BONJOUR L'ESTONIE

Doctor's malpractice conviction appeal to be heard by Supreme Court

The Supreme Court decided to hear the case of Pärnu Hospital doctor Carmen Heinväli, who was convicted of criminal negligence after a baby was born with a permanent disability due to labor complications.

Heinväli's attorney, Raul Palmaru, says he wants the conviction overturned because, he argues, there was a lack of elements required to constitute criminal negligence.

In June, the Tallinn Circuit Court upheld the Pärnu County Court's verdict. Heinväli was sentenced to an eight-month suspended sentence with three years probation and was ordered to pay the equivalent of 1,500 euros.

The Pärnu County Court rejected the victim's counsel's bid for more than 60,000 euros in damages, and did not strip Heinväli of her doctor's license.

Heinväli was an on-duty physician in the case in question in early 2007. She was accused of failing to correctly evaluate the course of a patient's labor, as a result of which the health of both the mother and the newborn was severely harmed.

Heinväli maintains her innocence. The Supreme Court has yet to set a date for the first hearing.

Estonia takes action on record-level AIDS rate

TALLINN — Estonia has the highest percentage of HIV/AIDS infection in the European Union, and the increasing number of cases is forcing the cash-strapped government to spend more on expensive medication.

Estonian government announced Thursday that it is dedicating 12.9 million krooni (€824,458) from its reserve funds to the Ministry of Social Affairs to purchase HIV/AIDS medications. The number of patients is estimated to increase by at least 200 people over the remainder of the year.

“If there were nearly 200 infected during the first half of the year then during the second half … another 200 infected might be found,” Nelli Kalikova, deputy director of the AIDS Prevention Center said.

The Ministry of Social Affairs currently has 67.1 million krooni (€4.3 million) in funding to treat 1,758 patients. However, according to Global Health Facts organization, in 2007-2008 Estonia had 9,900 people living with HIV/AIDS and the number is growing each year. According to Estonian Health Board, already 201 infected people were discovered this year. More than 7,000 new cases were found since the HIV/AIDS epidemic began in August 2000.

Estonia ranks second in Europe in terms of use of opiates

The latest World Drugs Report indicated that Estonia ranks second in Europe in terms of use of opiates, writes LETA/National Broadcasting.

According to the report, Estonia follows closely Scotland – 1.5% of the adult population here use opium-based drugs, including heroin. Consumption of cannabis is also growing – this is used by six per cent of the adult population.

Indrek Kalikov, syringe replacement project manager of the Aids Support Centre, noted that experts have remarked an increase in drugs consumption among Estonian-speaking population in particular.

While the international anti-drugs day was celebrated across the world with a number of events on Saturday, Estonia did not pay any attention to this day.

Juhan Tere

Use of evidence-based pharmacotherapy after myocardial infarction in Estonia

Mortality from cardiovascular disease in Estonia is among the highest in Europe. The reasons for this have not been clearly explained.

Also, there are no studies available examining outpatient drug utilization patterns in patients who suffered from acute myocardial infarction (AMI) in Estonia. The objective of the present study was to examine drug utilization in different age and gender groups following AMI in Estonia.

Methods: Patients admitted to hospital with AMI (ICD code I21-I22) during the period of 01.01.2004-31.12.2005 and who survived more than 30 days were followed 365 days from the index episode.

Data about reimbursed prescriptions of beta-blockers (BBs), angiotensin converting enzyme inhibitors/angiotensin II receptor blockers (ACE/ARBs) and statins for these patients was obtained from the database of the Estonian Health Insurance Fund. Data were mainly analysed using frequency tables and, where appropriate, the Pearson's chi2 test, the Mann-Whitney U-test and the t-test were used.

A logistic regression method was used to investigate the relationship between drug allocation and age and gender. We presented drug utilization data as defined daily dosages (DDD) per life day in four age groups and described proportions of different combinations used in men and women.

Physical activity of Estonian family doctors and their counselling for a healthy lifestyle

Physical activity offers major health benefits and counselling for it should be integrated into the medical consultation. Based on the literature, the personal health behaviour of the physician (including physical activity) is associated with his/her approach to counselling patients.

Our hypothesis is that family doctors (FD) in Estonia are physically active and their recommendation to counsel patients with chronic diseases to use physical activity is high. The study was also interested in how FDs value physical activity among other important determinants of a healthy lifestyle, e.g. nutrition, non-consumption of alcohol, and non-smoking.

