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Biomedical subjects

B Grab

Publications and source records attributed to B Grab.

At least 19 recordsLinked to original sources
PubMed1989

[Health survey in the elderly using home interviews: study of various indicators].

Questions asked on the occasion of health survey at home usually refer to frequency of medical consultations and prescribed drugs, but often also to reported somatic symptoms and self-evaluated general health status. Interview data collected in a population of aged widows and widowers revealed a high degree of concordance between these various health indicators, justifying in particular the value assigned to the subjective appreciation of the level of general health.

Aged↗
PubMed1988

High density lipoprotein (HDL) subfractions in cardiovascular patients with low levels of HDL-cholesterol. Influence of hypertriglyceridaemia on subfraction concentration and composition.

The major high density lipoprotein (HDL) subfractions were examined in angiographically defined cardiovascular patients with low HDL-cholesterol (HDL-C) levels. The aims were to study subfraction concentration and composition, and the extent to which hypertriglyceridaemia (HTG) modified these variables. Normotriglyceridaemic (NTG)-low HDL-C patients showed similar subfraction composition to age-matched healthy controls. However, these groups showed notable differences in subfraction composition compared to HTG-low HDL-C patients, particularly with regard to the HDL2 subfraction. HDL subfraction mass was significantly reduced in both cardiovascular groups; the HTG group showed a greater reduction in HDL2, whilst the NTG group showed a greater reduction in HDL3. The major HDL apoprotein (apo A-I) was lower in both subfractions of the cardiovascular patients. Apo A-II showed significant reductions only in the HTG patients.

Apolipoprotein A-I↗
PubMed1988

The transmission potential of monkeypox virus in human populations.

Data on monkeypox in Zaire over the five years 1980-1984 are analysed to assess the protection imparted by past smallpox vaccination and the transmission potential of the virus in unvaccinated communities. Attack rates in individuals with and without vaccination scars indicated that smallpox vaccination (discontinued in 1980) imparted approximately 85% protection against monkeypox. It is predicted that monkeypox virus will continue to be introduced into human communities from animal sources, and that the average magnitude and duration of monkeypox epidemics will increase as vaccine-derived protection declines in the population. On the other hand, current evidence indicates that the virus is appreciably less transmissible than was smallpox, and that it will not persist in human communities, even in the total absence of vaccination. The findings thus support the recommendation of the Global Commission for the Certification of Smallpox Eradication to cease routine smallpox vaccination in monkeypox endemic areas, but to encourage continued epidemiological surveillance.

Democratic Republic of the Congo↗
PubMed1988

Human monkeypox: disease pattern, incidence and attack rates in a rural area of northern Zaire.

Human monkeypox is a zoonosis that occurs sporadically in the tropical rainforest of western and central Africa. This article presents the results of epidemiological features of 91 monkeypox patients reported in Bumba zone in northern Zaire during the period 1981 to 1985. Their age ranged from 7 months to 29 years (93% below 15 years of age). 11% of patients had visible smallpox vaccination scars. Deaths occurred sporadically; the overall case-fatality rate was 9%. 91 patients arose in 61 separate outbreaks; 42 of them consisted of only a single case. The source of infection was suspected to be animal for 70 cases, and human for the remaining 21 cases. The illness occurred in all months of the year. There was a considerable clustering of cases in the northern part of the zone. The average annual incidence rate in the observed zone was 0.63 cases per 10,000 population with marked differences in age, time and place. The average annual primary attack rate among unvaccinated individuals (1.7/10,000) sharply contrasted with those vaccinated (0.04/10,000). The secondary attack rate for contacts without vaccination scar (4.3%) differed significantly from those who had been vaccinated in past (0.7%). Many unvaccinated contacts living under conditions of maximal exposure to index cases escaped not only the disease but also infection. The low incidence rate of human monkeypox indicates its limited public health importance even in a well-known enzootic area.

Adolescent↗
PubMed1988

Clinico-epidemiological features of monkeypox patients with an animal or human source of infection.

