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PubMed2006

[Multiple endocrine neoplasia type 2A].

Multiple endocrine neoplasia (MEN) type 2A, or Sipple syndrome, is a rare autosomal dominantly inherited syndrome, which is characterized as combination of medullary thyroid carcinoma, pheochromocytoma, primary hyperparathyroidism, sometimes with rarer inherited disorders like Hirschsprung disease and cutaneous lichen amyloidosis. Syndrome is caused by germinative mutations in c-ret protooncogene, which are typical for different MEN 2 syndromes. We report a clinical case of MEN 2A. A 43-year-old female patient was operated on for pheochromocytoma 7 years after diagnosis and treatment of spread medullary thyroid carcinoma. This is the most common combination of MEN 2A tumors. Diagnosis was based upon clinical data, tumors combinations and analysis of inherited endocrine pathology in first-line relatives. This syndrome has already been diagnosed in Lithuania, but in the last decade after determining the genetic basis of MEN 2 and applying modern genetic examinations in clinical praxis, the strategy of diagnostics and prophylaxis of this syndrome has changed and survival prognosis for patients with this syndrome has improved. Conception of pathogenesis and clinical features of MEN 2A syndrome, genetic selection of inheritors of this syndrome is one more step in early cancer diagnosis, which allows to use cancer prevention measures in time, to apply effective treatment and improve patients' prognosis. Reporting this clinical case of MEN 2A we aimed to pay attention of general practitioners to this rare, but in Lithuania diagnosed too, syndrome and its clinic, diagnostic, and treatment features.

Adrenal Gland Neoplasms↗
PubMed1994

[Trends in the field of tuberculous diseases in the Eastern Europe and former U.S.S.R].

According to WHO questionnaire data, reports of national ministries of health, medical associations and other medical institutions, tuberculosis morbidity in the majority of the East European countries and CIS surpasses that for the West Europe. In 1990-1992 it varied from 18 to 80 cases per 100,000 people. The lowest morbidity was recorded in the Czech Republic, the highest in Roumania and Kazakhstan. In Estonia, Latvia, Lithuania, Russia and Ukraine tuberculosis morbidity tends to a slow reduction, while in Armenia, Kyrgyzstan, Latvia, Lithuania, Moldova, Roumania, Turkmenistan mortality rates constantly grow. Antituberculous therapeutic and prophylactic policy in the East Europe and CIS should be aimed at finding the resources for adequate supply of the population with antituberculous medications, introduction of WHO-recommended short course of chemotherapy. On demand, health care system should be restructured and new educational programs for specialists and the population introduced.

Adolescent↗
PubMed1998

Prevalence of Lithuanian mutation among St. Petersburg Jews with familial hypercholesterolemia.

We used polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) analysis to detect LDL receptor gene defects in the St. Petersburg population. We have found a deltaG197 mutation in several patients of Jewish origin. The mutation named is shown to be responsible for one-third (7/23) of familial hypercholesterolemia (FH) cases in St. Petersburg Jews and absent in patients of Russian descent. The prevalence of a deltaG197 mutation in St. Petersburg Jews is consistent with its origin in Lithuania or Poland. The deltaG197 mutation can be easily detected in polyacrylamide minigels because of formation of specific heteroduplexes during PCR with DNA of heterozygous patients. Taken together with high prevalence of the mutation in St. Petersburg Jews, this observation provides an opportunity for DNA diagnostics of FH in this ethnic group.

DNA Mutational Analysis↗
PubMed2001

Human anotocephaly (aprosopus, acrania-synotia) in the Vilnius anatomical collection.

A genetic theory of "multifactorial" malformations, i.e., anomalies of blastogenesis or organogenesis, involving polygenic predisposition with morphogenetic threshold effect, was developed by Sewall Wright in the 1920s and remains an essential basis of birth defects biology. Because of the phenomenon of universality, i.e., the deployment of identical inductive, or pattern-forming, upstream molecular mechanisms during the earliest stages of mammalian morphogenesis, Wright's work on guinea pig otocephaly is highly pertinent to "corresponding," i.e., homologous malformations in humans. This concept is illustrated on the hand of a human fetus in the Vilnius (Lithuania) Pathological Museum with anotocephaly, i.e., anencephaly and otocephaly so severe as to correspond to Wright's guinea pig otocephaly grade 11 or 12. The observation also supports our apology for old museums and old books as repositories for anomalies, no less important for their rarity.

Anencephaly↗
PubMed2007

Screening for depression and anxiety disorders in primary care patients.

