10178 research outputs found
Sort by
Epistatic effect of Ankyrin repeat and kinase domain containing 1 - Dopamine receptor D2 and Catechol-o-methyltransferase single nucleotide polymorphisms on the risk for hazardous use of alcohol in Lithuanian population
No full textAim: The Lithuanian population has outstanding rates of alcohol consumption and alcohol related mortality. Alteration of brain dopaminergic system play a role in the risk for addiction disorders. We evaluated the association of one single nucleotide polymorphism rs1800497 in the Ankyrin Repeat and Kinase Domain Containing 1 - Dopamine Receptor D2 complex (ANKK1-DRD2) and a catechol-o-methyltransferase (COMT) rs4680 single nucleotide polymorphism with the risk for alcohol use disorder and impulsiveness in Lithuanian population. Both genetic polymorphisms are known to alter brain dopaminergic activity, thus we also investigated the possible interaction effect of these polymorphisms. Methods: The study included 329 participants recruited from the local community. Hazardous alcohol use was evaluated using the Alcohol Use Disorder Identification Test (AUDIT). Impulsiveness was measured using the Barratt Impulsiveness Scale - 11 (BIS-11). Between group differences of AUDIT and BIS-11 scores were examined stratified by genetic polymorphisms and their combinations. The independent effect of each polymorphism and their interaction for hazardous alcohol use were evaluated using adjusted logistic regression analyses. Results: The ANKK1-DRD2 rs1800497 polymorphism was associated with total AUDIT score, but not with the hazardous use of alcohol, as indicated by the AUDIT test cut-off of 8. The COMT rs4680 GG genotype was associated with the hazardous use of alcohol (adjusted OR = 2.094, p=0.029), but this association was not statistically significant after adjustment for multiple comparisons. Presence of both COMT rs4680 and ANKK1-DRD2 rs1800497 GGxCT/TT polymorphisms was associated with significantly increased risk for hazardous use of alcohol (adjusted OR = 5.016, p=0.005). The COMT rs4680 and ANKK1-DRD2 rs1800497 genetic polymorphisms, and their combination were not associated with impulsiveness
The perspectives of patients with type 2 diabetes mellitus on marketing mix elements in primary health care: a quantitative study from Lithuania
No full textA competitive advantage in health care institutions can be cultivated by marketing activities and value creation for patients with chronic diseases in primary health care. Type 2 diabetes mellitus (T2DM) is a major challenge in primary health care, as managing risk factors and managing patient knowledge can help to prevent a number of major of complications. This study reveals the expectations and attitudes of patients with T2DM regarding marketing mix elements in the management of their condition. Aim of the study: To explore the perspectives of patients with T2DM on marketing mix elements in the primary health care institutions of Lithuania. Materials and methods: The design of the national study was based on a survey of patients with T2DM that was conducted after consultation with a family physician in primary health care institutions in Lithuania. The survey was conducted from October 2017 to January 2018, and involved 510 patients with T2DM. Data analysis included factor analysis and linear logistic regression. A hypothetical model was built, defining the relationships between marketing mix elements and both perceived value (emotional, functional, and social) and satisfaction with primary health care services. Results: The marketing mix element of ‘Service’ is statistically significantly dependent on the gender of the respondents, and is expressed more frequently by women (rcr = 0.118, P = 0.007). The occupation of respondents with T2DM (rcr = 0.151, P = 0.009) and affiliation to primary health care institution (rcr = 0.091, P = 0.040) statistically positively affect the marketing mix element of ‘Price’. The marketing mix elements of ‘Promotion’ and ‘People’ do not statistically significantly depend on the sociodemographic characteristics of the respondents. Only a weak correlation between the sociodemographic characteristics of the respondents and the marketing element of ‘Place’ was found. The ‘Process’ element is statistically significantly more relevant to patients with an average monthly income of €350 (rcr = 0.104, P = 0.019). The element of ‘Physical evidence’ is more statistically significantly related to respondents with an average monthly income of €350 (rcr = 0.092, P = 0.038). Conclusions: Marketing mix analysis provides information about patients’ expectations of primary health care services and identifies areas of improvement for the health services provided by primary health care institutions. The competitiveness of primary health care services is strengthened by enhancing value for patients, by using elements of the health care marketing, and by increasing patient satisfaction
Changes in prehospital stroke care and stroke mimic patterns during the COVID-19 lockdown