Methods: Physicians on the electronic list were contacted by e-mail and sent a questionnaire. The first part assessed physical activity by the International Physical Activity Questionnaire (IPAQ) short form.

Self-reported physical activity during one week was calculated as total physical activity in minutes per week (MET min/week). The second part of the questionnaire included questions about the counselling of patients with chronic disease concerning their physical activity and a healthy lifestyle.

The study focused on female FDs because 95% of the FDs in Estonia are women and to avoid bias related to gender.

Overview of the National Electronic Health Record System developed by Estonia

The development of the Estonian eHealth Record System has been progressing steadily since its launch in December 2008. It will continue gradually until 2013.

The idea of an Electronic Health Record (EHR) System for Estonia emerged in 2002. The purpose was to develop a nation-wide framework (database) to facilitate the exchange of digital medical documents and of health information. These were only available in local databases and information systems which were not able to communicate with each other.

In 2005, the Estonian Ministry of Social Affairs launched a new eHealth concept by phasing in four projects, namely: 'Electronic health records', 'Digital images', 'Digital Registration' and 'Digital Prescription'. The result of their implementation is the integrated Electronic Health Record System which was launched on 17 December 2008. 

In March 2010, the EHR System contained over 1 million medical documents, including: discharge letters (inpatients and outpatients), referrals, links to digital images and electronic prescriptions (since 1 January 2010).

The Health Services Organisation Act and Associated Acts Amendment Act of 20 December 2007 established an obligation for healthcare providers to forward their patients' medical data to the EHR system as from 1 September 2008. The rules for the use of this data state that only the patient's attending physician or a medical assistant has the right to make enquiries about the patient's data. Conducting such enquiries outside of a treatment process is not allowed.

Scientists say recession may spark Baltic TB surge

The Baltic States risk seeing an upsurge in tuberculosis (TB) cases because of the recession brought about by the financial crisis, scientists said on Wednesday, and Latvia is particularly vulnerable.

Researchers who studied the effects of recession on rates of the highly infectious disease during the fall of the Soviet Union in the early 1990s found a strong link between the two and said their findings suggest a similar pattern could emerge now.

"Put simply, there's a lot less money around for spending on public health," said Nimalan Arinaminpathy of Britain's Oxford University, who led the study.

Tuberculosis, which is caused by the Mycobacterium tuberculosis bacteria, is one of three primary diseases linked to poverty, the other two being AIDS and malaria.

The scientists designed models based on economic figures and tuberculosis data and predicted that Latvia, Estonia and Lithuania could see TB increases in the coming years.

Their estimates were for 200 excess cases of tuberculosis per 100,000 people in the population in Latvia, 130 per 100,000 in Lithuania and 75 per 100,000 in Estonia compared with some 40 per 100,000 in Russia over the period of recession and recovery.

Emerging World Pharma Inc. continues its investment into generic drug manufacturing in developing countries

MANASSAS - Emerging World Pharma Inc., an investor in generic based pharmaceutical companies manufacturing within developing nations, has provided an initial investment into European Global Pharma that will be used to fund a generic drug manufacturing facility in Estonia.

The investment would entitle Emerging World Pharma to an initial 10% of profits obtained from the marketing and distribution of generic pharmaceuticals sold. The company retains an option to increase the percentage of profit on additional investments of up to 25%.

www.emergingpharma.com

93 new HIV cases have been registered in Estonia in 2010

93 new HIV cases have been registered in Estonia in 2010 (January-March), LETA/Delfi reports. 23 of the new cases were prison inmates.

In January, 33 new cases were registered, in February 31 and in March so far 29 cases.

Over the years, 7,413 cases of HIV have been registered in Estonia and 291 cases of AIDS.

Estonia donates excess new flu vaccine to World Health Organisation

The Estonian Social Ministry is considering whether to return the excess new flu vaccine to producers or donate to the World Health Organisation (WHO) for countries who need help, LETA/Postimees writes.

Since a new seasonal flu vaccine would be developed for the next winter, and that might include the new flu component, the majority of vaccine bought by Estonia will most likely remain unused.

