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OBJECTIVE: Due to the inconsistency of the evidence about the cancer risk among patients with schizophrenia, the aim of this study was to analyse cancer mortality and morbidity in patients with schizophrenia treated in a single centre in Lithuania during the study period of 1992-2020. MATERIALS AND METHODS: A retrospective cohort study was conducted in Vilnius Republican Psychiatric Hospital, the biggest specialised psychiatric hospital in Lithuania, with approximately 5000 hospital admissions annually. The patients' cohort was established by identifying all patients with the diagnosis of schizophrenia (ICD-10 code F20) in the hospital database from 1 January 1992 until 31 December 2017. The cancer cases and cancer deaths in the cohort were identified in the Lithuanian Cancer Register through linkage procedures. The analysis of risk was based on a comparison of observed and expected numbers of cancers and deaths. Expected number of cancer cases were calculated by multiplication of the exact person-years under observation in the cohort by sex, calendar year and a 5-year age-group-specific national incidence and mortality rate. All statistical analyses were carried out using STATA 15 statistical software. RESULTS: During the follow-up, out of 8553 patients, 673 cases of cancer were diagnosed in both sexes. Statistically significantly lower risk for overall cancer incidence was observed in men (SIR 0.74, 95% CI 0.66-0.83), but not in women (SIR 1.07, 95% CI 0.97-1.18). Statistically significant lower overall cancer mortality risk was observed in men (SMR 0.82, 95% CI 0.70-0.96), while in the women's group, risk of cancer deaths was significantly higher compared to the general population (SMR 1.28, 95% CI 1.11-1.48). We observed lower risk for pancreatic cancer (SIR 0.36, 95% CI 0.14-0.96), non-melanoma skin cancer (SIR 0.54, 95% CI 0.33-0.88) and prostate cancer (SIR 0.69, 95% CI 0.55-0.87) in men and higher risk for malignant neoplasm of liver (SIR 2.58, 95% CI 1.53-4.36) and skin melanoma (SIR 2.03, 95% CI 1.12-3.66) in men and for breast cancer (SIR 1.38, 95% CI 1.14-1.66) and corpus uteri cancer (SIR 1.56, 95% CI 1.18-2.07) in women. CONCLUSIONS: The current results of our study indicate lower risk of overall cancer incidence and mortality in male patients with schizophrenia, while female patients had a higher mortality risk, alongside variations in the risk of different cancer types. This information is important not only for patients, but for healthcare specialists to develop effective disease-specific preventive interventions and programmes.
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Neoplasias , Esquizofrenia , Femenino , Humanos , Masculino , Estudios de Cohortes , Hospitales , Incidencia , Neoplasias/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Lituania/epidemiología , MorbilidadRESUMEN
BACKGROUND Bacterial meningitis is a serious and life-threatening condition that requires prompt diagnosis and treatment. This retrospective study aimed to identify causes, presentation, and predictive factors for outcomes of community-acquired bacterial meningitis in 86 adults in Vilnius, Lithuania between 2018 and 2021. MATERIAL AND METHODS We performed a retrospective study of demographic, clinical, and laboratory records of 86 adult patients admitted to Vilnius University Hospital Santaros Clinics with a diagnosis of acute bacterial meningitis during the period of 2018-2021. RESULTS Of 86 patients, 54 (62.79%) were men. The median (Md) age of patients was 58 (range, 18-83) years and the median duration of hospitalization was 20 (range, 3-92) days. Patients were first hospitalized in the Intensive Care Unit (ICU) in 59.3% of cases. The most prevalent concerns were headache (66.28%), febrile temperature (56.98%), general fatigue (53.49%), and confusion/sleepiness (52.33%). Of 57 (66.28%) etiologically confirmed cases, the most prevalent agent was Listeria monocytogenes (29.82%), followed by Streptococcus pneumoniae (28.07%) and Neisseria meningitidis (28.07%). Patients with meningitis caused by L. monocytogenes were the oldest (P=0.003) and had the longest hospitalization (P<0.001). Fatigue was the prominent symptom in patients with meningococcal meningitis (81.2%, P=0.010). Twelve patients (13.95%) have died. Advanced age and low (<100 cells per µL) white blood cell (WBC) count in cerebrospinal fluid (CSF) were associated with lethal outcome, whereas headache was associated with favorable outcome. CONCLUSIONS Clinical characteristics of community-acquired acute bacterial meningitis differ based on etiological factors. Patient age, CSF WBC count, and headache may be significant predictive factors for outcomes of bacterial meningitis.
