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PubMedDate not supplied

The Yugoslavia Prospective Lead Study: contributions of prenatal and postnatal lead exposure to early intelligence.

To investigate associations between the timing of lead (Pb) exposure on early intelligence, we examined the results of psychometric evaluations at ages 3, 4, 5, and 7 years, from 442 children whose mothers were recruited during pregnancy from a smelter town and a non-lead-exposed town in Yugoslavia. We compared the relative contribution of prenatal blood lead (BPb) with that of relative increases in BPb in either the early (0-2 years) or the later (from 2 years on) postnatal period to child intelligence measured longitudinally at ages 3 and 4 (McCarthy GCI), 5 (Wechsler Preschool and Primary Scale of Intelligence-Revised, WPPSI-R IQ), and 7 (Wechsler Intelligence Scale for Children-version III, WISC-III IQ), controlling for: Home Observation for Measurement of the Environment (HOME) quality; maternal age, intelligence, education, and ethnicity; and birthweight and gender. Elevations in both prenatal and postnatal BPb were associated with small decrements in young children's intelligence.

Analysis of Variance↗

PubMedDate not supplied

Mortality trends of malignant tumours of digestive organs in Belgrade, Yugoslavia, 1975-1997.

AIM: To analyse mortality trends of malignant digestive tract tumours. MATERIAL AND METHODS: Population of Belgrade (Yugoslavia) in the period 1975-1997. Mortality rates were standardized by direct method using world population as the standard. For time series, exponential trends were calculated by the use of three-year moving average rates. RESULTS: In males, the highest mortality rate was for stomach cancer: 14. 6 per 100,000 (average for the period 1975-1997), followed by cancer of liver and cancer of colon: 8.4/100,000, cancer of rectum: 8.1/100,000, cancer of pancreas: 7.3/100,000, oesophageal cancer: 2.8/100,000 and gallbladder cancer: 2.0/100,000. In males, upward mortality trends for carcinomas of colon, rectum, pancreas, oesophagus, gallbladder and bile ducts were observed. The mortality rates series for stomach cancer and liver cancer did not fit any usual trend function. In females, the highest mortality rate was also for stomach cancer 7.7 per 100,000, then for cancer of colon: 6.0/100,000, cancer of rectum: 5.3/100,000, cancer of liver: 4.4/100,000, cancer of pancreas: 4.4/100,000, gallbladder cancer 3.4/100,000 and oesophageal cancer: 0.8/100,000. In females, upward mortality trends were observed for colon and rectal cancer, cancer of pancreas, and gallbladder and bile duct cancer. Downward mortality trends were present for stomach cancer and liver cancer. Mortality rates series for oesophageal cancer did not fit any usual trend function. CONCLUSIONS: In the majority of digestive tracts cancers, an upward mortality trend was observed which is in keeping with the mortality trends of these malignant tumours in many other countries.

Colonic Neoplasms↗

PubMed1994

An economic evaluation of the introduction of vaccination against hepatitis A in a peacekeeping operation. The case of the United Nations Protection Force in Yugoslavia.

The costs and benefits of vaccinating troops on United Nations tours in Yugoslavia against hepatitis A were compared. The marginal cost of one case of hepatitis A avoided by vaccination was calculated and compared with the marginal cost of achieving the same outcome by passive immunization. The cost-benefit ratio (medium estimate) for troops at low risk of contracting hepatitis A was 0.01 and for those at high risk was 0.03. Vaccinating troops against hepatitis A for a single deployment appears to be an inefficient procedure, especially in troops at low risk. However, in professional troops from countries of low hepatitis A endemicity who are likely to be involved in several operational deployments, vaccination becomes more efficient the more times the same troops are deployed.

Cost-Benefit Analysis↗

PubMed1998

Risk factors for Toxoplasma infection in a reproductive age female population in the area of Belgrade, Yugoslavia.