Mood and anxiety disorders are highly prevalent in primary health care. In this study we assessed performance of the Hospital Anxiety and Depression Scale (HADS) for screening of depression and anxiety disorders in a population of primary care patients. A total of 503 primary care patients consecutively admitted to the primary care medical center in Kaunas, Lithuania, completed the study. We found that the HADS subscale of depression (HADS-D) at a cutoff score of 6 or more showed the best performance screening for a major depressive episode diagnosed by means of the Mini International Neuropsychiatric Interview (MINI), with a sensitivity of 80%, specificity of 69%, positive predictive value of 80%, negative predictive value of 92%, and area under the receiver operating characteristic (ROC) curve of 0.75. Performance of the HADS-D against MINI diagnosis of dysthymia was weak. The HADS subscale of anxiety (HADS-A) at a cutoff score of 9 or more showed the best performance screening for MINI diagnosis of overall anxiety disorders, with a sensitivity of 77%, specificity of 75%, positive predictive value of 53%, negative predictive value of 90%, and area under the ROC curve of 0.76. These results suggest that in primary care patients HADS is an adequate screening instrument for the MINI diagnoses of major depressive episode, but not for dysthymia at a cutoff score of 6, and for anxiety disorders at a cutoff score of 9.

Adolescent↗
PubMed2006

Characterization of HCV strains in an oncohematological pediatric department reveals little horizontal transmission but multiple introductions by un-screened blood products in the past.

Because several children were found infected with hepatitis C virus (HCV) at a pediatric oncohematological department in Vilnius, 474 children were tested for anti-HCV. Fifty-eight percent of 96 children treated with blood and plasma products manufactured before the introduction of anti-HCV screening of blood in Lithuania in 1994 were positive for anti-HCV versus 3.4% of those treated after 1994. The possible route of transmission for 45 of these was investigated by phylogenetic analyses within the NS5B region. Children treated before 1995 were infected with a multiplicity of strains of different subtypes, predominantly 1b found in 21 cases, 3a in 5 cases, 2 in 3 cases, 1a in 1 case, and not subtypeable genotype 1 strains in 2 cases. Children who had received blood products after 1994 were infected with only two subtypes, 1b in six and 3a in seven. Genetic analysis showed multiple introductions of HCV before 1995 and that horizontal spread between patients had occurred only to a minor extent at the department. However, two transmission chains involved children treated before 1995. Another chain involved five children treated after 1994. Since the most important risk factor for acquiring hepatitis C was blood products manufactured before the introduction of donor screening for anti-HCV, the spread between children would not have been revealed without molecular tools. These and the background strains provide the first reported sequence data on Lithuanian HCV strains. In general, these were shown to form autochthonous clades, except the 3a strains that were related to strains from the former USSR.

Blood Banks↗
PubMed2004

Field study on changes in viability of airborne fungal propagules exposed to UV radiation.

The responses of airborne fungi to UV-B under natural conditions were investigated at the coastal station in Preila, Lithuania. Results of this investigation demonstrated that solar radiation has a marked lethal effect on outdoor airborne fungi. Sensitivity to solar radiation was the highest for the fungal propagules collected late in the evening (relative recovery 6.2%) and early morning (25.3%). The lowest sensitivity to solar radiation was observed for fungal propagules collected at midday (50.0%) and in the afternoon (53.0%). The reason for the lethal effect is thought to be elimination of the sensitive fraction of the night-time fungal populations as solar radiation gradually increases beginning at dawn. Among 356 fungus strains isolated during the investigations, 128 can be characterized as potential pathogens, and 21 strains among those most common in fungal populations belonging to plant, animal, and human pathogen groups. The collected fungal populations were exposed to solar UV-B irradiation for 2 h (from 12 p.m. to 2 p.m.). Fungal communities in the air samples were composed of saprotrophs, some of which are regarded as potential phytopathogens (Alternaria, Cladosporium, and Fusarium) or as entomopathogens (Beauveria, Paecilomyces, and Metarhizium). The airborne fungal species identified after exposure to solar radiation were predominantly: Aspergillus niger, Alternaria alternata, Cladosporium cladosporioides, Arthrinium phaerosporum, and dematiaceous sterile mycelium.

Air Microbiology↗
PubMed2004

Leachate toxicity assessment by responses of algae Nitellopsis obtusa membrane ATPase and cell resting potential, and with Daphtoxkit F magna test.

