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PubMed1991

Prevalence of neural tube defects in 20 regions of Europe and the impact of prenatal diagnosis, 1980-1986. EUROCAT Working Group.

STUDY OBJECTIVE: The aims were (1) to determine whether in Europe, 1980-86, geographical differences in total prevalence of neural tube defects persist; (2) to examine the stability of total prevalence rates over time; (3) to evaluate the impact of prenatal diagnosis in terms of frequency and timing of termination of pregnancy. DESIGN: Prevalence rates of neural tube defects were determined from case registration data in 20 EUROCAT regional registers of congenital anomalies, 1980-86. The chi 2 test for homogeneity in proportions was used to test whether differences in total prevalence rates were significant between regions or over time. SETTING: Geographically defined populations were used in the Republic of Ireland, United Kingdom, Belgium, The Netherlands, Luxemburg, Denmark, France, Italy, Yugoslavia, and Malta. PATIENTS: The patients were 3113 cases of anencephaly, spina bifida, encephalocele, and iniencephaly. Total cases (livebirths, stillbirths and induced abortions following prenatal diagnosis) were registered in 14 regions. Induced abortions were excluded from registration in six regions. MEASUREMENTS AND MAIN RESULTS: Total prevalence rates (including livebirths, stillbirths and induced abortions) were 24 to 38 per 10,000 in six areas of Ireland and United Kingdom. Average total prevalence rate in eight continental European areas was 11.5 per 10,000. There was a secular decline in total prevalence in Dublin (Republic of Ireland) and Northern Ireland (United Kingdom) and a fluctuation in Glasgow, Liverpool, and South Glamorgan (United Kingdom). Total prevalence in continental Europe was stable over time. There was no significant geographical or secular variation in the spina bifida to anencephaly ratio (1.3). The ratio of encephalocele to other neural tube defects was lower in the British Isles (0.09) than in continental Europe (0.18). The impact of prenatal diagnosis and termination of pregnancy is increasing over time. Terminations were performed 1984-86 in at least 80% of total cases of anencephaly in 6/11 centres registering induced abortions, and in at least 40% of total cases of spina bifida in four centres. Serum alpha fetoprotein screening in British centres was associated with earlier prenatal diagnosis of spina bifida than ultrasound screening in other centres. CONCLUSIONS: Geographical and secular variation in total prevalence of neural tube defects persists in Europe 1980-86, independent of the practice of prenatal diagnosis. There is considerable regional variation in the impact of prenatal diagnosis in terms of frequency and timing of diagnosis and pregnancy termination linked to different policies and practices of prenatal screening.

Abortion, Induced↗
PubMed1989

Alterations in the laryngeal mucosa after exposure to asbestos.

The laryngeal mucosa of 195 workers in an asbestos cement factory (Salonit Anhovo, Yugoslavia) and in a control group was examined. The factory manufactures asbestos cement products containing about 13% of asbestos (8% amosite, 12% crocidolite, and 80% chrysotile) of different provenance. Alterations in the laryngeal mucosa were more frequent in the factory workers than in the control group. The changes, mostly consistent with chronic laryngitis, were closely related to the degree of workplace pollution and less so to the duration of employment Ten workers exhibiting the most severe clinical changes underwent biopsy, the results of which showed histomorphological changes characteristic of hyperplastic chronic laryngitis. Four tissue specimens were examined also by scanning electron microscopy and in three of them asbestos fibres were found on the epithelial surface. No case of laryngeal carcinoma was identified. On the basis of our results it is thought that asbestos related changes of the larynx should receive more attention and that the use of the term "laryngeal asbestosis" is justified. The clinical picture is non-specific but in view of their frequency such changes should be considered a consequence of exposure to asbestos.

Adult↗
PubMed1984

Life style and national and international trends in coronary heart disease mortality.

