Kaunas Region Research Articles

Effects of age, period and cohort on stroke mortality among a middle-aged Lithuanian urban population from 1980 to 2004

The main purpose of this paper was to assess the effect of age, period, and cohort on stroke mortality rates among a Lithuanian urban population aged 25-64 years (1041 men and 724 women) between 1980 and 2004. Routine stroke mortality data were obtained from official Kaunas region mortality register by codes 430-438 and I60-I69 in the 9th and in the 10th revisions of the International Classifications of Diseases (ICD), respectively. Mortality rates per 100,000 persons for men and women were age-adjusted using the age distribution of the European Standard Population. Age-specific mortality rates were analysed by sex, period, and birth cohort in eight 5-year age groups and five 5-year age groups. Goodness of fit of the Poisson regression models were evaluated using Pearson and Freeman-Tukey residuals. The age-period and age-period-cohort models provided a significantly better fit than a model with the factors "age'' and "cohort''. During the study period, mortality rates decreased from 46.8 to 33.0 per 100,000 for men, and from 20.2 to 18.1 per 100,000 for women (average annual decrease of -1.3%, p<0.1 for men, and -1.6%, p<0.03 for women). An age effect was present in both sexes. The definite upward period effect was observed from 1990 to 1994 both among men and women, and was followed by a sharp fall during 2000-4. Cohort and period effects have contained relevant information which partially explained trends in stroke mortality among a 25-64 year-old Lithuanian urban population. During the period of 1980-2004, the mortality trend declined among women only. The period effect contains relevant information for the explanation of increasing mortality rates during 2000-4 among men and women. The Poisson regression models could be applied for the examination and explanation of the different causes of the population mortality.

Effects of age, period, and cohort on stroke mortality among the Lithuanian urban population during the 24-year follow-up period

Abstract The main purpose of this paper was to assess the effects of age, period, and cohort on stroke mortality among the urban Lithuanian population. Routine stroke mortality data among the Lithuanian urban population aged 25–64 years (1041 men and 724 women) between 1980 and 2004 were obtained from the official Kaunas region mortality register and classified by codes 430–438 and 160–169 in the 9th and 10th revisions of the International Classifications of Diseases (ICD), respectively. Mortality rates per 100,000 persons for men and women were age-adjusted using the age distribution of the European Standard Population. Goodness of fit of the Poisson regression models was evaluated using the Pearson and Freeman-Tukey residuals. During the study period, mortality rates decreased from 46.8 to 33.0 per 100,000 for men, and from 20.2 to 18.1 per 100,000 for women (average annual decrease of −1.3%, p&lt;0.1 for men, and −1.6%, p&lt;0.03 for women). An age effect was present in both sexes. The definite upward period effect was observed from 1990 to 1994 both among men and women, and was followed by a sharp fall during 2000–2004. Cohort and period effects have contained relevant information that partially explained trends in stroke mortality among 25–64 year-olds in the Lithuanian urban population. The Poisson regression models could be applied for the examination and explanation of the different causes of the population mortality.

Quantitative HPLC determination of phenolic compounds in yarrow

The qualitative and quantitative compositions of flavonoids (vicenin-2, luteolin-3′-di-O-glycoside, luteolin-7-O-glycoside, rutin, apigenin-7-O-glycoside, luteolin, apigenin) and chlorogenic acid in herb, leaves, and stems of yarrow (Achillea millefolium) samples collected in the Kaunas region of Lithuania have been studied by means of high-performance liquid chromatography (HPLC). It is established that these substances exhibit a characteristic distribution with predominant formation of apigenin-7-O-glycoside and luteolin-7-O-glycoside among the identified flavonoids in the herb of yarrow whereas the leaves contain predominantly chlorogenic acid, rutin, and apigenin-7-O-glycoside; the stems, predominantly chlorogenic acid, rutin, apigenin-7-O-glycoside, and luteolin-7-O-glycoside. The results can be used to choose selection donors of this medicinal plant material.

STUDY OF POSSIBILITIES TO ESTABLISH REGIONAL TRANSPORT TERMINAL IN KAUNAS

The article describes the creation of regional transport terminals and their usage as a tool to control material flows in the distribution channels. In the first part of the article the authors analyze the role of intermodal transport terminal within international business system, legal aspects of Lithuanian and EU regulations as well as the laws of Lithuanian transport regional transport terminal establishment in Kaunas. The evaluation of alternative locations for establishment of terminal in Kaunas region is presented.

