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The paper presents the results of a primary medical examination and of a prospective, on the average 14-year follow-up study of the male population of Kaunas aged 45-59 years (n = 2452). The prevalence of overweight, according to the WHO criteria, was 48.7%, that of obesity 20.5%. With increasing body mass index (BMI) there occurred a statistically significant increase of main risk factors of ischaemic heart disease (IHD) and of IHD itself. The results of the prospective study showed a U-shaped relationship between BMI and mortality from all cardiovascular diseases, and a J-shaped relationship between BMI and mortality from IHD and morbidity of acute myocardial infarction, respectively. The same relationship held true even after standardization of the level of all other risk factors using the multiple logistic function. Thus, the overweight was confirmed as an independent IHD risk factor in the given population.
The authors present the analysis of the incidence of epidemic cerebrospinal meningitis in the USSR from 1937 to 1974, and of meningococcus infection from 1965 to 1974. A rise of the meningococcus infection incidence from 1969 to 1974 was recorded 28 years after the elevation of 1940-1942 and was 1.5 times below this latter rise. The rise in 1969-1974 was characterized by marked signs peculiar to the infection with the droplet transmission mechanism; among those who contracted the disease prevalence was seen among children aged under 14 years (63-72%). A marked affection of juveniles was noted. Three types of the dynamic of the meningococcus infection incidence in the republics located in different climatic-geographical zones of the USSR were noted: slow, gradual increase of the level, interrupted and explosive. Such character was determined in the dynamics of the seasonal elevations of morbidity. Antiepidemic measures including a complex of nonspecific measures could not be assessed as sufficiently effective. This finds reflection in the natural course of the epidemic process of the meningococcus infection which remains uncontrolled. From the patients with generalized form of the disease meningococci of group A were isolated in 80-100% of cases, from the number of those typed. The group-specific reference of the nasopharyngeal strains depended on the epidemic situation: strains of serological group A prevailed at the period of the morbidity elevation, and other serological groups (particularly of C and B) increased at its decline.
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In this article the peculiarities of psychiatric comorbidity in pathological gambling were investigated. The authors were based both on the data of many foreign scientists and on their own one. Our data on 77 cases of pathological gambling were collected based on interviews of Lithuanian psychiatrists and psychotherapists about their patients with gambling addiction in period from 1991 to 2001. The data that we publish and analyze allows us to make conclusions that pathological gambling can reveal together with very wide spectrum of psychiatric disorders, but more often with alcoholism and depression. The mechanism of psychiatric comorbidity in pathological gambling is very complex.
The Department of Histology and Embryology at Kaunas University was established in 1923. Professor E. Landau was the very first to head the Department. He arrived in Kaunas from the University of Bern (Switzerland) and worked here from 1923 till 1932. At that time the staff of the Department had only four people: professor E. Landau, head of the Department, J. Bubenaite, senior assistant, D. Kesiūnaite, assistant, and J. Masevicius, laboratory assistant. From 1934 till 1937 the Department was headed by professor V. Danchakova, who came from Columbian University in New York. From 1939 till 1971 the Department was headed by professor B. Abraitis, and from 1971 till 1994 by professor A. Vitkus. In 1994 associate professor K. Baltrusaitis was elected head of the Department. At present time the staff has five lecturers and four laboratory assistants. Various preparations for histology classes are being produced by the laboratory and teaching personnel. According to the curriculum requirements, lectures courses of histology, cytology and embryology are delivered to the first and second year students of the Faculties of Medicine, Odontology, Nursing and Public Health, taking into account specific aspects of each speciality. An optional course is also provided to senior students wishing to study the problems of histogenesis and changes associated with aging of body tissues. In 2003 professor A. Valanciūte was elected head of the Department. The main research problem deals with experimental ischemic heart disease and the solution of problems of experimental myocardial infarction. The results of all thesis research works can be summed pointing out 12 presented inventions and more than 20 rationalizations. Staff of the Department also takes part in the realization of an international project called "Biotechnet".
