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INTRODUCTION Insomnia became an object of concern in Aristotelian times, when he wrote a monograph on sleep disorders (350 BC). Although community of science and medicine has been interested in sleep disorders for almost 2000 years, however, there are not much information about the prevalence of insomnia, especially among citizens of developing countries. Epidemiological information about prevalence of insomnia and sleep complaints varies in different countries [Roth et.al., 1996], because of diversity of methodology for data collection. According to data of research carried out in the United States of America, Europe and Australia, 10–49% of population are not satisfied with their sleep quality. [Walsh, Ustun, 1999]. According to data of lifestyle research in Lithuania (1996), insomnia was a problem for 22.5% of male (from 20 to 64 years old) and 29.3% of female [Grabauskas, Klumbienė, 1998]. Sleep complaints among Lithuanian citizens have not been researched up to now, although, as foreign scientists maintain, sleep disorder can accelerate development of many somatic as well as mental diseases, besides, after a few sleepless nights, follows irritability, decrease of efficiency, it is difficult to concentrate, considerably increases risk of traffic accidents or accidents at work [Balter, Uhlenhuth, 1992]. Supposedly, there is a connection among heart and vascular diseases, sleep disorders and depression [Mahowald et.al., 1989]. Research that was carried out abroad proved... [to full text]

Good health is a fundamental resource for social and economic development. Non-communicable chronic diseases (NCDs) such as cardiovascular diseases (CVD), cancer, chronic respiratory diseases and diabetes mellitus are reaching epidemic proportions worldwide. Over the last decades NCDs remain the main public health problem in Lithuania also. The leading NCD’s in the Lithuania are CVD and cancer. The key targets of the Health 21 policy for WHO European Region as well as of Lithuanian Health Programme are reduction of morbidity and mortality from CVD, cancer and other NCD’s. The leading strategy to tackle NCDs is control and prevention of risk factors. Common, modifiable risk factors underlie the major NCD’s. Seven risk factors are responsible for the majority of NCD in the European region: high blood pressure, tobacco, alcohol, high cholesterol, being overweight, low intake of fruits and vegetables, and physical inactivity. The lifestyle habits start to develop in childhood. Children and adolescents begin to smoke and use alcohol, adopt unhealthy nutrition habits and sedentary lifestyle. Harmful lifestyle choices lead to children’s overweight, increase of their blood pressure (BP), and metabolic disorders. Many epidemiological studies designed to assess the association between health indices in childhood and adulthood were conducted over the last years. However, the number of longitudinal, cohort studies that would follow people from childhood to middle age and would apply the... [to full text]

Tyrimo tikslas – įvertinti kraujospūdžio kitimo ir su sveikata susijusios gyvenimo kokybės sąsajas tarp vyrų ir moterų, kuriems nustatytas padidėjęs kraujospūdis, dalyvavimo profilaktinėse kraujospūdžio reguliavimo grupėse laikotarpiu. Naudota metodika: Gyvenimo kokybės – 100 klausimynas (WHOQOL-100). Profilaktinėse grupėse dalyvavo 110 terapinės apylinkės pacientų. Visus keturis užsiėmimus lankė atitinkamai 80 pacientų. Pacientai buvo prašomi užpildyti GK-100 klausimyną, siekiant nustatyti kraujospūdžio kitimus užsiėmimų metu ir sąsajas su pacientų gyvenimo kokybės ypatumais. Tiriamieji dalyvavo keturiuose vienos valandos užsiėmimuose, kurie vyko kartą per savaitę vakare. Visoms keturioms pacientų grupėms vedami tie patys užsiėmimai taikant modifikuotą progresyvios raumenų relaksacijos metodą, diskusiją gyvenimo būdo keitimo klausimais ir abiejų šių metodų (raumenų relaksacijos ir diskusijos) derinį. Tyrimo rezultatai parodė, jog moterų ir vyrų grupėse statistiškai reikšmingas kraujo spaudimo sumažėjimas stebimas užsiėmimo pabaigoje. Aukštesni statistiškai reikšmingi arterinio kraujo spaudimo rodikliai susiję su vyresnio amžiaus ir žemesnio išsilavinimo rodikliais vyrų ir moterų grupėse. Aukšti statistiškai reikšmingi arterinio kraujo spaudimo rodikliai susiję su blogesne gyvenimo kokybe, o mažesni - su geresne gyvenimo kokybe. / Purpose of the survey is to assess the relations between blood pressure changes and health-related quality of life in men and women with high blood pressure during the period of blood pressure regulation in preventive groups. Methodology used: The Quality of Life - 100 Questionnaire (WHOQOL-100). Preventive groups involved 110 patients in the therapeutic environs. 80 patients attended all four workshops. Patients were asked to fill in WHOQOL-100 questionnaire to determine the associations with health – related quality of life and blood pressure variations in workshops. Patients participated in four one-hour classes, held once a week in the evening. All four groups of patients were involved in workshops using the modified progressive muscle relaxation method, the discussion on the changing of lifestyle and the combination of both of these methods (progressive muscle relaxation and discussion). The study showed that statistically significant decreased blood pressure was observed in men and women groups at the end of each workshop. Higher statistically significant arterial blood pressure was related to the older age and lower level of education in men and women groups. Higher statistically significant arterial blood pressure was related to poorer health – related quality of life, as lower arterial blood pressure was associated with better health – related quality of life.