No full textThe impact of COVID-19 lockdown on prehospital stroke care is largely unknown. We aimed to compare stroke care patterns before and during a state-wide lockdown. Thus, we analysed prospective data of stroke alerts referred to our stroke centre between 1 December 2019 and 16 June 2020, and compared them between two periods—15 weeks before and 13 weeks during the state-wide lockdown declared in Lithuania on 16 March 2020. Among 719 referrals for suspected stroke, there was a decrease in stroke alerts (rate ratio 0.61, 95% CI (0.52–0.71)), stroke admissions (0.63, 95% CI (0.52–0.76)), and decrease in prehospital stroke triage quality (positive predictive value 72.1% vs. 79.9%, p = 0.042) during the lockdown. The onset-to-door time was longer (153.0 vs. 120.5 min, p = 0.049) and seizures and intracranial tumours were more common among stroke mimics (16.9% vs. 6.7%, p = 0.012 and 9.6% vs. 3.0%, p = 0.037, respectively). We conclude that there was a decline in prehospital stroke triage quality during the lockdown despite low COVID-19 incidence in the country. Moreover, we observed an increase in hospital arrival delays and severe conditions presenting as stroke mimics. Our findings suggest that improved strategies are required to maintain optimal neurological care during public health emergencie
Exercise and use of enhancement drugs at the time of the COVID-19 pandemic: a multicultural study on coping strategies during self-isolation and related risks
No full textIntroduction: Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance. Objectives: To assess the role of anxiety about appearance and self-compassion on the practice of physical exercise and use of IPEDs during lockdown. Methods: An international online questionnaire was carried out using the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS) in addition to questions on the use of IPEDs. Results: The sample consisted of 3,161 (65% female) adults from Italy (41.1%), Spain (15.7%), the United Kingdom (UK) (12.0%), Lithuania (11.6%), Portugal (10.5%), Japan (5.5%), and Hungary (3.5%). The mean age was 35.05 years (SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise with peaks registered in the UK (11.0%) and Spain (5.4%). The sample reported the use of a wide range of drugs and medicines to boost image and performance (28%) and maintained use during the lockdown, mostly in Hungary (56.6%), Japan (46.8%), and the UK (33.8%), with 6.4% who started to use a new drug. Significant appearance anxiety levels were found across the sample, with 18.1% in Italy, 16.9% in Japan, and 16.7% in Portugal. Logistic regression models revealed a strong association between physical exercise and IPED use. Anxiety about appearance also significantly increased the probability of using IPEDs. However, self-compassion did not significantly predict such behavior. Anxiety about appearance and self-compassion were non-significant predictors associated with engaging in physical exercise. Discussion and Conclusion: This study identified risks of problematic exercising and appearance anxiety among the general population during the COVID-19 lockdown period across all the participating countries with significant gender differences. Such behaviors were positively associated with the unsupervised use of IPEDs, although no interaction between physical exercise and appearance anxiety was observed. Further considerations are needed to explore the impact of socially restrictive measures among vulnerable groups, and the implementation of more targeted responses
SARS-COV-2 serologinis paplitimas Lietuvoje: nacionalinio populiacijos tyrimo rezultatai
No full textBackground. Betacoronavirus SARS-CoV-2 has spread in early 2020 worldwide just in several months. The official statistics are consistently collected, but this is mainly based on symptomatic reports. This study was aimed to estimate the seroprevalence of SARS-CoV-2 infection in Lithuanian population. Materials and methods. Study was conducted during August–September 2020 in 6 municipalities of Lithuania. The sample comprised 3087 adult participants from the general population (mean age 53.7 years, 64% female). SARS-CoV-2 antibodies were assessed using AMP IgM/IgG Rapid Test, other data were based on self-report. Seroprevalence was assessed as a crude estimate and as adjusted by sensitivity-specificity of the test. Results. The crude seroprevalence in the total sample was 1.9%, the adjusted – 1.4%, ranging from 0.8% to 2.4% across municipalities. Among seroprevalent cases, 67.2% had IgG, 29.3% had IgM, and 3.5% had both IgG and IgM. An increased risk for seropositive test was observed among people who reported having had close contacts with SARS-CoV-2 positives (OR=5.49, p<0.001). At the borderline significance were female gender (OR=1.75, p=0.082) and non-smoking status (OR=2.95, p=0.072). Among the seropositive participants, 69.0% reported having had no COVID-19 symptoms since 1 March 2020, while 31.0% reported having had at least one of the symptoms. Conclusions. The SARS-CoV-2 seroprevalence in Lithuanian sample in August–September 2020 was 1.4%, ranging from 0.8% to 2.4% across municipalities. Given the overall official data, by the end of study (11 September 2020) the total COVID-19 rate in Lithuania was 117.5 per 100,000 population or 0.12%. This suggests more than 10 times higher prevalence of virus across the population than the official estimates
