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PubMed2003

[Drug-resistant tuberculosis in Kaunas region 1997-2001].

Two thousand four hundred thirty nine cases of tuberculosis were confirmed by the method of culture of the sputum at Kaunas Romainiai tuberculosis hospital during the period of 1997-2001. Out of them, 669 of them were diagnozed for the first time (not treated or treated for less than 1 month). Out of confirmed cases, 1601 of confirmed cases were the "old" ones (treatment failures, relapses, treated with one or two courses of antimicrobial therapy). The resistance to H, R, E, S and multidrug resistance have been investigated. We have revealed that among the "new" cases of tuberculosis the resistance of M. tuberculosis has decreased. In 1997 the resistance to H was 27.5 percent. However, it decreased 5.3 percent in 2000 and to 8.7 percent in 2001. In 1997 the resistance to R was 19.9 percent and it has decreased to 9.0 percent and 1.9 percent in 1998 and 1999, respectively. No R resistance cases were diagnozed in 2000 and 2001. In 1997 the resistance to E was 1.1 percent. It reached 1.5 percent in 1998 and there was no resistance to E in 1999-2001. In 1997 the resistance to S was 15.6 percent. In 1998 it was 26.3 percent and dropped to 1.8 percent in 2000.

Antitubercular Agents↗
PubMed2003

[Atmosphere air pollution and health of Kaunas children].

Many studies support the impact of long-term exposure to air pollution on respiratory and allergic symptoms and illnesses. The aim of the study was to assess the prevalence of respiratory and allergic symptoms and illnesses in children living in 4 districts of Kaunas, to estimate the indices of respiratory function and to assess the relationship between mentioned indices and air pollutants such as dust, sulfur dioxide and nitrogen dioxide. A cross-sectional survey included 840 Kaunas children (34 subjects in Senamiestis, 288 in Zaliakalnis, 128 in Petrasiūnai and 390 in Silainiai) aged 6-7 years, whose parents filled out the questionnaire and children performed respiratory function test. Response rate varied from 58.6 percent to 69.2 percents depending on district. Questionnaire of International Study of Asthma and Allergy in Childhood (ISAAC) was used. The parameters of respiratory function (FVC, FEV1, FEV1/FVC, MEF25, MEF50, MEF75, PEF) were measured with Pony Graphics 3.5. The data showed that prevalence of respiratory and allergic symptoms and illnesses in children living in 4 districts of Kaunas did not differ significantly. In most of the cases it was similar to that found in Riga and Tallinn. There is a significant relationship between MEF25, MEF50, MEF75, PEF and sex as well as gas for cooking.

Age Factors↗
PubMed2003

[The investigation of the condition of oral cavity among the schoolchildren of 5th-6th grade].

The data of dental caries prevalence and intensity among schoolchildren of the fifth-sixth grade of six schools in Vilnius were analyzed. It was found that 83% of 908 investigated schoolchildren had carious teeth, 75.9% of them had dental caries in the permanent teeth and 7.1% in the milkteeth (permanent teeth were healthy). The dental caries of permanent teeth was 6.2% more frequent among the girls in comparison with the boys and was 5.8% more frequent among the Lithuanian pupils in comparison with investigated pupils of other nationalities. The prevalence of caries increased with the schoolchildren age and was 20.6% more frequent among 13-year old pupils in comparison with the 11-year old. The intensity of caries increased with the age and was higher among the pupils with bad oral hygiene, which was found in 19.5% of investigated schoolchildren.

Adolescent↗
PubMed2003

[Morbidity and attack rate of lung tuberculosis in Kaunas city and Kaunas district during 2000-2002].