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Meningitis Bacterianas , Neisseria meningitidis , Masculino , Adulto , Humanos , Recién Nacido , Lactante , Femenino , Estudios Retrospectivos , Lituania/epidemiología , Meningitis Bacterianas/epidemiología , Meningitis Bacterianas/diagnóstico , Meningitis Bacterianas/tratamiento farmacológico , Cefalea/etiologíaRESUMEN
BACKGROUND: Familial hypercholesterolemia (FH) is one of the most common autosomal dominant diseases. FH causes a lifelong increase in low-density lipoprotein cholesterol (LDL-C) levels, which in turn leads to atherosclerotic cardiovascular disease. The incidence of FH is widely underestimated and undertreated, despite the availability and effectiveness of lipid-lowering therapy. Patients with FH have an increased cardiovascular risk; therefore, early diagnosis and treatment are vital. To address the burden of FH, several countries have implemented national FH screening programmes. The currently used method for FH detection in Lithuania is mainly based on opportunistic testing with subsequent cascade screening of index cases' first-degree relatives. METHODS: A total of 428 patients were included in this study. Patients with suspected FH are referred to a lipidology center for thorough evaluation. Patients who met the criteria for probable or definite FH according to the Dutch Lipid Clinic Network (DLCN) scoring system and/or had LDL-C > = 6.5 mmol/l were subjected to genetic testing. Laboratory and instrumental tests, vascular marker data of early atherosclerosis, and consultations by other specialists, such as radiologists and ophthalmologists, were also recorded. RESULTS: A total of 127/428 (30%) patients were genetically tested. FH-related mutations were found in 38.6% (n = 49/127) of the patients. Coronary artery disease (CAD) was diagnosed in 13% (n = 57/428) of the included patients, whereas premature CAD was found in 47/428 (11%) patients. CAD was diagnosed in 19% (n = 9/49) of patients with FH-related mutations, and this diagnosis was premature for all of them. CONCLUSIONS: Most patients in this study were classified as probable or possible FH without difference of age and sex. The median age of FH diagnosis was 47 years with significantly older females than males, which refers to the strong interface of this study with the LitHir programme. CAD and premature CAD were more common among patients with probable and definite FH, as well as those with an FH-causing mutation. The algorithm described in this study is the first attempt in Lithuania to implement a specific tool which allows to maximise FH detection rates, establish an accurate diagnosis of FH, excluding secondary causes of dyslipidaemia, and to select patients for cascade screening initiation more precisely.
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Algoritmos , LDL-Colesterol , Hiperlipoproteinemia Tipo II , Receptores de LDL , Humanos , Hiperlipoproteinemia Tipo II/epidemiología , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo II/sangre , Lituania/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Receptores de LDL/genética , LDL-Colesterol/sangre , Pruebas Genéticas/métodos , Tamizaje Masivo/métodos , Anciano , Mutación , Proproteína Convertasa 9/genética , Proproteína Convertasa 9/sangreRESUMEN
BACKGROUND: Lithuania has one of the highest averages in the European Union when it comes to psychological and/or economic intimate partner violence (PE-IPV). IPV survivors are several times more likely to have mental health conditions than those without IPV experiences. The aim of this article is to study the prevalence, characteristics and attitudes of PE-IPV survivors in Lithuania, and the predictors of them accessing mental health services. METHODS: A cross-sectional study based on a national survey representative of the adult population. The survey was implemented by a third-party independent market research company employing an online survey panel. Logistic regression models were used in the analysis. RESULTS: Almost 50% of women in Lithuania experience PE-IPV. Females are significantly more likely to experience it than males. The vast majority of women find PE-IPV unacceptable; however, only one-third of survivors seek any type of help. Only one-tenth approach mental health services, with divorcees being at higher odds of doing so. CONCLUSIONS: Further research is needed to explore predictors and contextual factors of why IPV survivors seek mental healthcare, or not. Policy implications include the need to eliminate IPV and mental health stigma; develop accessible mental health services and effective treatment approaches.