Relationships between young men’s health-related behaviour, psychological distress, physical education and sports experience
No full textBackground. Negative health-related behaviours among young adults are common worldwide. Most of young males are physically inactive, have poor diets, drink a lot of alcohol or smoke, and such behavior causes physical and mental health disorders (Aubert et al., 2018). Nowadays more mental health problems are diagnosed among young people than a decade. Researchers are trying to determine the causes of harmful behaviour in adults, but the impact of previous physical education on further health-related behaviours in adults has not been studied. Methods. Physical activity, alcohol consumption and cigarette smoking was evaluated according to the 2008 US Department of Defense Survey of Health Related Behaviours (Bray et al., 2009). Adherence to a healthy eating pattern was evaluated using the Mediterranean diet adherence screener (MEDAS). Psychological distress was assessed using the six-item Kessler scale (Kessler et al., 2003). Results. Nearly half of young adults were physically inactive, ate poorly, had harmful habits, one of ten had high psychological distress. Two thirds of the respondents participated in sports in childhood, 61% of young people liked the physical education lessons, 44% of them attended every PE lesson. Lower distress was significantly associated with better nutrition, higher physical activity, lower alcohol consumption, and smoking. Also, significant associations were found between higher alcohol consumption and more frequent smoking. Higher incomes, younger age, better perception and attendance of PE classes in the past, active lifestyle in childhood and adulthood are the predictive factors of more favourable health-related behaviours and better mental health. Conclusions. Harmful health-related behaviours are prevalent among young adults, one of tenth has high psychological distress. Although the majority of young adults were active in childhood, the percentage of active adults decreases significantly. More favourable health-related behaviours are related to less distress. Better economic status, better PE experiences in childhood, sports activities in adulthood lead to better health-related behaviours and less distress
Epidemiology, etiology, pathogenesis and diagnostics of hip and knee osteoarthritis
No full textOsteoarthritis is a common cause of knee or hip joints function disorder. Dysfunction of movement, constant pain, and joint stiffness are the main reasons of individual inability to function properly in daily activities, sometimes could even lead to one’s disability. Nowadays, the impact of osteoarthritis in daily routine and health care centers is expected to be increasing because of the aging population and higher obesity rates. According to this, the understanding of pathogenesis and risk factors of the disease is important for diagnostics ant treatment. It was recently discovered that the mechanisms associated with impaired cartilage metabolism in the subchondral bone, inflammation, as well as pathological processes in the synovium play a significant role in the OA pathogenesis. These pathological changes can be discovered clinically or using imaging modalities. Aim: To select and analyze scientific publications which study knee and hip joint osteoarthritis epidemiology, etiology, pathogenesis and diagnostics. Methods: the review of literature was managed by using “PubMed” medical database, selecting publications which investigated knee and hip joints osteoarthritis. Conclusion: after review of the literature, epidemiology, etiology, pathogenesis, and diagnostics of the knee and hip joints osteoarthritis are presented
Trends in Incidence and Mortality of Skin Melanoma in Lithuania 1991-2015
No full textBACKGROUND: We aimed to investigate age-specific and sex-specific incidence trends of melanoma in Lithuania from 1991 to 2015.
METHODS: Analysis was based on data from the population-based Lithuanian Cancer Registry database for 1991-2015, and 6024 cases of skin melanoma were identified. Age-adjusted rates (ASRs) by sex and age group were calculated. Adjustment for ASRs was done using the old European standard population, where a total of three age groups were considered: 0-39, 40-59 and 60+. Additionally, the annual percent change (APC) was calculated, and 95% confidence intervals for APC were calculated.
RESULTS: Between 1991 and 2015, the overall melanoma rates increased by an annual percent change (APC) of 3.9% in men (95% CI, 3.6-4.1%) and 2.3% in women (95% CI, 2.1-2.5%). The highest incidences of new cutaneous melanoma cases were observed between old adults (60+) of both sexes, while the lowest incidence rates were observed in the young adult group (up to 39 years old), with the lowest APC (1.6% in males and 0.4% in females). The overall number of melanoma deaths during 1991 and 2015 increased from 64 to 103 deaths per year, and the age-standardized rate (ASR) increased 1.3 times (from 1.8 to 2.4).