UNLABELLED: The aim of the study was to estimate the changes of lung tuberculosis attack rate and morbidity and its changes in Kaunas city and Kaunas district during 2000-2002. MATERIAL AND METHODS: We analyzed results of National tuberculosis registry entries during 2000-2002 years period concerning new tuberculosis cases and relapses in Kaunas city and Kaunas district. RESULTS: We found significant decrease in lung tuberculosis morbidity from 59.11/100000 to 37.2/100000 (p=0.001) and attack rate from 71.25/100000 to 49.08/100000 (p=0.0026) in Kaunas city during 2000-2002 period respectively. Decrease in Kaunas district in the same time was not significant. The rate of lung tuberculosis relapses during 2000-2002 period in Kaunas city and Kaunas district increased, but not significantly. CONCLUSIONS: The morbidity and attack rate of lung tuberculosis in Kaunas city decreased significantly during 2000-2002. The rate of lung tuberculosis relapses during 2000-2002 in Kaunas city and Kaunas district didn't change significantly.

Data Interpretation, Statistical↗
PubMed2003

[Smoking prevalence among university hospital staff].

Addiction to smoking was assessed in staff of Kaunas University of Medicine Hospital based on the results of an anonymous questionnaire. A total of 3090 valid questionnaires were collected (56.5% of whole sample). Prevalence of smokers was 13.3% (37.6% men and 9.7% women), former smokers - 6.0% (16.0% men and 3.7% women) and non-smokers - 80.7% (46.4% men and 86.6% women). The 30-39 year old age men and 18-39 year old women groups present the highest prevalence of smoking (48.8% and 14.9%, accordingly). The highest prevalence of tobacco smoke was found among auxiliary personnel men and women (44.9% and 11.3%, accordingly) and the lowest - among doctors (36.4% and 7.6%, accordingly). The received data enable to evaluate smoking prevalence among University Hospital staff and allow smoking control policy measures.

Adolescent↗
PubMed1976

[Registration of cases of non-hospitalized patients sudden death due to acute myocardial infarct and acute coronary insufficiency and its importance for further improvement in the control of ischemic heart disease].

An analysis is presented on the recording, in accordance with the WHO programme, of extramural deaths in the city of Kaunas attributable to acute myocardial infarction and acute coronary insufficiency. In 89 patients who died outside of hospital walls the morphological studies revealed only a scar (not exceeding 0.5 cm in size) of a sustained acute myocardial infarction. In 64% of them the diagnosis of acute myocardial infarction was not made intravitally. The recording of cases of extrahospital mortality is of great practical importance. It indicates that the medical aid to patients with ischaemic heart disease remains insufficient.

Acute Disease↗
PubMed2003

[Bone mineral density in healthy Lithuanian women].

OBJECTIVE: The purposes of this investigation were to determine spine and femoral bone mineral density for a representative sample of healthy women of Lithuanian descent and to compare these results with US/European reference data. METHODS: We randomly selected 1200 women aged 20-79 years from Lithuanian population registers. Densitometry of the lumbar spine and left proximal femur was determined by a LUNAR DPX-IQ system (Lunar corp., Madison, WI). The general exclusion criteria for the construction of representative samples of Lithuanian women included early menopause and diseases, use of drugs and toxic habits such as smoking and alcoholism, known to affect bone and mineral metabolism. RESULTS: Eight-hundred-seven women completed the study. The bone mineral density results were grouped into 10-year age cohorts. A comparison between the Lithuanian and Caucasian data, using the two-tailed t-test, showed that there was no statistically significant difference between them for all age groups at the P<0.05 level. The Lithuanian women show the expected gradual reduction of bone mineral density with age, after peaking at 20-39. The bone mineral density of Lithuanian women tends to mirror rates of loss established for US/European subjects. CONCLUSION: Our bone mineral density measurements for healthy Lithuanian females are not significantly different from the normative Caucasian female reference data both in terms of average values and degree of spread.

Absorptiometry, Photon↗
PubMed2003

[Vilnius rheumatoid arthritis registry].