An international comparison of trends in mortality from coronary heart disease (CHD) since 1968 shows a sizeable decline in the U.S.A., Australia, New Zealand, Finland, Canada, Belgium and Japan. By contrast England, Wales and Scotland had shown no evidence of decline in CHD mortality until 1979. This has resulted in a marked deterioration in the CHD ranking of Scotland and England and Wales relative to other countries. Sweden, Hungary, Poland, Yugoslavia, Bulgaria, Rumania and the U.S.S.R. have all had increases in CHD mortality. There are many possible reasons for these changes. In general, countries that had had a decrease in CHD mortality have experienced changes in the type and/or quantity of fat in the national diet. The changes in CHD mortality in Sweden and Japan are out of line with the pattern in other countries. There is some evidence that changes in smoking and blood pressure control may have contributed to changes in CHD mortality. Changes in physical activity may have also played a part.

Adult↗
PubMedDate not supplied

The research career of Richard B. Stein (1940-).

This report reviews the research and mentoring career of Richard B. Stein (1940-). In 1962, he completed a B.S. degree in physics at the Massachusetts Institute of Technology, USA, and thereafter an M.A. (1964), Ph.D. (1966), and postdoctoral training (1966-68) at the University of Oxford, UK. He subsequently assumed a faculty position at the University of Alberta (Canada), where he is currently an active researcher and mentor. To this point in 2004, Stein has trained and collaborated closely with over 160 scientists, largely neuroscientists and biomedical engineers, from 27 countries. He and his former trainees and collaborators have made important contributions on topics that span the cellular-to-behavioral spectrum of movement and rehabilitation-prosthetics neuroscience. His mentors, trainees, and collaborators include scientists whose countries of origin are: Australia, 2; Austria, 1; Belgium, 1; Bulgaria, 1; Canada, 64; China, 6; Denmark, 1; Germany, 1; Great Britain, 16; Hong Kong, 4; India, 5; Iraq, 2; Italy, 2; Japan, 10; Kenya, 1; New Zealand, 4; Pakistan, 1; Palestine, 1; Poland, 1; Romania, 1; South Africa, 1; Sri Lanka, 1; The Netherlands, 1; Turkey, 1; Uruguay, 1; USA, 21; and Yugoslavia, 6. In all instances, Stein's research collaborations and mentoring have advanced the careers of his trainees and junior collaborators, a well-deserved and important compliment to a stellar movement neuroscientist.

Animals↗
PubMed1998

Diversity among xanthomonads pathogenic on pepper and tomato.

Xanthomonas campestris pv. vesicatoria, causal agent of bacterial spot of tomato and pepper, had been considered for nearly 70 years to be a relatively homogeneous organism. However, in the past decade this bacterium was determined to be composed of two genetically and phenotypically distinct groups. The two groups, designated A and B, were distinguished based on amylolytic activity, expression of unique protein bands, reaction on differential hosts (tomato races T1 and T2), reaction patterns with monoclonal antibodies, DNA restriction profiles, and DNA:DNA hybridization. The A and B groups were placed into X. axonopodis pv. vesicatoria and X. vesicatoria, respectively. A third group, designated C, was pathogenically (race T3) and serologically distinct from A and B strains, and formed unique DNA restriction profiles. DNA:DNA hybridization data suggest that C is distinct but related to A strains and may represent a subspecies of A. A final group, designated D, consisted of X. gardneri, an organism identified in Yugoslavia in 1957, and also found in Costa Rica. Group D was determined to be genetically distinct from strains within the other two groups; it represents a third Xanthomonas species pathogenic on tomato and pepper.

Journal Article↗
PubMed1997

The public health aspects of complex emergencies and refugee situations.

Populations affected by armed conflict have experienced severe public health consequences mediated by population displacement, food scarcity, and the collapse of basic health services, giving rise to the term complex humanitarian emergencies. These public health effects have been most severe in underdeveloped countries in Africa, Asia, and Latin America. Refugees and internally displaced persons have experienced high mortality rates during the period immediately following their migration. In Africa, crude mortality rates have been as high as 80 times baseline rates. The most common causes of death have been diarrheal diseases, measles, acute respiratory infections, and malaria. High prevalences of acute malnutrition have contributed to high case fatality rates. In conflict-affected European countries, such as the former Yugoslavia, Georgia, Azerbaijan, and Chechnya, war-related injuries have been the most common cause of death among civilian populations; however, increased incidence of communicable diseases, neonatal health problems, and nutritional deficiencies (especially among the elderly) have been documented. The most effective measures to prevent mortality and morbidity in complex emergencies include protection from violence; the provision of adequate food rations, clean water and sanitation; diarrheal disease control; measles immunization; maternal and child health care, including the case management of common endemic communicable diseases; and selective feeding programs, when indicated.

