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PubMedDate not supplied

Biochemical reconstruction of three cases of death--results of international cooperation.

Biochemical serotonin and histamine determinations were applied to the reconstruction of three suspected homicide cases. To distinguish between ante-mortem and post-mortem wounds and to time the ante-mortem injuries the concentrations of free histamine and serotonin in the wound samples and in the control samples from neighbouring intact skin were examined. The results of these biochemical determinations allowed a reconstruction of the events and one of the three cases was shown to be suicide instead of homicide. The methods can be used at least during the first 4--5 days after death and sometimes even longer. This allows for international cooperation when investigating and reconstructing complicated cases of death.

Adult↗
PubMed2003

International cooperation in veterinary public health curricula using web-based distance interactive education.

The expanding field of Veterinary Public Health places new demands on the knowledge and skills of veterinarians. Veterinary curricula must therefore adapt to this new profile. Through the introduction of case studies dealing with up-to-date issues, students are being trained to solve (real-life) problems and come up with realistic solutions. At the Department of Public Health and Food Safety of the Veterinary Faculty at the University of Utrecht in the Netherlands, positive experiences have resulted from the new opportunities offered by the use of information and communication technology (ICT) in education. The possibility of creating a virtual classroom on the Internet through the use of WebCT software has enabled teachers and students to tackle emerging issues by working together with students in other countries and across disciplines. This article presents some of these experiences, through which international exchange of ideas and realities were stimulated, in addition to consolidating relations between universities in different countries. Long-distance education methodologies provide an important tool to achieve the increasing need for international cooperation in Veterinary Public Health curricula.

Animals↗
PubMedDate not supplied

Importance of international cooperation in food safety.

All countries need to ensure that national food supplies are safe, of good quality and available in adequate amounts at affordable prices to ensure good nutrition and health for all population groups. The enforcement of food standards by efficient national food control authorities in domestic markets and at the points of import and export has been increasingly recognized as a means of raising the value of exported goods by reducing the number of rejected or reconditioned consignments, and of ensuring the safety of the food and its acceptability by the final consumer. However, those national efforts have sometimes induced some non-tariff barriers to food trade and distribution. In addition, new developments in the technologies of food production, processing and marketing pose a new challenge to ensure safety of food. The strengthening of national food control infrastructures in particular in developing countries including the strengthening of staff capabilities, the need for harmonization of food at international levels, the need for collection and exchange of data on food control and food contamination issues are essential elements to ensure food safety in the world. International cooperation has an important role to play in achieving these essential elements.

Food Additives↗
PubMed1990

The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: Surgical results.

A prospective, observational clinical trial was conducted by the International Cooperative Study on the Timing of Aneurysm Surgery to determine the best time in relation to the hemorrhage for surgical treatment of ruptured intracranial aneurysms. Sixty-eight centers contributed 3521 patients in a 2 1/2-year period beginning in December, 1980. Analysis by a prespecified "planned" surgery interval demonstrated that there was no difference in early (0 to 3 days after the bleed) or late surgery (11 to 14 days). Outcome was worse if surgery was performed in the 7 to 10-day post-bleed interval. Surgical results were better for patients operated on after 10 days. Patients alert on admission fared best; however, alert patients had a mortality rate of 10% to 12% when undergoing surgery prior to Day 11 compared with 3% to 5% when surgery was performed after Day 10. Patients drowsy on admission had a 21% to 25% mortality rate when operated on up to Day 11 and 7% to 10% with surgery thereafter. Overall, early surgery was neither more hazardous nor beneficial than delayed surgery. The postoperative risk following early surgery is equivalent to the risk of rebleeding and vasospasm in patients waiting for delayed surgery.

Adolescent↗
PubMed2002

Biological weapons and bioterrorism preparedness: importance of public-health awareness and international cooperation.

Biological weapons and biological terrorism have recently come into focus due to the deliberate release of Bacillus anthracis via mail delivered in the USA. Since the 1930s, biological weapons have been developed in a number of countries. In 1975, the Biological and Toxin Weapons Convention entered into force; this prohibits the use of these weapons and has been signed by a large majority of countries (144). Unfortunately, several countries failed to respect this treaty. The Soviet Union continued and expanded its biological weapons program, and after the Gulf War it was revealed that Iraq also had an extensive biological weapons program. Large-scale deliberate release of, Bacillus anthracis, for example, or an epidemic following a release of smallpox virus, would have a devastating effect. This has motivated the world community to strengthen the Biological and Toxin Weapons Convention with a control mechanism which has, as yet, not been successful. Sweden, like other countries, is enhancing its preparedness with regard to stocks of antibiotics and vaccines, related to these improving the diagnostics these and similar agents, and is setting up an epidemiologic task force that can be used in infectious disease emergencies such as the deliberate release of biological warfare agents. International cooperation in this area has to be enhanced, not least in the European Union.

Biological Warfare↗
PubMed2005

[How to cope with the global tuberculosis burden--experiences and perspectives for Japan's international cooperation].