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Violencia de Pareja , Servicios de Salud Mental , Sobrevivientes , Humanos , Lituania/epidemiología , Femenino , Adulto , Estudios Transversales , Violencia de Pareja/psicología , Violencia de Pareja/estadística & datos numéricos , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Prevalencia , Persona de Mediana Edad , Sobrevivientes/psicología , Sobrevivientes/estadística & datos numéricos , Adulto Joven , Adolescente , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Encuestas y Cuestionarios , AncianoRESUMEN
BACKGROUND: Lithuania, a Baltic country in the European Union, can be characterized by high alcohol consumption and attributable burden. The aim of this contribution is to estimate the mortality burden due to alcohol use for the past two decades based on different relative risk functions, identify trends, and analyse the associations of alcohol-attributable burden with alcohol control policies and life expectancy. METHODS: The standard methodology used by the World Health Organization for estimating alcohol-attributable mortality was employed to generate mortality rates for alcohol-attributable mortality, standardized for Lithuania's 2021 population distribution. Joinpoint analysis, T-tests, correlations, and regression analyses including meta-regressions were used to describe trends and associations. RESULTS: Age-standardized alcohol-attributable mortality was high in Lithuania during the two decades between 2001 and 2021, irrespective of which relative risks were used for the estimates. Overall, there was a downward trend, mainly in males, which was associated with four years of intensive implementation of alcohol control policies in 2008, 2009, 2017, and 2018. For the remaining years, the rates of alcohol-attributable mortality were stagnant. Among males, the correlations between alcohol-attributable mortality and life expectancy were 0.90 and 0.76 for Russian and global relative risks respectively, and regression analyses indicated a significant association between changes in alcohol-attributable mortality and life expectancy, after controlling for gross domestic product. CONCLUSIONS: Male mortality and life expectancy in Lithuania were closely linked to alcohol-attributable mortality and markedly associated with strong alcohol control policies. Further implementation of such policies is predicted to lead to further improvements in life expectancy.
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Consumo de Bebidas Alcohólicas , Esperanza de Vida , Humanos , Masculino , Lituania/epidemiología , Riesgo , Política PúblicaRESUMEN
BACKGROUND: Ageing populations experience greater risks associated with health and survival. It increases the relevance of identifying variables associated with mortality. Grip strength (GS) has been identified as an important biomarker for all cause and cardiovascular mortality, however, its prognostic value has not been studied in Lithuania. The aim of the present study is to evaluate the relationship of GS to vital status in a representative sample of the Lithuanian 45-72-year-old urban population during the period of 12 years of follow-up and to explore associations of GS with all-cause mortality and mortality from cardiovascular diseases (CVD). METHODS: Within the framework of the international study Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) 7,115 men and women 45-72 years of age were examined in the baseline survey (2006 to 2008). Data from the Official Lithuanian Mortality Register were used to evaluate CVD and all-cause mortality from follow-up till 2020. Cox proportional hazards regression was used, and four models for all-cause and CVD mortality were assessed. RESULTS: The mean GS was significantly higher among survivors' men and women as compared to individuals deceased from CVD and other causes of death. In survivor men and women groups, minimal values of GS in all terciles were higher as compared to all three deceased groups. In both men and women groups, the lowest GS (1st tercile) was associated with a significantly higher risk of all-cause and CVD mortality as compared to the highest levels of GS (3rd tercile) in three Cox regression models. In both men and women were found to have a 1.34- and 1.35-fold higher risk of all-cause mortality, respectively, at lower GS, but no significant difference in the risk of CVD mortality. When GS was treated in all models as decrement per 1 kg and decrement per 1 SD, in both men and women, the risk of all-cause mortality significantly increased with decreasing of GS. CONCLUSIONS: The mean GS was significantly higher among survivors' men and women as compared to deceased from CVD and other causes of death. Risk of all-cause mortality significantly increased with decreasing of GS.
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Enfermedades Cardiovasculares , Sistema Cardiovascular , Masculino , Humanos , Femenino , Anciano , Persona de Mediana Edad , Lituania/epidemiología , Factores de Riesgo , Fuerza de la ManoRESUMEN
BACKGROUND: The World Health Organization (WHO) has outlined a set of targets to achieve eliminating hepatitis C by 2030. In May 2022, Lithuanian health authorities initiated a hepatitis C virus (HCV) screening program to start working towards elimination. In the program, bonus was given to general practitioners (GPs) to promote and conduct anti-HCV tests for two situations: (1) one time testing for individuals born in 1945-1994 and (2) annual HCV testing for persons who inject drugs or are living with human immunodeficiency virus (HIV) regardless of age. This study aimed to model the current viral hepatitis C epidemiological status in Lithuania and to outline the requirements for WHO elimination targets using the first-year HCV screening results. METHODS: Individuals were invited to participate in the anti-HCV screening by GPs during routine visits. Patients who tested positive were then referred to a gastroenterologist or infectious disease doctor for further confirmatory testing. If a patient received a positive RNA test and a fibrosis staging result of ≥ F2, the doctor prescribed direct-acting antivirals. Information on the patients screened, diagnosed, and treated was obtained from the National Health Insurance Fund. The Markov disease progression model, developed by the CDA Foundation, was used to evaluate the screening program results and HCV elimination progress in Lithuania. RESULTS: Between May 2022 and April 2023, 790,070 individuals underwent anti-HCV testing, with 11,943 individuals (1.5%) receiving positive results. Anti-HCV seroprevalence was found to be higher among males than females, 1.9% and 1.2%, respectively. Within the risk population tested, 2087 (31.1%) seropositive individuals were identified. When comparing the screening program results to WHO elimination targets through modelling, 2180 patients still need to be treated annually until 2030, along with expanding fibrosis restrictions. If an elimination approach was implemented, 1000 new infections would be prevented, while saving 150 lives and averting 90 decompensated cirrhosis cases and 110 hepatocellular carcinoma cases. CONCLUSIONS: During the first year of the Lithuanian screening program, GPs were able to screen 44% of the target population. However, the country will not meet elimination targets as it currently stands without increasing treatment levels and lifting fibrosis restrictions.