The contribution to Toxoplasma infection of known transmission risk factors such as consumption of undercooked meat, contact with soil, and contact with cats, as well as that of age, degree of education, residence in central vs. suburban city communities, and year of entry into the study, has been investigated in a group of 1157 female residents (age range 15 to 45 years) of a defined geographic area (Belgrade) during a 4-years period (1988-1991). The rate of infection increased with age, ranging from 57% to 93%, with an overall mean of 77%. However, it decreased significantly over the study period (p < 0.01). Of the potential risk factors examined, regression analysis showed that the following: age (relative risk (RR): 1.18, 95% confidence interval (CI): 1.02-1.37, p = 0.022), undercooked meat consumption (RR: 2.22, 95% CI: 1.2-2.86, p = 0.001), and the year of entry into the study (RR: 0.69, 95% CI: 0.6-0.8, p = 0.000) were significantly associated with infection. However, while the consumption of undercooked meat contributed to the frequency of infection in the whole group, its significance increased with the degree of education but decreased with age, and was greater in women residing in the suburbs. In addition, in women below age 20, exposure to soil (farming, gardening) was significantly associated with infection (RR: 1.38, 95% CI: 1.12-1.97, p = 0.037). Since cats are the single source of toxoplasma oocysts, the above finding indicates that cats are an epidemiologically significant source of environmental contamination in Belgrade. However, cat ownership itself as a criterion of contact with cats was not associated with infection (p = 0.326). In the absence of a general screening in pregnancy program in Yugoslavia, these data point out the groups of pregnant women at the highest risk of infection and provide a basis for a region-appropriate educational program to prevent congenital toxoplasmosis.

Adolescent↗

PubMed2001

Forced displacement in Yugoslavia: a meta-analysis of psychological consequences and their moderators.

A meta-analysis was conducted to synthesize what is known about differences in mental health between refugees and nonrefugees from the former Yugoslavia. The analysis focused on moderating effects of a variety of enduring, contextual stressors. Results indicated that refugees suffer significantly more mental health impairment than nonrefugees. The psychological consequences of forced displacement were found to vary significantly as a function of chronic stressors (e.g., locus of displacement and type of accommodation in exile) and were also associated with otherfactors (e.g., degree of war exposure in the nondisplaced groups, participant age, and time of data collection as reflected in year of publication). Implications for the study of refugee mental health are discussed.

Adult↗

PubMed2001

Influence of socio-economic crisis on epidemiological characteristic of suicide in the region of Nis (southeastern part of Serbia, Yugoslavia).

It is well known that gross social crises greatly influence the change in epidemiological features of suicide. The aim of this study is to determine whether the social-economic crisis in Yugoslavia influenced the change in epidemiological features of suicide in the region of Nis (southeastern Serbia). The material included death certificates for 1987-1999. The rates were calculated per 100,000 inhabitants (1991 Census) and standardization was performed by direct method (Segi's world population was used as standard population). Generally, trends for suicide rates in the region of Nis from 1987 to 1999 have decreasing tendency among both sexes. The average annual suicide rate in the region during the period 1987/1989 (relatively economically and politically stable) was 14.8 among males, and 6.8 among females. In 1999 (maximum influence of socio-economical and political crisis) suicide rate among males was 13.8 and among females it was 3.7. The decrease in suicide rate in females can be observed in all age groups, and in males in the age groups 15-29 and 50-64. During 1999, compared to 1987/1989, the increase in the number of suicides is perceived in the summer months (1999 -41.5%; 95% CI: 30.8-52.2%; 1987/ 1989 -23.8%; 95% CI: 18.9-28.7%), as well as the decrease of suicide on Monday (1987/1989 -21.2%; 95% CI: 16.2-26.1%; 1999 -9.8%; 95% CI: 3.4 16.2%). During 1999 the rate of suicides committed by fire arms increased (from 8.1 to 14.5%), while there was a decrease in poisoning, in both males (from 26.3 to 9.7%; p < 0.05) and females (from 39.1 to 10.0%; p < 0.05). During 1999 significant changes in epidemiological features of suicide were registered, compared to 1987/1989. These changes were probably enhanced by changed socio-economic factors (primarily war action and the bombing of Serbia, as well as the decline of standard of living and other aspects of economic and political crisis), which requires additional, more complete and thorough research.

Adolescent↗

PubMed2004

Medication management reviews for people from the former Yugoslavia now resident in Australia.

