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PubMed2006

[Vaccination against hepatitis B and epidemiological situation of this disease in European countries in the years 1990-2001].

Programme of vaccination in 52 countries of European Region does not include vaccination against hepatitis B of newborns and infants in 13 countries (25,0%), of older children and adolescents in 28 countries (53,8%) and among them newborns, infants older children and adolescents in 8 countries (15,4%). The best coverage of vaccination was found in Italy, Bulgaria, Poland, Romain and Lithuania. Number of cases of hepatitis B in the years 1990-2001 in 10 countries among 22 (45,4%), decreased in 6 countries (27,2%), increased in 4 countries (18,2%). The biggest improvement of epidemiological situation of hepatitis B was found in Poland.

Child↗
PubMed2006

In the European Union, TB patients from former Soviet countries have a high risk of multidrug resistance.

SETTING: Fourteen countries of the European Union (EU). OBJECTIVE: To explore determinants of resistance to isoniazid and rifampicin (multidrug-resistant tuberculosis [MDR-TB]) among tuberculosis (TB) patients in the EU. DESIGN: Pooled TB case notification data for 2003 from the-Baltic States (Estonia, Latvia, Lithuania) and Austria, Belgium, the Czech Republic, Denmark, Finland, Germany, Luxembourg, The Netherlands, Slovenia, Sweden and the UK were investigated using bivariate and multivariable analysis. RESULTS: Of 12,109 cases with data, MDR-TB occurred in 709 cases, 91% of whom were from countries of the former Soviet Union (FSU), including the Baltic States. At multivariable analysis, MDR-TB was strongly associated with previous treatment in both Baltic and non-Baltic countries (adjusted OR 9.5 and 6.4, respectively), and inversely related to age >64 years (OR 0.4 and 0.2). In non-Baltic countries, MDR-TB was more strongly related to origin from the FSU (OR 19.7, reference non-Baltic EU) than from other regions (up to OR 2.3). Among cases pooled from all countries, provenance from the FSU was very strongly linked to MDR-TB in both previously untreated (OR 24.9) and previously treated (OR 53.7) cases. CONCLUSION: Within a context of increasing mobility, public health workers should be aware of a higher risk for MDR-TB among patients from the FSU as well as among patients previously treated for TB.

Adult↗
PubMed2006

[Effect of combined treatment methods on quality of life in patients with pancreatic cancer].

In Lithuania, about 400 cases of pancreatic cancer are diagnosed each year, and more than 50% of patients are diagnosed with stage IV disease. Quality of life is an important issue in pancreatic cancer patients. A prospective randomized clinical study on the treatment of patients with resectable and unresectable pancreatic cancer was conducted at the Department of Oncology of Kaunas University of Medicine Hospital, and in this study, quality of life was analyzed. The aim of the study was to analyze the effect of combined treatment methods on quality of life in patients diagnosed with pancreatic cancer. MATERIAL AND METHODS. During 2000-2005, two concomitant chemoradiation treatment methods (radiotherapy with 5-fluorouracil and radiotherapy with gemcitabine) were analyzed in the study. A total of 60 patients were enrolled: 41 patients diagnosed with resectable and 19 patients diagnosed with unresectable pancreatic cancer. Quality of life was assessed using European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaire. Three main quality of life scales (general health status, functional, and symptom scales) were assessed and compared between two treatment groups. RESULTS. The analysis of quality of live assessment showed a statistically significant decrease in quality of life after treatment in patients with resectable pancreatic cancer and treated with radiotherapy and gemcitabine. Decreased quality of life later after treatment was also observed in patients diagnosed with unresectable pancreatic cancer and treated with the same regimen. Treatment with radiotherapy and 5-fluorouracil changed only some aspects of quality of life and did not have a significant impact on quality of life.

Adult↗
PubMed2006

[Environmental protection techniques used in the federal state of Baden-Württemberg in Germany].

Within the framework of the programme "Partnership for Sustainable Development" The Ministry of Environment of the German Federal State of Baden-Württemberg has come up with a project "Study Visit--Environmental Protection Techniques". It was intended as a three-week study visit for environmental protection experts from Central and Eastern European Countries (CEEC) to learn about the environmental protection techniques used in this federal state. Visits were paid to companies producing, applying or installing plants based on the state-of-the-art environmental protection techniques. The project started in 2005 and will last five years. The first visit to Baden-Württemberg was scheduled for 25 September-14 October 2005 for 12 experts from 12 countries: Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Ukraine.

