[The incidence and diagnostics of congenital heart defects in Kaunas infant population during 1999-2005]. / Igimtu sirdies ydu paplitimas ir diagnostika Kauno vaiku populiacijoje 1999-2005 m.

UNLABELLED: The objective of this study was to determinate the incidence and diagnostics of congenital heart defects in Kaunas infant population in 1999-2005 and to compare the data obtained with the data of years 1995-1998. SUBJECT AND METHODS: The study population comprised all newborns born in Kaunas city during 1999-2005. Congenital heart defects were registered based on clinical diagnosis after its verification using the data from consulting centers and pediatric outpatient departments. To assess the incidence of congenital heart malformations in newborn population, we conducted a validated newborn register based on maternal residential district. Modern epidemiological methods were used for data analysis. RESULTS: In 1999-2005, there were 24 069 live births in Kaunas: 2231 newborns were born with congenital anomalies, 198 had congenital heart malformations. The incidence of congenital heart defects was 8.2 per 1000 live newborns. The majority of congenital heart malformations were diagnosed in delivery units (93.94%). We have analyzed the relationship between birth weight and gestational age of newborns with congenital heart malformations. Newborns with low birth weight were at significantly higher risk of congenital heart malformation than newborns with normal birth weight (OR=3.52, 95% CI, 2.25-5.47). Our data also showed that newborns born before 32 weeks of gestation had a 5-fold increased risk of congenital heart malformation (OR=5.20; 95% CI, 2.50-10.84) and infants born before 37 weeks of gestation had a 4-fold increased risk (OR=4.08; 95% CI, 2.68-6.19) compared with newborns born after 37 weeks of gestation. CONCLUSIONS: This study shows that incidence of congenital heart anomalies in Kaunas newborn population was 8.2 cases per 1000 live newborns in 1999-2005. It was determined that during 1999-2005, the number of above-mentioned anomalies diagnosed in delivery units increased by 23%.

Exposure to urban nitrogen dioxide pollution and the risk of myocardial infarction.

OBJECTIVES: This study attempted to determine whether long-term exposure to nitrogen dioxide (NO2), an indicator of motor vehicle exhaust, increases the risk of myocardial infarction (MI). METHODS: A population-based case-control study was conducted among men aged 25-64 years and residing in Kaunas, Lithuania. The study included all cases of first-time myocardial infarction in 1997-2000. Interviews with patients treated in hospitals elicited information on smoking and other risk factors, including residential histories. A high response rate (77.4%) resulted in 448 cases and 1777 controls. Nitrogen dioxide (NO2) was selected for analysis as an indicator of traffic-related air pollution. The annual air pollution levels were estimated for the residential districts; thereafter the data were linked to the home addresses of the cases and controls. RESULTS: After adjustment for age, education, smoking, blood pressure, body mass index, marital status, and psychological stress, the risk of myocardial infarction was higher for the men exposed to medium [odds ratio (OR) 1.43, 95% confidence interval (95% CI) 1.04-1.96] and high (OR 1.43, 95% CI 1.07-1.92) NO2 levels. The data suggested a stronger association among 55- to 64-year-old men. The risk of myocardial infarction increased by 17% among the 25- to 64-year-old men (OR 1.17, 95% CI 1.01-1.35) and by 34% among those aged 55-64 years (OR 1.34, 95% CI 1.08-1.67) from the first to the third tertile of NO2 exposure. CONCLUSIONS: The results indicate that urban NO2 pollution may increase the risk of myocardial infarction and that vehicle emissions may be of particular importance.

Socioeconomic differences in myocardial infarction risk among 35-64 year old women in Kaunas, Lithuania.

AIM: To investigate the risk of a first myocardial infarction among different occupational categories in 35-64 year old women in Kaunas, Lithuania, a country in a transition market economy. METHODS: We carried out a case-control study among women aged 35-64 who were residents in Kaunas between 1997-2000. We identified first nonfatal myocardial infarction cases (n = 191) from the hospital register (International Classification of Diseases, 10-th revision, code 121). Controls (N = 482) were selected on the basis of age and city district of residence. We obtained information on occupation, smoking, hypertension, psychosocial and behavioral factors. We used the International Standard Classification of Occupations (ISCO) to code for occupational categories and conducted logistic regression analysis to evaluate the relationship between a number of selected risk factors and myocardial infarction risk. RESULTS: We found that legislators, senior officials and managers (1-st ISCO category) had a 2.64-fold increased risk for myocardial infarction and and service, shop and market sales workers (5-th ISCO category) 2-fold increased myocardial infarction risk as compared to technicians and associate professionals (3-rd ISCO category). CONCLUSIONS: Our results on the role of socioeconomic gradient on myocardial infarction risk differ from findings in industrialized countries.

[Social status, psychological stress and myocardial infarction risk among 35-64-year-old women]. / Socialiniu ir psichologiniu veiksniu itaka 35-64 metu moterims susirgti miokardo infarktu.

We examined the association between social status, assessed by education and occupational categories and risk of myocardial infarction. We conducted a case-control study among 35-64 year-old women of Kaunas. Cases were 191 women with first myocardial infarction treated in hospitals in 1997-2000, and controls were 482 women in the same age group, randomly selected, without ischemic heart disease. We used multiple logistic regression to estimate the adjusted odds ratios of developing myocardial infarction in relation to social status and psychological stress. The study results indicated that stress, arterial hypertension, smoking, overweight and low education increased the risk of first myocardial infarction among 35-64 years old women. Managers and service, market sales workers had about twice higher risk for myocardial infarction than associate professionals (OR = 2.64; 95% CI 1.17-6.62 and OR = 2.18; 95% CI 1.03-4.63 correspondingly).