AIM: The objective of this prospective study was to conduct medication management reviews (MMR) in people from a non-English speaking background (NESB) (Bosnian/Serbian/Croatian, from former Yugoslavia, currently residing in Australia) in their native language in order to identify medication-related problems (needs analysis) and implement appropriate therapeutic interventions, in collaboration with their general practitioners (GPs). METHODS: Twenty-five participants entered the study. Each was interviewed and medication-related issues were identified by the health care team. RESULTS: Various interventions (over 150 for the whole group, an average of 6 per participant), based on actual and potential medication-related problems, were designed to improve the use of medicines. The MMRs introduced effective changes into the participants' health care. Psychological (e.g., feeling depressed) and sociological factors (e.g., costs of medicines, not understanding labels written in English) were identified as having significant impacts on medication management. CONCLUSIONS: These data confirmed there are avoidable medication-related problems in people from a NESB. GPs and pharmacists working in health care teams with a trained interpreter could greatly improve medication use through regular review and a team approach to problem identification and solving.

Australia↗

PubMed1999

Tinea pedis and onychomycosis in Danish soldiers before and after service in ex-Yugoslavia.

Seventy-three 1-year-experienced Danish soldiers were examined for tinea pedis as well as onychomycoses before and after a duty period of 6 months in ex-Yugoslavia. The incidence of fungal infections was 16.4% before and 32.3% after their duty period abroad. At first investigation Trichophyton rubrum and T. mentagrophytes were dominant but onychomycosis and tinea pedis were found as well. In contrast, Candida albicans was the predominant pathogen in the second investigation. We explain this by means of the more aggressive nature that yeasts can show when host-parasite relations are disturbed or compromised. Twelve soldiers with positive mycology were offered treatment and the final investigation showed a cure rate of 50%. This result is satisfactory in view of the difficult sanitary conditions.

Adolescent↗

PubMed2000

Lead exposure and motor functioning in 4(1/2)-year-old children: the Yugoslavia prospective study.

OBJECTIVE: To investigate associations between lead exposure and early motor development. STUDY DESIGN: We conducted standardized assessments of motor function (Bruininks-Oseretsky Test of Motor Proficiency and Beery Developmental Test of Visual-Motor Integration) at age 54 months in 283 children whose mothers were recruited in pregnancy from a smelter town and a non-lead-exposed town in Yugoslavia and who have been monitored twice yearly since birth. Blood lead concentration (BPb) was summarized in a measure reflecting the average of the child's semiannual serial log BPbs through 54 months. RESULTS: Multiple regression showed that taken together, anthropometric measures (birth weight, body mass index) and markers of a stimulating and organized home life (HOME scale, parental education and intelligence, availability of siblings) explained a significant 10% to 18% of the variance in motor functioning. Beyond these contributions, BPb was significantly associated with poorer fine motor and visual motor function but was unrelated to gross motor coordination. CONCLUSIONS: Modest associations between early lead exposure and fine motor and visual motor functioning appear even after statistical adjustment is done for other contributors to motor development. Associations with BPb are specific to these areas of motor skill; gross motor development was unaffected.

Child Development↗

PubMedDate not supplied

Polychlorinated biphenyl residues in foods from a contaminated region of Yugoslavia.

PCB levels in food and the dietary intake of PCBs from food grown in a contaminated region in Bela Krajina (Slovenia, Yugoslavia) are reported. A large variation in the contribution of PCB congeners to total PCB levels in food of animal and leafy vegetable origin was found. Although guidelines for PCB tolerances exist only for food of animal origin, it was estimated that leafy vegetables and unpeeled fruits from the contaminated region present a significant source of human exposure to PCBs. PCB residues in fish and eggs exceeded the tolerances set by the FDA. Utilizing the official statistical data on food consumption, the dietary intake of PCBs from food of animal origin decreased from 1985 to 1988 from 14.5 to 1.6 mg/year per person, respectively, after the use of PCBs ceased in the nearby plant. The dietary intake in 1988 of PCBs from foodstuffs of vegetable origin and fruits was 4.6 mg/year per person. The quantitation of PCBs was made from the sum of 36 individual PCB congeners, obtained by high resolution gas chromatography with an electron capture detector.