Hospitalization in Hemodialysis Patients in One Region of Lithuania

The objective of our study was to evaluate hospitalization rates in hemodialysis patients in the region of Kaunas, the second largest city in Lithuania. We analysed ambulatory case records of 187 ESRD patients dialysed in all 7 hemodialysis centers in the Kaunas region over the year 2002. During the year 2002 the unadjusted hospitalization rate over a 1 year period in all dialysed patients (the prevalent patients, n=187) was 1.4 hospitalizations per patient year at risk. There were 17.5 hospital days per patient year at risk, the mean length of one hospitalization being 12.5 days. The most frequent causes of hospitalization were cardiovascular diseases (25%), infections (22%), and access related complications (10%). Of the 187 patients, 55 started hemodialysis in the year 2002 (incident patients). The comparison of prevalent patients with incident patients revealed a higher hospitalization rate in the incident patients (unadjusted hospitalization rate was 1.9 hospitalizations per patient year at risk). The length of hospitalization (29.1 hospital days per patient year at risk) and the mean length of one hospitalization (15.1 days) were longer in the incident patients than the prevalent patients. In the year 2002, the National Sickness Fund paid $361 per year for hospitalizations of one hemodialysis patient and $10,800 per year for the dialysis procedures of one hemodialysis patient. The hospitalization rate in Lithuania for patients undergoing hemodialysis is similar to that of other European countries while hospitalization costs are lower.

Problems with film processing in medical X-ray imaging in Lithuania

Optimisation in X-ray imaging in order to reduce patient doses during diagnostic X-ray examinations is a complex process given the high level of image quality required. When quality systems are implemented as a basis for optimisation, attention should be paid to the qualifications of the staff and quality control of the equipment and of the X-ray imaging procedures, as well as to the methods used to evaluate the quality of these procedures. Until recently, quality control procedures at health care institutions in Lithuania were limited to the testing of X-ray units. Since film processing is one of the most important factors influencing patient doses and image quality during X-ray examinations, in 2003 the Kaunas department of the Radiation Protection Centre organised inspections of film processing laboratories in 11 health care institutions-hospitals and outpatient departments-in the Kaunas region. Problems of non-compliance with requirements identified during these inspections are discussed in this paper. Most of the health care institutions inspected already had quality assurance programmes. However, the implementation of these programmes was sometimes erratic because of the insufficient attention paid to the film developing processes. The worst situation was found in 4 institutions where the films were developed manually. Only 3 of the 11 departments inspected had sensitometers and densitometers for quality control of the processing. In many cases there was no control of chemicals, film sensitivity and density, or else control was irregular. In only a few departments were the effects of repeated controls investigated and discussed. Despite the current problems occurring in medical X-ray diagnostic departments in Lithuania, the situation is rapidly improving. New equipment is being installed, new devices for quality control are being used and, last but not least, the view of hospital administrators, radiologists and laboratory workers towards quality assurance and quality control is changing.

Socialinis kapitalas: nuo mokslinių tyrimo perspektyvų prie empirinių pastebėjimų. Gero valdymo klausimas

Social capital is a term, which is widely used in social sciences today. The concept has been coined by the French philosopher and sociologist Pierre Bourdieu and popularized by the American political scientist Robert Putnam. However, the two authors talk of rather different phenomena while using the same term; they assign different importance (cause-effect) to different components and events of the social life; they draw rather dissimilar recommendations concerning actions of the public authorities and individuals. In this text the two theories are outlined, then some data from the survey “Social capital in Kaunas and Kaunas region” conducted in spring 2003 are presented and interpreted. The interpretation does not allow much hope that the social capital understood as participation in social activities and voluntary organizations might in some automatic (miraculous) way – without changing power relations and increasing material well being of the majority of social groups – lead to enhanced citizenship and community development. Active and responsible role of the municipalities (local authorities) might be one of the actual leverages to encourage and improve development of civil society (non-governmental organizations). Sociological research shows that the social capital in a constructive way shall be understood as dependent variable, which might be positively influenced (affected) by the “good” governance.

