[Hospitals in Lithuania in the Middle Ages. (On 450 years of hospitals in Lithuania)].
Explore the source record for details and available documents.
Hospitals↗
SEARCH · PubMed Health
Results for “LITHUANIA”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Physician workforce reform in Lithuania: an inevitable transition.
The health system in Lithuania before independence was the same centralized system, the Semashko model that was prevalent throughout the former Soviet Union. The Soviet system focused more on quantity than quality, which resulted in a greater number of physicians per 100,000 than found in Western Europe. As in other Central and Eastern European countries, the health system in Lithuania has undergone substantial change since 1990. A major part of the reform of physician workforce in the former communist countries has been development of primary health care as a centerpiece of the health systems. This move in Lithuania has been hindered to some degree by the shortage of general or family practitioners. The focus on specialists in the old Soviet system led to a severe shortage of physicians in general practice. Only about 10% of physicians were general practitioners (GPs) in 1993 compared to a European Union average of 35%. That percentage had increased to 16% by 1998. Programs have been established to both train new GPs and to retrain specialists to become GPs, although a shortage of teachers and finances are problems facing these programs. Although the physician workforce in Lithuania has undergone substantial reform since 1990, real change has been slow. The physician to population ratio in Lithuania has failed to decline, moving from 387 per 100,000 population in 1991 to 398 in 1997, before dropping to 395 in 1998. The ratio remains substantially higher than current EU averages, reflecting a difficulty in reducing the number of physicians. Here we review what has happened to the physician workforce in Lithuania since independence and evaluate policies implemented. Efforts to reduce the number of physicians are also assessed. The results in Lithuania are compared to those in other CEE countries and to EU averages.
Adult↗
Health behaviour in Estonia, Finland and Lithuania 1994-1998. Standardized comparison.
BACKGROUND: The Finbalt Health Monitor project collects standardized information on health and health-related behavioural activity and related trends in Finland and those Baltic countries that have major public health problems with noncommunicable diseases related to lifestyle and behavioural factors. The aims of this study were to compare patterns of and trends in selected health behaviours and their socioeconomic associations in Estonia, Finland and Lithuania in the period 1994-1998. METHODS: Standardized questionnaires were posted to nationally representative samples in 1994, 1996 and 1998. Response rates varied between 62% and 83%. The total number of respondents was 3808 in Estonia, 9608 in Finland and 5716 in Lithuania. Prevalence of smoking, consumption of strong alcoholic beverages, use of vegetable oil in food preparation and leisure-time physical exercise were analysed in this study. RESULTS: No major changes in daily smoking, consumption of strong alcoholic beverages and leisure-time physical exercise emerged. However, the use of vegetable oil increased rapidly in Estonia and particularly in Lithuania (from 41% to 81%). In 1994 the prevalence of daily smoking was 53%, 28% and 44% among men and 24%, 18% and 6% among women in Estonia, Finland and Lithuania, respectively. In Lithuania the prevalence of smoking among women was notably low but increased (from 6% to 13%). The prevalence of strong alcoholic beverage consumption was similar in all countries. Leisure-time physical exercise was most common in Finland. The socioeconomic differences remained similar in all countries, unhealthy behaviours were typical among the less educated groups and men, especially in the age groups 34-49 years. CONCLUSIONS: The sociodemographic pattern of risk-related lifestyles appears to be rather similar and stable in Estonia, Finland and Lithuania. However, from the view point of possible public health implications the rapid changes in the prevalences of some behaviours are notable.
Adult↗
A comparison of avoidable mortality in Lithuania and Sweden 1971-1990.