THE AIM: To evaluate the prevalence and time trends of smoking habits among middle-aged Kaunas population during 20 years and its relation with sociodemographic status. MATERIAL AND METHODS: Four cross-sectional surveys were carried out according to the WHO MONICA protocol in 1983-1985, 1986-1987, 1992-1993, and 2001-2002. During these surveys, 2,450, 1,762, 1,238, and 1,404 persons aged 35-64 years, respectively, were screened. Data of the last survey were used to evaluate the relationship between smoking habits and sociodemografic status (educational level, occupation). Data of all four surveys were used to assess the prevalence of smoking habits among the Kaunas population aged 35-64 years and its trends during 20 years. Regular smoker was subject who smoked at least one cigarette per day. Prevalence rates for age group of 35-64 years were age-standardized using the European population as the standard. RESULTS: According to the results of the last survey, 41.4% of men and 11.3% of women were regular smokers. During the last twenty years the prevalence of regular smokers increased by 2.7-fold among women and didn't change among men. Age, educational level, occupation and age when starting smoking showed a strong relationship with the smoking habits among men. Education level didn't show any association with smoking habits among women. The lowest prevalence of the regular smoking was among men with a higher education (24.9%) and among professional workers (27.1%) as compared to those with a lowest education (44.6%, p<0.01) and workers (47.3%, p<0.001), respectively. Among all regular smokers, 65.2% of men started to smoke at age 16-21 years, and 52.3% of women - at age 22 years or more. During 20-year period the prevalence of never smokers decreased (beta=-0.95, p<0.05) and that of ex-smokers increased (beta=0.96, p<0.05) among women. No statistically significant trends in smoking habits were detected among men during the study period. CONCLUSION: The prevalence of never smokers decreased and that of ex-smokers increased among women 2.7-fold while no significant changes in smoking habits were found among men during 20-year study period. The lowest prevalence of regular smokers was among men with higher education and among professional workers.
OBJECTIVES: The aim of the work was to evaluate the incidence of occupational skin diseases in nurses, their morbidity rate, symptoms, possible causes and relation with occupational environment. MATERIALS AND METHODS: The study group consisted of 706 nurses of different hospital departments. A questionnaire and collection of information about the use of disinfectants were the main investigation methods. RESULTS: It was revealed that 47.3% nurses were suffering from occupational skin diseases. Allergic contact dermatitis was found to be the most frequent (28.5%) disease. Irritant contact dermatitis of non-allergic origin was diagnosed in 8.4% of nurses. The main symptoms of occupational skin diseases were itching and reddening. CONCLUSION: The risk of developing occupational dermatitis was increased by working with aldehydes and hydrogen peroxide as well as by using latex gloves and long working hours.
UNLABELLED: Leaves, flowers and fruits of single-styled hawthorn are used for production of pharmaceuticals with cardiotonic, coronary vasodilatoric and hypotensive action. Amount of flavonoids accumulated in crude drug of hawthorn is a parameter of quality. OBJECTIVE: To establish the difference in amounts of flavonoids accumulated in the crude drug of single-styled hawthorn. MATERIALS AND METHODS: Different examples of crude material from some Lithuanian regions were extracted with ethanol; flavonoids were measured by spectroscopic method and by HPLC (high performance liquid chromatography). RESULTS: From 0.77% to 2.80% of flavonoids are determined in the leaves and flowers; amounts of hyperosid were 0.16-0.87%; vitexin-o-rhamnosid 0.14-0.40%; rutin 0.10-0.19%. Flavonoids maximum percent was determinate in crude material examples collected at the single-styled hawthorn flowering time; the decline of amounts of flavonoids accumulated in the crude material of hawthorn was determined from May to August (realization of correlation coefficient r=-0.90). Hyperosid maximum percent was determined in crude material examples collected at flowering time; the decline of amounts of hyperosid accumulated in the crude material was determined from May to August (r=-0,94). Amounts of rutin and vitexin-o-rhamnosid in leaves were less than flowers; there was the decline of amounts of rutin and vitexin-o-rhamnosid in leaves from May to August. The percent of flavonoids 0.09 to 0.24 is determined in fruits. CONCLUSION: Lithuanian single-styled hawthorn populations can supply quality crude material from May to August; the bigger amounts of flavonoids were determined in crude drug examples collected at flowering time.