A microscale bioassay based on 50% inhibition of K(+), Mg(2+)-ATPase activity in a microsomal fraction isolated from Nitellopsis obtusa cells was developed. Compared to that for a plasma membrane fraction purified in a sucrose gradient, the preparation procedure for a microsomal fraction is less time consuming and the yield is substantially higher. Characteristics of the microsomal preparation proved to be similar to those of the highly purified plasma membrane preparation (Manusadzianas et al., 2002), at least for heavy metals. Sensitivity to CuSO(4) of the frozen (-8 degrees C) microsomal fraction [49 +/- 17 (SD) microM; n = 8] did not significantly differ from that of the freshly isolated one (52 +/- 30, n = 8), at least for 40 days. Toxicity of leachate water from Kairiai (northern Lithuania) solid waste landfill was assessed by taking samples from various points including temporary reservoirs and analyzing them immediately after spillage (summer 2002) and after storage for almost 2 years at 4 degrees C-6 degrees C. Two tests with the macrophytic alga Nitellopsis obtusa (Charatox, 45-min EC(50) of resting potential depolarization, and ATPase assay, IC(50) of membrane ATPase activity) and one test with the crustacean Daphnia magna (Daphtoxkit F, 48-h 50% immobilization) tests were used. In general, all three tests showed successively decreasing values of landfill leachate toxicity with an increasing degree of dilution with surface waters. The possibility of employing preserved algal preparations on demand in test batteries seems to be promising, especially in emergencies.

Adenosine Triphosphatases↗
PubMed1991

Geographical distribution gradients of the major PKU mutations and the linked haplotypes.

Analysis of 81 phenylketonuria families from Bulgaria, Lithuania and eastern Germany demonstrated a high frequency of haplotype 2 and the associated Arg408----Trp408 substitution. Haplotype 3 and the splicing mutation in intron 12 are rare or absent in the groups studies. Pooling the data on European populations suggests a Balto-Slavic origin of the defect in codon 408 of the phenylalanine hydroxylase gene and a geographical gradient in the distribution of both major PKU mutations which may contribute to the higher incidence of classic PKU in northern Europeans.

Bulgaria↗
PubMed1994

The ethno-demographic status of the Baltic States.

"The essay examines historic and current ethnodemographic trends in spatial and cultural contexts in the Baltic States. Fifty years of Soviet rule, with deliberate policies to dilute the relative homogeneity of the Balts through ethnocide, in-migration, and political dominance by Moscow, has left tensions between citizens of the Baltic States and illegal immigrants, mostly Russians. Estonians, and Latvians, in particular, fear ethnic and cultural extinction. The process of ethnic dilution and mixing under the Soviets is examined in terms of rural-urban contexts, the workplace, employment, housing, and education. Europe's smallest ethnic group, the Livs of Latvia, is also examined. Current demographic trends are analysed and prospects for ethnic harmony in these multi-ethnic societies are interpreted. A recurrent theme is that Latvia, with 52% of the population Latvian, is facing the most difficulties; Lithuania, with 80% Lithuanians, the least."

Culture↗
PubMed2001

A comparison of the prevalence of islet autoantibodies in children from two countries with differing incidence of diabetes.

AIMS/HYPOTHESIS: To examine the prevalence of sub-: clinical islet autoimmunity in children from two countries with a twofold to threefold difference in incidence of childhood Type I (insulin-dependent) diabetes mellitus. METHODS: Sera were collected from 2,860 English and 3,053 Lithuanian non-diabetic schoolchildren according to the same protocol. Occult diabetes was excluded by blood glucose measurement. Antibodies to GAD and the protein tyrosine phosphatase IA-2 were measured with standardised radiobinding assays in a single laboratory. Islet cell antibodies and insulin autoantibodies were additionally measured in all samples with GAD and/or IA-2 antibody levels above the 97.5th centile of the English schoolchildren. RESULTS: Of Lithuanian schoolchildren 2.7 % had GAD antibodies above the 97.5th centile of the English schoolchildren but only 0.2 % had antibodies to IA-2 above this threshold (p < 0.001). Islet cell and/ or insulin autoantibodies above the 97.5th centile were found in 22 Lithuanian and 16 English schoolchildren and the overall prevalence of two or more antibodies on or above the 97.5th centile was similar [0.7 % (0.5-1.1) vs 0.6 % (0.4-1.0)] in the two cohorts. CONCLUSION/INTERPRETATION: The prevalence of multiple antibody markers was similar in the cohorts from the two populations, despite the two to three-fold difference in incidence of diabetes. The unexpectedly high prevalence of subclinical islet autoimmunity suggests that the incidence of diabetes in Lithuania is likely to increase in the near future.