BACKGROUND: In reforming the Lithuanian health care system it is important to evaluate the health status of the population and the outcome of health care by comparison to Western European countries. The aim of this study is to examine the possibility of comparing data on avoidable mortality in Lithuania with Sweden and, when realistic, to compare avoidable mortality rates between Lithuania and Sweden. METHODS: Comparisons were made for the time period 1971-1990. During this period a basic tabulation list including 200 groups of causes of death modified from WHO's International Classification of Diseases was obligatory for all Soviet Republics. This limited the opportunity for comparisons with Western European countries. However, for most of the selected avoidable death indicators comparisons with Sweden were made possible by slightly modifying the indicators. RESULTS: In the age group 5-64 years in 1971-1975 the total mortality in Lithuania was 60% higher than that in Sweden. In 1986-1990 this gap had increased to 90%. For most avoidable death indicators the difference was even greater, i.e. the death rate in Lithuania was several times higher than that in Sweden. For instance, death rates for tuberculosis were 36 times higher and for appendicitis, cholelithiasis and cholecystitis six times higher in Lithuania. For several avoidable causes of death, such as tuberculosis, appendicitis and hypertensive and cerebrovascular disease the gap widened during the study period. CONCLUSIONS: The results indicate potential fields for improvement of the health care system in Lithuania. The importance of implementing international classification systems for epidemiological surveillance of the outcome of health care is stressed.
Adolescent↗
Diagnosis of non-viral sexually transmitted infections in Lithuania and international recommendations.
The aim of this study is to evaluate the range, quality and availability of diagnostic services for non-viral sexually transmitted infections (STIs), i.e. C. trachomatis, N. gonorrhoeae, T. vaginalis and T. pallidum, in Lithuania from September 2002 to December 2003. Surveillance data describing the organisation and performance characteristics of non-viral STI diagnostic services in Lithuania were collected using a questionnaire and subsequent site-visits. International evidence-based recommendations for non-viral STI diagnosis were used to evaluate the quality of the STI diagnostics. There were 171 facilities providing non-viral STI diagnostic services for the 3.5 million inhabitants of Lithuania. However, only 6% (n=9) of the respondents (n=153) could provide a confirmatory diagnosis, in accordance with international recommendations, for the full minimum range of relevant non-viral STIs in Lithuania, i.e. C. trachomatis, N. gonorrhoeae, T. pallidum, and T. vaginalis. In addition, accessibility to STI diagnostic services differed significantly among the different counties in Lithuania. Several of the respondents analysed low numbers of samples each year, and overall the sampling size was extremely low, especially for C. trachomatis diagnostics. In Lithuania, optimisation of non-viral STI diagnostics as well as of epidemiological surveillance and management of STIs is crucial. It may be worth considering a decrease in the number of laboratories, with those remaining having the possibility of performing STI diagnostic services that are optimised, in concordance with international recommendations, standardised, and quality assured using systematic internal and external quality controls and systems. In addition, establishment of national inter-laboratory networks and reference centres for non-viral STIs is recommended.
Female↗
A fourfold difference in the incidence of type 1 diabetes between Sweden and Lithuania but similar prevalence of autoimmunity.
We investigated whether other autoimmune disorders in addition to type 1 diabetes are more common in Sweden than Lithuania, and if there are any differences in inheritance patterns of both type 1 diabetes and other autoimmune disorders. Data from 517 children in southeast Sweden and 286 children in Lithuania aged 0-15 years were included in the study. Age- and sex-matched control children were randomly selected. Information was collected by questionnaire. Of the children with diabetes in Sweden, 13.2% had a family member with type 1 diabetes compared to 7% of children with diabetes in Lithuania (P < 0.01) (OR = 2.01). No such difference was seen for other autoimmune diseases in family members of children with diabetes (Sweden 12%, Lithuania 14%, n.s.). Control children in Lithuania had family members with autoimmunity more frequently (15.3%) than control children in Sweden (7.4%, P < 0.001) (OR = 2.26). This difference was most pronounced in mothers. The Lithuanian control children had an autoimmune disease more frequently than the controls in Sweden (4.7% versus 1.5%, respectively, P < 0.001) (OR = 3.21). There seem to be environmental factors that specifically contribute to the development of type 1 diabetes, factors which are less related to the development of autoimmunity in general.
Adolescent↗
Survival of breast cancer patients in Lithuania and Norway, 1988-1992.
