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PubMed2006

Anthropometrical data and physical fitness of Lithuanian soldiers according to the sociodemographic characteristics.

The aim of this study was to assess the anthropometrical data and physical fitness of soldiers according to the sociodemographic characteristics during one-year compulsory military service. The height and weight of 197 soldiers were measured at the beginning and at the end of their service, and body mass index was calculated. The physical fitness was evaluated using index of ability on the basis of 2 km walking test. Conscripts from cities were taller than conscripts from rural areas. At the beginning of the service every fifth was overweight (25< or = body mass index <30 kg/m2) or obese (body mass index > or =30 kg/m2): 17.9% of conscripts from rural areas as well as 17.6% from urban were overweight and 1.9% from rural as well as 1.1% from urban areas were obese. A tendency that the weight of conscripts gradually increased with the level of education was observed. There were no significant differences in index of ability according to the level of soldiers' education as well as place of residence. During one-year service the height of soldiers did not change, however, their weight increased in average by 5.5+/-4.5 kg (p<0.01). The part of overweight persons at the end of the service increased 2.3-fold. Physical fitness of soldiers after one-year service significantly decreased compared with the beginning of the service. In order to decrease the rate of overweight soldiers and to increase their physical fitness the health promotion programs in Lithuanian Army are needed.

Adult↗
PubMed2005

Dental restorations quality in Lithuanian adolescents.

The aims were to estimate the quality of dental restorations in Lithuanian adolescents and to relate differences in quality of restorations to gender, urbanization and residency. A total amount of 885 adolescents in 22 randomly pre-selected areas were clinically examined. The California Dental Association Quality Evaluation System was used for the assessment of the quality of dental restorations. 60.35 % of all restorations were not acceptable and had to be changed. 47.58 % of them must be replaced because of not acceptable anatomic form. Only in 8.9 % of participants all their fillings were considered as satisfactory, while in 24.8 % of adolescents all their fillings had to be changed. Regarding the reasons for the need to replace restorations substantial differences among different geographical regions were found, whereas in relation to gender and urbanization the differences were less pronounced.

Adolescent↗
PubMed2006

Analysis of odontogenic cysts of the jaws.

In this study 850 cases of odontogenic cysts of the jaws, treated in Kaunas University of Medicine Hospital during the period of 1986-2004, were analyzed in order to evaluate the incidence of these cysts and other aspects of clinical and therapeutic interest such as their clinical features, changes they caused in the facial and mandible structures, and the teeth that had caused the pathology. Case histories of 455 men and 395 women had been analyzed. The age of the patients varied from 4 to 87 years, with the average of 35.8. More than half of the diagnosed cysts (63%) were present in the maxilla, 37% of them--in the mandible. The common complaints of the patients were bump, swelling, pain, discharge leaking from the fistula or alveolus after tooth extraction, increased teeth mobility, paresthesia; changes in the maxillofacial system - intraoral or facial asymmetry, inflated bone with sensation of an egg shell cracking revealed under palpation, swelling at the mucofacial fold, mobile teeth and fistula. While comparing the causative groups of antagonistic teeth in the maxilla and mandible, we found the proportion to be (in order from the right to the left): molars--1:1, premolars 1.3:1, fore teeth--3.3:1, fore teeth 3.8:1, premolars 1.2:1, molars 0.7:1. Odontogenic cysts may be present in both sexes; maxillary cysts are 1.5 times as frequent as mandibular cysts. The pathology may equally affect both sides of jaws, most cysts being diagnosed in the maxillary fore teeth area from tooth 13 to tooth 23. The following pairs of changes in maxillofacial system are frequently present: inflated body of bone or alveolus--increased mobility of teeth; the formed fistula--swelling at the mucofacial fold, swelling at the mucofacial fold--pain. The applied treatment of cysts was surgical--cystotomy or cystectomy.

Adolescent↗
PubMed2006

Opinion of patients on accessibility of primary health care centers in Siauliai region.