Diet↗

PubMed2001

Life situation and posttraumatic symptoms: a follow-up study of refugees from the former Yugoslavia living in Sweden.

Posttraumatic symptoms were assessed by means of the Harvard Trauma Questionnaire among 27 severely traumatized refugees from the former Yugoslavia in psychiatric treatment and then 3 years later, after an average of 5.5 years in Sweden. At follow-up the subjects also answered a questionnaire about their life situations. No significant change in average symptom level had taken place at follow-up. Seventeen subjects met the DSM IV criteria for posttraumatic stress disorder (PTSD) at both times. However, five subjects who met the PTSD criteria in the first study did not at follow-up, and the opposite was true for another five subjects. Fifteen subjects reported contact with psychiatric care during the past year. Unemployment and dependence on social welfare were high at follow-up. The unemployment rate of 32% was almost six times greater than that for the regular Swedish labor force but comparable to that of the whole Bosnian labor force in Sweden. Social contacts with the majority population were as common as with compatriots, but two-thirds of the subjects expressed a wish for more social contacts outside the family. Positive factors in the subjects' life situations were the housing situation and the fact that most subjects had at least reasonable knowledge of the majority language. However, a minority of the group still had no formal competence in Swedish, with negative consequences for labor market integration and social contact with Swedes. Two-thirds of the group had made no definite decision to stay in Sweden.

Adult↗

PubMed2003

Cognitive abilities related to post-traumatic symptoms among refugees from the former Yugoslavia in psychiatric treatment.

The overall aim was to study the relationship between post-traumatic symptoms and cognitive abilities among traumatized refugees from the former Yugoslavia, in psychiatric treatment. The results showed that a diagnosis of post-traumatic stress disorder (PTSD), as well as a higher level of post-traumatic symptoms, was significantly associated with poorer average cognitive performance. Three of four tests of fluid intelligence, and the Benton Visual Retention Test, assessing episodic memory, were the most discriminating. A specific constellation of PTSD symptoms, dominated by arousal and intrusive symptoms, had a significant overall correlation with intellectual performance. One implication of the study is that assessment of cognitive abilities might be advisable in this patient group, in particular when arousal and re-experiencing symptoms are frequent.

Adult↗

PubMed2002

Transport of toxic organic aerosol pollutants from Yugoslavia to Greece during the operation "Allied Force".

Between March 24 and June 10, 1999 a large number of chemicals were ejected into the atmosphere because of air strikes on chemical industries and oil storage facilities in former Yugoslavia. Chemicals released into the atmosphere under suitable meteorological conditions can be transported across borders to large distances. The releases may have contained not only conventional air pollutants but also semi-volatile organic compounds (SOCs) which include dioxins, furans, PCBs and PAHs, all known to be hazardous to health. A measuring programme was initiated at Democritus University Thrace, Greece to monitor the chemical characteristics of atmospheric aerosol during February, March and April 1999. Particulate matter (aerosol) was collected on filters and was analysed using high-resolution gas chromatography coupled to high-resolution mass spectrometry for their content in SOCs. In the present work we show evidence of two events with three to twenty fold increased SOCs in the atmosphere of Northern Greece which were associated with air masses transported from the conflict area, following the destruction of chemical plants and oil storage facilities.

Aerosols↗

PubMedDate not supplied

Psychosocial healing and post-conflict social reconstruction in the former Yugoslavia.

Post-conflict reconstruction encompasses social, physical and political reconstruction. Social reconstruction entails rebuilding the human interactions that allow a society to function. This involves the healing of psychological and social wounds of individuals and society. Psychosocial healing is a process to promote psychological and social health of individuals, families and community groups. The Medical Network for Social Reconstruction in the Former Yugoslavia has pioneered a broad range of psychosocial healing programmes including community-integration programmes, development of volunteer action, and training of professional and lay people to take part in psychosocial healing. These programmes have demonstrated that psychosocial healing can be an effective way to heal post-conflict societal trauma and contribute to rebuilding society with an improved quality of life.