In Norway, the incidence of breast cancer is almost twice that in Lithuania, whereas the mortality rates of the disease are approximately the same in both countries. The aim of the present study was to compare the survival of breast cancer patients in the two countries according to stage. The material from both countries included cases diagnosed between 1988 and 1992 with complete follow-up of date of death to the end of 1995. The Norwegian data consisted of all 9403 new cases recorded by the Norwegian Cancer Registry. The Lithuanian data included in all 1649 new cases treated at the Oncology Centre in Vilnius, which represents 40% of breast cancer cases in Lithuania--these cases had the same distribution of the disease by age and stage as for the whole country. The overall 5-year relative survival was lower in Lithuania (57.3%) than in Norway (78.4%). Lower survival was observed in Lithuania compared with Norway for all stages. In stage I, the difference was 7.8% in absolute terms which could be explained by a higher proportion of small tumours among the Norwegian cancer cases (63.7% of tumours were 2 cm or less, while in Lithuania the proportion of small stage I tumours was only 27.9%). Therefore, early diagnosis within the stage I category seems relevant. The difference in survival was, however, most pronounced in stage II (20%) and III (29%). In Norway, the better overall survival is partly explained by a more favourable stage distribution. The lower survival of Lithuanian cases within stage categories could be explained by more advanced metastases to regional lymph nodes and by higher proportions of large tumours within stage.
Adult↗
Time trend of childhood type 1 diabetes incidence in Lithuania and Sweden, 1983-2000.
AIM: To compare the time trend of childhood type 1 diabetes over an 18-y period in Lithuania and Sweden--countries with different incidence levels and different socio-economic conditions. METHODS: Percent average incidence change per year between 1983 and 2000, based on 8031 Swedish and 1100 Lithuanian cases in the age group 0-14 y, was calculated using Poisson regression. RESULTS: Average age- and sex-standardized incidence/100 000/y was 28.9 (95% CI: 28.2-29.5) in Sweden and 7.5 (95% CI: 7.1-8.0) in Lithuania. Between 1983 and 2000, the average increase per year was 2.2% in Sweden (95% CI: 1.7-2.6) and 2.3% in Lithuania (95% CI: 1.1-3.5), but the latter trend depended on an increase during the last few years of the period, and only for girls. In Sweden, incidence increased significantly in all age groups, but more so in the younger groups (3.0%, 2.2% and 1.7% per year in 0-4, 5-9 and 10-14-y age groups, respectively), while in Lithuania a significant increase was found only in the 10-14-y age group (3.0%). In Sweden, a trend towards a younger age at diagnosis was indicated for both boys and girls when comparing 1983-1991 and 1992-2000, whereas in Lithuania, the changes in age distribution over time were small, with an opposite tendency for boys. CONCLUSION: Incidence variability over time differed considerably in the two countries in the region of the Baltic Sea, suggesting a complex effect of environmental risk factors, some of which may be associated with wealth and socio-economic conditions.
Adolescent↗
Seasonal patterns of suicides over the period of socio-economic transition in Lithuania.
BACKGROUND: In Lithuania, suicides are a grave public health problem, requiring more extensive investigation. The aim of the study was to assess the seasonal variations of suicides in Lithuania throughout the years 1993-2002, describing patterns by gender, age and method of suicide. METHODS: The study material consisted of all registered suicides (n = 16,147) committed throughout 1993-2002 in Lithuania. Smoothed trends were inspected. The seasonal effect was explored using monthly ratio statistics and spectral analysis. RESULTS: Suicides in Lithuania have a distinct annual rhythm with peaks in summer and troughs in December. The December frequencies fell by more than 23% in men and 30% in women, while June peak reached nearly 23% in men and July peak exceeded 29% in women, compare with the average levels, (p < 0.05). Hanging was the most common method of suicide both in men and women comprising up to 90% among all suicides in 1998-2002. Among different methods, only hanging suicides showed significant seasonal variations, especially in men. The seasonal amplitude has decreased over time. CONCLUSION: Substantial seasonal variations in suicides were associated with a high proportion of hanging. Extremely high suicide rates in Lithuania require further extensive studies and urgent preventive programs, taking into account the suggestions of this survey.
Adult↗
The organisation of the State Food and Veterinary Service of Lithuania.