This article presents the data about the accessibility of primary health care in Siauliai region and about factors related to the patients' perceived access to primary care. The survey was carried out in June 2004, in the context of a joint project of Kaunas University of Medicine and NIVEL, the Netherlands Institute of Health services research. Patients, treated in private and public health care centers in Siauliai region, took part in this survey. The majority of patients are positive about territorial accessibility of primary health care, indicating that it is easy to get to primary health care centers. Patients expressed a high level of satisfaction with the behavior of reception desk personnel. However, they are more critical about waiting time for the general practitioner's consultation: every third noted that they had to wait for far too long. The majority of respondents pointed out that general practitioners rooms and waiting corridors are convenient and comfortable, and that general practitioners have sufficient medical equipment. Most of the patients are very well informed and satisfied with the opening hours of primary health care centers. The main factors related to the patients' evaluations of primary health care accessibility were living place of patients and type of ownership of health care center. Patients living in the towns were less likely to evaluate the accessibility of primary health care centers positively, compared to those living in the city of Siauliai. Patients receiving health care services in private centers were much more positive about access to services than those receiving services in public centers.

Adult↗
PubMed2006

[Tendencies on ability related to competence education when realizing undergraduate public health study system].

The aim of this paper is to reveal tendencies on competence and ability education when realizing undergraduate public health study program in the interaction context of traditional and modern higher education features. Competence is implementation of qualification or the ability to act, conditioned by individual's knowledge, skills, motives, personal characteristics, and values. The integrated competence is necessary for the change of the internal and external work conditions; it is based on the integrity of behavior and knowledge that conditions the essential change of activity. The holistic competence is necessary for a new work development and the transfer of qualification to new situations; it is conditioned by holistic approach toward education. When researching undergraduate public health study program in the context of traditional and modern higher education features at Kaunas University of Medicine, the following problems were stated: insufficient qualities of student's self-analysis, self-directed learning and formation of communication skills; insufficient communication of teachers and students during study process; limited possibilities team work with representatives of other professions when solving problems of public health improvement.

Clinical Competence↗
PubMedDate not supplied

[Microbiological decomposition of organic matter in the bottom sediments of Lithuanian lakes].

The rates of the processes of bacterial sulfate reduction (SR) and decomposition of organic matter (D(total)) were studied in the bottom sediments (BS) of 14 lakes in Lithuanian national and regional parks in the summers of 1998-2002. Anaerobic processes accounted for an average of 92% of D(total) in the depressions of deep-water lakes; for the sediments of shallow lakes, high rates of oxygen uptake were noted. The SR rate in different lakes varied from 0.09 to 2.60 mg S(2-)/(dm3 day). At low sulfate concentrations (13.3-70.6 mg S-SO4(2-) /dm3), characteristic of the BS of freshwater ecosystems, the main factor that affected the SR rate in the BS of the lakes studied was the content of readily available organic matter, only in special cases, was it affected by a change in the sulfate ion concentration. In shallow lakes, both temperature-dependent activation of sulfate-reducing bacteria and their inhibition by acidification of the environment were recorded. The contribution of SR to D(total) was 0.2 to 11.0%.

Anaerobiosis↗
PubMed2006

Simultaneous coronary artery bypass grafting and vascular operations: early and mid-term results.

AIM: The purpose of this study was to estimate the results of surgical strategy for patients undergoing simultaneous coronary and peripheral artery surgical interventions and to compare their early and mid-term clinical results with the results of the isolated coronary artery bypass grafting (CABG) operations. METHODS: From 1999 to 2005, 78 patients underwent simultaneous vascular reconstructions following CABG. All the patients were divided into 3 groups: CABG and carotid artery group (CAG), CABG and peripheral vascular group (PVG), and CABG and abdominal aortic aneurysm group (AAAG). RESULTS: In CAG, early mortality was 2%, postoperative myocardial infarction and stroke rates were 2% and 6.1%, respectively. In PVG, one (4%) patient had postoperative stroke, and there were neither deaths nor myocardial infarctions. PVG and CAG did not differ significantly in postoperative complications and mortality rates from the isolated CABG group. The simultaneous abdominal aortic aneurysm operations were related to higher early mortality rate (2 out of 6). Using the Kaplan-Meier analysis, the 3-year overall survival probability in the simultaneous operation group was 82%; the 5-year overall survival probability, 74%. PVG and CAG did not differ in the survival probability from the isolated CABG group. The survival probability in AAAG was lower than in the isolated CABG group. CONCLUSION: The simultaneous CABG and vascular operations whenever indicated are feasible procedures to be performed on patients with concomitant carotid artery and/or peripheral vascular occlusive disease. The surgical management of coronary artery disease followed by abdominal aortic aneurysm repair remains still controversial.