Community-Institutional Relations↗

PubMed2003

Characterization of the molecular defect in the ATP7B gene in Wilson disease patients from Yugoslavia.

Wilson disease (WD) is an autosomal recessive disorder of copper metabolism resulting from the absence or dysfunction of a copper transporting P-type ATPase (ATP7B). Approximately 150 mutations of the ATP7B have been identified to date. In this paper, we report the results of molecular characterization and genotype-phenotype analysis, which we have carried out on 35 patients from Yugoslavia affected by WD. Using single-strand conformational polymorphism (SSCP) followed by direct sequencing, we characterized the molecular defect in 80% of WD chromosomes and found 11 different mutations, three of which are novel. The most common mutations that accounted for the molecular defect in 71.3% of WD chromosomes were H1069Q (48.9%), 2304-2305insC (11.4%), R616Q (5.7%), and A1003T (5.7%). The results produced in this paper indicate that the best strategy for mutation detection in Yugoslavian patients with WD is an SSCP analysis of exons 14, 8, 5, and 13, where most of the defects (73.1%) lie, followed by mutation analysis of the remaining exons in ATP7B in patients in whom the mutation was not detected by the finitial screening. These data can be used to develop straightforward genetic testing in this population or in other countries composed of a genetically mixed population like the United States, where a significant number of immigrants came from Central and Eastern Europe.

Adenosine Triphosphatases↗

PubMed1998

The significant increase in incidence of Graves' disease in eastern Serbia during the civil war in the former Yugoslavia (1992 to 1995).

The incidence of Graves' disease for the last 25 years in eastern Serbia (Yugoslavia), Timok Region is reported. Registration of all Graves' disease patients was conducted in the Endocrinology-Thyroid Unit of Nuclear Medicine Service, Medical Center Zajecar. Timok Region has a population of 315,000 people in seven counties. From 1971 to 1980 an average of 16 new patients per year were registered; from 1981 to 1990 an average of 33 patients per year were registered; in 1995 the number reached 100, and in 1996 there were 148 newly registered patients. Some of the possible factors influencing this significant annual increase of autoimmune hyperthyroidism are discussed.

Demography↗

PubMed1991

Epidemiology of Crohn's disease in Zagreb, Yugoslavia: a ten-year prospective study.

A ten-year prospective study of Crohn's disease was carried out in Zagreb, Yugoslavia. It included both inpatients and outpatients regardless of the extent and severity of the disease. The mean annual incidence rate was 0.7 per 100,000 between 1 January 1980 and 31 December 1989. There was no increase in the incidence of Crohn's disease during the study period. The prevalence of Crohn's disease was 8.3 per 100,000 on 31 December 1989. The results confirm the low frequency of Crohn's disease in central and southern Europe.

Adolescent↗

PubMed1991

A prospective study of birthweight and length of gestation in a population surrounding a lead smelter in Kosovo, Yugoslavia.

This paper tests the hypothesis that exposure to lead during pregnancy is associated with reduced intrauterine growth and an increase in preterm delivery. The sample comprises women, recruited at mid-pregnancy, residing in Titova Mitrovica, a lead smelter town, or in Pristina, a non-exposed town 25 miles away. Both towns are in the province of Kosovo, Yugoslavia. Mean blood lead concentrations (BPb's) at mid-pregnancy were 0.92 mumol/L (+/- 0.38, N = 401) in the exposed town and 0.27 mumol/L (+/- 0.09, N = 506) in the comparison town. No differences were found between towns for either birthweight or length of gestation. Mean birthweight was 3308 (+/- 566) grams in Titova Mitrovica and 3361 (+/- 525) grams in Pristina. Mean length of gestation was 274 (+/- 18.8) days in Titova Mitrovica and 275 (+/- 15.6) days in Pristina. After adjustment for the effects of potential confounders, no significant relationships were found between maternal BPb measured at mid-pregnancy, at delivery or in the umbilical cord and either birthweight, length of gestation, or preterm delivery (less than 37 weeks). We conclude that exposure to environmental lead does not impair fetal growth or influence length of gestation.

Adult↗