Moksliniais tyrimais nustatyta, kad širdies ir kraujagyslių sistemos ligų rizikos veiksniai atsiranda jau vaikystėje. Arterinė hipertenzija – vienas pagrindinių širdies ir kraujagyslių sistemos ligų rizikos veiksnių, neretai pasireiškia jau paauglystėje. Padidėjęs arterinis kraujo spaudimas, ilgainiui pažeidžia organus taikinius: kraujagysles, širdį, smegenis, inkstus, akis. Todėl nepavėluotam gydymui užtikrinti vis aktualesnė tampa ankstyva AH diagnostika, kuri leistų sumažinti ligos progresavimą, pailginti laiką iki komplikacijų pasireiškimo ir užtikrinti geresnę gyvenimo kokybę, nes sveikatos būklė vaikystėje turi įtakos sveikatos būklei suaugus. Pirmą kartą Lietuvoje kompleksiškai įvertinta sveikų ir sergančių pirmine arterine hipertenzija paauglių fizinė ir psichinė sveikata. Nustatėme, jog sergant pirmine arterine hipertenzija paauglystėje prasideda vidinės miego arterijos sienelės ankstyvi struktūriniai ir funkciniai pakitimai, kuriuos sukelia arterinė hipertenzija, rūkymas, alkoholio vartojimas bei uždegiminio proceso aktyvumas. Pirmą kartą vertinta paauglių arterinės hipertenzijos įtaka trombocitų agregacinei funkcijai, degranuliacijos reakcijai bei trombocitų ir monocitų adhezijai. Tyrime nustatyta, jog arterinė hipertenzija bei padidėjusi kūno masė veikia elgesio ir emocijų sutrikimus, gali padidinti širdies ir kraujagyslių ligų riziką. / Hypertension is one of the main causes of cardiovascular disease and the reason of early death in the world. Growing epidemiology data support a correlation between blood pressure at childhood and adolescence with the incidence of hypertension at adulthood. This is the first study in Lithuania presenting complex assessment of physical and mental health of healthy adolescents as well as of those with primary arterial hypertension. We found out that in case of primary arterial hypertension in adolescence development of early structural and functional changes of internal carotid artery takes place; these changes are determined by arterial hypertension, smoking, alcohol consumption and activity of inflammation process. The influence of arterial hypertension of the platelets aggregation function, reaction of degranulation and formation of platelets-monocytes complexes in adolescents was assessed for the first time. It was demonstrated in the study that arterial hypertension and increased body mass has an effect on behavioural and emotion disorders and may increase cardiovascular risk.

Moksliniais tyrimais nustatyta, kad širdies ir kraujagyslių sistemos ligų rizikos veiksniai atsiranda jau vaikystėje. Arterinė hipertenzija – vienas pagrindinių širdies ir kraujagyslių sistemos ligų rizikos veiksnių, neretai pasireiškia jau paauglystėje. Padidėjęs arterinis kraujo spaudimas, ilgainiui pažeidžia organus taikinius: kraujagysles, širdį, smegenis, inkstus, akis. Todėl nepavėluotam gydymui užtikrinti vis aktualesnė tampa ankstyva AH diagnostika, kuri leistų sumažinti ligos progresavimą, pailginti laiką iki komplikacijų pasireiškimo ir užtikrinti geresnę gyvenimo kokybę, nes sveikatos būklė vaikystėje turi įtakos sveikatos būklei suaugus. Pirmą kartą Lietuvoje kompleksiškai įvertinta sveikų ir sergančių pirmine arterine hipertenzija paauglių fizinė ir psichinė sveikata. Nustatėme, jog sergant pirmine arterine hipertenzija paauglystėje prasideda vidinės miego arterijos sienelės ankstyvi struktūriniai ir funkciniai pakitimai, kuriuos sukelia arterinė hipertenzija, rūkymas, alkoholio vartojimas bei uždegiminio proceso aktyvumas. Pirmą kartą vertinta paauglių arterinės hipertenzijos įtaka trombocitų agregacinei funkcijai, degranuliacijos reakcijai bei trombocitų ir monocitų adhezijai. Tyrime nustatyta, jog arterinė hipertenzija bei padidėjusi kūno masė veikia elgesio ir emocijų sutrikimus, gali padidinti širdies ir kraujagyslių ligų riziką. / Hypertension is one of the main causes of cardiovascular disease and the reason of early death in the world. Growing epidemiology data support a correlation between blood pressure at childhood and adolescence with the incidence of hypertension at adulthood. This is the first study in Lithuania presenting complex assessment of physical and mental health of healthy adolescents as well as of those with primary arterial hypertension. We found out that in case of primary arterial hypertension in adolescence development of early structural and functional changes of internal carotid artery takes place; these changes are determined by arterial hypertension, smoking, alcohol consumption and activity of inflammation process. The influence of arterial hypertension of the platelets aggregation function, reaction of degranulation and formation of platelets-monocytes complexes in adolescents was assessed for the first time. It was demonstrated in the study that arterial hypertension and increased body mass has an effect on behavioural and emotion disorders and may increase cardiovascular risk.