Aged↗
PubMed2006

[Evaluation of diagnostic criteria for metabolic syndrome to identify insulin resistance].

UNLABELLED: The aim of study was to evaluate the possibilities of different diagnostic criteria for metabolic syndrome in identifying subjects with insulin resistance and to assess the prevalence of metabolic syndrome according to gender in one Lithuanian district. MATERIALS AND METHODS: A randomly selected sample of 1,115 subjects aged 45-96 years (562 men and 553 women) was formed from general population of Raseiniai district. Insulin resistance was estimated using the homeostasis model assessment. Metabolic syndrome was determined according to the definitions of the World Health Organization, National Cholesterol Education Program Adults Treatment Panel III, and International Diabetes Federation. RESULTS: Using the World Health Organization criteria, metabolic syndrome was observed in 384 (34.4%) subjects (no difference between genders); according to the National Cholesterol Education Program--in 336 (30.1%) patients (in 107 men (19.0%) and 229 women (41.4%), p < 0.001); using International Diabetes Federation criteria--in 474 (42.5%) (175 men (31.1%) and 299 women (54.1%), p < 0.001). Overall, 314 (28.5%) subjects were insulin resistant (no difference between genders). The highest prevalence of insulin resistance was determined in subjects with metabolic syndrome diagnosed according to the World Health Organization criteria--70.3% (n = 267), p < 0.05. Odds ratios to identify insulin-resistant subjects with metabolic syndrome according to the World Health Organization criteria and the International Diabetes Federation criteria were 22.4 and 2.3, respectively. CONCLUSIONS: The highest prevalence of metabolic syndrome was determined according to the International Diabetes Federation criteria. According to the National Cholesterol Education Program and International Diabetes Federation criteria metabolic syndrome was observed more frequently in women. The highest prevalence of insulin resistance was determined in metabolic syndrome group based on World Health Organization criteria. Using the World Health Organization and International Diabetes Federation criteria for metabolic syndrome provides more opportunities to identify subjects with insulin resistance.

Age Factors↗
PubMed2006

Bacteremias in patients with severe burn trauma.

UNLABELLED: The aim of the study was to investigate the causative agents of bacteremia in burned patients during 1999-2003. MATERIAL AND METHODS: All case records of 82 burned patients with bacteremia treated at the Department of Plastic Surgery and Burns of Kaunas University of Medicine Hospital were analyzed during 1999-2003. RESULTS: Mean body surface area burned in bacteremic patients was 29%. Bacteremia was diagnosed, on an average, on the 15th day after hospitalization and the 16th day after the burn. The causative agent of bacteremia in 71% of cases was methicillin-resistant Staphylococcus aureus; 11% of bacteremias were caused by Pseudomonas aeruginosa, and in 78% of cases Pseudomonas was sensitive to gentamicin. In all years, methicillin-resistant Staphylococcus aureus was the most common agent of bacteremia. Altogether, 55 patients out of 82 recovered. The mean duration of inpatient treatment was 48 days. CONCLUSIONS: Bacteremia was diagnosed at the beginning of the third week of hospital stay. More than half of bacteremic patients (67%) survived. The most common causative agents of bacteriemia were methicillin-resistant Staphylococcus aureus and gentamicin-sensitive strains of Pseudomonas aeruginosa.

Adult↗
PubMed2006

Evaluation of odontological assistance to soldiers going on a mission, and prognostication of their odontological problems.