Conservation of Natural Resources↗
PubMed2006

[Breastfeeding and medications].

Breastfeeding is the most healthful method of feeding neonates and infants. In 2001 about 98% of new mothers in Lithuania started breastfeeding their neonates. One-third of nursing women (34%) discontinued breastfeeding at the time when infant reached the age of 3 months. About 56% of women breastfed their infants longer than 4 months. Only 3-6% of nursing women discontinued breastfeeding after the fourth month. Discontinuation of breastfeeding in 21-23% of all cases was directly or indirectly associated with use of medications. Such data suggest that there is a lack of information often leading physicians to advise mothers to discontinue breastfeeding because of medication use. The aim of this article was to survey the situation about classification of drugs used during breastfeeding and factors influencing drug transfer into milk in order to give more information for physician concerning the use of medication during breastfeeding. In this review, a short description of main pharmacokinetic characteristics, influencing drug transfer into milk; information on the classification of drugs used during breastfeeding; some considerations on drug safety and possible adverse effects of medications on breastfed infant; the list of drugs preferred for nursing women are presented.

Age Factors↗
PubMed1991

[Occupational morbidity due to the effects of vibration and noise in leading USSR industries and main objectives of its prevention].

The article presents data on the prevalence and dynamics of noise and vibration related occupational morbidity in different regions of the USSR, branches of industry and professional groups. Diseases caused by noise and vibration present major and ever growing occupational pathology in the Soviet Union. Particularly high morbidity rates were traced in the Russian Federation, Ukraine, Kazakhstan and Lithuania, primarily in coal mining, metallurgy, machinery construction branches of industry, and, as to occupational hypoacusis,--in metallurgy, some branches of machinery construction, automobile construction and light industry. Vibration related risk factors were revealed in such professional groups as choppers, emery polishers, tool sharpeners, loggers, drill operators; noise related risk factors--in blacksmith's works, weaving and some others. Certain decrease in occupational morbidity rate was registered before 1985 with a tendency to increase in the last 4-5 years. Prevention of vibration and noise related morbidity should include complex measures, modernization of industrial sites and health services improvement.

Female↗
PubMed1986

Lung cancer in the USSR: patterns and trends.

Lung cancer in the USSR has become the most frequent type of tumour in males. In females, however, lung cancer rates are far behind rates for cancer of the breast, stomach and cervix. In 1980, lung cancer accounted for about one-fourth of newly diagnosed cancer cases in males and about one-sixth of all cancer cases in both sexes. The incidence of lung cancer is increasing in the USSR. In the five Soviet republics for which time trends have been examined in this paper, increases in lung cancer incidence have been observed in men for all ages, with the exception of the age group 30-39 years. Modest increases in lung cancer are seen in women in the older age groups, while small decreases or stabilization of rates are observed in younger age groups. However, there are two exceptions: statistically significant increases in Georgia for women aged 40-49 years, and an upward trend in Lithuania in urban females born in the years 1932 and 1937, suggesting that these particular groups of women smoke more than other women in the areas for which lung cancer time trends have been analysed. The continued increase in cigarette consumption in this country explains the rising trends in lung cancer and, moreover, leads to the prediction that this increase will continue for another 30-40 years.

Adolescent↗
PubMed1979

Comparative findings on body size of children and youths living at urban centers and in rural areas.

The focus of this paper is on rural-urban differences in human body size during the period between ages 8 years and 15 years. Groups of village and city residents are compared on standing height, body weight, and other somatic dimensions. Wide variation is found: from data collected during 1955--1972, urban children and youths in Costa Rica, Finland, Jamaica, Lithuania, Poland, Romania, and South Africa are larger than their rural coevals by more than 3.0 cm in standing height, and 2.0 kg in body weight; while from measures taken during 1889--1910, urban children and youths in East Germany and England are smaller than their rural peers by 1.2 cm to 2.3 cm in standing height, and 0.6 kg to 0.8 kg in body weight. Intermediate differences characterize groups in Bulgaria, France, Ghana, Italy, Japan, Surinam, the Soviet Union, and the United States.

Adult↗
PubMedDate not supplied

[The incidence of tuberculosis in Romania in 1993].

