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At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

[The spread of HIV/AIDS in Ukraine].

BACKGROUND: In the end-year report 2004 of the European Centre for the Epidemiological Monitoring of AIDS (EuroHIV), the number of newly diagnosed HIV infections in Ukraine ranks second in the WHO European Region after the Russian Federation. METHODS: An analysis of the HIV/AIDS reports from the official epidemiological register of the Ukrainian Centre for AIDS Prevention between 1987 and 2005 was undertaken. In addition, reports from the seroepidemiological monitoring were utilised. RESULTS: According to the Ukrainian Ministry of Health, the cumulative number of reported HIV infections by the end of 2005 amounts to more than 88,900 cases with 13,786 new reports in 2005. The number of newly-registered AIDS cases rose from 45 in 1995 to 4220 in 2005. However, because of many unreported HIV diagnoses, the actual numbers are presumed to exceed the official reports considerably. Most of the infections are associated with injection drug abuse. The second most important route of transmission is sexual contact, also due to an increase in commercial sex. Vertical transmissions from infected mothers to their children rank third. CONCLUSION: HIV was not a significant problem in the Ukraine before 1995. Since 1995 there has been a considerable increase in the number of newly registered HIV cases. At the beginning of the epidemic, HIV was mainly transmitted through sexual contacts in the Ukraine. Since 1995 infected drug users have been the main source of infection in the spread of the epidemic. Unless effective preventive measures are taken, and unless there is more investment in development projects, the HIV/AIDS epidemic in Ukraine could also affect the health system in neighbouring European countries.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Changes in the scope of care provided by primary care physicians.

BACKGROUND: Strategies to control medical costs and improve the quality of care often translate into decisions affecting the range of services primary care physicians provide to patients, which patients are referred for specialty care, and the points in disease processes at which referrals are made. This study focused on physicians' assessments of changes in the scope of care provided by primary care physicians and their assessments of the appropriateness of the scope of the care that primary care physicians are expected to provide. METHODS: We analyzed data from the 1996-1997 Community Tracking Study Physician Survey. Telephone interviews were conducted with 12,385 physicians (reflecting a response rate of 65 percent) who were drawn from a representative random sample of physicians providing direct patient care in the continental United States and not employed by the federal government. The analysis was based on responses from the 7015 primary care physicians and 5092 specialists who had been in practice for at least two years. RESULTS: Thirty percent of the primary care physicians and 50 percent of the specialists reported that the scope of care provided by primary care physicians had increased during the previous two years. Twenty-four percent of the primary care physicians and 38 percent of the specialists reported that the scope of care expected to be provided by primary care physicians was greater than it should be. According to multivariate analysis, primary care physicians other than general or family practitioners (i.e., pediatricians and general internists), those who were in one- or two-physician practices, those who received revenues from capitation, and those who served as gatekeepers for their patients' care were significantly more likely to report that the scope of care they were expected to provide was greater than it should be. CONCLUSIONS: The finding that nearly one in four primary care physicians reported that the scope of care they were expected to provide was greater than it should be arouses concern about the potential impact of changes in the delivery of health care. The associations we found between financial and administrative aspects of managed care and physicians' concern about the scope of care they provide to their patients deserve careful consideration.

Data Collection↗
PubMed2006

HIV epidemiology in the Northwestern Federal District of Russia: dominance of HIV type 1 subtype A.

A rapidly advancing epidemic of HIV-1 infection has been documented among injecting drug users (IDUs) in Russia. The Northwestern Federal District was the first of the seven Russian Federal Districts involved in a drug-related HIV epidemic through an outbreak in Kaliningrad in 1996. The Northwestern Federal District has a high HIV prevalence rate having reached 252 per 100,000 by the end of 2003, exceeding the Russian average (180) by 1.4 times. The epidemic peaked in 2001. Since then the annual number of new cases has decreased, probably reflecting saturation among at least some IDU populations. However, at the same time, the heterosexual spread of HIV has become more prominent. To study the genetic epidemiology of HIV-1, samples were collected from 150 individuals covering a wide geographical area and different transmission groups in the Northwestern Federal District. Phylogenetic analysis revealed that an Eastern European subtype A HIV-1 strain similar to those reported earlier among IDUs in other regions of Russia accounted for 80% of HIV-1 infections and was the predominant subtype in six out of seven administrative territories studied both among IDUs and heterosexually infected persons. As an exception to the dominant role of the Eastern European subtype A strain, the CRF03-AB strain was found to be dominant in the city of Cherepovets located in the north central European Russian territory of Vologda Oblast. This is the first report of the CRF03-AB strain causing an outbreak outside the Kaliningrad region.

Disease Outbreaks↗
PubMed2001

The Brazilian investment in science and technology.