The aim of the study was to evaluate the condition of the oral cavity in soldiers going on a military mission, the level of odontological assistance to them, and to prognosticate possible odontological problems during the mission period. We studied 50 soldiers going on a military mission in Iraq. During the study we applied odontological examination and panoramic imaging. We found that soldiers' teeth were treated, and they received comprehensive odontological assistance: 18% of soldiers had their teeth restored with single crowns and bridges, and 56% of soldiers had underwent endodontic treatment of their teeth. During the radiological examination we diagnosed individual cases of dental caries on the contact surfaces of teeth, and determined the level of the filling of root canals of endodontically treated teeth and the relationship of this level with radiological changes in apical periodontium. 67.3% of teeth had incompletely filled root canals, and radiological changes in their apical periodontium were reliably more frequent (80.6%) than in the apical periodontium of teeth with completely filled root canals (19.4%) (p<0.001). Of significant concern is the fact that frequently teeth with incompletely filled root canals and apical periodontal damage are restored using radical post-core and crowns. Radiological examination showed that in teeth with signs of chronic apical periodontitis and insufficient quality of filling, the condition may become more acute and cause odontological problems. A part of odontological problems in soldiers may be caused by incorrect position of the third molars in the jaw and possible aggravated eruption of these teeth.

Adult↗
PubMed2006

[Evaluation of factors influencing effectiveness of kinesitherapy in patients after traumatic brain injury].

OBJECTIVE OF THE STUDY: To establish the factors, which have an influence on recovery of motor and cognitive functions in patients after moderate or severe traumatic brain injury, when kinesitherapy is applied during the acute stage of injury and early stage of rehabilitation. MATERIAL AND METHODS: Subjects were 131 patients (99 men and 32 women) with a mean age of 39.5+/-15.9 years. Patients were divided into two subgroups according to degree of injury: severe injury (103 subjects) and moderate injury (28 subjects). During acute stage of injury, patients were treated at the Unit of Brain Injuries, Kaunas University of Medicine Hospital; thereafter, 80 patients continued rehabilitation at the Unit of Neurorehabilitation, while 51--in another rehabilitation centers. Recovery of motor and cognitive functions was evaluated using Functional Independence Measure: during acute stage of injury (beginning and end) and during early stage of rehabilitation (beginning, day 25, and end). RESULTS: In order to determine the effect of kinesitherapy, the influence of following factors was evaluated: meningitis, cranial nerves damage, musculoskeletal system dysfunctions, plegia of extremities, speech and cognitive dysfunctions, behavioral changes, sleep disorders, depression, pneumonia, edema, hydrocephalus, epilepsy. The motor score in patients after moderate traumatic brain injury at the beginning of acute stage was 32.4+/-12.7, while in patients after severe injury it was 21.3+/-7.7 (p<0.01). At the end of this stage, the difference between subgroups was insignificant: 61.8+/-24.0 and 60.9+/-22.5, respectively (p>0.05). At the beginning of acute stage of injury, cognitive function score differed significantly: in moderate injury subgroup, the score was 14.2+/-5.5, while in severe injury subgroup - 10.0+/-4.9 (p<0.01). At the end of early stage of rehabilitation, no significant difference in cognitive function scores was found between subgroups: 22.3+/-8.4 and 22.5+/-8.6 scores, respectively (p>0.05). CONCLUSIONS: Insufficient recovery of motor functions during period of kinesitherapy was influenced by depression, pneumonia, plegia of extremities, speech and cognitive dysfunctions, sleep disorders, dysfunctions of musculoskeletal system, behavioral changes, while the recovery of cognitive functions was influenced mainly by pneumonia, speech and cognitive dysfunctions, and sleep disorders (p<0.05).

Activities of Daily Living↗
PubMed2006

[The results of thyroid ultrasound examination in randomly selected schoolchildren].