The situation of tuberculosis in Romania has been progressively deteriorated since 1986. Using the data from the TB notification forms and demographic data for the number of inhabitants by sex and age groups in various districts in 1993, there have been calculated the main TB epidemiometric indicators for 1993. TB notification rate in 1993 in Romania (89.4%000) is plotted against values in other countries of the Europe Region WHO in figure 1 and against the mean values for in the six WHO regions in figure 2; the dynamic of the annual values 1991-1994 in the 41 districts of Romania are presented in figure 3 and a comparison of the annual values 1985-1993 in Romania versus other countries with rising values (USA, Denmark and Lithuania) in figure 4. Data concerning TB notification rate in children (20.7%000 in 1993) and its dynamic during the last 8 years is presented in table II, high values districts in table III, the prevalence of sources in tables IV and the TB mortality (10.1%000 in 1993) and its trend during the last 11 years in table V. A series of 8 annexes presents 1993 data on TB notification number and rate by disease localisation, bacteriologic confirmation and sex, for each of the 41 districts of the country. All data are meant to reveal the magnitude of "TB problem" in Romania, to allow optimisation of the main control actions and planning of the necessary means.

Adolescent↗
PubMed1994

Clinical and endoscopic signs for the prediction of recurrent bleeding from gastroduodenal ulcers.

OBJECTIVE: To evaluate the prognostic importance of various clinical and endoscopic signs in patients who rebled after endoscopic treatment of gastroduodenal ulcers, and to create a predictive index using regression analysis. DESIGN: Retrospective study. SETTING: Teaching hospital, Lithuania. SUBJECTS: 659 patients whose bleeding peptic ulcers were treated endoscopically (out of a total of 949 with bleeding peptic ulcers seen from 1982-1991). INTERVENTIONS: Endoscopic haemostasis (laser or electrocoagulation, or injection sclerotherapy). MAIN OUTCOME MEASURES: Mortality, incidence of rebleeding, and identification of prognostic factors. RESULTS: Of the 75 patients who rebled 25 died (33%), compared with 23 of the 584 who did not (4%). 57 patients (76%) rebled within two days of endoscopy, and 70 (94%) within a week. 59 variables from the group of 75 who rebled and from a control group of 100 who did not were analysed by logistic regression to construct a predictive index. The following 12 variables were found to be significantly associated with recurrent haemorrhage: frequency and type of bleeding; length of time between episodes of bleeding at home; shock index on admission; speed of reduction in haemoglobin concentration; size and type of ulcer, and whether it was complicated; endoscopic appearance of ulcer; number of ulcers, sex of the patient, and presence of associated diseases (liver disease, coagulopathy, hypertension, or heart disease). The accuracy of the index varied from 78.4% in the prediction of a high risk of rebleeding to 100% in the prediction of a low risk. CONCLUSION: By using the predictive index we have been able to improve our management of patients with bleeding peptic ulcers.

Duodenal Ulcer↗
PubMed1993

Tobacco or health.

Tobacco smoking is the major cause of premature death among men in the CCEE/NIS. Reliable information on smoking prevalence and tobacco use is scarce, but the overall evidence points to two different patterns: a traditional and a high prevalence pattern. The traditional pattern dominates in the NIS and some of the CCEE, and is characterized by a high smoking rate in men (about 50%) and a low rate in women (10%). Smoking by women, however, is increasing, starting with the younger age groups. The high prevalence pattern found in the Czech Republic, Hungary and Poland, for example, shows a high smoking prevalence in women (about 25%) in addition to a high prevalence in men. Predictions made in 1990 indicated further increases or stable tobacco consumption in the CCEE/NIS by the year 2000, in contrast with the steady decrease in western European countries. When smoking is combined with other types of harmful health behaviour and environmental influences, the result is some of the highest mortality rates from lung cancer and other diseases in the world. This situation has caused severe concern in public health professionals in many of the affected countries, but not in the public and policy-makers. The fundamental changes in social and economic structures have both improved and decreased opportunities to promote nonsmoking. In the short term, the negative influences seem to dominate, although some countries, such as Lithuania and Poland, are now introducing their first realistic policies on tobacco. In most countries, however, tobacco control has to compete with other issues for priority on a crowded public health agenda.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Epidemiologic situation of diphtheria in the European region of the World Health Organization in 1992 and during the first half of 1993].