OBJECTIVE: To analyze the disease characteristics, health status, working ability, treatment specificities of rheumatoid arthritis (RA) patients referred to Vilnius rheumatoid arthritis register and to compare the data with those reported from other countries rheumatoid arthritis registers. MATERIALS AND METHODS: Rheumatoid arthritis patients' characteristics were analysed using the data of the Vilnius Rheumatoid arthritis register established in the end of 1998 and comprising 1018 rheumatoid arthritis patients from 486506 adult Vilnius citizens. The data were compared to those reported from Oslo Rheumatoid arthritis register, Norfolk Arthritis Register and German rheumatological database. RESULTS: Of all patients, 83.7% were women on the average 60.4 years old. The average disease duration was 12.2 years. Of the whole group of patients, 24% were working people, as many as 58.2% were disabled and most often had the second-third functional class. Non-steroidal anti-inflammatory drugs were taken practically by all rheumatoid arthritis patients (98.3%); 74.3% of the patients were taking corticosteroids. The corticosteroid injections into the joints, mostly into the knee-joints, had been performed to 53.5% of the patients in the past. The treatment with disease-modifying antirheumatic drugs (DMARDs), most commonly sulfasalazine, was applied to 85.6% of rheumatoid arthritis patients. Surgery of joints was applied to 13.4% of the patients: synovectomy to 8.7%, prosthesis operations to 4.7%. Prosthesis operations were performed on the average after 16 years from the beginning of the disease. CONCLUSION: The majority of rheumatoid arthritis patients were elder women. As a rule, the treatment with DMARDs, most commonly sulfasalazine, was prescribed to the patients who had been ill for a short period of time. The rheumatoid arthritis patients in Vilnius were more often unemployed, disabled, with worse physical function. The demografical data of responders and non-responders were similar.

Adrenal Cortex Hormones↗
PubMed2003

Changes of patients' satisfaction with the health care services in Lithuanian Health Promoting Hospitals network.

The aim of this study is to evaluate the changes of patients' satisfaction with health care services in Lithuanian Health Promoting Hospitals network. In a survey, which was carried out by Lithuanian Health Promoting Hospitals network, 1271 patients took part in 2000 and 1467 patients in 2002. The patient's satisfaction with health care services was evaluated using a uniform anonymous questionnaire. The patients were asked to evaluate hospital environment (neatness, cleanliness, and food quality), the quality of health personnel work (attentiveness, care, risk factors, and tests used for diagnosis and treatment) rating from 1 (very bad) to 6 (excellent). It was ascertained that, during the period between both surveys, the number of patients who evaluated the sanitary conditions in the ward as excellent and very good, increased from 49.2% to 59.9%, p<0.05. According to the data received from both surveys, the hospital food quality was rated more critically than the hospital environment. The number of patients, who noted that the food quality was satisfactory, decreased from 29.8% to 22.0%, p<0.05 within the period analyzed. However the number of patients who had a positive opinion of the health care personnel's attentiveness and help while explaining the causes and consequences of various illnesses increased. Patients' assessment of the physician work remained the same. The majority of the patients (95.1% in 2000 and 94.9% in 2002) appreciated the overall performance of the physicians, and rated it very good and excellent. The analysis of patients' satisfaction is a simple study of a constituent part of the health care service quality assessment and an objective prerequisite for the improvement of the quality of the health care services.

Food Service, Hospital↗
PubMed2003

Educology and languages for the educational development of medical studies.

In the process of professional education and training, general education that is realized in non-specialty curricula of professional education and training is oriented towards three directions: the development of cognitive competence, the development of the personal and social, as well as professional competence. The report discusses the possibilities for educational development in the elective course of educology as well as the educational possibilities of languages when striving to achieve the goals of the general education of the health professionals, which are conditioned by the change in biomedical studies in the context of the interaction between the classical tradition and contemporary tendencies oriented towards wider understanding of health. The report analyzes which expression of the educational directions of educology and of languages is best revealed in biomedical studies when striving to achieve new goals. The health professionals' studies primarily take place at Kaunas University of Medicine, therefore in this article we present the data on the observation of the process of developing general humanitarian competence in the health professional, namely, the analysis of the curricula and student dynamics within the curricula of optional languages during the period of 1997 to 2001. We also clarify the dynamics of the elective course of educology in Kaunas University of Medicine curricula; finally, we generalize the results of the questionnaire-based inquiry of students who chose this elective course during 1999-2002. The theoretical analysis of the curricula and the results of the inquiry allow for making a conclusion on the modernization tendencies of biomedical studies, manifesting themselves through the need for the expansion of narrow professional competence, contemporary professional education, and the realization of well-rounded education.