UNLABELLED: Iodine deficiency is an actual problem of public health and mostly manifests as enlargement of the thyroid (goiter). OBJECTIVE: The aim of the study was to determine the prevalence of goiter using different evaluation criteria and to establish the relationship between changes in thyroid volume and dimensions of the body. MATERIAL AND METHODS: Thyroid palpation and ultrasound examination were performed in 310 (7-11-year-old) randomly selected schoolchildren from two Lithuanian nearby small towns (Birzai and Rokiskis) in the district with lowest urinary iodine excretion (5.4 and 4.5 microg/dl). The size of thyroid gland was determined by inspection and palpation using the World Health Organization criteria. All children were examined ultrasonographically; thyroid volume was assessed by two criteria: F. Delange (1997) and M. B. Zimmermann (2004). RESULTS: There were no differences in means and medians of age and all body parameters (height, weight, body surface area, body mass index) in boys and girls of the same age. Higher means and medians of the body surface area in all age groups were found in Birzai as compared to Rokiskis (p<0.05). Comparing body mass index of all investigated schoolchildren with upper limits (97th percentile) of body mass index of normal British children, no statistically significant difference in the prevalence of obesity between towns was observed (1.9% - in Rokiskis, 5.0% - in Birzai; p>0.05). Grouping the children according to age revealed a higher prevalence of goiter in Birzai as compared to Rokiskis (88% vs. 63%, respectively, according to M. B. Zimmermann and 25% vs. 10%, respectively, according to F. Delange; p<0.05). There was no significant difference in the prevalence of goiter between the towns when children were grouped by body surface area. In all groups by age and body surface area, the mean thyroid volume exceeded 97th percentile by M. B. Zimmerman and did not exceed by F. Delange. CONCLUSIONS: The prevalence of goiter, assessing the thyroid volume in 7-11-year-old children by the different criteria, is significantly different. We recommend using the criteria based on body surface area in order to evaluate the constitutional characteristics of individual child's development.

Age Factors↗
PubMed2006

[Prognosis of Kaunas men population (15 years and older) survival].

The use of automated informational data processing system (created in 1988-1989) allowed to accumulate unique information on the health status of 12,241 men aged over 15 years. Data base includes information on risk factors (arterial hypertension, excess weight, smoking), occupation and character of work, requirements in specialized care, volume of investigations throughout the period of 11 years (1988-1998). Of 12,241 men 1,132 (9.2%) died and all causes of death were documented. Application of modified Weibul and logistic regression models with inclusion of such informative indicators as ischemic heart disease, tumors, diabetes mellitus, arterial hypertension, excess weight, smoking, character of work, the number of deaths in male population for 10 years could be predicted with accuracy >91.0%. The use of these models gives an opportunity to detect groups of men with elevated risk (with ischemic heart disease, tumors, diabetes mellitus, arterial hypertension, excessive weight, smoking, top executives by character of work) for application of preventive and appropriate health measures, since the majority of informative predictors of death are correctable.

Adolescent↗
PubMed2006

The impact of unrepaired versus repaired mitral regurgitation on functional status of patients with ischemic cardiomyopathy at one year after coronary artery bypass grafting.