Adolescent↗
PubMed2005

Two decades of acute hematogenous osteomyelitis in children: are there any changes?

Our purpose was to compare the clinical course of acute hematogenous osteomyelitis (AHO) 20 years ago and today in the Department of Paediatric Surgery, Kaunas Medical University Hospital, Lithuania. Retrospective data analysis from patients aged 1-16 years with confirmed diagnosis of AHO was performed. The data were collected from 1982 to 2003. The incidence of AHO per year for 1,00,000 children (0-16 years) was analyzed for that period. The patients were divided into two groups-group A, treated in 1982-1983, and group B, treated in 2002-2003. The number of patients, patient age, duration of illness, complications, and length of hospital stay were compared using statistical methods for nonparametric data analysis (Mann-Whitney U test, chi-square criterion). Linear regression was used for incidence analysis. Population data were obtained from the Lithuanian Statistics Department. From 1982-2003, 758 patients were treated. The incidence of AHO increased from 1982. There was no statistically significant difference between the periods 1982-1983 and 2002-2003 in median patient age (10.36 and 10.72 years, respectively), in gender proportion (20.4% and 29.8% of the cases were girls), or in median duration of symptoms until admission (4 days and 3 days, respectively, p=0.058). Median hospital stay and duration of antibiotic therapy were longer in the period 1982-1983 (50 days and 43 days) than during 2002-2003 (29 days and 29 days). The differences in frequency of positive blood cultures (36.4% in group A and 64.9% in group B, p=0.046) and frequency of periosteal abscess (40.8% in group A and 19.3% in group B, p=0.015) were statistically significant. An increase in AHO incidence is seen when comparing contemporary data and the data from two decades ago, but nowadays the clinical course is less complicated and is marked by shorter hospital stays and shorter duration of antibiotic therapy.

Acute Disease↗
PubMed2005

High incidence of 4153delA BRCA1 gene mutations in Lithuanian breast- and breast-ovarian cancer families.

BRCA1 and BRCA2 gene mutations confer a high lifetime risk to breast and ovarian cancers. We have screened cancer patients from 13 families with at least three breast and/or ovarian cancers from Lithuania for 5382insC, C61G and 4153delA BRCA1 gene mutations. One of three mutations was found in 9 of the 13 studied families (69%). 4153delA was the most frequently detected and accounted for 56% of all identified mutation. 5382insC and C61G accounted for 33% and 11% of found mutations, respectively. Significantly higher, than in other populations, incidence of 4153delA indicates that this may be founder BRCA1 mutation characteristic for Lithuanians. Our analysis shows that testing of 4153delA, 5382insC, C61G BRCA1 mutations should be extremely effective and inexpensive tool in testing Lithuanian population aimed to identify individuals with high risk of breast and ovarian cancers.

BRCA1 Protein↗
PubMed2006

Rupture of tubal pregnancy in the Vilnius population.

OBJECTIVES: To evaluate the determinants of tubal rupture in women who suffered from ectopic pregnancy in relation to their demographic profile and medical history. STUDY DESIGN: This retrospective observational clinical study was conducted in five general hospitals in Vilnius, Lithuania. The population was composed of 879 women with surgically proven ectopic pregnancy. Tubal rupture was diagnosed at the time of surgery. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for tubal rupture. RESULTS: The occurrence of tubal rupture was 29.5% (259/879). It was encountered significantly more often in women with age of > or =35 years (odds ratio 1.9 [1.3-2.8]). Patients whose EP was located in the isthmus were at higher risk of having tubal rupture (odds ratio 3.2 [2.2-4.5]) while known risk factors for EP were not associated with an elevated risk. CONCLUSIONS: Our data suggest that age of > or =35 years and implantation in the straightest segment of the tube could be associated with increased rate of tubal rupture. Of particular interest is the overall tubal rupture prevalence (29.5%) observed since these women were managed in an environment where transvaginal ultrasound equipment and quantitative assessment of beta-human chorionic gonadotrophin were not routinely available.

Adult↗
PubMed2005

Meteorological factors and air pollution in Lithuanian forests: possible effects on tree condition.

