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At least 19 recordsLinked to original sources
PubMed1993

Action plan for a tobacco-free Europe: implementation in central and eastern Europe, 1993-94. WHO Regional Office for Europe.

Major political and social changes in central and eastern European (CEE) countries offer new opportunities and challenges in tobacco control. Action against tobacco in CEE countries is part of an overall European strategy, the action plan for a tobacco-free Europe. Several CEE countries have voiced their concern about the deterioration of tobacco control and about the entry of the international tobacco industry. In response, the Regional Office has set up a framework for an international task force. The core of the task force consists of the EURO staff and a special consultant. Several European countries and organizations have already expressed their willingness to joint the task force by seconding an expert to participate in the country missions and consensus conferences. This paper describes particular steps to implement the action plan in central and eastern Europe. It outlines priority action to be carried out by the CEE countries themselves and describes possibilities for assistance by all European countries. A key role is assigned to a European alliance on tobacco or health to create psychological and material prerequisites for action as well as act in an advisory role. Some of the projects are already underway, but they can be considerably strengthened by extra resources and support. Some of the projects are possible only with new resources. The project proposals are classified according to the six areas of the new action plan but presented in a different order. This paper sets out a range of activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Environmental Health↗
PubMed2004

Lower incidence rates but thicker melanomas in Eastern Europe before 1992: a comparison with Western Europe.

The objective of this study was to investigate the epidemiology of melanoma across Europe with regard to Breslow thickness and body-site distribution. Incidence data from Cancer Incidence in 5 Continents and the EUROCARE-melanoma database were used: 28?117 melanoma cases from 20 cancer registries in 12 European countries, diagnosed between 1978 and 1992. Regression analysis and general linear modelling were used to analyse the data. Melanomas in Eastern Europe were on average 1.4 mm thicker (P<0.05) than in Western Europe and appeared more often on the trunk. From 1978 to 1992, their Breslow thickness had decreased in Western but not Eastern Europe. There was a latitude gradient in incidence, with highest rates in southern regions in Eastern Europe and an inverse gradient in Western Europe, with highest rates in the North. Mortality:incidence ratios were less favourable in southern parts across Europe, especially in Eastern Europe. If Eastern European populations copy the sunbathing behaviour of the West it is likely that in the near future a higher melanoma incidence can be expected there.

Adult↗
PubMed2003

Changing epidemiology of malignant cutaneous melanoma in Europe 1953-1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia.

We analyzed time trends in incidence of and mortality from malignant cutaneous melanoma in European populations since 1953. Data were extracted from the EUROCIM database of incidence data from 165 cancer registries. Mortality data were derived from the WHO database. During the 1990s, incidence rates were by far highest in northern and western Europe, whereas mortality was higher in males in eastern and southern Europe. Melanoma rates have been rising steadily, albeit with substantial geographic variation. In northern Europe, a deceleration in these trends occurred recently in persons aged under 70. Joinpoint analyses indicated that changes in these trends took place in the early 1980s. In western Europe, mortality rates have also recently leveled off [estimated annual percentage change (EAPC) from -13.6% (n.s.) to 3.3%], whereas in eastern and southern Europe both incidence and mortality rates are still increasing [incidence EAPCs 2.3-8.9%, mortality EAPCs -1.8% (n.s.) to 7.2%]. Models including the effects of age, period and birth cohort were required to adequately describe the rising incidence trends in most European populations, with a few exceptions. Time trends in mortality were adequately summarized on fitting either an age-cohort model (with the leveling off of rates starting in birth cohorts between 1930 and 1940) or an age-period-cohort model. The most plausible explanations for the deceleration or decline in the incidence and mortality trends in recent years in northern (and to a lesser extent western) Europe are earlier detection and more frequent excision of pigmented lesions and a growing public awareness of the dangers of excessive sunbathing.

Adult↗
PubMed1997

Fertility and contraception in Europe: the case of low fertility in southern Europe.

Demographic trends in Europe can be summarized in terms of a declining proportion of its population in the world total, low fertility, and a slow population growth. Fertility in Western Europe was already below the replacement level in 1970-75 and has remained low. Fertility has substantially declined in Eastern and Southern Europe, with Italy and Spain recording one of the lowest levels (1.2 children per woman) in 1994. Some explanations of the dramatic fertility decline in Southern Europe are: (1) The emancipation of women and their increased participation in the labor force; (2) Economic aspects such as costs for child care and education; and (3) The couple's motivation for low fertility because of the expanded choices for travel and leisure and their concerns for improving their standard of living. Social pressures on childbearing outside marriage remain quite strong; cohabitation and extramarital births is Southern Europe are not as prevalent as in other European regions and there is a trend toward delaying the birth of the first child rather than foregoing childbearing.