An analysis of Brazilian federal expenditures in science and technology is presented is this study. The 1990-1999 data were compiled from records provided by two federal agencies (MCT and CNPq) responsible for managing most of the national budget related to these activities. The results indicate that the federal investments in Brazilian science and technology stagnated during the last decade (US$ 2.32 billion in 1990, US$ 2.39 billion in 1996, and US$ 2.36 billion in 1999). In contrast, a great increase in private investments in research was acknowledged both by industry and by the government during the same period, from US$ 2.12 to US$ 4.64 billion. However, this investment did not result in an increase in invention patents granted to residents (492 in 1990 and only 232 in 1997) or in a reduction of patent costs. Despite this unfavorable scenario, the number of graduate programs in the country has increased two-fold in the last decade and the contribution of Brazilians to the database of the Institute for Scientific Information has increased 4.7-fold from 1990 (2,725 scientific publications) to 2000 (12,686 scientific publications). Unstable federal resources for science, together with the poor returns of private resources in terms of developing new technologies, may jeopardize the future of Brazilian technological development.

Brazil↗
PubMed2004

Will the Supreme Court finally eliminate ERISA preemption?

David Trueman's article reviews the history of ERISA preemption by analyzing seminal Supreme Court cases and predicts the future of ERISA preemption in his analysis of recent federal case law. Traditionally, the ability to hold a managed care entity responsible for its actions has been hampered by a strict interpretation of the preemption clauses of ERISA but as the Supreme Court's jurisprudence has evolved and loosened, several federal courts have allowed suits against managed care companies to go forward. Conflict among the federal circuits has arisen and the Supreme Court has granted certiorari to two cases from Texas in order to clarify ERISA preemption. Mr. Trueman discusses the future of ERISA preemption in light of these decisions.

Employee Retirement Income Security Act↗
PubMedDate not supplied

[Factors associated with initiation, continued use, and psychoactive substance abuse among Mexican adolescents].

This article describes the results from a drug use survey conducted among high school students of the Federal District. The analysis suggested that being male and attending the last three years of high-school, differentiated significantly users from non users. These two variables, along with an older age, differentiated students that had used one substance from those that had used more than one. These variables had no effect on the decision of stopping the use after experimenting or continuing the use of substances. Significant variables were also perception of availability, having friends, parents or brothers that use substances, or to knowing drug users; peer approval and low perception of risk. Depression symptoms differentiated only users from non users but suicidal tendency grew with use; receiving information from friends influenced the decision of experimenting and of using more than one substance. Finally, the more severe patterns were related to the perception that there are no consequences for drug use in the school.

Adolescent↗
PubMed1986

From Roosevelt to Reagan: federal spending for mental retardation and developmental disabilities.

Results of an analysis of 50 years of federal government spending for mental retardation and developmental disabilities were summarized. Spending for services and income maintenance grew rapidly from the early 1950s through fiscal year (FY) 1981. Since FY 1981, total federal spending for mental retardation has plateaued. Federal support for research and training has declined steadily since the early 1970s. The lack of support for research and training imperils the achievement of national objectives in prevention of retardation and integration of retarded individuals into community settings.

Child↗
PubMedDate not supplied

[Leptospirosis in the Southern Federal District of the Russian Federation].

The retrospective and operative epidemiological analysis of leptospirosis morbidity on the administrative territories of the Southern Federal District during the period of 1990-2002 was carried out. The dynamics and tendencies of morbidity in individual administrative units of the region were shown. Materials on the negative influence of the emergency situation arising in the region as the result of the natural calamity in summer 2002 were presented. As shown in this work, timely decisions on the stabilization of epidemiological situation taken at the period of high flood and inundation in summer 2002 in the Southern Federal District and their efficient execution made it possible to keep the epidemiological situation in leptospirosis under control.

Communicable Disease Control↗
PubMed1991

Polyadenylic-polyuridylic acid plus locoregional and pelvic radiotherapy versus chemotherapy with CMF as adjuvants in operable breast cancer. A 6 1/2 year follow-up analysis of a randomized trial of the French Federation of Cancer Centers (F.F.C.C.).