Clinical and laboratory examinations were carried out on a total of 338 monkeypox patients in Zaire from 1981 to 1986. An animal source of infection was suspected in 245 (72%) and interhuman transmission for the remaining 93 patients. Among those whose infection was presumably acquired from an animal source, the most affected groups were children aged 3-4 years (27%) and 5-6 years (20%), while only 4% of cases were over 15 years old; there was a considerable preponderance of males (58%) over females (42%), especially in the age group 5-14 years. Among those presumably infected by person-to-person transmission, the age distribution was more uniform, adult patients tending to be relatively more common, and there were more females (57%) than males (43%).Based on comparisons of the frequency and intensity of clinical signs and symptoms among patients infected from an animal source and those who were infected by another patient, there was no evidence that the disease becomes more severe and the transmitted virus more virulent or more easily transmissible from person to person after one or more passages through human hosts.

Adolescent↗
PubMed1988

Human monkeypox: secondary attack rates.

Data on human monkeypox collected in Zaire during the six years 1981-86 were analysed to assess the extent of interhuman transmission of monkeypox virus. Among the 2278 persons who had close contact with 245 monkeypox patients infected from an animal source, 93 fell ill and were presumed to have been infected from the known human source: 69 of these were spread in the first generation, 19 in the second generation, and the remaining five cases in the third and fourth generation.The secondary attack rates were correlated with the age, sex, place of residence, and vaccination status of the contacts. There was an overall 3% probability of becoming ill following infection from a known human source. The affected household was the main focal point for interhuman transmission of monkeypox virus. The highest attack rate (11.7%) occurred among unvaccinated household contacts in the age group 0-4 years. However, the majority of susceptible persons who had been close to patients in the confined space of poorly ventilated huts failed to develop illness. There was no evidence of an increase in the secondary attack rate between 1970-80 and 1981-86.The inefficient spread from person to person, even in conditions of maximum exposure, supports the concept that monkeypox virus is poorly adapted for sustained transmission between humans and that such transmission does not pose a significant health problem.

Adolescent↗
PubMed1988

Human monkeypox: confusion with chickenpox.

Human monkeypox is a zoonosis occurring sporadically in the tropical rain forest of western and central Africa. The exact incidence and geographical distribution are unknown, since many cases are not recognized. Special surveillance was established in three regions in Zaire in 1981 that led to a substantial increase in reported cases. The question arose as to the possibility that clinical diagnostic errors cause some cases of monkeypox to be misdiagnosed as other eruptive diseases. This paper presents the results of a study assessing the extent of and reasons for these clinical diagnostic errors in areas where health staff as well as the general public are aware of human monkeypox. In Zaire in the period 1981-1986, 977 persons with skin eruption not clinically diagnosed as human monkeypox were laboratory tested. 3.3% of human monkeypox cases were found among 730 patients diagnosed as cases of chickenpox, 7.3% among cases diagnosed as "atypical chickenpox" and 6.1% among cases with skin rash for which clinical diagnosis could not be established. The diagnostic difficulties were mainly based on clinical features characteristic of chickenpox: regional pleomorphism (in 46% of misdiagnosed cases), indefinite body-distribution of skin eruptions (49%), and centripetal distribution of skin lesions (17%). Lymph-node enlargement was observed in 76% of misdiagnosed patients. In the absence of smallpox, the main clinical diagnostic problem is the differentiation of human monkeypox from chickenpox. The presence of lymphadenopathy, pre-eruptive fever and slower maturation of skin lesions are the most important clinical signs supporting correct diagnosis of monkeypox.

Adolescent↗
PubMed1987

[Apoprotein E (apo E) phenotype and serum lipids in diabetics].

Apo E isoforms have been determined among diabetics. The allele distribution epsilon 2, epsilon 3 and epsilon 4 does not differ from the control population. Diabetics with epsilon 2 allele have increased serum triglycerides compared to diabetics with epsilon 3 and epsilon 4 alleles. In diabetics with E2/2 phenotype both serum cholesterol and serum triglycerides are elevated. The phenotype of apoprotein E does influence serum lipids in diabetics.