OBJECTIVE: Objective of this survey--possibilities of implementation of pharmaceutical care elements in daily work of Lithuanian community pharmacies. All pharmacists have to ensure the best quality of pharmaceutical services which they render to their patients. Pharmacists also must improve the quality of pharmaceutical services, according to recommendations of pharmaceutical care. For a start they should implement at least separate elements of pharmaceutical care if they are going to provide pharmaceutical care services in their community pharmacies in the future. That's why this survey was designed to clarify the possibilities of implementation of separate pharmaceutical care elements in to daily work of community pharmacies. MATERIAL AND METHODS: Material of this survey--pharmaceutical services rendered in Lithuanian community pharmacies. This survey has an analytical character and was accomplished with questionnaire. Chiefs of community pharmacies were asked to complete of questionnaire. We gave 150 questionnaires and received answers from 128 pharmacists. RESULTS: After gathered data analysis we found out that only 2% of pharmacies are almost prepared and well equipped for provision of pharmaceutical care services; however, they still have to rearrange their facilities. CONCLUSIONS: Lithuanian community pharmacies are not ready to work according to recommendations of pharmaceutical care today. Some elements of pharmaceutical care (such as blood pressure measurement, provision of written information for patient, etc.) are already implemented by almost all Lithuanian community pharmacies. If pharmacists want to provide pharmaceutical care services they should create a database of patient medication records in pharmacy. Unfortunately Lithuanian pharmacists do not have such databases today. Only with such databases there is a possibility to render pharmaceutical services of the best quality.
OBJECTIVES: To examine whether the managers of Lithuanian community pharmacies need a special information system for the creation of patients' medication record in the pharmacy. To design the system and to analyze the possibilities of its application. RESEARCH MATERIALS AND METHODS: In order to determine the need for a specialized information system a questionnaire-based survey of pharmacies managers was used. During the development of information system the detailed requirements analysis was performed and basing on this analysis the architecture of the system and its user interface were designed. System was built using "Microsoft Access 2000" and "Visual Basic 6" development tools. RESULTS: Survey revealed that managers of community pharmacies require an information system for the creation of patients' medication record in the pharmacy. The design of the system was prepared and the initial version was built. Examinations of the developed system showed that it could be used to form the patient information database, which would improve the quality of service. CONCLUSION: The developed information system or its analogue should be used in community pharmacies because absence of the patients medical records database makes it impossible to implement the recommendations of good pharmacy practice.
This publication deals with so far untreated topic in the historiography of Lithuanian medicine and pharmaceutics--the founding of Vilnius City municipal pharmacy and its activities in 1913-1915. The research is based on recently discovered archival documents and publications. In Tsarist Russia, the municipal or cities' medical organization was established in those parts of the Empire, which were not under the authority of "zemstvy". These also included the Lithuanian gubernijas. The history of municipal medicine in Vilnius dates back to 1876. This is one of the reasons why Vilnius had the most sophisticated infrastructure of municipal medicine. Since its very founding, the municipal pharmacy has become an integral part of city health care system. It sold medicines for a cheaper price; some medications were distributed as charity; the pharmacy served the local medical institutions.
UNLABELLED: THE AIM of this study was to reveal trends in height, weight, and body mass index of preterm very low birth weight children from birth up to 5 years of age. MATERIAL AND METHODS: The present study is based on cross-sectional growth study carried out in the Clinic of Neonatology of Kaunas University of Medicine. Total sample consisted of 735 children from birth up to 5 years of age: 379 preterm children with very low birth weight; and 356 term children with normal (appropriate for gestation age) birth weight. Height, weight, body mass index were measured. In order to verify if normal birth weight group corresponds to Lithuanian standards, the data of normal birth weight group children were compared with Lithuanian standard measures. Then data of very low birth weight group and normal birth weight group were compared. RESULTS: We found that height and weight of very low birth weight girls and boys were significantly lower than height and weight of term normal birth weight infant from birth up to 5 years of age (p<0.01). The body mass index of very low birth weight girls was significantly lower than that of term normal birth weight girls at birth (p<0.01) and at age of 4 years (p<0.05). The body mass index of very low birth weight boys was significantly lower than that of term normal birth weight boys at birth and from age of 2 up to the age of 5 years (p<0.01). These data show that very low birth weight boys differently from girls were more slender than term normal birth weight infant of the same age. CONCLUSIONS: It has been shown that preterm very low birth weight infants have different patterns of growth than term normal birth weight infants. The very low birth weight infants have not caught up on their retardation at the age of 5 years.
The review presents the facts of the origination of hospitals in Lithuanian villages based on historical documents. This process took place within the occupation period of czarist Russia. The recurrence of epidemics of grave infections diseases, such as cholera, typhus and diphtheria was one of the most important reasons leading to the establishment of network of rural health care institutions. Free outpatient and inpatient treatment of rural population was introduced for the first time, however this was accomplished not in all small towns. Kedainiai is a very old town with interesting and unique history. The article reviews development of health care in Kedainiai within the period of Kaunas Province.