The author describes the State Food and Veterinary Service of Lithuania, the competent authority for public and animal health in Lithuania. The Director of the Service, the Chief Veterinary Officer, reports directly to the Prime Minister. Lithuania is divided into ten counties and thirty-four districts. The State Food and Veterinary Service has regional units in all the counties and districts and has a staff of 1,380 employees. The main tasks of the State Food and Veterinary Service are to implement the basic EU principles of market supervision in Lithuania, with an emphasis on ensuring food safety and control; to establish a unified food control system following the principle "from farm to fork"; to create a favourable environment for the free movement of goods between Lithuania and the countries of the EU while ensuring the safety of imported products of animal origin; to promote continuous improvements in the welfare of animals and to protect the animal population from contagious diseases.
Animal Diseases↗
Physicians resources in Lithuania: change comes slowly.
AIM: To analyze the structure of the physician workforce in Lithuania at the time when the country gained independence, changes it has undergone since 1990, and physician resource planning activities. METHODS: National and international databases were examined to determine the changes in the structure of physician workforce after 1990. Studies and reports, funded by international and national governmental organizations, were reviewed to examine the recommendations for physician resource planning and the rate of their acceptance. Since there was no government plan, a study using Delphi technique was conducted to find consensus among practitioners and policy makers on the physician-to-population ratio needed in Lithuania. Medical residents and physicians in Lithuania were surveyed to assess their emigration intentions. RESULTS: In comparison with other Baltic countries, the number of physicians in Lithuania has remained high despite dramatic reductions in the number of students enrolled to medical schools. There is still a maldistribution of physician resources geographically and by specialty. The government has accepted few recommendations based on the international studies. None of the internal databases provided all the needed information on the physician workforce and the existing databases could not be linked to gain access to all required information. CONCLUSIONS: The physician-to-population ratio remained high after Lithuania had gained independence. There has been little planning at the government level to determine the number of physicians needed in a reformed health system. Changes in the number of students admitted to medical schools did not follow from a well thought-out long-term plan for physician workforce the country will need in the future. To develop a frequently updated database of physicians is essential for the successful planning of future physician workforce.
Databases as Topic↗
[Interventional cardiology in Lithuania: current status and perspectives].
The objective of the article is to evaluate current status of interventional cardiology in Lithuania, to compare these data with the results of interventional cardiology of other European countries and to discuss about perspectives of interventional cardiology in Lithuania. A detailed questionnaire of interventional cardiology of European Society of Cardiology was used for analysis of Lithuanian interventional cardiology data of 2000-2002. Lithuanian interventional cardiologists in 2000-2002 annually performed respectively 1535, 1666 and 2085 coronary angiographies, 500, 532 and 632 PTCA, 120, 133 and 193 stenting procedures per 1000000 inhabitants. According to morbidity of heart diseases in Lithuania and the rate of interventional procedures in Europe, in 2004 more than 9000 coronary angiographies should be performed, 3000 percutaneous transluminal coronary angioplast procedures, and 2000 coronary stent implantations in Lithuania. Achievement of such results would be possible, if the State Sickness Fund and the Ministry of Health would pay more attention to financial problems of interventional cardiology in Lithuania. In conclusion, it can be stated that there are good perspectives for Lithuanian cardiologists to achieve mean European level of interventional procedures in the nearest future.
Angioplasty, Balloon, Coronary↗
[Tendencies of cataract surgery in Lithuania].
OBJECTIVE: To review the tendencies of cataract surgery in Lithuania. MATERIALS AND METHODS: More than ten years the data are collected from all medical institutions in Lithuania, where cataract surgery is performed. Each year from 1994 standardized questionnaires are sent to all centers of the cataract surgery and afterwards collected in the database. The questionnaires contain questions regarding the incidence of cataract surgery, operation methods, the rate of applied intraocular lenses, their models, etc. RESULTS: A total of 74,954 cataract operations were performed in Lithuania from 1994 till 2004. Phacoemulsification for the first was used in Lithuania in 1996. Since that time, 18,393 phacoemulsification operations have been performed. The first foldable intraocular lens was implanted in Lithuania in 1998. A total of 5,140 foldable intraocular lenses were implanted till 2005. It makes up 7.36% from total number of implanted intraocular lenses during the period under review. CONCLUSIONS: We have been observing a great quantitative and qualitative increase in the amount of cataract surgeries for last ten years. This is due to the newest cataract surgery methods (manual small incision cataract surgery, phacoemulsification), introduction of viscoelastic agents, new generation lenses (foldable: acrylic, silicone), and modern phacoemulsificators to clinical practice.