Adult↗
PubMed2002

Multicentre assessment of linezolid antimicrobial activity and spectrum in Europe: report from the Zyvox antimicrobial potency study (ZAPS-Europe).

OBJECTIVE: To evaluate the in vitro spectrum and activity of linezolid, a recent oxazolidinone, according to well-controlled surveillance data from 42 medical centers in 13 countries throughout Europe. METHODS: Participants tested the susceptibility of 125 clinical strains of enterococcal and staphylococcal species against 13 drugs using reference broth microdilution trays or the standardized disk diffusion method of the National Committee for Clinical Laboratory Standards (NCCLS). Streptococcal species (n = 25 at each center) were tested against six drugs using E test (AB BIODISK, Solna, Sweden). Quality assurance testing was conducted using NCCLS-recommended strains and verification of resistance to linezolid and other selected agents was performed by retesting strains at the regional (Europe) and international (USA) monitor sites. RESULTS: A total of 5598 strains from throughout Europe (91% compliance) were tested. Vancomycin resistance was reported in only 0.6 and 3.0% of Enterococcus faecalis and E. faecium, respectively. Penicillin resistance occurred in 25.1% of Streptococcus pneumoniae; 4.9% at the high-level (> or =2 mg/L). The MIC90 for linezolid was 1 mg/L for streptococci and 2 mg/L for enterococci and staphylococci. Using the US FDA- and EUCAST-recommended susceptible breakpoints for linezolid, there were no confirmed reports of linezolid resistance [minimum inhibitory concentration (MIC), > or =8 mg/L]. The distribution of linezolid MIC values was unimodal and varied between 0.25 and 1 mg/L for streptococci (>90% of isolates), and between 1 and 2 mg/L for staphylococci (>90%) and enterococci (>95%). There were no differences in linezolid susceptibility in the vancomycin-, oxacillin-, or penicillin-resistant subsets of strains when compared to susceptible organism populations. CONCLUSIONS: Compared to the North American component of this study, there was substantially less vancomycin resistance among E. faecium isolates (Europe 3.0% vs. North America 63.4%). While the occurrence of penicillin-resistant S. pneumoniae in Europe and North America was similar (25.1% vs. 29.7%), the recovery of high-level penicillin-resistant strains was nearly three-fold higher in North America (4.9% vs. 13.2%). Only linezolid was universally active against all the tested Gram-positive isolates at </=4 mg/L.

Acetamides↗
PubMed1994

Comparison of serological and DNA HLA-DR typing results for transplantation in Western Europe, Eastern Europe, North America and South America.

In a previous study, DNA typing revealed that 25% of serological HLA-DR typings of kidney transplants were incorrect. In the current study, we analyzed whether this error rate had improved in recent years, and whether there were differences according to geographical region. From 1988 to 1991 the error rate of serological typing improved slightly in Western Europe from 19% to 16%, and in North America, from 21% to 16%. In Eastern Europe, the error rate decreased from 49% to 33% in 1991, whereas the rate remained high in South America at 60% in 1988 and 72% in 1991. The high error rates in South America and Eastern Europe reflected a lack of good quality serological typing reagents. The 16% typing errors in Western Europe and North America demonstrated the current limit of serological techniques for cadaver donor typing and underlined the need for prospective DNA typing.

DNA↗
PubMed1996

Epidemiology of AIDS-related Kaposi's sarcoma in Europe over 10 years. AIDS in Europe Study Group.

OBJECTIVES: To determine the incidence and risk factors associated with Kaposi's sarcoma (KS) occurrence as an AIDS-defining condition or after the diagnosis of AIDS. DESIGN: Multicentre retrospective cohort study of AIDS in Europe database from 52 clinical centres in 17 European countries. METHODS: Patients' charts (n = 6546) were reviewed and collected in the database of the AIDS in Europe Study Group from 1979 to 1989. At the time of AIDS diagnosis 1394 patients had KS, whereas an additional 525 others developed KS after AIDS diagnosis. Univariate analysis and development of multivariate models determined factors associated with KS occurrence. RESULTS: Frequency of KS as an AIDS-defining condition significantly declined over time (P < 0.0001). In our cohort of patients, homo-/bisexual men from central Europe with CD4 cell counts > 150 x 10(6)/l were statistically more likely to develop KS at the time of AIDS diagnosis (P < 0.0001). For patients with an AIDS diagnosis other than KS, the probability of developing KS during the follow-up was 10 and 24% after 12 and 36 months, respectively. Variables significantly associated with a further KS development were transmission group, central European residence, previous herpes simplex infection other than ulcers, and low CD4 cells (< 150 x 10(6)/l). Previous zidovudine therapy had no influence on KS appearance. For patients who developed KS subsequent to AIDS diagnosis, there was no significant decline of the incidence over the 10-year time period. CONCLUSIONS: This large cohort study clearly shows that demographic data such as sex, transmission group and region of Europe have a major influence on KS development. It also suggests that KS as an AIDS-defining disease occurs earlier in the course of the chronic HIV infection than other opportunistic diseases. Reasons for geographical variations and its declining frequency as an initial AIDS diagnosis remain undetermined.