Social Ministry people’s health department adviser Martin Kadai said that they intend to discuss with vaccine producers what the chances are of returning the excess vaccine to them. He didn’t want to comment in more detail since meetings haven’t yet taken place. Also a proposal will be made to donate the excess vaccine to WHO.

WHO’s representative in Estonia Jarno Habicht said that coordinating humanitarian aid is one of the tasks of WHO. The organisation will try to take the vaccine to many states so that it would be justly available.

“There are talks under way at present with a bit more than ten states who are making or considering making a donation of new flu vaccine to WHO,” said Habicht. Estonia hasn’t yet submitted an official proposal.

Estonia bought in December and January last year 250,000 dosages of new flu vaccine. According to Health Board data, less than 50,000 vaccinations had been carried out by the end of February. It will become clear in April how much vaccine will be unused as then healthcare staff submits the final vaccine expense reports.

World Health Organization : financing Estonian healthcare sector needs changes

In a joint report compiled by the Health Insurance Fund, the Ministry of Social Affairs and by the World Health Organization (WHO), the conclusions note that the current system for financing the Estonian health care sector is not viable in a long-term perspective and needs changes in tax system in order to achieve sustainability, Estonian daily newspapers write.

Among the major changes proposed by WHO in the reports “Possibilities of guaranteeing sustainability of financing of the Estonian healthcare system” are the recommendations for the state to start paying medical insurance for pensioners as well as collecting social tax on dividend revenue, informs LETA.

As of now, Estonia is among the few European countries where the medical insurance system relies on the contribution of the working population alone and hence approximately 50% of the residents have to earn the funds that pay for services that are used by 95% of the population while 5% has no medical insurance.

Estonian Pharmaceutical Market To Increase By CAGR Of 5.56%

New report provides detailed analysis of the Healthcare and Medical market.

In our regional Business Environment Ratings (BER) matrix for Q210, Estonia is ranked 12th of the 20 key markets within Emerging Europe, up from 14th in the previous quarter. The improvement is a reflection of the country embarking upon a gradual economic recovery, although some risks have emerged in recent months.

These include the announced introduction of a new reference pricing system for reimbursement purposes, which will be based on active ingredients and route of administration, and speedier approval times for parallel imports. If the new regulations are implemented in a timely fashion - they are scheduled for April 2010 - we will update our forecasts accordingly.

Currently, we expect the Estonian pharmaceutical market to increase by a modest compound annual growth rate (CAGR) of 5.56% in local currency terms, rising from EEK3.52bn (US$315mn) in 2009 to EEK4.62bn (US$372mn) in 2014.

The national healthcare insurance body will continue to focus on costcontainment, both through direct budgetary reductions and the shifting of financial responsibility for medical services onto the patient (such as the recent increase in fees for hospital stays). Additionally, the increase of market values as measured in US dollars is under threat from the expected weakening of the Estonian kroon.

First batch of swine flu vaccine arrives in Estonia

The first 50,000 dosages of so-called swine flu vaccine arrived in Estonia.

According to ERR, the vaccine was sent to Estonia from Austia in a refrigerated truck since the vaccine must be kept between 2 and 8 degrees Celsius all the time.

Aare Järvelaid, CEO of Oriola that will store the vaccine, confirmed that the shipment has arrived and will be sent to county centres tomorrow. The company has also checked the trucks temperature logs to be sure that vaccine has been kept in requested temperature range.

"We have already ordered vehicles and cold boxes that will be used to transport vaccine into county centres," said Järvelaid.

The ministry of social affairs said that it expects the first people in the risk groups to be vaccinated this week.

Another 100,000 dosages of vaccine should arrive in Estonia by the end of December and another 40,000 dosages in January and February.

Five people who were diagnosed of swine flu have died in Estonia.

Toomas Hõbemägi

Vaccinations against A/H1N1 flu administered free of charge for risk groups

The Government decided that people in risk groups would get vaccinations against the A/H1N1 flu free of charge. According to Minister of Social Affairs Hanno Pevkur, the vaccine should arrive in Estonia by 15 December at the latest, and it is planned to start vaccinations immediately thereafter. In Estonia, vaccinations will be voluntary.

I am most pleased that the Government considered it necessary to provide protection to all those in risk groups, regardless of the financial means of the person, said Minister of Social Affairs Pevkur. Vaccinations against the A/H1N1 flu will be administered primarily by family physicians, based on their practice lists. Vaccinations for expectant women will be administered by women´s health centres, and by other healthcare institutions for pregnant women registered with them. Vaccinations for healthcare professionals will be carried out by a specific order of the healthcare provider.