CONCLUSIONS: The incidence and mortality of skin melanoma seem to be increased in all age groups. These trends indicate that skin protection behavior is not sufficient in our population and more efforts need to be taken in order to decrease incidence and mortality rates
Effect of pelvic floor muscle strengthening exercises on urinary incontinence in women after uterus removal surgery
No full textBackground. Hysterectomy (HT) is a very common procedure in which the uterus is removed surgically. The extent and type of HT surgery may vary, but the surgical intervention itself is a risk factor for the development of postoperative urinary incontinence regardless of the extent and type of surgery (Skorupska, Mio - tla, Kubik–Komar, Rechberger, Adamiak–Godlewska & Rechberger, 2016). Tech - niques for preventing urinary incontinence include maintaining proper weight, limiting the number of children, making lifestyle adjustments, and educating to perform pelvic floor muscle (PFM) training exercises correctly (Habib & Chaud - hary, 2016). However, there is still a lack of research on how PFM training can be combined with other interventions (Silantyeva et al., 2019), and different authors presernt conflicting results. Aim. The purpose was to evaluate the effect of pelvic floor muscle strengthe - ning exercises on urinary incontinence in women after uterus removal sur gery. Methods. The first group of subjects received biofeedback and usual physical therapy (BF + UT), while the second group of patients received only usual therapy (UT). All subjects were assessed for perceived pain, PFM strength, quality of life associated with urinary incontinence, and overall quality of life, before and after exposure. Pain intensity and PFM stregth were additionally assessed after 5 and 10 days. Results. After exposure, there was a significant increase in outcome in the BF + UT group – PFM strength, and quality of life associated with urinary incontinence compared to the UT group. Perceived pain and overall quality of life outcomes did not differ between groups (p > 0.05). Conclusion. Usual therapy combined with biofeedback is more effective in in - creasing pelvic floor muscle strength, and quality of life related to urinary inconti - nence, in terms of behavior, than usual therapy alone
Evaluation of the relationship between slow-waves of intracranial pressure, mean arterial pressure and brain tissue oxygen in TBI: a CENTER-TBI exploratory analysis
No full textBrain tissue oxygen (PbtO2) monitoring in traumatic brain injury (TBI) has demonstrated strong associations with global outcome. Additionally, PbtO2 signals have been used to derive indices thought to be associated with cerebrovascular reactivity in TBI. However, their true relationship to slow-wave vasogenic fluctuations associated with cerebral autoregulation remains unclear. The goal of this study was to investigate the relationship between slow-wave fluctuations of intracranial pressure (ICP), mean arterial pressure (MAP) and PbtO2 over time. Using the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) high resolution ICU sub-study cohort, we evaluated those patients with recorded high-frequency digital intra-parenchymal ICP and PbtO2 monitoring data of a minimum of 6 h in duration. Digital physiologic signals were processed for ICP, MAP, and PbtO2 slow-waves using a moving average filter to decimate the high-frequency signal. The first 5 days of recording were analyzed. The relationship between ICP, MAP and PbtO2 slow-waves over time were assessed using autoregressive integrative moving average (ARIMA) and vector autoregressive integrative moving average (VARIMA) modelling, as well as Granger causality testing. A total of 47 patients were included. The ARIMA structure of ICP and MAP were similar in time, where PbtO2 displayed different optimal structure. VARIMA modelling and IRF plots confirmed the strong directional relationship between MAP and ICP, demonstrating an ICP response to MAP impulse. PbtO2 slow-waves, however, failed to demonstrate a definite response to ICP and MAP slow-wave impulses. These results raise questions as to the utility of PbtO2 in the derivation of cerebrovascular reactivity measures in TBI. There is a reproducible relationship between slow-wave fluctuations of ICP and MAP, as demonstrated across various time-series analytic techniques. PbtO2 does not appear to reliably respond in time to slow-wave fluctuations in MAP, as demonstrated on various VARIMA models across all patients. These findings suggest that PbtO2 should not be utilized in the derivation of cerebrovascular reactivity metrics in TBI, as it does not appear to be responsive to changes in MAP in the slow-waves. These findings corroborate previous results regarding PbtO2 based cerebrovascular reactivity indices