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Consumidores de Drogas , Hepatitis C Crónica , Hepatitis C , Abuso de Sustancias por Vía Intravenosa , Masculino , Femenino , Humanos , Anciano , Lituania/epidemiología , Antivirales/uso terapéutico , Estudios Seroepidemiológicos , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Hepatitis C/prevención & control , Hepacivirus , Organización Mundial de la Salud , FibrosisRESUMEN
Currently, research on apicomplexan Sarcocystis parasites is mainly carried out by analyzing animal carcasses. However, environmental studies would not only allow faster detection of possible sources of infection but also avoid the use of animals for investigations. Therefore, in the current study, we aimed to identify tested Sarcocystis species in sediment collected from water bodies located in the southeastern Baltic countries. A total of 99 sediment samples were collected during the summer from different types of water bodies in Estonia, Latvia, Lithuania, and Poland. Species-specific nested PCR targeting cox1 gene was used for the detection of selected Sarcocystis species (S. cruzi, S. bovifelis, S. hirsuta, S. arieticanis, S. tenella, S. capracanis, S. miescheriana, and S. bertrami) infecting livestock. The results showed a statistically lower (p < 0.05) occurrence of Sarcocystis parasites in Estonia (50%) compared to three countries, where the detection rate of Sarcocystis spp. DNA was remarkably higher, ranging from 88 to 100%. Among Sarcocystis species tested, S. cruzi (83.8%) and S. arieticanis (55.6%) using cattle and sheep as their intermediate hosts were most commonly identified. The detection rates of some of the analyzed Sarcocystis species were significantly different in southeastern Baltic countries. It is discussed that the detection rates of certain Sarcocystis species depend not only on the number of animals per 1 km2 but also on various ecological factors and farming practices that differ in the amount of contact domestic animals have with predators and the potential for animals to become infected through natural water or food sources.
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Ecosistema , Sedimentos Geológicos , Sarcocystis , Sarcocystis/genética , Sarcocystis/aislamiento & purificación , Sarcocystis/clasificación , Animales , Sedimentos Geológicos/parasitología , Polonia , Ovinos , Reacción en Cadena de la Polimerasa , Sarcocistosis/parasitología , Sarcocistosis/veterinaria , Sarcocistosis/epidemiología , Bovinos , Lituania/epidemiología , Países Bálticos , Biodiversidad , ADN Protozoario/genética , Letonia/epidemiología , EstoniaRESUMEN
In 2023, an increase of OXA-48-producing Klebsiella pneumoniae was noticed by the Lithuanian National Public Health Surveillance Laboratory. Whole genome sequencing (WGS) of 106 OXA-48-producing K. pneumoniae isolates revealed three distinct clusters of carbapenemase-producing K. pneumoniae high-risk clones, including sequence type (ST) 45 (n = 35 isolates), ST392 (n = 32) and ST395 (n = 28), involving six, six and nine hospitals in different regions, respectively. These results enabled targeted investigation and control, and underscore the value of national WGS-based surveillance for antimicrobial resistance.