Age Factors↗
High work disability rate among rheumatoid arthritis patients in Lithuania.
OBJECTIVE: To evaluate labor force characteristics among patients with rheumatoid arthritis (RA) in Lithuania. To assess if Lithuania's transition from a state-planned to a free-market economy after 1990 changed the employment perspectives of patients with RA. METHODS: RA patients, age 16-65 years (n = 238), were randomly selected from the RA register in Vilnius. They completed questions about sociodemographics, working status, and disease characteristics, they underwent a clinical examination, and they completed the modified Health Assessment Questionnaire and the Short Form 36. RESULTS: Age- and sex-adjusted employment was 24.2% lower and work disability 51.7% higher in patients compared with the general population in Lithuania. After 10 years of disease, 48% of the patients had withdrawn from the labor force. In those with a paid job, the average sick leave in the past year was 31.9 days compared with the national average of 10.8 days. Although disease activity was not significantly different in employed compared with work-disabled patients, physical function and perceived quality of life (except general health) were worse among patients with work disability. The change in economic organization in 1990 was noted to increase the risk for work withdrawal by a factor of 2.75 (95% confidence interval 1.68-4.53). CONCLUSION: In Lithuania, the impact of RA on work disability is important. Although work disability in Lithuanian patients with RA seems more pronounced compared with reports from Western societies, variables associated with work disability are comparable. The transition to a market-orientated economy in 1990 increased the risk of becoming work disabled.
Absenteeism↗
The change in O3, SO2 and NO2 concentrations in Lithuania.
Due to the dynamic nature of the atmosphere, substantial amounts of gaseous and particulate pollutants are transported to the areas distant from their sources. In order to determine the regional concentration levels of atmospheric pollutants in Lithuania, concentrations of gaseous O3, SO2, NO2 and other pollutants have been measured at the Preila background station (55 degrees 20' N and 21 degrees 00' E, 5 m a.s.l.) since 1981. The long-term concentration data set enabled us to get temporal trends, both on a seasonal and longer time scale, to identify source areas of pollutants and to relate them to the emission data. Based on the data obtained, the different tendencies in the pollutant concentration changes were revealed. Positive trends for ozone (of 2.9% per year during 1983-2000) and a distinct negative trend for both sulphur dioxide (of 3.8% per year during 1981-2000) and nitrogen dioxide (of 3.8% per year during 1983-2000) were found. The air mass back-trajectory analysis was used to assess the source region of air pollutants transported to Lithuania. The pollutant concentration levels were compared with their emission changes in Europe and Lithuania. The general trends in SO2 as well as in NO2 concentrations observed are consistent with changes in SO2 and NO2 emissions in Europe and Lithuania.
Air Movements↗
Detection of human hantavirus infections in Lithuania.
BACKGROUND: In Europe certain hantaviruses are known to cause hemorrhagic fever with renal syndrome of different severity. The objective of the present investigation was to study the presence of hantavirus infections in Lithuania. MATERIAL AND METHODS: Two different serum panels from cancer patients (n = 438) and blood donors (n = 299) from Lithuania were tested by monoclonal antibody capture IgG ELISA using yeast-expressed recombinant nucleocapsid (rN) proteins of Puumala virus (PUUV), Hantaan virus (HTNV) and Dobrava virus (DOBV). The reactivity of ELISA-positive sera was proven in Western blot tests using various hantavirus rN proteins. Selected serum samples were further analyzed by focus reduction neutralization assays. RESULTS: In the IgG ELISA 39 sera from the cancer patients and four sera from blood donors were found to be reactive with at least one of the rN proteins. By immunoblot using the three yeast-expressed rN proteins, the ELISA reactivity of 36 of 39 and two of four serum samples from cancer patients and blood donors, respectively, was confirmed; this corresponds to a seroprevalence of 8.2% and 0.7%, respectively. In ELISA, the majority of the samples reacted exclusively with rN proteins of HTNV and DOBV (31 of 36 and one of two in the two groups). In the group of sera selected for serotyping by focus reduction neutralization assay, this dominance was confirmed by the identification of eight DOBV but only four PUUV infections. No infection by HTNV or another hantavirus besides DOBV and PUUV was verified. Anti-hantavirus-positive human sera were detected in all seven investigated counties of Lithuania. CONCLUSION: In Lithuania at least two hantaviruses, DOBV and PUUV, circulate and cause human infections. Additional investigations are needed to study the seroprevalence more precisely and to search for clinical cases of hantavirus infections.