Pulmonary arterial hypertension (PAH) is a rare but fatal disease with an annual mortality rate of 15% despite current therapies. Uncontrolled proliferation of pulmonary artery smooth muscle cells (PASMCs) results in adverse vascular remodeling contributing to PAH. Understanding the mechanisms of PASMC proliferation may identify new targets for treatment. Chloride currents/channels (ICl) are expressed in PASMCs and their roles in proliferation have been suggested based on their importance in resting membrane potential and cell volume regulation. The present study explored the role of ICl in proliferation in rat and human PASMCs. We found that either nonspecific ICl inhibitors (DIDS or NPPB) or a putative specific blocker of swelling-activated ICl (ICl,swell) reduced proliferation of PASMCs cultured in serum-containing media. Patch-clamp studies showed that proliferating PASMCs had increased baseline ICl and ICl,swell in association with depolarized membrane potentials. Quantitative real-time RT-PCR studies identified expressions of CLC-3, a candidate gene of ICl,swell, and several other CLC genes in proliferating PASMCs. While selective knockdown of CLC-3 with lentiviral shRNA reduced PASMC proliferation, it had no effect on ICl,swell. These findings are consistent with the conclusion that ICl regulate proliferation of PASMCs and suggest that selective ICl inhibition may be useful in treating pulmonary arterial hypertension.

Pulmonary arterial hypertension (PAH) is a rare but fatal disease with an annual mortality rate of 15% despite current therapies. Uncontrolled proliferation of pulmonary artery smooth muscle cells (PASMCs) results in adverse vascular remodeling contributing to PAH. Understanding the mechanisms of PASMC proliferation may identify new targets for treatment. Chloride currents/channels (ICl) are expressed in PASMCs and their roles in proliferation have been suggested based on their importance in resting membrane potential and cell volume regulation. The present study explored the role of ICl in proliferation in rat and human PASMCs. We found that either nonspecific ICl inhibitors (DIDS or NPPB) or a putative specific blocker of swelling-activated ICl (ICl,swell) reduced proliferation of PASMCs cultured in serum-containing media. Patch-clamp studies showed that proliferating PASMCs had increased baseline ICl and ICl,swell in association with depolarized membrane potentials. Quantitative real-time RT-PCR studies identified expressions of CLC-3, a candidate gene of ICl,swell, and several other CLC genes in proliferating PASMCs. While selective knockdown of CLC-3 with lentiviral shRNA reduced PASMC proliferation, it had no effect on ICl,swell. These findings are consistent with the conclusion that ICl regulate proliferation of PASMCs and suggest that selective ICl inhibition may be useful in treating pulmonary arterial hypertension.

<p>S. 1-96: sammanfattning, s. 97-134: 5 uppsatser</p> / digitalisering@umu

Pulmonary arterial hypertension (PAH) is a lethal disease, characterized by functional or structural abnormalities involving distal pulmonary arterioles that result in increased pulmonary vascular resistance (PVR) and ultimately right heart failure. Our objective is to establish a conditional transgenic system in mice, to test the hypothesis that lung EC apoptosis at the level of distal pulmonary arterioles is necessary and sufficient to cause a PAH phenotype. In a pilot study, the Fas-Induced Apoptosis (FIA) construct was expressed under the control of endothelial-specific Tie2 promoter in transgenic mice (i.e. EFIA mice). Administration of a small molecule dimerizing agent, AP20187, resulted in lung modest dose-dependent PAH, which was associated with proliferative vascular lesions localized to distal lung arterioles in a small proportion of mice. Due to the low level of transgene expression in preliminary EFIA lines, we re-designed the transgenic vector by incorporating a more robust endothelial promoter (superTie2). The new construct was transfected into HUVEC and BAEC and analyzed by monitoring immunofluorescence (DsRed). Data from the EFIA model suggests that EC apoptosis may be sufficient to induce a PAH phenotype with the characteristic lung vascular lesions. The EFIA model will allow us to better explore the mechanism that links distal lung EC apoptosis with reactive vascular cell proliferation in the pathogenesis of this devastating disease.