In sixties and seventies small number of diphtheria cases was registered in European countries and diphtheria seems to go to be eliminated. Between 1982 and 1985 the first wave of diphtheria epidemic, and since 1990 the second wave were observes. Majority of cases during the first epidemic was registered in Soviet Union, but also in Germany, Italy, Portugal, Turkey and Sweden. Since 1990 increasing numbers of cases were registered in Russia and Ukraine. Some imported cases from these countries were observed in Bielorussia, Lithuania, Latvia, Estonia, Poland, Finland, Norway. Prophylactic measures undertaken in Russia and Ukraine were not sufficient. Shortage of vaccines were the most important reason of this situation. In 1992 one case and in first six months of 1993 five cases of diphtheria were imported in Poland. Production of Td vaccine started in Poland in 1991 and vaccination of adolescents in 19 as well as vaccination of some risk groups were introduced especially in the east port of country.

Adolescent↗
PubMed1993

The seventh pandemic of cholera in the USSR, 1961-89.

Over the period 1961-89 a total of 1,713,057 cases of cholera were reported to WHO from 117 countries in all continents. The course of the epidemic fell into three periods: in period I (1961 to 1969), 24 countries (predominantly in Asia) reported about 419,968 cholera cases; in period II (1970 to 1977), 73 countries from Asia, Africa, Europe, and the Americas reported 706,261 cases; and in period III (1978 to 1989), 83 countries reported 586,828 cases. The global epidemic was at its most severe in 1967-74. Subsequently morbidity declined and up to 1989 had remained high and stable, with 44,000-52,000 cases per annum. In the USSR 10,723 cholera cases and carriers were reported between 1965 and 1989 from 11 republics (but not Latvia, Lithuania, Estonia, or Armenia). In 1965 and 1970-74 large-scale outbreaks of imported cholera were characteristic of the epidemic in the USSR. Thereafter morbidity declined, and sporadic cases were reported along with environmental, predominantly nontoxigenic strains of cholera vibrio. Most of the outbreaks in the 1970s were waterborne, and virulent strains containing the vct-gene were isolated from samples of water. Large-scale outbreaks continued that were associated with seafood and dairy produce that were contaminated with cholera vibrio. Clinical cases of cholera as well as a considerable number of carriers of avirulent nontoxigenic strains were reported. The epidemiological situation in the USSR is unstable, with cases of cholera and virulent strains from surface water being reported every year.(ABSTRACT TRUNCATED AT 250 WORDS)

Carrier State↗
PubMed1997

East meets West: a comparison of eastern block/western aeromedical practices.

Under the auspices of the European Command (EUCOM) Military-to-Military Exchange Program, the authors participated in 13 trips to visit aeromedical facilities of nine Eastern European nations (Albania, Belarus, Bulgaria, Czech Republic, Hungary, Lithuania, Poland, Romania, and Slovakia). In addition, eight of these Eastern European nations visited United States Air Force (USAF) aeromedical facilities. This article highlights the similarities and differences noted between the USAF and Eastern Europe in the practice of aerospace medicine. Flight surgeons from both Eastern Europe and the USAF address issues such as physiologic stresses of flight (acceleration, hypoxia, etc.) and lifestyle stresses (rest, diet, alcohol, cigarettes, etc.). Eastern European Flight Surgeons do not regularly fly. The Eastern European approach to medical standards and screening for aviation applicants is much stricter and more comprehensive than ours. Several of the nations visited had active research programs at their central aeromedical institute emphasizing aircrew selection and retention standards. With the exception of the Czech Republic, Eastern European nations did not routinely grant waivers for chronic medical conditions such as hypertension in aircrew. Soviet-built aircraft had many unique features such as an outside-in attitude indicator and an auto-recovery system.

Aerospace Medicine↗
PubMedDate not supplied

In vivo studies on lysosubtilin. 2. Efficacy for treatment of post-partum endometritis in cows.

Lysosubtilin is a broad-spectrum preparation of lytic enzymes from Bacillus subtilis designed for veterinary medicine. This study demonstrates its efficacy for the treatment of post-partum endometritis in cows. Prior to the determination of optimal therapeutic doses, samples taken from the uterus of sick animals were examined microbiologically. The examinations revealed a high incidence of polymicrobial infections (65.0%) caused by various mixtures of bacteria (both Gram-positive and Gram-negative) and fungi/yeasts. Dose-determination studies involved 160 cows with clinical signs of post-partum endometritis. For treatment both aqueous and oil-based formulations were tested and the optimal dose was found to be 2 x 10(6) U lysosubtilin dissolved in 100 mL of distilled water. When administered intrauterinarily twice a week until recovery this dose resulted in a 100% clinical recovery rate (versus 90%) and a statistically significant decrease (73 +/- 5 d), when compared with cows treated with neofur (92 +/- 9 d, P < 0.05) in the calving-to-conception interval. These findings were confirmed by results of field trials performed in four Former Soviet Union republics (Byelarus, Estonia, Lithuania, Russia) on 932 cows. Increases in clinical recovery (93.7 versus 80.2%, P < 0.05) and conception rates (64.4 versus 45.8%, P < 0.01) were found to be statistically significant when compared with cows treated with neofur or uterosan. We therefore conclude that lytic enzyme preparations are prospective antimicrobial drugs and when used to combat animal diseases they may serve as a possible alternative to common antibiotics.