This study investigates changes in tree condition and environmental factors in Lithuania during the active growing season in 1991-2001. The average crown defoliation and the proportion of healthy trees of Pinus sylvestris, Picea abies, Betula sp., Fraxinus excelsior, Alnus incana, Alnus glutinosa, Populus tremula, and Quercus robur, meteorological (average temperature, amount of precipitation, hydrothermal coefficient) and air pollution data (acidity of precipitation, concentrations of SO2, NO2 and exposure of O3) were analysed. During the period 1991-2001 the condition of Pinus sylvestris, Populus tremula showed a tendency of improvement, while defoliation of Fraxinus excelsior significantly increased. The proportion of healthy trees correlated well with the average temperature and O3 (AOT40), while defoliation correlated well with the acidity of precipitation and the concentrations of SO2 and NO2. Deciduous species appeared to be more sensitive to O3 exposure and conifers to the concentrations of SO2 and NO2.

Acid Rain↗
PubMed2006

Tick-borne encephalitis in the Baltic States: identifying risk factors in space and time.

This paper presents preliminary results in our investigations of the biological (abiotic and biotic) and non-biological causes of the spatial heterogeneity and temporal change of tick-borne encephalitis (TBE), both within and between Estonia, Latvia, and Lithuania. Spatial analysis revealed that the land cover and precise seasonal patterns of climatic indices (temperature and normalized difference vegetation index) can explain 55% of the observed spatial variation in TBE incidence over the period 1993-98 across all the Baltic States. Temporal analysis of climatic variables indicates a very specific change in spring temperature conditions from 1993 onwards that could enhance the transmission of TBE virus. Further time series analysis of climate, together with analysis of biotic factors, socio-economic conditions, and human behaviour is being undertaken to explain the epidemiological patterns more fully.

Animals↗
PubMed2006

Human papillomavirus and p53 polymorphism in Lithuanian cervical cancer patients.

BACKGROUND: Cervical cancer is the fourth most common cancer for women in Lithuania. One of the important cervical cancer risk factors is human papillomavirus (HPV) infection. Recent literature has considered p53 allelic polymorphism to be a putative predisposing factor for cervical carcinoma development. OBJECTIVE: The aim of this study was to elucidate the prevalence of HPV, especially HPV 16, in cervical cancer patients and in healthy women, to investigate the distribution of p53 gene 72 codon polymorphism and to correlate these to cervical cancer risk in Lithuanian women. METHODS: 588 women were included in the study: 212 women with primary diagnosed cervical cancer (case group) and 376 healthy volunteers (control group). RESULTS: A high prevalence of HPV DNA was detected in cervical cancer patients, 92.0%, and in control women, 23.6% (P < 0.0001). HPV 16 is the most frequent HPV type in cervical cancer patients. In the case of squamous cell carcinoma, this type was detected in 55.8%, in adenocarcinoma - 35.3%. In the control group, this type was detected in 19.0%. A statistically significant difference in the distribution of p53 alleles between the case and the control groups was found. CONCLUSIONS: Cervical cancer risk in Lithuanian patients is associated with HPV infection (OR = 75.39; 95% CI 33.61-192.98), especially HPV 16 type (OR = 100.3; 95% CI 46.05-238.59) and p53 homozygous Arg/Arg allele (OR = 2.10; 95% CI 1.10-4.19).

Adolescent↗
PubMed2003

Differences in health complaints among university students from three European countries.

BACKGROUND: The purpose of this research was to assess the prevalence of somatic and psychosomatic health complaints in a cross-national population of university students and to study risk factors associated with health complaints. METHODS: The analysis was based on samples of first-year students from Pamplona (Spain), Bielefeld (Germany), and Kaunas (Lithuania). The total sample included 2343 students. Ten health complaints were measured by a symptom checklist with a self-administered questionnaire. Sociodemographic and lifestyle data were also collected. Factor analysis was employed to develop three complaint scores. RESULTS: Multifactorial logistic regression analysis revealed substantial associations between the factors female gender and psychosocial stress and high levels (>median) of complaint scores. Furthermore, after adjustment for age, sex, and lifestyle variables Lithuanian students were less likely to report gastrointestinal complaints (OR 0.62, CI 0.43-0.90) and neck ache/backache (OR 0.41, CI 0.28-0.61) compared to Spanish students. In addition, German students were less likely to report psychosomatic (OR 0.49, CI 0.35-0.69) and gastrointestinal complaints (OR 0.47, CI 0.34-0.65) than their Spanish peers. CONCLUSIONS: Although the results cannot be generalized to the general population of the respective countries, the different profiles of reported complaints should give rise to special interventions in this young population.

Adolescent↗