In this study, patients with operable breast cancer T2 or T3, treated by mastectomy + axillary dissection and with invaded axillary nodes (N+), were randomized to receive either: 1) postoperative locoregional and pelvic radiotherapy (RX) and Poly(A).Poly(U) (AU), 60 mg IV once a week for 6 weeks, or 2) CMF (cyclophosphamide 100 mg/sqm P.O. on days 1-14, methotrexate 40 mg/sqm IV on day 1 and 8, fluorouracil 600 mg/sqm IV on day 1 and 8; monthly cycle, for 6 months. Between March 1982 and December 1985, 517 patients were enrolled, 257 of whom were treated by RX + AU and 260 with CMF. The main clinical, pathological and prognostic characteristics were equally distributed in the two groups. The present analysis was conducted after a mean follow-up of 69 months (S.D. = 13). There was no significant difference in overall survival (OS) between the two groups (test adjusted by center and menopausal status); the five-year OS rate was 74% in the RXAU group and 77% in the CMF group. Relapse-free survival (RFS) was significantly higher (p = 0.05) in the RXAU group compared to the MCF group; the five-year RFS rates were 57% and 46% in the two groups respectively. This short, well-tolerated combined RXAU treatment appears to be as efficient as CMF and might offer an alternative to chemo- or hormonotherapy, in case of contraindications to these treatments.

Adult↗
PubMed1998

Cost-effectiveness analysis of tuberculosis control policies in Ivanovo Oblast, Russian Federation. Ivanovo Tuberculosis Project Study Group.

Many of the current tuberculosis control programmes in the Russian Federation are based on costly strategies which are underfunded and use long, individualized treatment regimens. This article compares, using a cost-effectiveness analysis, the new WHO strategy implemented in the Ivanovo Oblast (case-finding among symptomatic patients (SCF) and shorter regimens) and the old strategy (active screening of the asymptomatic population (ACF) and longer regimens). The cost per case cured was calculated at different levels of cure rate (45-95%) using three scenarios to describe the new WHO strategy (use of WHO-recommended regimens and three options at increasing rates of admission) and a fourth scenario to describe the old strategy (all patients admitted for the whole treatment and longer regimens). The cost per case detected was determined by calculating the following: yield of the new and old strategy (number of examinations necessary to diagnose one case); cost of the diagnostic process; multiplying yield per cost according to the three scenarios describing the new WHO strategy and a fourth scenario describing the old strategy. In the Ivanovo Oblast the cost per case cured, at 85% cure rate level, ranged from US$ 1197 (new strategy, scenario 1 without food) to US$ 6293 (old strategy, scenario 4) the cost per case detected ranged from US$ 1581 (new strategy, scenario 1) to US$ 4000 (old strategy, scenario 4). Significant savings can result from shifting towards the new WHO strategy. Decision-makers and health administrators should be responsible for re-investing the financial and human resources mobilized by the adoption of cost-effective strategies within the TB control programme.

Antitubercular Agents↗
PubMed1991

Internal and external quality control in the toxicological analysis of blood and urine samples in the Federal Republic of Germany.

Due to a technical rule for dangerous agents (TRGS 410), issued by the Ministry of Labor in the Federal Republic of Germany in 1979, toxicological analyses in biological materials must be carried out under conditions of "statistical quality control". This quality-control scheme provides internal and external control programmes. For internal quality control, the results of many years of experience with five commercially available control specimens and one "home-made" control have been evaluated. The control samples showed good, comparable results over a long period. Except in a few cases, there was good agreement between our results and the assigned values. Since 1982, the German Society of Occupational Medicine has offered eight intercomparison programmes for external quality. In samples from 80-90 laboratories, 6 metals in blood and around 20 inorganic and organic parameters in urine in 2 concentration adjustments have been analysed. Successful participation was certified if both results obtained for one parameter were within the tolerance range (assigned value +/- 3 SD). The average success rate was around 60%.

Blood Chemical Analysis↗
PubMed1994

[Trend analysis in Hodgkin disease mortality in the German Federal Republic 1955-1989: a comparison of log-linear models with descriptive standard methods].

Age-Period-Cohort (APC) models have become a widely accepted method to analyse incidence and mortality rates of cancer or other diseases. In this paper we compare simple descriptive methods such as plotting age-specific rates and standardized rates with regression models in order to investigate mortality rates of Morbus Hodgkin's disease in Germany (West-Germany) between 1955 and 1989. With any of the approaches it can be seen that the mortality of Morbus Hodgkin's disease has been decreasing around 1970. Although APC-models allow some detailed investigation of the separate influence of the age, period and cohort effect, the results are difficult to interpret as there is no unique solution for the parameter estimates (identification problem of APC-models). For the mortality of Morbus Hodgkin's, the result of the APC-modelling shows that the decrease of mortality is overestimated if the cohort effect is not taken into consideration. We therefore conclude that the interpretation of the APC-model should be done in connection with other methods to avoid misinterpretation. The combination of both approaches will lead to a better understanding of the incidence or mortality patterns of cancer.

Adult↗
PubMed2000

Use of ion-selective electrodes for blood-electrolyte analysis. Recommendations for nomenclature, definitions and conventions. International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). Scientific Division Working Group on Selective Electrodes.