Alleles↗
PubMed1987

Stochastic model for interhuman spread of monkeypox.

With the eradication of smallpox, systematic routine vaccination with vaccinia has ceased and an increasing proportion of the human population in tropical rain forest areas of central and western Africa lacks vaccinia-derived immunity to monkeypox virus. This raises the question of the ability of monkeypox virus to establish and maintain itself in an unvaccinated population through continuous man-to-man transmission. A computerized stochastic model of Monte Carlo type was constructed to assess this potential risk. Simulated series were repeated 100 times to obtain distributions of predicted outcomes for decreasing levels of vaccination coverage (70 per cent, 50 per cent, and 0 per cent). The results revealed a substantial increase in new secondary cases in the total absence of vaccinia-induced immunity. Nevertheless, none of the simulated series did lead to an "explosive" epidemic. The model clearly indicated diminishing numbers of cases in successive generations and eventual cessation of transmission. Therefore, it appears highly improbable that the virus could maintain itself permanently in communities by interhuman transmission. After the eradication of smallpox, human monkeypox constitutes the most important orthopoxvirus infection in man, but analysis of information collected up to this time suggests that it does not represent currently a serious public health problem or a challenge to the achieved eradication of smallpox.

Adolescent↗
PubMed1986

HDL cholesterol levels in patients with myocardial infarction and their families.

The present study using a quartile distribution of myocardial infarction patients demonstrated that the first-degree relatives of the myocardial infarction patients with the lowest HDL cholesterol have similarly the lowest HDL cholesterol. Low HDL cholesterol among these relatives was not secondary to increased VLDL triglycerides, as it persisted when subjects with hyper VLDL triglycerides were excluded. Familial low HDL cholesterol could not be attributed to known environmental factors as their levels did not differ significantly between the groups compaired. There was a significant correlation between HDL cholesterol levels of the parents and that of their younger offspring. The correlation was not significant with the offspring aged 20 and over. It appeared that there was a familial trend in low HDL cholesterol levels, more apparent among the young offspring than among the adult offspring, who may possibly not share any more the parental environment for factors liable to influence HDL cholesterol. This finding is compatible with a hereditary trait.

Adult↗
PubMed1986

Apoprotein D in a healthy, male population and in male myocardial infarction patients and their male, first-degree relatives.

This report examines the correlation of serum apoprotein D with other lipoprotein lipids and apoproteins in a healthy, male population and compares the levels of high density lipoprotein apoprotein D of this control population with 2 samples composed of male, acute myocardial infarction patients and their healthy, male, first-degree relatives. Highly significant correlations were observed with very low density lipoprotein lipids (negative), high density lipoprotein lipids (positive) and serum triglycerides (negative). Serum and low density lipoprotein apoprotein B was not correlated with serum apoprotein D, whereas apoprotein A-I from serum and high density lipoproteins was strongly correlated with apoprotein D. A significant reduction in high density lipoprotein apoprotein D was observed in male, myocardial infarction patients. Their male, first-degree relatives also had lower apoprotein D levels, but the difference was not significant.

Adult↗
PubMed1978

[Role of epidemiological models in surveillance of communicable diseases (author's transl)].

The interpretation of basic information obtained through surveillance of communicable diseases requires knowledge of the expected trend of the epidemiological phenomena under observation. The more precise the epidemiological forecasts are, the more efficient the methods of surveillance will be. With a few examples the author describes briefly the role of epidemiological models to produce reliable previsions, the principles ruling their construction, their use on computer to simulate known epidemiological situations as well as the impact of interventions on the disease dynamics. Mention is also made of the model contribution to the cost-benefit and cost-effectiveness analyses of control programmes subjected to epidemiological surveillance.

Communicable Disease Control↗