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Infecciones por Klebsiella , Klebsiella pneumoniae , Humanos , Klebsiella pneumoniae/genética , Lituania/epidemiología , Tipificación de Secuencias Multilocus , Infecciones por Klebsiella/epidemiología , Infecciones por Klebsiella/tratamiento farmacológico , beta-Lactamasas/genética , Proteínas Bacterianas/genética , Hospitales , Brotes de Enfermedades , Pruebas de Sensibilidad Microbiana , Antibacterianos/farmacología , Antibacterianos/uso terapéuticoRESUMEN
OBJECTIVES: The current study examined the links and interactions among headaches, screen-based media use, physical activity, sleep, and the family environment in Lithuanian school-aged children during the second COVID-19 lockdown. METHODS: The study comprised data of 541 children aged 7-14 years from different Lithuania regions, and without chronic health conditions or developmental disorders. Information about the child was provided by their parents or caregivers who filled questionnaire on child's screen time, sleep duration and quality, physical activity, parental distress, parent-child relationship, history of child's headaches and infectious diseases. RESULTS: During the study period, 54% of the children had headaches, and the frequency was positively associated with child's age, screen time and parental distress, as well as negatively related to physical activity (PA), sleep quality, and the parent-child relationship. Parental education was related to child's PA, screen time and sleep quality. The results of binary logistic regression analysis and path analysis revealed that sleep quality and parental distress were significant predictors of headaches in children. CONCLUSIONS: Family and child or adolescent education and lifestyle modification aiming to improve sleep hygiene and PA, and to reduce screen-based sedentary behaviour should be provided. Family centred approach for more effective coping with distress and improvement of parent-child relationship is also important in treating child and adolescent headache.
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COVID-19 , Ejercicio Físico , Cefalea , Tiempo de Pantalla , Humanos , COVID-19/epidemiología , Niño , Adolescente , Masculino , Femenino , Cefalea/epidemiología , Lituania/epidemiología , Relaciones Padres-Hijo , SARS-CoV-2 , Encuestas y Cuestionarios , Pandemias , Cuarentena/psicologíaRESUMEN
Background and Objectives: This study aimed to determine the relationship between non-simultaneous contralateral hip fractures, urban and rural differences, fracture localization, time between fractures, physiotherapy applications, comorbidity, and the second fracture outcomes. Materials and Methods: We retrospectively analyzed 107 patients aged 65 and older with proximal femur fractures (PFFs) who underwent surgery at Düzce University Medical Faculty between January 2010 and December 2022. High-energy fractures, pathological fractures, and patients with a history of old fractures were excluded. Results: The study included 66 females (61.7%) and 41 males (38.3%), with a mean age of 83.76 years. The mean interval between two fractures was 28.3 months. There was no statistical difference between the localization of the first and second fractures (p = 0.107). However, there was a significant difference in the first PFF localizations of patients living in rural areas (p = 0.023). Patients with heart failure, respiratory failure, osteoporosis, and cognitive impairment had shorter intervals between fractures (p < 0.001). Conclusions: This study shows that age, female gender, place of residence, comorbid diseases, and whether physical therapy is received after the first fracture are significant risk factors for a second hip fracture in patients over 65 years of age.
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Fracturas de Cadera , Humanos , Femenino , Masculino , Estudios Retrospectivos , Anciano , Anciano de 80 o más Años , Fracturas de Cadera/cirugía , Factores de Riesgo , Comorbilidad , Lituania/epidemiologíaRESUMEN
Background and Objectives: Parkinson's disease (PD) is associated with various non-motor symptoms, including minor hallucinations, comprising visual illusions and presence and passage hallucinations. Despite their occurrence, even in newly diagnosed PD patients, data regarding the prevalence and characteristics of minor hallucinations, visual illusions in particular, remain limited. The aim of this study was to address this knowledge gap by assessing the prevalence of minor hallucinations in PD patients, with a focus on visual illusions. Materials and Methods: In this prospective pilot study, we enrolled 35 PD patients without dementia and 35 age- and gender-matched PD-unaffected individuals. Cognitive function was assessed using the Montreal Cognitive Assessment, clinical data were collected, and all subjects were assessed via questionnaires regarding 20 types of visual illusions and other minor hallucinations. Results: The prevalence of minor hallucinations was significantly higher among PD patients compared to controls (45.7% vs. 11.4%, p = 0.003). PD patients reported visual illusions and presence hallucinations more frequently than the controls (37.1% vs. 8.6% and 22.9% vs. 2.9%, p = 0.009 and p = 0.028, respectively), with no significant difference in passage hallucinations (20% vs. 8.6%, p = 0.306). In the PD group, the most frequently observed visual illusions were complex visual illusions, kinetopsia, and pelopsia; the latter was also the most common visual illusion in the control group. PD patients experiencing visual illusions were more likely to report presence hallucinations compared to patients without visual illusions (53.8% vs. 4.5%, p = 0.002); no significant differences in other clinical characteristics were found. Conclusions: Minor hallucinations are a common phenomenon among PD patients without dementia, with a higher prevalence than among healthy controls. Visual illusions are the most prevalent type of minor hallucinations, affecting more than a third of PD patients, with complex visual illusions, kinetopsia, and pelopsia being the most frequently reported types.