Curriculum↗
PubMed2003

[Medical care of persons aged 25-84 years with acute myocardial infarction in Kaunas in 1996 (ischemic heart disease register data)].

AIM: To evaluate peculiarities of medical care provided for patients with acute myocardial infarction (AMI) depending on sex and age in Kaunas in 1996. METHODS: Kaunas community-based ischemic heart disease register conducted according to the WHO MONICA Project methodology was the source of the data. RESULTS: Number of diagnosed acute myocardial infarctions among Kaunas population aged 25-84 years in 1996 was 1269. Only 28 day AMI survivors were considered in the present study (n=626). During first 4 hours from onset of chest pain male patients sought for medical assistance as frequently as female AMI patients: 38.1% and 34.0%, respectively. A mobile team provided first medical aid in 62.3% of cases. Thrombolytics were used in each 11th men and in 3% of women. Percutaneous coronary angioplasty was carried out in 4.9 and 1.2% of men and women, respectively. Coronary angiography and angioplasty were more often performed in men (13.1 and 4.9%, respectively) than in women (2.7 and 1.2, respectively).

Adult↗
PubMed2003

[Trends in mortality of Lithuanian population throughout the first decade of Independence].

The aim of the study was to assess trends in overall mortality and the impact of the major causes of death to the overall mortality changes during the different periods of 1990-2000. Data about the population and the deceased was obtained from Lithuanian Department of Statistics. Mortality rates were age-standardized. Coefficient of logarithmic regression was used for the assessment of the trends in mortality. The impact of the major causes of death to the changes in overall mortality was estimated applying the methodology of I.M. Joung (1996). Trends in mortality of Lithuanian population were not uniform throughout the period of 1990-2000. The average increase in mortality during the period of 1991-1994 reached 4.1% per year, while in 1995-2000 similar decreasing trend was observed. Statistically significant increase was noted only in the age group of 20-64, while the decline was characteristic for all other age groups. Mortality of young population was decreasing more significantly. Negative changes in mortality during the period of 1990-1994 were mainly determined by external causes of death (45.1% in males and 28.3% in females), and positive changes that occurred in 1995-2000 were determined by mortality from cardiovascular diseases (nearly 50%). The impact of cancer and respiratory diseases was significant neither for negative, nor positive changes in overall mortality.

Accidents↗
PubMed2003

[Narcotic abuse and HIV infection in prisons].

Number of drug using people in Lithuanian prisons has been growing every year: in the beginning of 2001, 1010 people in total were on a record of dispensary care, which made 8.8% of all imprisoned persons at that time. The same percent has increased in the beginning of 2002 reaching 12.25%, and growing up to 13.3% in the beginning of 2003. Drug availability and unsafe use of illegal drugs, especially sharing of needles and syringes in one of the fourteen country's penal establishments - Alytus strict regime correctional facility - resulted in a rapid HIV outbreak in spring 2002. Three hundred prisoners infected with HIV were identified during the voluntary testing. Though majority of prisoners are quite well informed about HIV, their knowledge does not alter the risky behavior. The well-informed on HIV prisoners, nevertheless, use drugs despite the risk of HIV infection. Furthermore, shortage in treatment of drug use, in rehabilitation and occupation of prisoners provide benevolent conditions for rapid spread of HIV and other blood-born infections in the Lithuanian penitentiaries. Many prisoners are not able to reintegrate into society after their release because of broken social relationships, lack of social services in the country, therefore they do often relapse into a drug use, and endanger not only their close people but also society in whole. HIV and virus hepatitis might be transmitted from them to a general population by a variety of transmission modes.

Adult↗