Tuberculosis is a global burden disease, most possibly ranking high among diseases over the coming several decades, with 2 million deaths and over 8 million new cases annually. How can TB be controlled and eradicated quickly in the world? A major answer will be the wider application of the most effective control programme, i.e. DOTS recommended by WHO. But it has been developed in the long try and error efforts, including the ones by Dr. K. Styblo of IUATLD in African countries. The key components of successful TB programme are summarised as follows, which Dr. Kochi of WHO adopted as a global policy package. They are; 1) political commitment, 2) case finding by sputum microscopy, 3) use of short course chemotherapy under supervision, 4) a secured supply of anti-TB drugs, and 5) a standardised recording, reporting and monitoring system. The targets by 2005 are set 85% cure rate and 70% detection rate. By 2002, however, only half the targets have been achieved, and global expansion of DOTS with other strategies need to be strengthened. Emerging threats are HIV epidemic, MDR-TB increase and health sector reform taking place in the world. Stop TB partnership with its office in WHO has been formed to strengthen a global capacity, mobilizing various technical and financial partners. Japan's contribution to the global TB problem started in early 1960s. In the last 40 years, technical cooperation in national TB programme (NTP) has been made through JICA in over 15 countries, including United Arab Emirates. Thailand, Nepal, Afghanistan, Tanzania, Indonesia, Solomon Islands, Yemen, Philippines, Cambodia, Myanmar, Pakistan, Zambia, and China (TB project is on-going in underlined countries). In these projects, capacity strengthening of NTP has been given priority, including construction of national TB center, a model area development, nationwide DOTS expansion in collaboration with WHO or others, supply of anti-TB drugs, TB laboratory network with QA, collaborative operational research. An operational research for community based DOTS and ART is newly started in Zambia under JICA project. Besides, over 1800 doctors and technologists from 90 countries have been trained at Research Institute of Tuberculosis (RIT) through its international training courses in the last 40 years. These courses are organised collaboratively with WHO or other agencies, inviting globally renowned lecturers and ex-participants, and have been reputed widely. We aim not only to teach skills and knowledge but also to motivate them to do something new. This becomes possible only through human relationship in the course. I may need to mention about my personal commitment: First, I have worked to develop a community based TB programme model utilising village health volunteers in Bangladesh in 1980s. This system has now covered over 70% of the total patients in the country through BRAC, local NGO. Secondly, the application of participatory action research (PAR) method in introducing or expanding DOTS in Bangladesh and other countries. Staff members of NTP and local/ peripheral workers participate in the trials and discuss actively in the workshops periodically. This PAR approach empowers both NTP managers and peripheral staff. Through the international cooperation, we aim ultimately at 1) support for self-reliance, 2) empowerment (capacity building for problem finding and solution) of the people concerned, and 3) promotion of global peace without arms.

Delivery of Health Care↗
PubMed1992

International cooperative study on the relationship between dietary factors and blood pressure: a preliminary report from the Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study. The CARDIAC Cooperative Study Research Group.

1. To investigate the epidemiological relationship of dietary factors to blood pressure (BP) and major cardiovascular diseases, we carried out the international cooperative Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study, which so far involves 48 centers in 20 countries as of August 1991. From each population, 100 men and 100 women aged 50-54 years were randomly selected for BP measurement, 24-h urine collection, blood tests, and medical interview. Various biological markers of diets from urine and blood were analyzed centrally in the Izumo CARDIAC center. 2. Cross center analysis using simple linear regression revealed strong significant correlations of body mass index (BMI) to systolic BP (SBP; p < 0.01) and diastolic BP (DBP; p < 0.001) in men. 24-h urinary sodium (Na) excretion in men also showed significant correlations with SBP (p < 0.05) and DBP p < 0.05) even after controlling for the effect of BMI (SBP; p < 0.05, DBP; p < 0.05). 3. Within center analysis using multiple linear regression implied that BMI and Na strongly adversely affect BP, whereas magnesium may have beneficial influence on BP. 4. Multicolinearities among 24h urinary sodium, calcium, and urea nitrogen were noted in men.

Body Mass Index↗
PubMed1999

Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER)

BACKGROUND: Pulmonary embolism (PE) remains poorly understood. Rates of clinical outcomes such as death and recurrence vary widely among trials. We therefore established the International Cooperative Pulmonary Embolism Registry (ICOPER), with the aim of identifying factors associated with death. METHODS: 2454 consecutive eligible patients with acute PE were registered from 52 hospitals in seven countries in Europe and North America. The primary outcome measure was all-cause mortality at 3 months. The prognostic effect of baseline factors on survival was assessed with multivariate analyses. FINDINGS: 2110 (86.0%) patients had PE proven by necropsy, high-probability lung scan, pulmonary angiography, or venous ultrasonography plus high clinical suspicion; ICOPER accepted without independent review diagnoses and interpretation of imaging provided by participating centres; 3-month follow-up was completed in 98.0% of patients. The overall crude mortality rate at 3 months was 17.4% (426 of 2454 deaths, including 52 patients lost to follow-up): 179 of 397 (45.1%) deaths were ascribed to PE and 70 of 397 (17.6%) to cancer, and no information on the cause of death was available for 29 patients. After exclusion of 61 patients in whom PE was first discovered at necropsy, the mortality rate at 3 months was 15.3% (365 of 2393 deaths). On multiple-regression modelling, age over 70 years (hazard ratio 1.6 [95% CI 1.1-2.3]), cancer (2.3 [1.5-3.5]), congestive heart failure (2.4 [1.5-3.7]), chronic obstructive pulmonary disease (1.8 [1.2-2.7]), systolic arterial hypotension (2.9 [1.7-5.0]), tachypnoea (2.0 [1.2-3.2]), and right-ventricular hypokinesis on echocardiography (2.0 [1.3-2.9]) were identified as significant prognostic factors. INTERPRETATION: PE remains an important clinical problem with a high mortality rate. Data from ICOPER provide rates and highlight adverse prognostic categories that will help in planning of future trials of high-risk PE patients.

Acute Disease↗
PubMedDate not supplied

The International Cooperative Study on Timing of Aneurysm Surgery--an update.

The timing of aneurysm surgery is one of the major controversies in the management of subarachnoid hemorrhage. The Cooperative Aneurysm Study is conducting an international epidemiological study to determine mortality and morbidity related to timing of surgery. From January, 1981 to July, 1983 over 3,500 patients have been registered from 68 centers. This preliminary report updates the progress of the study, describes the patient population, and presents overall outcome results.

Female↗