 3 days a week and leisure time physical activity less than two/three times a week) to the self-assessed health after adjustment to the age and education in Estonia, Finland, Latvia and Lithuania. METHODS: Data from cross-sectional surveys carried out in all the above-mentioned countries were used. The methodology and questionnaires of the surveys were standardized between the participating countries within the Finbalt Health Monitor System. Logistic regression was used to assess the effect of self-perceived health status on prevalence of health behaviours. RESULTS: In Finland both women and men rated their health better than both genders in all the Baltic countries. In Finland self-assessment of health is significantly associated with most health behaviours, but in the Baltic counties the associations are weak or unstable. CONCLUSION: The results suggest that in Finland as in many other stable countries self-assessed health status was related to health behaviours and can be used as an indicator of health behaviours. In the Baltic countries, factors other than health behaviours may be more relevant to the self assessment of health status.

Adult↗

PubMed2005

Higher than expected prevalence of congenital cryptorchidism in Lithuania: a study of 1204 boys at birth and 1 year follow-up.

BACKGROUND: Cryptorchidism at birth is one of the symptoms of testicular dysgenesis syndrome (TDS). The aim of the study was to detect prevalence of cryptorchidism in Lithuanian newborn boys. METHODS: A total of 1204 consecutively born boys were examined within the first days after birth in one regional hospital. Boys cryptorchid at birth were reexamined 1 year later. RESULTS: The prevalence of cryptorchidism at birth was 5.7% (69 cases). Cryptorchidism was associated with low birth weight (P < 0.0001), preterm delivery (P < 0.0001), small gestational weight (P = 0.03) and other congenital abnormalities of genitalia (P = 0.0001). No correlation between cryptorchidism at birth and maternal age, birth order or mode of delivery was demonstrated in this study, but paternal body mass index <20 kg/m2 was found to be a significant risk factor (P = 0.001). The prevalence of congenital cryptorchidism at 1 year of age was 1.4%. CONCLUSIONS: We detected lower frequency of cryptorchidism at birth in Lithuanian boys than in Danes (9.0%), but higher than in Finns (2.4%). We had expected the frequencies in Lithuania and Finland to be relatively similar because the other symptoms of TDS (incidence of testicular cancer and semen quality) are close in these countries.

Birth Weight↗

PubMed2004

Meeting patient's expectations in primary care consultations in Lithuania.

OBJECTIVE: Patient satisfaction with health care services is considered an important factor of health care. Although research on patient satisfaction has become standard in Western Europe, in countries such as Lithuania the concept of patient satisfaction is still a relatively new one. This study aimed to investigate how the meeting of patients' expectations is related to increased satisfaction with medical consultation. STUDY DESIGN: The methodology used by Williams et al. in the UK was applied to the Lithuanian health care setting. Forty physicians from 22 primary health care centres attending courses on general practice at Vilnius University were recruited for the study. Every third adult patient coming to a practice during a 5-day period was invited to participate in the study. In all, 609 patients coming to meet their physician regarding health problems were included in the study sample. The patients were asked to complete three standardized questionnaires: the Patient Intentions Questionnaire prior to the consultation, and the Expectations Met Questionnaire and Medical Interview Satisfaction Scale after the consultation. Cronbach's alpha statistic was used for the validation of the questionnaires and principal components analysis was used to determine the factors of patient expectations. RESULTS: The response rate was 78%. ANALYSIS: of 460 sets of questionnaires revealed that satisfaction with medical consultation is higher among patients who have a greater number of expectations met. Physicians' success in meeting different types of patient expectations also had different influences on patient satisfaction. The most important expectations to be met were "understanding and explanation", followed by expectations of "emotional support", while "getting information" was less important. CONCLUSIONS: The most frequently reported expectations on the Patient Intentions Questionnaire were for "getting information" and "understanding and explanation" of the patients' health problem items, and the least mentioned were for emotional support items. Patients with more expectations met were found to have significantly higher scores on the satisfaction index. Satisfaction with the consultation is best predicted by meeting the patient's expectations for understanding and explanation, and for emotional support. Providing desired information to the patient as well as meeting the patient's expectations for diagnostic procedures and treatment is less associated with patient satisfaction.

Analysis of Variance↗

PubMed1997

Fatalities from myocardial infarction in Nordic countries and Lithuania. The MONICA Investigators.

AIM: To investigate fatalities from myocardial infarction at 28 days and one-year among patients aged 35-64 years in the Nordic and Lithuanian centres participating in the World Health Organization MONICA (Monitoring of Trends and Determinants of Cardiovascular Disease) Project. METHODS AND RESULTS: Altogether 9100 myocardial infarction events registered according to the protocol of the MONICA Project were included in the study. For these events, one-year follow-up was carried out using routine mortality statistics. Fatalities were expressed as age-standardized means per year for a 3-year period from the mid-1980s. The myocardial infarction fatalities at 28 days (including out-of-hospital deaths) in the eight participating populations varied among men, between 36.5% (95% confidence interval 32.6-40.4%) in Iceland and 54.6% (51.2-57.9%) in Kaunas, Lithuania, Among women, it varied from 32.4% (26.4-38.4%) in Iceland to 57.5% (51.8-63.2%) in Glostrup, Denmark. More than half of this mortality occurred suddenly and the patient did not reach hospital alive. Fatalities for the period from day 28 to one year varied among men, from 5.3% (2.9-7.6%) in Iceland to 10.9% (8.0-13.8%) in North Karelia, Finland, and among women from 3.5% (0.4-6.5%) in Kuopio, Finland, to 13.5% (7.2-19.7%) in Glostrup, Denmark. CONCLUSIONS: Approximately half of the myocardial infarction patients died within one year after the onset of the attack and half of those who died, died out-of-hospital. While the myocardial infarction fatalities differed considerably between the participating populations, differences of this magnitude are unlikely to be totally explained by differences in the registration procedures. Further comparisons of acute coronary care and secondary prevention measures are warranted.