Animals↗
PubMed1998

Female suicides and alcohol consumption during perestroika in the former USSR.

During 1984-1990, a decline in suicide rates of 32% for males and 19% for females took place in the former Soviet Union. The observed annual decrease in mortality from suicide was most marked for men in 1984-1986 and for women in 1984-1988. This article illuminates the hypothesis that the restrictive anti-alcohol campaign initiated by Gorbachev on 1 June 1985, in which prices of alcoholic beverages were raised substantially, had an impact on female mortality from suicide in the former Soviet Union. Data regarding alcohol consumption, female violent death (n = 451,537), suicide (n = 94,149), death due to accidental alcohol poisoning (n = 28,078), and undetermined death, whether accidental or self-inflicted (n = 23,982) were analysed for three Slavic (Russia, Belarus and the Ukraine), three Baltic (Lithuania, Latvia and Estonia) and two Central Asian republics (Kazakhstan and Kirgizia). Regression analyses with alcohol consumption as the independent variable and female suicide rates and female violent-death rates as dependent variables showed that suicide and alcohol consumption, as well as violent death and alcohol consumption, were positively correlated. However, alcohol seems to have a lower explanatory value for female suicides and female violent deaths compared with male suicides and male violent deaths. The attributable fraction of alcohol for female suicides in the whole USSR (27%) is estimated at approximately half of that for male suicides (50%).

Adolescent↗
PubMed1998

[Treatment with erythropoietin in Central and Eastern Europe].

Human recombinant erythropoietin (r-HuEpo) was introduced widely to the clinical practice more than ten years ago. In many countries belonging to Central and Eastern Europe (CEE) use of this drug was very delayed mainly due to the high costs of treatment. The aim of the presented study was to estimate actual possibilities of r-HuEpo administration in thirteen CEE countries. Survey was performed using especially prepared questionnaires including questions connected with r-HuEpo and filled out by the members of the Central and Eastern Advisory Board in Chronic Renal Failure. Below mentioned numbers of patients were under the control of the responders during performing the survey: on hemodialysis (HD) 1119, on peritoneal dialysis (PD) 205 and 1556 after renal transplantation (RT). Respectively in subsequent groups 53.5% (HD), 41.5% (PD) and 16.2 (RT) of patients were treated using r-HuEpo. Possibilities of treatment differs significantly between two groups of countries. In those with better developed economy (Croatia, Czech, Hungary, Macedonia, Poland, Slovakia, Slovenia, Yugoslavia) 60-70% of dialysed patients were given r-HuEpo and in the rest of countries (Bulgaria, Latvia, Lithuania, Romania, Russia) this drug was administered in 10-35% of patients. The most popular way of the r-HuEpo administration were subcutaneous injections (89.3%) comparing with only 10.7% of patients getting this important hormone intravenously. Average weekly dose of r-HuEpo was 71-90 IU/kg/week in so treated patients and 91-100 IU/kg/week in whom drug was administered i.v., in majority of patients two or three times weekly. Major part of responders tried to achieve as the optimal level of Hb 10-12 g/dl but simultaneously in 1/3 of centres only achieving of the Hb level 9-10 g/dl was possible. The general majority of responders were not satisfied with the obtained results and recognised economical constrains as the main reason of such a situation. These problems were more widely observed in predialysis patients, because only few of them were on r-HuEpo treatment. Side effects of this drug expressed rarely and main of them were development or acceleration of hypertension (16%) and thrombotic complications in the vascular access (8%). The main cause of hyporesponsiveness to drug was iron deficit despite of the adequate monitoring of responders were convinced that further avoiding of economical constrains would be benefit dialysis and predialysis patients. It is especially important looking on the literature finding supported by personal experience showing that r-HuEpo was positive impact on the quality of life, status of the cardiovascular system, endocrine, metabolic and immunological disorders observed in uremic patients.

Drug Administration Schedule↗