This paper will familiarize the reader with the terms used to describe the behavior of ion-selective electrodes, particularly in relation to their use in clinical chemistry for determination of blood electrolyte cations. It serves as an introduction to a series of papers dealing with important cations in blood, namely calcium, sodium, and potassium. The detailed relationships between the ion activity determined by means of ion-selective electrode potentiometry in undiluted specimens, and the total substance concentration measured by flame atomic-emission spectrometry are described by flow chart and equations. Adoption of a convention for reporting results is recommended. The Working Group on Selective Electrodes has taken into account recent revisions of IUPAC recommendations on nomenclature and selectivity coefficient determinations for ion-selective electrodes, and benefited from the experience of a member of the WG, who was also involved in the IUPAC discussions. Nomenclature for determined quantities follows previous IUPAC/IFCC joint recommendations.

Electrodes↗
PubMed1981

[Vocational rehabilitation of heart patients. An analysis of "vocational rehabilitation cases" closed by the federal employment institute (author's transl)].

The number of heart/circulatory disease rehabilitation cases closed annually by the Federal Employment Institute has remained almost the same over the 1972-1978 period. In 1978 the national total of closed heart/circulatory disease cases amounted to 6,325, with 945 of the clients having attended vocational rehabilitation measures/courses. Some 25 percent of the cases are classified as "condition following myocardial infarction"; in male clients, this applies to about one third. Compared to the number of male clients, women are strongly under-represented in vocational rehabilitation of heart/circulatory disease patients. In relation to the structure of the gainfully employed population total, the frequency of vocational rehabilitation measures on heart/circulatory disease diagnoses varies strongly among the individual Laender employment office districts. Considerable differences are apparent when the age structure of heart/circulatory disease rehabilitation cases is compared with that of any other disability group. In case of the first, the number of cases increases with age, while the trend is the very opposite in the latter case. This fact shows that vocational rehabilitation measures for heart/circulatory disease patients need come up to special conditions, and that they have to be determined on different criteria. The rate of integrational solutions considered a positive outcome is considerably lower for heart/coronary disease rehabilitees than for the total of rehabilitees. The participation in vocational rehabilitation programmes of 14.9 percent equally is considerably lower than the corresponding percentage of the total number of rehabilitation cases (26.2 percent).

Female↗
PubMed2001

Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group.

BACKGROUND: Surgery is the main prognostic factor in retroperitoneal sarcoma. However, despite progress, surgery alone is rarely curative, and analysis of the causes of failures and of other prognostic factors are warranted to ascertain treatment orientations. METHODS: Data of patients treated from 1.80 to 12.94 for primary retroperitoneal sarcoma were extracted from the French Federation of Cancer Centers Sarcoma Group registry. Univariate and multivariate analysis were performed for initial local control and for local and general outcome. One hundred sixty-five patients (median age, 54 years; range, 16--82 years) were identified. Median tumor size was 15 cm (range, 2--70 cm); 31% of tumors presented with neurovascular or bone involvement. Liposarcoma, leiomyosarcoma, and malignant fibrous histiocytoma represented 66% of the tumors. Eighty-four percent of the tumors were of high or intermediate grade. Twenty patients had initial metastases. Multimodality treatment included surgery (150 patients), radiotherapy (92 patients), and chemotherapy (77 patients). Complete excision was achieved in 94 of 145 nonmetastatic patients. Median follow-up was 47 months (range, 3--160 months). RESULTS: Actuarial overall 5-year survival rate (median) was 46% (51 months). The main prognostic factors for survival were initial metastases and surgery, which represented the major treatment-linked factor. High-grade of tumors affected local recurrence, metastatic recurrence, and survival. Adjuvant radiotherapy was significantly associated with reduced local recurrence. Various evolutive patterns were observed with histologic subtypes. CONCLUSIONS: Aggressive surgery remains mandatory in retroperitoneal sarcoma, but a randomized trial is needed to evaluate the place of radiotherapy for local control.

Adolescent↗
PubMedDate not supplied

[Genetic analysis of wild measles virus strains isolated in the european part of the Russian Federation].

Eleven wild measles virus isolated, in 1988 and in 1999-2001 in the European territory of the Russian Federation, were investigated. On the basis of an analysis of N-gene region sequences, encoding the COOH terminal end of nucleoprotein, the isolates were divided into 2 subgroups. According to the WHO classification, subgroup 1 was in line with genotype A and subgroup 2--with genotype D. Subgroup 2 was close to genotype D4 but differed from it according to its composition of nucleotides on the average by 2.8%, and according to its amino-acid composition--by 2.6%. with respect to the WHO criteria, the latter can be referred to preliminarily as an independent genotype. Finally, the measles viruses' strains of genetic groups A and D circulated in the Russian Federation in 1988, and in 1999-2001.

Adolescent↗