BACKGROUND AND AIM OF THE STUDY: The issues regarding the appropriate management of patients with ischemic mitral regurgitation (MR) and advanced left ventricular (LV) dysfunction are controversial and limited. The present study was undertaken to evaluate the mid-term dynamics of MR, LV dimensions, function and NYHA functional class in patients with ischemic cardiomyopathy (ICM) and MR who underwent coronary artery bypass grafting (CABG) either alone or combined with mitral valve (MV) repair. METHODS: A total of 199 patients with LV ejection fraction (LVEF) <35% were included in the study. Of these patients, 73 had MR grade 2+ (group 1), 66 had 0 or 1+ MR (group 2) and underwent isolated CABG, and 60 had MR > 2+ and underwent CABG with MV repair (group 3). RESULTS: At one year after surgery, the severity of MR was unchanged from preoperative grade in group 1 (2.1 +/- 0.5 vs. 1.97 +/- 0.8), and increased in group (0.76 +/- 0.43 vs. 1.44 +/- 0.77; p < 0.05), but was significantly lower in group (2.8 +/- 0.5 vs. 1.6 +/- 0.7; p <0.05). In group 1, the LV end-systolic volume index (LVESVI) tended to increase, the LV end-diastolic volume index (LVEDVI) increased from 69.6 +/- 22.6 to 79.6 +/- 23.2 ml/m2 with an increase in LVEF (from 27.9 +/- 5.9 to 31.3 +/- 9.4%), and pulmonary artery pressure (PAP) increased from 31.9 +/- 7.0 to 39.5 +/- 17.4 mmHg. In group 2, the LV volumes tended to increase, LVEF increased from 30. 3 +/- 4.1 to 34.9 +/- 9.1%, and PAP remained unchanged. In group 3, the LVESVI decreased from 55.4 +/- 16.9 to 47.1 +/- 21.7 ml/m2, LVED-VI tended to decrease, LVEF increased from 31.4 +/- 8.6 to 36.5 +/- 11.3%, and PAP decreased from 35.5 +/- 6.0 to 32.8 +/- 8.3 mmHg. CONCLUSION: Isolated CABG in patients with ICM had no favorable effect on MR reduction, and did not prevent its development. MR grade 2+ in patients with ICM at one year after isolated CABG had a deleterious effect on LV functional status, with progression of LV dilatation and increased PAP. A significant reduction or elimination of MR after combined surgery had a marked positive impact on reverse LV remodeling, including regression of LV dilatation, an increased LVEF, and decreased PAP.

Aged↗
PubMed2006

[Complications after spinal cord injuries and their influence on the effectiveness of rehabilitation].

In this article, literature data on complications after spinal cord injuries and their influence on the efficiency of rehabilitation are analyzed. The spinal cord injury is associated with physical and psychological disorder that causes disability and requires intensive treatment. Authors in their articles indicate that many people after spinal cord injuries have complications. The most common complications are: skin breakdown, urinary tract infection, pulmonary complications, spasticity, pain, autonomic dysreflexia, cardiovascular disease, osteoporosis and fractures, heterotopic ossification, deep vein thrombosis. These complications make patients' rehabilitation more difficult and limit their self-care independence, and the treatment of such complications is very expensive.

Adult↗
PubMed2006

Prevalence and risk factors of genital Chlamydia trachomatis infection.

The aim of the study was to provide a survey and generalization of literature data on the epidemiological situation of Chlamydia trachomatis infection in various countries, preventive screenings and risk factors of the infection. We performed a survey of articles published during 1998-2005 and selected from bibliographical medical search databases presenting data on the prevalence of Chlamydia trachomatis and the main risk factors for this sexually transmitted infection. Chlamydial infection is the most common among sexually transmitted genital infections worldwide. It has been found that the main risk factors for Chlamydia trachomatis infection are age, irregular and/or accidental sexual relationships and change of sexual partners, failure to use or erratic use of barrier contraception during intercourse, and insufficient knowledge about sexual life and care for one's sexual health. Most countries do not have national preventive screening programs or exhaustive information about the prevalence of Chlamydia trachomatis infection. The comparison of the prevalence and incidence of Chlamydia trachomatis infection among different countries is complicated due to the different diagnostic methods and sample selection techniques applied; however, in order to decrease the prevalence of chlamydial infection and its impact on the reproductive health of the society, significant attention should be paid to sexual education, preventive screening of people in high-risk groups, as well as to early diagnostics and timely treatment.

Adolescent↗
PubMed1991

[Results of epidemiological and clinical studies of the prevalence of chronic nonspecific diseases of the respiratory organs among rural population].

The results of many years' investigations conducted in 3 experimental republican regions are presented. The investigations were aimed at establishing the reliable indices of the prevalence of chronic nonspecific respiratory diseases in rural population and the development of preventive measures in subjects at a high risk of tuberculosis infection in certain patients with chronic nonspecific respiratory diseases who have some post-tuberculous lung changes. It is emphasized that rendering of the preventive and therapeutic aid to pneumologic patients requires joint efforts of phthisiatrists, pneumologists and therapeutists.

Chronic Disease↗