Cause of Death↗
PubMed1998

Relationship of some risk factors with typical and atypical manifestations of coronary heart disease.

BACKGROUND: This analysis explores whether 'typical' clinical manifestations of coronary heart disease (CHD) such as myocardial infarction and sudden death, relate to major cardiovascular risk factors in the same way as the 'atypical' manifestations, e.g. heart failure and chronic arrhythmias. PATIENTS AND METHODS: Sixteen cohorts of men aged 40-59 in seven countries were examined, risk factors measured (age, systolic blood pressure, serum cholesterol and smoking habits) and 25-year mortality data collected in a systematic way. Cohorts were located in the US (n = 1), Finland (n = 2), the Netherlands (n = 1), Italy (n = 3), former Yugoslavia (n = 5), Greece (n = 2) and Japan (n = 2), with a total of 12,763 individuals. Ecological analysis based on regression equations and correlation among cohorts, and individual analyses based on proportional hazard models in pools of cohorts were conducted with typical and atypical CHD deaths as dependent variables. RESULTS: The ecological analysis suggests a significant relationship of populational mean levels of serum cholesterol and of systolic blood pressure to age-adjusted death rates from typical CHD manifestations. The relationships for atypical CHD deaths were not statistically significant. In the ecological approach with multivariate analysis, none of the risk factors showed relevant associations with event rates, except serum cholesterol and typical CHD deaths. The ecological relationship of serum cholesterol to atypical CHD death rates was negative but not significant. On average, mean age at death was statistically higher among atypical CHD than typical CHD patients (70.2 vs. 65.8 years). In the individual multivariate analysis conducted on pools of countries, the relationship of risk factors with typical CHD deaths was direct and significant for age, systolic blood pressure, and smoking habits in Northern Europe and America and Southern Europe, but only for systolic blood pressure and smoking habits in Japan, whereas for atypical CHD, the predictive factors were age, systolic blood pressure and cigarette smoking in Northern Europe and America and Southern Europe, but only age in Japan. CONCLUSIONS: The usual relationship of blood pressure and smoking habits and the differential relationship of serum cholesterol with atypical CHD (negative or absent) versus typical CHD (direct and significant) could be explained by 'two different diseases' or by a mix of poorly classified conditions among the atypical cases.

Adult↗
PubMed1992

Is Microsporum canis infection about to become a serious dermatological problem?

In Europe, especially in the Mediterranean, the incidence of Microsporum canis infection has been on a steep increase during the recent years. In some countries (Italy) and geographic areas (Slovenia), M. canis is the most often isolated dermatophyte. In Slovenia (Yugoslavia), a dramatic increase in the incidence of M. canis infection has been observed recently, both in absolute figures and as compared to the rest of isolated dermatophytes. M. canis is a cause of tinea most prevalent in children. All attempts made during the past 6 years to eliminate the natural source of infection, represented mainly by stray cats, have failed. M. canis infection is becoming a serious epidemiologic problem in Europe. For its solution, integrated efforts of medical and veterinary services, and probably more stringent rules and controls in this particular area, will be required.

Adolescent↗
PubMed1985

Season dermatitis ex insectis caused by stings of Sclerodermus domesticus.

Case history of five members from the same family is reported. They developed papulourticarial pruritic rash on the skin of their torsos and extremities during their summer stay in an old family house. The cause was an insect determined as Sclerodermus domesticus, known for its parasitism on larvae of a wood pest. Examination of the furniture revealed a lot of holes typical for these pests. Cases of stings of these insects have not been described in Yugoslavia till now.

Animals↗
PubMed1984

Bifonazole cream in the treatment of superficial candidosis. A double-blind comparative study.