Adult↗

PubMed2003

Current status of internal dosimetry in Lithuania.

After Lithuania regained independence, the legal basis for existing radiation protection was modified radically according to the IAEA, ICRP recommendations and the requirements of legislation of the European Community. The legal basis for internal dosimetry and a functioning system of assessment of exposure to intake of radionuclides have been created in the Radiation Protection Centre (regulatory authority in radiation protection). Direct and indirect measurements of concentrations of radionuclides are used for the assessment of internal doses of workers and the public.

Air Pollution, Indoor↗

PubMed2000

The relationship of childhood to adult blood pressure: longitudinal study of juvenile hypertension in Lithuania.

OBJECTIVE: To assess changes in blood pressure from childhood to adulthood and the ability to predict adult blood pressure. DESIGN: Longitudinal study of a cohort of children with baseline data and a follow-up survey after 20 years. SETTING: Epidemiological survey of schoolchildren and subsequent inhabitants of Kaunas, a town in Lithuania. PARTICIPANTS: The children came from 15 schools and accounted for 25% of all 12- and 13-year-old children born in 1964 in Kaunas. The first survey (n = 1082) was carried out in 1977. The same population was re-examined in 1997 (n = 505). Data from 217 men and 288 women, who participated in both the first and the most recent surveys, is presented. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure at the age of 32-33 years. RESULTS: In the 20 years between the two surveys blood pressure increased more in men than in women. Statistically significant correlation between childhood and adult blood pressure levels was estimated (for systolic blood pressure r=0.40 in men and r=0.24 in women; for diastolic blood pressure r=0.14 in men and r=0.34 in women). Stepwise regression analysis of the data showed that the best predictors of adult blood pressure were the initial childhood blood pressure levels and change in BMI during the 20-year period for both men and women. Other factors were less predictive. CONCLUSIONS: Childhood blood pressure is related to adult levels and, together with changes in body mass index, is a significant predictor of adult blood pressure.

Adolescent↗

PubMed2004

Cancer incidence in the workers cohort of textile manufacturing factory in Alytus, Lithuania.

Altogether 14,650 workers employed at least for 1 year a the textile factory in Alytus, Lithuania, were included in the cohort and followed during the period from 1978 to 1997. The standardized incidence ratio (SIR) for men was 1.28. The incidence of esophagus cancer was significant higher (SIR 3.42). It increased only slightly for lung (SIR 1.35). In the women cohort, SIR was 1.05. However, there was a significant increase of the incidence of gallbladder cancer (SIR 3.19). Among textile-processing (spinning and weaving departments) women workers, we found elevated total cancer incidence (SIR 1.35), incidence of breast cancer (SIR 1.49), and cervical cancer (SIR 1.82). In this cohort increased SIR values were observed for more than 10 years since first exposure for all cancer (SIR 1.70) and cervical cancer (SIR 2.44).

Adult↗

PubMed2006

The distribution of Salmonella serovars in chicken and humans in Lithuania.

We studied serovars of Salmonella strains isolated from chicken and humans in Lithuania over the period from 2000 to 2004. Salmonella strains were isolated and identified according to the techniques recommended by International Organisation for Standardization (Microbiology of Food and Animal Feeding Stuff--Horizontal Method for the Detection of Salmonella, 1998, ISO, Geneva). The per cent of infected flocks with Salmonella in separate years was between 1.01% and 3.2% during the period of investigation. The contamination rate of broiler legs and breasts was higher (2.36% and 4.25%) than that of wings (0.82%). Eighteen serovars of Salmonella were identified from the total 300 isolated samples. The most prevalent serovars in chicken were Salmonella Enteritidis, Salmonella Infantis and Salmonella Typhimurium. Other serovars such as Salmonella Montevideo, Salmonella Djugu, Salmonella Isangi, Salmonella Bovismorbificans, Salmonella Mbankada, Salmonella Hadar were detected only in one to two samples. In general, similar serovars of Salmonella were found in humans and chicken (S. Enteritidis and S. Typhimurium), although distinct serovars were found only in humans or only in chicken. Analysis of the distribution of Salmonella serovars in humans during the seasons of the year indicated that the highest incidence of Salmonella was in Summer and in the beginning of Autumn. Analysis of the distribution of serovars during the study period indicated that there is a shift over time in both humans and chicken.

Animals↗

PubMed1999

Time trends in suicide mortality in Lithuania.

OBJECTIVE: The aim of this study was to analyse the time trends of suicides during the period 1970-1995 in Lithuania, and to assess the importance of the effects of age, period and birth cohort as risk factors. METHOD: Trends in suicides and average annual changes were based on logarithmic regression analysis. For assessment of the effects of age, period and birth cohort on suicide mortality, a log-linear regression model with parameters representing age, period and cohort effects was fitted. RESULTS: Between 1970 and 1995 age-standardized suicide rates almost doubled. There was an increase in suicides in birth cohorts of males from 1910 to 1950, and in cohorts born after 1965. In females, an increase was observed in all successive birth years from 1905 to 1925 and after 1970. The period effect in males and the cohort effect in females were dominant. CONCLUSION: It is unlikely that suicide rates will decrease in the near future.

Adolescent↗