Obligately thermophilic, aerobic, proteolytic, endospore-forming strain N-3(T) was isolated from a high-temperature oilfield in Lithuania. 16S rRNA gene sequence analysis placed this strain in genetic group 5 of the endospore formers. Geobacillus thermoleovorans appeared to be the closest phylogenetic neighbour (99.4 % sequence similarity). The G+C content of strain N-3(T) was 52.5 mol% and matched the range established for the genus Geobacillus. Studies of DNA-DNA relatedness and morphological and physiological analyses enabled strain N-3(T) to be described as a member of the genus Geobacillus, but could not assign this strain to any other known species of this genus. Results of this polyphasic study allowed characterization of strain N-3(T) as a novel species in the genus Geobacillus - Geobacillus lituanicus sp. nov. This species can be distinguished from G. thermoleovorans and Geobacillus stearothermophilus on the basis of 16S rRNA gene PCR-RFLP assays with the restriction endonucleases AluI, HaeIII and TaqI. The type strain of the novel species is N-3(T) (=DSM 15325(T)=VKM B-2294(T)). (+info)
The patient role in decision-making in Lithuanian health care.
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The objective of the study is to explore the attitudes of Lithuanian citizens to health care system and to evaluate their social role in decision-making about their health care. MATERIAL AND METHODS: The national cross-sectional survey was conducted March 1-7, 2004. Multi-stage random sampling across the country included adult Lithuanian residents, interviewed in their home (n=1007). The response rate was 56.5%. The attitudes of citizens were evaluated using an anonymous questionnaire, originally developed and adopted with the reference to experience of previously conducted studies. RESULTS: Majority of polled women and men (84.6% and 72.6%) recognized health as very important value in their life and as the most important among other social values. The overall mean of trust in health care system - 41.3%, trust in physicians - 69.9%, implementation of right to health care - 48.9%, concern about health care - 96.5% and patient impact in health care decisions - 19.1%. Nearly half of respondents (47.4%) prefer informative general practitioner-patient interaction model, which is realized in most cases (58.8%). Partnership (shared decision-making) as interaction model is expected by 37.2% of polled respondents and realized in every sixth case in primary care. CONCLUSIONS: Health as value is the most preferred among Lithuanian citizens. Younger and more educated people trusted less in health care system, but are more motivated to play an active role in health care decision-making. The informative model of doctor-patient is dominant, while partnership is not so exposed as being expected by patients. (+info)
Alcohol consumption in Lithuanian school-aged children during 1994-2002.
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Alcohol consumption becomes an important social and health problem among youth in many countries. Analysis of data on alcohol consumption behavior from World Health Organization Cross-National Study on Health Behavior in School-aged Children (HBSC) is presented in the article. This survey is carried out in majority of European countries including Lithuania. Aim of this study was to analyze features and trends of alcohol consumption among representative sample of 11, 13 and 15-year-old school children and to compare results with international data. METHODS: Patterns and trends of alcohol consumption were analyzed in three cross sectional questionnaire surveys of the representative sample of Lithuanian secondary school student's aged 11, 13 and 15 years in 1994, 1998 and 2002. Respectively, 5428, 4513 and 5645 respondents have filled in the questionnaires anonymously in the classroom according the methodology of international HBSC study. RESULTS: Boys were using alcohol on the regular basis (once a week or more often) more frequently than girls. Prevalence of regular alcohol consumption has increased from 9.4 to 13.6% in boys and from 4.2% to 6.5% in girls (p<0.05). Beer was the most popular alcohol drink among the students and was consumed respectively by 8.9%, 10.2% and 12.7% boys, and by 3.4%, 4.6%, 5.4% girls at least once per week. Prevalence of respondents who have reported the drunkenness (two or more times) has increased in boys from 13.3% to 30.1%, and in girls from 27.1% to 19.6% during period 1994-2002 (p<0.05). CONCLUSIONS: Trend of increase of alcohol consumption among school-aged children was observed in Lithuania during 1994-2002. Boys tend to be more frequent regular users of alcohol than girls. Alcohol consumption was significantly increasing with age. Alcohol use behaviors of Lithuanian school-aged children tend to be closer to countries of the Western Europe and the Nordic countries during the period of observation. (+info)
Sequential organ failure assessment score as the determinant of outcome for patients with severe sepsis.
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AIM: To evaluate the impact of organ dysfunction in severe sepsis and determine the effectiveness of organ dysfunction scores to discriminate outcome after admission to the intensive care unit (ICU). METHODS: Patients with a diagnosis of severe sepsis and at least one organ dysfunction on the first day in the ICU (n=117) were included in the prospective observational study. The presence of organ dysfunction was assessed using a Sequential Organ Failure Assessment (SOFA). The severity of illness was assessed using a Simplified Acute Physiology Score (SAPS) II during the first 24 hours after the admission to the ICU. The main outcome was survival status on day 28 after admission to the ICU. RESULTS: Most common sites of infection were intra-abdominal and respiratory system (77 and 38 cases, respectively). Median SAPS II score on admission was 47 points (25th-75th quartiles range, 37-57 points). Twenty eight days survival rate was 41%. The best discrimination results were shown for cumulative scores with the highest for the SOFA score on day 3 in the ICU. The ability to discriminate outcome on day 1 was weak for the presence of dysfunction in all organ systems except neurological. The discriminative power of organ dysfunction scores increased during the stay in the ICU. Neurological and cardiovascular dysfunctions were the independent risk factors for mortality. CONCLUSION: The SOFA scores showed high accuracy in describing the course of organ dysfunction for the patients with severe sepsis. Evolving organ dysfunction following admission to the ICU strongly affected the outcome. Cumulative SOFA scores were better in discriminating outcome compared to single organ dysfunction scores. (+info)
Interaction among general practitioners age and patient load in the prediction of job strain, decision latitude and perception of job demands. A cross-sectional study.