Have a look inside your body

By Ella Karapetyan

TALLINN - Our bodies are our most important possession. They are intricately developed machines; more complex and wondrous than all the computers and gadgetry we surround ourselves with today. Yet, many of us do not know what makes us tick - how we function, what we need to survive, what destroys us, what revives us.
For nearly 35,000 years, since the first known depiction of the human form, we have been fascinated by our own bodies. Through the ages artists have sought to represent the body through sculptures, paintings, prints and sketches. The “Bodies Revealed” exhibition  now presents the real thing!

From Nov. 13 to Feb. 28, Tallinn is hosting the world-known international exhibition called “Bodies Revealed,” which is a phenomenal exhibition about the amazing and complex machine we call the human body. This is an opportunity for those that don’t understand the science behind a lot of the exhibits to learn about the body.
Tallinn’s Solaris Center welcomes all its visitors and guests to take part in this exhibition, organized by Dr. Roy Glover, a former anatomy professor at the University of Michigan, and Premier Exhibition, Inc. The exhibition features real human bodies and organs that have been donated to medical science.

HIV experts voice concerns on World Aids Day

A H1N1 Influenza

The Estonian Health Protection Inspectorate has created a telephone hotline for questions about the novel influenza A/H1N1 (human swine influenza).

The hours of operation for the phone line with number 510 2270 are Monday through Friday from 8.00 to 17.00. The standard per-minute rate as specified in the service package is applicable. During evening and weekend hours you can call the family physician hotline at 1220.

Russia + Estonia strengthen drug fighting cooperation

Russia and Estonia agreed on Wednesday to strengthen joint efforts to fight drug trafficking.

Extra provisions to a 2006 agreement were signed in the Estonian capital of Tallinn by the head of the Russian Federal Drug Control Service, Viktor Ivanov, and Estonian Interior Minister Marko Pomerantz.

Pomerantz said the signing underlined that "both Estonia and Russia continue to consider the battle against drug crime very important, and that both countries are ready to develop cooperation."

Ivanov said Russian-Estonian cooperation in battling drug crime was effective.

"Many cases have been investigated and drug dealers have been detained, both in the framework of bilateral cooperation and cooperation with Scandinavian countries," he said.

A 13-year-old child in Estonia died of swine flu

A boy from the Harju County died from the virus H1N1 on the night before Monday, writes EPL Online/LETA.

The child got ill last Friday and he developed a high fever, reported the Ministry of Social Affairs. An ambulance was called on Saturday and the 13-year-old patient was administered fever-reducing medicine, but next morning he had to be hospitalised due to his bad state of health.

The Ministry of Social Affairs announced that the circumstances of the case are being specified; among other things the ministry is trying to determine whether the child had any other illnesses besides the swine flu.

As of last Friday – November 20 –, 269 cases of flu A(H1N1) have been confirmed in Estonia. The Ministry of Social Affairs stated that there is no cause to declare Estonia an area of epidemic.

Estonian doctor denies aid to Russian patients

TALLINN - A doctor in ex-Soviet Estonia's capital Tallinn denied medical help to two Russian patients because they could not speak Estonian, Estonian television reported on Saturday.

A patient named Dmitry came to see a surgeon in a Tallinn hospital over a jaw injury on Friday, but the doctor demanded he speak Estonian and refused to examine him otherwise.

Dmitry's friend, Yekaterina, who spoke Estonian, wanted to help, but the doctor called both of them "swine" and said they should see a "psychiatrist" instead.

At the hospital's registration desk, the young people met with another Russian-speaking patient of that doctor who told them a similar story.

The patients said they would go to court if the hospital does not punish the doctor.

In televised comments, the Baltic state's social affairs minister, Hanno Pevkur, said medical aid should not be mixed up with a language exam and pledged to discuss the incidents with hospital officials.

This is not the first medical scandal involving Russian speakers in Estonia, where a doctor has been fired from a hospital for chucking the passport of a Russian patient into the dustbin because the teenager couldn't speak Estonian. The story received a lot of media attention.

The Baltic state pursues a rather controversial language policy that leads to tensions with a substantial Russian minority, most of who have lived in the republic since it was part of the Soviet Union.