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Alucinaciones , Ilusiones , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/psicología , Enfermedad de Parkinson/epidemiología , Alucinaciones/epidemiología , Alucinaciones/etiología , Femenino , Masculino , Lituania/epidemiología , Anciano , Estudios Prospectivos , Ilusiones/fisiología , Ilusiones/psicología , Persona de Mediana Edad , Proyectos Piloto , Prevalencia , Encuestas y CuestionariosRESUMEN
Background and objectives: while acute ischemic stroke is the leading cause of epilepsy in the elderly population, data about its risk factors have been conflicting. Therefore, the aim of our study is to determine the association of early and late epileptic seizures after acute ischemic stroke with cerebral cortical involvement and electroencephalographic changes. Materials and methods: a prospective cohort study in the Hospital of the Lithuanian University of Health Sciences Kaunas Clinics Department of Neurology was conducted and enrolled 376 acute ischemic stroke patients. Data about the demographical, clinical, radiological, and encephalographic changes was gathered. Patients were followed for 1 year after stroke and assessed for late ES. Results: the incidence of ES was 4.5%, the incidence of early ES was 2.7% and the incidence of late ES was 2.4%. The occurrence of early ES increased the probability of developing late ES. There was no association between acute cerebral cortical damage and the occurrence of ES, including both early and late ES. However, interictal epileptiform discharges were associated with the occurrence of ES, including both early and late ES.
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Corteza Cerebral , Electroencefalografía , Epilepsia , Accidente Cerebrovascular Isquémico , Humanos , Masculino , Femenino , Estudios Prospectivos , Electroencefalografía/métodos , Anciano , Persona de Mediana Edad , Corteza Cerebral/fisiopatología , Epilepsia/fisiopatología , Epilepsia/complicaciones , Accidente Cerebrovascular Isquémico/complicaciones , Accidente Cerebrovascular Isquémico/fisiopatología , Lituania/epidemiología , Incidencia , Convulsiones/fisiopatología , Convulsiones/etiología , Convulsiones/epidemiología , Factores de Riesgo , Estudios de Cohortes , Anciano de 80 o más Años , Isquemia Encefálica/fisiopatología , Isquemia Encefálica/complicaciones , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatologíaRESUMEN
(1) Background: High blood pressure (HBP) and obesity are significant and growing public health issues worldwide. Our study aimed to evaluate the associations of neck circumference (NC), mid-upper arm circumference (MUAC), and wrist circumference (WrC) with HBP among Lithuanian children and adolescents aged 7-17 years. (2) Methods: In this cross-sectional study, data on BP and anthropometric measurements were analysed in 3688 children and adolescents aged 7-17 years. Multivariate logistic regression analysis was used to estimate the associations between anthropometric indices and HBP. (3) Results: Overall, the prevalence rates of elevated BP and hypertension were 13.7% and 12.9%, respectively. After adjustment for age, BMI, and WC, statistically significant elevated aORs were observed for associations between greater NC, MUAC, WrC, and HBP in boys (aORs: 2.13, 2.46, and 2.48, respectively) and in girls (aORs: 2.01, 2.36, and 2.09, respectively). Moreover, per-unit increase in NC, MUAC, and WrC was also associated with greater odds of HBP in boys (aORs: 1.20, 1.21, and 1.37, respectively) and in girls (aORs: 1.10, 1.10, and 1.21, respectively). The analysed anthropometric indices presented higher area under the curve values for predicting HBP in boys than in girls. (4) Conclusions: This study suggests that higher NC, MUAC, and WrC are associated with increased odds of HBP in Lithuanian children and adolescents.
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Hipertensión , Muñeca , Masculino , Femenino , Niño , Humanos , Adolescente , Estudios Transversales , Brazo/anatomía & histología , Lituania/epidemiología , Índice de Masa Corporal , Hipertensión/epidemiología , Presión Sanguínea/fisiología , Circunferencia de la CinturaRESUMEN
African swine fever (ASF) is one of the most severe suid diseases, impacting the pig industry and wild suid populations. Once an ASF vaccine is available, identifying a sufficient density of vaccination fields will be crucial to achieve eradication success. In 2020-2023, we live-trapped and monitored 27 wild boars in different areas of Lithuania, in which the wild boars were fed at artificial stations. We built a simulation study to estimate the probability of a successful ASF vaccination as a function of different eco-epidemiological factors. The average 32-day home range size across all individuals was 16.2 km2 (SD = 16.9). The wild boars made frequent visits of short durations to the feeding sites rather than long visits interposed by long periods of absence. A feeding site density of 0.5/km2 corresponded to an expected vaccination rate of only 20%. The vaccination probability increased to about 75% when the feeding site density was 1.0/km2. Our results suggest that at least one vaccination field/km2 should be used when planning an ASF vaccination campaign to ensure that everyone in the population has at least 5-10 vaccination sites available inside the home range. Similar studies should be conducted in the other ecological contexts in which ASF is present today or will be present in the future, with the objective being to estimate a context-specific relationship between wild boar movement patterns and an optimal vaccination strategy.