This is the summary of a prospective, randomized, double-blind study comparing four therapeutic regimens: bifonazole cream applied once or twice daily, clotrimazole and placebo twice daily during 4 weeks for the treatment of cutaneous candidosis. The study is multicentric and was accomplished in four centres of different climate: Costa Rica, Dominican Republic, Sweden and Yugoslavia. The trial was carried out with approximately identical numbers of patients: 275 in total. The duration of treatment was 4 weeks and the check-ups were done before, during and 2 weeks after the end of the therapy. The results have shown the great efficacy of bifonazole cream (65-75%) in comparison to placebo (19.4%). There was no significant difference in applying bifonazole cream once or twice daily. So the reasonable therapy with bifonazole as to apply it only once a day, is confirmed. The excellent tolerance and absence of side-effects in such an extended study have once more proved the value of this antimycotic in topical treatment of cutaneous candidosis.

Adolescent↗
PubMed1988

Broncho-Vaxom in children with rhinosinusitis: a double-blind clinical trial.

Fifty-one children aged 4-12 years, presenting with an acute epidose of chronic rhinosinusitis, were treated for 6 months with either Broncho-Vaxom (BV; marketed in Yugoslavia under the trade mark of Broncho-Munal) or placebo under double-blind randomized conditions. The efficacy of BV was assessed on the basis of clinical symptoms (cough, nasal discharge, congestion of nasal mucosa), number and duration of concomitant treatments (antibiotics, secretolytics, antitussives), number and duration of acute episodes during the trial and serum IgA levels. In BV treated patients the incidence and duration of infectious episodes and the number and duration of concomitant treatments decreased significantly in comparison with the placebo group, and the clinical response correlated positively with an increase in the serum levels of IgA. The results of treatment of acute episodes of chronic rhinosinusitis in children demonstrated the curative and prophylactic efficacy of BV.

Acute Disease↗
PubMed1982

Psychosomatic factors in the process of cancerogenesis. Theoretical models and empirical results.

The core of the authors' research program consists in the assumption that complex statistical interactions of sociological and psychological factors with pathophysiological and standard risk factors are more important for the early detection, prediction and prevention of cancer than one or just a few medical risk factors, e.g. the relationship between smoking and lung cancer. As the analysis of these relationships can only be done in interdisciplinary research, interpretation and discussion of social scientific, molecular biological and epidemiological aspects was attempted. In the first part we explicate a model of relevant propositions from the psychosomatic literature to explain the relationship between psychosocial factors of carcinogenesis. A discussion of the authors' research program contains additional variables and propositions. It appears to the authors that among the psychosocial and sociological factors of carcinogenesis, the molecular biological variables are especially relevant, as they form the intervening link between the social science variables and cancer. Discussion of the methodology and the sampling of the authors' empirical studies follows. Two prospective studies, carried out in Yugoslavia and West Germany, are described in detail. The data of these studies are used in the empirical analysis. In the next part the empirical results of different multivariate analyses are presented: The effects of the sociological and psychological variables on carcinogenesis are described; standard risk factors and biochemical-molecular biological factors are brought together, special attention being given to the interaction between these two groups of variables.

Adult↗
PubMed1983

Smoking as a risk factor for lung cancer and cardiac infarct as mediated by psychosocial variables. A prospective investigation.

In 1965-66, a prospective psychosomatic investigation was started with 1,353 relatively old inhabitants of the village of Crvenka, Yugoslavia. The present article reports on the relevance of smoking for the incidence of lung cancer and cardiac infarct. The main results are: (1) The relevance of smoking is reduced, but not eliminated, by introducing psychosocial control variables, suggesting that the latter have direct influences both on smoking and on the diseases. (2) The relevance of smoking interacts very strongly with psychosocial background conditions: it is nearly reduced to zero when the latter are favorable, and is correspondingly high when they are unfavorable. The results are also interpreted in biochemical terms.

Aged↗
PubMed1978

Treatment of bilateral renal pelvic and ureteral tumors. A review of 45 cases.