We investigated effect of risk factors on elevated first myocardial infarction risk among professional drivers. We carried out case-control study among men aged 25-64 years in Kaunas in 1997-2000. We identified myocardial infarction cases (n=448) from the myocardial infarction hospital register (International Classification of Diseases, 10-th revision, code 121). Controls (n=1777) were selected on the basis of age, gender and city district of residence. We obtained information on sociodemographic, psychosocial and behavioral factors. We used the International Standard Classification of Occupations (ISCO) to code for occupations and conducted logistic regression analysis to evaluate association of risk factors with myocardial infarction in professional drivers. Compared with other occupations being a professional driver was associated with increased risk of first myocardial infarction with odds ratio (OR) adjusted for smoking, hypertension, presence of stress, obesity and educational status 1.42 and 95% confidence intervals (CI) 1.06-1.90. However additional adjustment for exposure to occupational vibration for 20 years or more eliminated effect of this occupation (OR 0.96, 95%CI 0.67-1.37). Among drivers exposure to occupational vibration for > or =20 years was most closely related to myocardial infarction (OR 3.01, 95% CI 1.54-5.89), while hypertension was associated with OR 2.80 (95% CI 1.58-4.96).
OBJECTIVE OF THE STUDY: To evaluate dynamics in prevalence of main risk factors of cardiovascular diseases among middle-aged Kaunas population between 1993 and 2002. MATERIAL AND METHODS: Four independent surveys in 1983-1984, 1986-1987, 1992-1993, and 2001-2002 were carried out in random samples of men and women aged 35-64 involving 2413, 1762, 1231 and 1403 persons respectively. The risk factors were defined within the framework of the WHO MONICA study (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease). RESULTS: During the 19 years the mean values of systolic blood pressure decreased among men. Among women decreased both mean values of systolic and diastolic blood pressure, however the prevalence of hypertension has decreased only among women by 11.9%, with no significant changes among men. The prevalence of overweight decreased among men, and the prevalence of obesity declined among women. Among women the body mass index decreased as well. No changes in the prevalence of hypercholesterolemia among men (80.7%) as well as among women (82.7%) have been detected, meanwhile the mean of total cholesterol among men increased from 5.9 mmol/l to 6.1 mmol/l and among women - from 6.09 mmol/l to 6.31 mmol/l (p<0.001). The prevalence of smoking has increased by 7.2% among women and didn't change among men. IN CONCLUSION: The decreasing trends in the prevalence of some risk factors have been estimated in Kaunas middle-aged population during 1983-2002 years. However the profile of cardiovascular disease risk factors is still rather high. Programs or strategies targeted to control levels of main cardiovascular disease risk factors are urgently needed.
UNLABELLED: THE AIM of the present study was to evaluate the trends in morbidity and mortality from ischemic heart disease and stroke in Kaunas population aged 25-64 years from 1983 to 2002. MATERIAL AND METHODS: The source of data is the official mortality statistics and Kaunas population-based ischemic heart disease and stroke registers. The methods used for the data collection were those applied by the WHO MONICA project. The object - all permanent residents of Kaunas aged 25-64 years who died from ischemic heart disease and stroke in 1983-2002 and experienced ischemic heart disease or stroke in 1983-2000. The age-standardized rates were calculated by the direct method and using the Segi's World and European population as a standard. Trends were analyzed using the method of linear regression on logarithms of the age-standardized annual rates. RESULTS: During 1983 to 2000, the morbidity from acute myocardial infarction among Kaunas men aged 25-64 years decreased by 0.8%/yr. (p=0.08), and during 1986-2000, the morbidity from stroke among men of the same age was without significant changes (-0.4%/yr., p=0.5). Among women, both the morbidity from acute myocardial infarction (1.6%/yr., p=0.006) and the morbidity from stroke (2.9%/yr., p=0.000002) rates among women increased statistically significantly. During 1983 to 2002, the mortality rates from acute myocardial infarction and stroke decreased statistically significantly among both men and women: among men - by 2.2%/yr., p=0.003, and by 2.9%/yr., p=0.004, respectively; among women - by 2.6%/yr., p=0.005, and by 3.2%/yr., p=0.002, respectively. CONCLUSIONS: The morbidity of acute myocardial infarction and stroke remained without significant changes among Kaunas men aged 25-64 years, while it increased statistically significantly among women of the same age during the last two decades. Among both men and women the mortality rates from both ischemic heart disease and stroke decreased significantly from 1983 to 2002.