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Virus de la Fiebre Porcina Africana , Fiebre Porcina Africana , Enfermedades de los Porcinos , Humanos , Porcinos , Animales , Fiebre Porcina Africana/epidemiología , Fiebre Porcina Africana/prevención & control , Sus scrofa , Lituania/epidemiología , Vacunación/veterinariaRESUMEN
This study aimed to determine resistance to antimicrobials of Staphylococcus aureus strains isolated from clinical specimens in Lithuanian hospitals and to identify the genes conferring resistance and virulence. The study was carried out from June 2019 to September 2021. S. aureus strains were isolated from skin, soft tissues, blood, lower respiratory tract, urine and other specimens. Antibiotic susceptibility testing was performed using the disc diffusion method according to EUCAST guidelines. All isolates were analyzed for detection of the ermA, ermC, mecA, mecC, tetK, tetM, and lukF-PV genes by multiplex real-time PCR. The 16S rRNA coding sequence was applied as an internal PCR control. Altogether, 745 S. aureus strains were analyzed. Antimicrobial susceptibility testing revealed that all isolates were susceptible to rifampin and vancomycin. Of the 745 strains, 94.8% were susceptible to tetracycline, 94.5% to clindamycin, and 88.3% to erythromycin. The lowest susceptibility rate was found for penicillin (25.8%). Six percent of the tested strains were methicillin-resistant S. aureus (MRSA). The majority of methicillin-resistant strains were isolated from skin and soft tissues (73.3%), with a smaller portion isolated from blood (17.8%) and respiratory tract (8.9%). The ermC gene was detected in 41.1% of erythromycin-resistant S. aureus strains, whereas ermA was detected in 32.2% of erythromycin-resistant S. aureus strains. 69.2% of tetracycline-resistant S. aureus strains had tetK gene, and 28.2% had tetM gene. 7.3% of S. aureus isolates harbored lukF-PV gene. The frequency of the pvl gene detection was significantly higher in MRSA isolates than in methicillin-susceptible S. aureus isolates (p < 0.0001).
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Toxinas Bacterianas , Exotoxinas , Leucocidinas , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Humanos , Staphylococcus aureus/genética , Antibacterianos/farmacología , Lituania/epidemiología , Prevalencia , Staphylococcus aureus Resistente a Meticilina/genética , ARN Ribosómico 16S , Farmacorresistencia Bacteriana , Infecciones Estafilocócicas/epidemiología , Eritromicina , TetraciclinaRESUMEN
Aims: To compare statin utilization and ischemic heart disease (IHD) mortality trends in Lithuania and Sweden and to assess correlations between the total utilization of statins and IHD mortality. Methods: An ecological study assessing time trends in statin utilization (DDDs per 1000 inhabitants per day; DDD/TID) and IHD mortality in Lithuania and Sweden between 2000 and 2020. Statin utilization data in Lithuania were wholesale trade data, and Swedish data were drugs dispensed at pharmacies. IHD mortality data were extracted from national databases as rates per 100 000 inhabitants. Associations between statin utilization and IHD mortality in Lithuania and Sweden were examined using Spearman's rank and Pearson's correlation coefficients, respectively. Results: Statin utilization increased from 16.8 to 135.8 DDD/TID in Sweden and from 0.2 to 61.8 DDD/TID in Lithuania between 2000 and 2020. Medium intensity was the most common statin dosage in Lithuania, while Sweden used more high intensity than moderate-intensity statins from 2017. IHD mortality in Lithuania remained high between 2000 and 2020 (from 359.1 to 508.8 deaths per 100 000 population), while it decreased markedly in Sweden (from 226.87 to 88.7 deaths per 100 000 population). IHD mortality and statin utilization were inversely correlated in Sweden (r = -0.993, P < 0.001), while a positive correlation was found in Lithuania (rs = 0.871, P < 0.001). Conclusion: Despite the growing statin utilization in both countries, Lithuania recorded a slight increase in IHD mortality rates unlike the situation in Sweden. This indicates room for improvement in the management of modifiable cardiovascular risk factors in Lithuania including how statins are prescribed and used in clinical practice.