A particular type of kidney disease, the so-called Balkan nephropathy, is to be observed in some areas in Yugoslavia. This type of disease is very often associated with ureteral and pelvic tumors. 495 cases were observed (308 of pelvic and 187 of ureteral origin). Taking into consideration the frequency of bilaterality (9%) as well as of renal insufficiency (50%), we have been forced to preserve the kidney in tumoral cases instead of performing radical nephrectomy. The results on 45 bilateral pelvic and ureteral tumors are presented in this paper.

Carcinoma, Papillary↗
PubMed2004

Incidence of stroke and stroke subtypes in Malmö, Sweden, 1990-2000: marked differences between groups defined by birth country.

BACKGROUND AND PURPOSE: The proportion of immigrants has increased in Sweden markedly during the last decades, as in many other Western countries. Incidence of stroke has increased during this period. However, it is primarily unknown whether incidence of stroke and stroke subtypes in Sweden is related to country of birth. METHODS: Incidence of first-ever stroke was followed during 10 years in a cohort consisting of all 40- to 89-year-old inhabitants in the city of Malmö, Sweden (n=118,134). Immigrants from 12 different countries were compared with native-born Swedes. RESULTS: Adjusted for age, sex, marital status, and socioeconomic indicators, the incidence of stroke (all subtypes) was significantly higher among immigrants from former Yugoslavia (relative risk [RR], 1.31; 95% CI, 1.1 to 1.6) and Hungary (RR, 1.33; CI, 1.02 to 1.7). A significantly increased incidence of intracerebral hemorrhage was observed in immigrants from Peoples Republic of China or Vietnam (RR, 4.2; CI, 1.7 to 10.4) and the former Soviet Union (RR, 2.7; CI, 1.01 to 7.3). Immigrants from Finland had a significantly higher incidence of subarachnoid hemorrhage (RR, 2.8; CI, 1.1 to 6.8). A significantly lower incidence of stroke was observed in the group from Romania (RR, 0.14; CI, 0.04 to 0.6). Immigrants from Denmark, Norway, Germany, Chile, Czechoslovakia, and Poland had approximately the same risk as citizens born in Sweden. CONCLUSIONS: In this urban population from Sweden, there are substantial differences in stroke incidence and stroke subtypes between immigrants from different countries. To what extent this could be accounted for by exposure to biological risk factors remains to be explored.

Adult↗
PubMed2001

Secondary myelofibrosis in visceral leishmaniasis--case report.

A 39-year-old woman with a history of travel to the Montenegrin coast presented with a 9-month long history of fever and weakness, and on examination was found to be emaciated with hepatosplenomegaly and pancytopenia. Marrow aspiration showed poor cellularity with abundant Leishman Donovan (LD) bodies in the macrophages. Bone marrow trephine biopsy revealed a marked myelofibrosis (Manoharan classification: grade III) with osteosclerosis. The impression smears of a trephine biopsy stained with Güiemsa also showed LD bodies. The patient did not exhibit evidence of any risk factors for visceral leishmaniasis (VL). She was treated with meglumine antimoniate (Glucantime) without any adverse effect. The spleen returned to a normal volume after 4 months and bone marrow trephine biopsy performed 6 months after initiation of the therapy had returned to normal. A diagnosis was difficult to establish as VL is rarely encountered in the continental parts of Yugoslavia, and with the presence of associated myelofibrosis it could easily have been mistaken for chronic idiopathic myelofibrosis. The association of myelofibrosis with visceral leishmaniasis has been reported in the literature only three times; we thus feel that documentation of this case is merited.

Adult↗
PubMed2005

Regional collaboration in reconstruction of mental health services in Bosnia and Herzegovina.

The war in the former Yugoslavia between 1991 and 1995 destroyed the mainly hospital-based mental health care system in Bosnia and Herzegovina. This report summarizes the situation before and after the war and describes efforts to rebuild and reform mental health services under politically and economically challenging conditions. As a result of these efforts, there are now 39 multidisciplinary community mental health centers that are linked to primary care and that aim to provide prevention, treatment, and rehabilitation of mental disorders. The reform process has been supported by international initiatives and is now continuing in collaboration with other countries in South Eastern Europe.

Bosnia and Herzegovina↗