Antibodies, Viral↗
Epidemic of suicide by hanging in Lithuania: does socio-demographic status matter?
OBJECTIVE: To analyse suicide by hanging, compared with other methods, by demographic and selected social factors in Lithuania, and to evaluate changes during 1993-1997, and 1998-2002. METHODS: Data on committed suicides were compiled from the Lithuanian Department of Statistics. Suicides were identified by the International Classification of Diseases (ICD): codes in ICD-9 E950-E959 and codes in ICD-10 X60-X84. These were categorized into seven groups by method of suicide. Particular attention was paid to suicide and self-inflicted injury by hanging, strangulation and suffocation (ICD-9: E953; ICD-10: X70). These data were analysed by gender, age, place of residence, education, and marital status. RESULTS: A total of 8324 suicides (6864 men and 1460 women) were committed during 1993-1997, and 7823 suicides (6455 men and 1368 women) during 1998-2002. Of all registered suicides in Lithuania during 1993-2002, hanging was the most common method. Over the period under investigation, hanging, in proportion to all other methods used to commit suicide, increased statistically significantly from 89.4% among men and 77.3% among women between 1993 and 1997 to 91.7% among men and 82.6% among women between 1998 and 2002. The most noticeable rise occurred among girls aged 10-19 years. The next most common methods among men were firearms and poisoning; among women, poisoning and jumping from high places were common methods. Hanging predominated in men, older people, rural residents and people with low levels of education. A logistic regression analysis showed that gender (odds ratio [OR]=2.4; 95% confidence interval [CI] 2.2-2.7), place of residence (OR=2.0; 95% CI 1.8-2.2) and education (OR=1.2; 95% CI 1.1-1.3), independently of other factors, had the strongest influence on the choice of hanging as the method of suicide between 1993 and 2002. Age had only a minor effect, and marital status had no significant effect on choosing hanging to commit suicide. CONCLUSIONS: Hanging is the most common method of suicide in Lithuania. The popularity of this highly lethal method may be one of the underlying causes for the high rate of committed suicides. Universal approaches to suicide prevention deserve serious consideration, especially challenging the social acceptability of hanging among men, older people, rural residents, and low educated groups of the population in Lithuania.
Adolescent↗
Changes in precipitation chemistry in Lithuania for 1981-2004.
This paper considers the spatial and temporal variability in concentrations of the potentially acidifying ions in precipitation in Lithuania during the 1981-2004 period. Chemical analysis of precipitation included measurements of pH, conductivity, sulfate (SO4(2-)), nitrate (NO3-), chloride (Cl-), ammonium (NH4+), sodium (Na+), potassium (K+), and calcium (Ca2+). Temporal trends in the potentially acidifying ion concentrations in precipitation and wet deposition were evaluated using the non-parametric Mann-Kendall test and Sen's slope estimator. A statistically significant decline was observed in non-sea salt sulfate (nssSO4(2-)) and hydrogen (H+) ions concentrations (82% and 79%, respectively) and wet depositions (88% and 74%, respectively). Temporal trends both in concentration and wet deposition of nitrate and ammonium were not as pronounced as trends in sulfate concentration. Analysis of air mass backward trajectories was applied to reveal the influence of air mass originating in different regions on wet deposition of acidifying species in Lithuania. Sector analysis clearly showed that wet deposition of sulfur and nitrogen in Lithuania is to a large extent anthropogenic and the main source regions of acidifying species contributing to wet deposition in Lithuania are in South and Central Europe.
Acid Rain↗