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Inhibidores de Hidroximetilglutaril-CoA Reductasas , Isquemia Miocárdica , Lituania/epidemiología , Suecia/epidemiología , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Isquemia Miocárdica/mortalidad , Isquemia Miocárdica/tratamiento farmacológico , Masculino , Femenino , Persona de Mediana Edad , Anciano , Utilización de Medicamentos/tendencias , Utilización de Medicamentos/estadística & datos numéricosRESUMEN
The Baltic states are the region in Europe where tick-borne encephalitis (TBE) is most endemic. The highest notification rate of TBE cases is reported in Lithuania, where the incidence of TBE has significantly increased since 1992. A recent study reported 0.4% prevalence of TBE virus (TBEV) in the two most common tick species distributed in Lithuania, Ixodes ricinus and Dermacentor reticulatus, with the existence of endemic foci confirmed in seven out of Lithuania's ten counties. However, until now, no comprehensive data on molecular characterisation and phylogenetic analysis have been available for the circulating TBEV strains. The aim of this study was to analyse TBEV strains derived from I. ricinus and D. reticulatus ticks collected from Lithuania and provide a genotypic characterisation of viruses based on sequence analysis of partial E protein and NS3 genes. The 54 nucleotide sequences obtained were compared with 81 TBEV strains selected from the NCBI database. Phylogenetic analysis of the partial E and NS3 gene sequences derived from 34 Lithuanian TBEV isolates revealed that these were specific to Lithuania, and all belonged to the European subtype, with a maximum identity to the Neudoerfl reference strain (GenBank accession no. U27495) of 98.7% and 97.4%, respectively. The TBEV strains showed significant regional genetic diversity. The detected TBEV genotypes were not specific to the tick species. However, genetic differences were observed between strains from different locations, while strains from the same location showed a high similarity.
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Virus de la Encefalitis Transmitidos por Garrapatas , Encefalitis Transmitida por Garrapatas , Ixodes , Animales , Lituania/epidemiología , Filogenia , Encefalitis Transmitida por Garrapatas/epidemiologíaRESUMEN
As the population continues to age, the occurrence of chronic illnesses and comorbidities that often necessitate the use of polypharmacy has been on the rise. Polypharmacy, among other factors that tend to coincide with chronic diseases, such as obesity, impaired kidney and liver function, and older age, can increase the risk of medication errors (MEs). Our study aims to evaluate the prevalence of MEs in the Internal medicine, Cardiology, and Neurology departments at the secondary-level university hospital. We conducted a prospective observational study of 145 patients' electronic or paper-based data of inpatient prescriptions and patients' pharmacokinetic risk factors, such as an impairment of renal and/or hepatic function, weight, and age. All included patients collectively received 1252 prescribed drugs. The median (Q1; Q3) number of drugs per patient was 8 (7;10). At least one ME was identified in 133 out of the 145 patients, indicating a significantly higher prevalence than hypothesized (91.7% vs. 50%; p < .001). There was moderate, positive correlation between the quantity of prescribed drugs and the number of MEs, meaning that the more drugs are prescribed, the higher the number of identified MEs (Spearman's ρ = 0.428; p < .001). These findings suggest that there is a need for continuous medication education activity for prescribing physicians, continuous evaluation of prescription appropriateness to objectively identify the MEs and to contribute to more rational patient treatment.
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Errores de Medicación , Polifarmacia , Humanos , Masculino , Estudios Prospectivos , Femenino , Estudios Transversales , Errores de Medicación/estadística & datos numéricos , Anciano , Persona de Mediana Edad , Prevalencia , Lituania/epidemiología , Anciano de 80 o más Años , Factores de Riesgo , Adulto , Hospitales UniversitariosRESUMEN
This article presents the dietary habits of Lithuanian first-grade (7-8-year-old) students over a 15-year surveillance period to understand the trends and changes in their nutrition patterns. The presented data were collected from three study rounds of the Lithuanian Growth Surveillance Study conducted between 2008 and 2023, with a total sample of 11,594 first-grade students from all 10 counties of Lithuania. The main findings reveal significant shifts in breakfast consumption, with an increase in daily breakfast intake observed over the surveillance period. Conversely, the consumption of cereal porridge showed a notable decrease, particularly in the frequency of consumption. Positive changes were noted in the consumption of vegetables and fresh fruits, indicating an improvement in dietary quality. Also, a concerning trend of declining consumption of certain nutritious food groups like fish and dairy products is identified, whereas the consumption of sugary beverages is low. These findings underscore the importance of ongoing efforts to promote healthier eating habits among school-age children in Lithuania. Addressing these trends requires a multifaceted approach involving education, policy changes, and community-based interventions to ensure the long-term health and well-being of children.