Tickborne encephalitis in an area of high endemicity in lithuania: disease severity and long-term prognosis.

Of 250 consecutively admitted patients with central nervous system (CNS) infections who were treated during a 1-year period, all 133 patients with tickborne encephalitis (TBE) were included in a prospective follow-up study. TBE presented as mild (meningeal) in 43.6% of patients and as moderate or severe (encephalitic) in 43.6% and 12.8% of patients, respectively. Paralytic disease was observed in 3.8% of the subjects, and cranial nerve injury was observed in 5.3%. One patient died of TBE. Permanent CNS dysfunction after 1 year was found in 30.8% of patients; in 8.5% of all TBE cases, severe disabilities required adjustment of daily activities. Corticosteroid treatment did not seem to improve outcome. A progressive course of TBE was noted in 2 patients. The risk of incomplete recovery was significantly higher among patients with the encephalitic form of TBE (odds ratio, 4.066; 95% confidence interval, 1.848-8.947). In conclusion, TBE is an important pathogen in CNS infection in the Kaunas region of Lithuania, and it causes long-lasting morbidity in one-third of cases.

Viking age horse graves from Kaunas region (Middle Lithuania)

AbstractBalts' territories have one peculiarity—large amounts of horse bones are found in burial grounds. This phenomenon is typical to the Prussians (5th–11th centuries) and Lithuanians (Kaunas region 8th–11th centuries)Horse burials of the 8th–11th centuries reflect the archaeological culture of Middle Lithuania most significantly.Several horse burial types have been defined on the basis of individuals; osteological signs and the archaeological data of the horse remains. A typical horse grave is when the whole horse was buried. Sometimes only a head or a head with forelegs, or scattered horse remains are found in a burial. The large number of burial grounds with an abundance of horse graves testifies to a very expressive ritual of horse offering in the Balts' region.On the basis of the data obtained, we determined that mostly 4–10 year old horses were buried in the grounds of Middle Lithuania.From the bone measurements, it has been determined that the length of metacarpals ranges between 180 and 216 mm (the average length 193.1±0.99 mm); the length of metatarsals between 218 and 253 mm (average length 233.9±0.73 mm).These data demonstrate that horses of different types were buried in Marvelė and Veršvai burial grounds (wither height 120–136 cm). A certain number of the larger horses (wither height 136–144 and 153 cm; length of metacarpals 210–222 mm) might not have belonged to local breeds.We have come to the conclusion that the most similar horse skeletons (according to the osteometric data) were found in Latvia. Copyright © 2001 John Wiley &amp; Sons, Ltd.

Rate of characteristics for osteoporotic fractures in the elderly population of Kaunas region, Lithuania.

Osteoporosis related with age is a well known problem in many Western countries. First investigations on osteoporosis in Lithuania were started few years ago. We investigated the rate of characteristic for osteoporosis fractures according to Kaunas Red Cross Hospital regional Traumatology department data. We have studied all cases of inpatients and outpatients over 65, who had Colles', hip or vertebral fracture, as this department serves for all Kaunas region, (580000 inhabitants: 17000 male and 35500 female over 65). The rate of fractures was counted per 1000 inhabitants over 65, comparing 1991 and 1993. We found, that about 1.65/1000 of men and 7.52/1000 of women had Colles' fracture in 1991, when the rate in 1993 accordingly was 1.60/1000 and 10.56/1000. The greater increase in rate we noticed studying cases of hip fractures: 1.60/1000 of men and 3.09/1000 of women in 1991, when 4.70/1000 of men and 6.76/1000 of women in 1993. We did not noticed a significant increase in vertebral fractures comparing number of inpatients in 1991 and 1993: 0.64/1000 of men and 0.59/1000 of women in 1991 and 0.65/1000 in 1993 of both sexes. We did notice the important role of falls to fracture rate, as increase of hip and Colles' fractures increased more than 2 times in winter season. Evaluating our data, we make a conclusion, that the rate of osteoporotic fractures increased comparing 1991 and 1993: Colles' fracture- 1,5 times and hip fracture 2 times in women group, when in men's group Colles' fracture rate did not change significantly and hip fracture increased 2,9 times. The growing number of fracture's rate in population over 65 shows, that problem of involutional bone disorders exists in Lithuania also.