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BACKGROUND: It is widely recognized and accepted that job strain adversely impacts the workforce. Individual responses to stressful situations can vary greatly and it has been shown that certain people are more likely to experience high levels of stress in their job than others. Studies highlighted that there can be age differences in job strain perception. METHODS: Cross-sectional postal survey of 300 Lithuanian general practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the Karasek scale. The analysis included descriptive statistics; logistic regression beta coefficients to find out predictors and interactions between characteristics and predictors. RESULTS: Response rate was 66% (N = 197). Logistic regression as significant predictors for job strain assigned - duration of work in primary care; for job demands- age and duration of working in primary care; for decision latitude- age and patient load.The interactions with regard to job strain showed that GP's age and job strain are negatively associated to a low patient load. Lower decision latitude for older GP age is strongly related to higher patient load. Job demands and GP age are slightly positively related at low patient load. CONCLUSIONS: Lithuanian GP's have high patient load and are at risk of stress, they have high job demands and low decision latitude. Older GP's perceive less strain, lower job demands and higher decision latitude in case of low patient load. Young GP's decision latitude has week association to patient load. Regarding to the changes in patient load younger GP's perceive it more sensitively as changes in job demands. (+info)
Novel 180- and 480-base-pair insertions in African and African-American strains of Helicobacter pylori.
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Helicobacter pylori is a genetically diverse bacterial species that chronically infects human stomachs and sometimes causes severe gastroduodenal disease. Studies of polymorphic DNA sequences can suggest geographic origins of individual strains. Here, we describe a 180-bp insertion (ins180), which is just after the translation stop of a gene of unknown function, near the promoter of jhp0152-jhp0151 two-component signal transduction genes in strain J99, and absent from this site in strain 26695. This ins180 insertion was found in 9 of 9 Gambian (West African), 9 of 20 (45%) South African, and 9 of 40 (23%) Spanish strains but in only 2 of 20 (10%) North American strains and none of 20 Lithuanian, 20 Indian, and 20 Japanese strains. Four South African isolates that lacked ins180 and that belonged to an unusual outlier group contained a 480-bp insertion at this site (ins480), whereas none of 181 other strains screened contained ins480. In further tests 56% (10 of 18) of strains from African Americans but only 17% (3 of 18) of strains from Caucasian Americans carried ins180 (P < 0.05). Thus, the H. pylori strains of modern African Americans seem to retain traces of African roots, despite the multiple generations since their ancestors were taken from West Africa. Fragmentary ins180-like sequences were found at numerous sites in H. pylori genomes, always between genes. Such sequences might affect regulation of transcription and could facilitate genome rearrangement by homologous recombination. Apparent differences between African-American and Caucasian-American H. pylori gene pools may bear on our understanding of H. pylori transmission and disease outcome. (+info)
Peculiarities of physical therapy for patients after traumatic brain injury.
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Literature review data about methods and means of physical therapy for patients after traumatic brain injury is presented in this article. Traumatic brain injury is an urgent medical and social problem all over the world. It is the most common cause of disability in Lithuania. Patient rehabilitation after traumatic brain injury is divided into two periods: acute and subacute. In the beginning of rehabilitation physical therapist evaluates patient's functional status, later he uses methods and means of treatment, and evaluates effectiveness of rehabilitation. Early verticalisation is very important for patients with coma. Physical therapy consists of prevention of complications, improvement of muscle force, and range of motions, balance, movement coordination, endurance and cognitive functions. Early rehabilitation is necessary for traumatic brain injury patients and use of physical therapy methods can help to regain lost functions and to come back to the society. (+info)
Medicosocial care for persons suffering from Alzheimer's disease and related disorders.
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Lithuania, like many European countries, is facing the problem of ageing population. The ageing society is accompanied by an increase in the prevalence of the disorders that are characteristic for old age. This article presents an overview of the current situation with respect to care of patients with dementia in Lithuania. Calculations based on epidemiological studies in other countries reveal that at least 31,000 persons may be suffering from dementia in Lithuania, with 6407 new cases occurring each year. Management of persons with dementia is mainly conducted by psychiatrists and neurologists with a few geriatricians. Mental health centers with interdisciplinary teams assure medical treatment, primary diagnosis of dementia, family consultations, managing of social and psychological problems and visits to homes when needed. Institutional services and home help services for persons with dementia are scarce and underdeveloped. Our future priorities in developing care for people with dementia are to improve the timely diagnosis and comprehensive management of dementia with the establishment of a continuity of high quality social services with special emphasis on home help and the support of family members. (+info)