AIDS-Related Opportunistic Infections↗
PubMed2001

Health behaviour, risk awareness and emotional well-being in students from Eastern Europe and Western Europe.

Life expectancy and other indices of health have deteriorated markedly in the former socialist countries of Eastern Europe over recent decades. The possible roles of lifestyles, knowledge about health and behaviour, emotional wellbeing and perceptions of control were assessed in a cross-sectional survey of young adults of similar educational status in Eastern and Western Europe. As part of the European Health and Behaviour Survey, data were collected in 1989-1991 from 4170 university students aged 18-30 years from Austria, Belgium, the Federal Republic of Germany, the Netherlands and Switzerland, and from 2293 students from the German Democratic Republic, Hungary and Poland. Measures were obtained of health behaviours, awareness of the role of lifestyle factors in health, depression, social support, health locus of control, and the value placed on health. After adjustment for age and sex, East European students had less healthy lifestyles than Western Europeans according to a composite index of 11 health behaviours, with significant differences for seven activities: regular exercise, drinking alcohol, avoiding dietary fat, eating fibre, adding salt to food, wearing a seat-belt, and using sunscreen protection. East European students were less likely to be aware of the relationship between lifestyle factors (smoking, exercise, fat and salt consumption) and cardiovascular disease risk. In addition, they were more depressed (adjusted odds of elevated scores on the Beck Depression Inventory of 2.46, 95% C.I. 1.95-3.09), reported lower social support, and had higher beliefs in the "chance" and "powerful others" locus of control. Internal locus of control levels did not differ across regions, and Eastern Europeans placed a higher valuation on their health. Unhealthy lifestyles associated with lack of information about health and behaviour, greater beliefs in uncontrollable influences, and diminished emotional well-being, may contribute to poor health status in Eastern Europe.

Adolescent↗
PubMedDate not supplied

The ethics of resuscitation; differences between Europe and the USA--Europe should not adopt American guidelines without debate.

There are differences between Europe and the USA in the style of medical decision-making for patients who are critically ill or requiring CPR. These differences are both legal and philosophical. They concern principally the degree of influence the patient and next of kin should have on critical medical decisions. Currently American physicians transfer more of the decision-making to patients and relatives than do their European counterparts. The current state of the art in cardio-pulmonary resuscitation (CPR) from cardiac arrest occurring out-of-hospital requires public education programmes. These heighten public awareness of CPR-related questions. There has been a wide acceptance in Europe of the American guidelines for CPR. Cultural and legal differences, however, should encourage the acceptance of specific European guidelines. The author believes that it is important to introduce in the European CPR programmes discussions on the ethical dilemmas that may occur. This may help to conserve the relatively high level of public trust that facilitates the patient-doctor relationship in Europe, compared with the USA. Arguments are also put forward for a heightened sensitivity in the European medical profession concerning communication with the patients and their next of kin and with the mass media, in view of the increasing public sophistication and interest that the citizen CPR programmes are generating.

Cultural Diversity↗
PubMed1999

Antimicrobial activity of gatifloxacin (AM-1155, CG5501), and four other fluoroquinolones tested against 2,284 recent clinical strains of Streptococcus pneumoniae from Europe, Latin America, Canada, and the United States. The SENTRY Antimicrobial Surveillance Group (Americas and Europe).

The newer fluoroquinolones generally have greater potency against Gram-positive cocci including Streptococcus pneumoniae. In this study, we report the activity of gatifloxacin (formerly AM-1155 or CG5501) compared with penicillin, erythromycin, and four other peer drugs, tested against 2284 strains isolated in North America (Canada and United States), Latin America (six nations), and Europe in 1997. Reference broth microdilution methods were used and results were interpreted by consensus standards. Gatifloxacin demonstrated uniform potency against pneumococci across all monitored geographic areas (MIC90, 0.5 microgram/mL; > or = 99.6% of strains inhibited at < or = 1 microgram/mL). This activity was comparable to trovafloxacin (MIC90, 0.5 microgram/mL) and sparfloxacin (MIC90, 0.5 microgram/mL) and two- to four-fold greater than that of ciprofloxacin or levofloxacin. The most resistant strains to the fluoroquinolones had mutations in both par C (Ser 79-->Phe) and gyr A (Ser83-->Lys or Phe). Penicillin resistance (MIC, > or = 0.12 microgram/mL) rates varied from 27.6% in Europe to 55.7% in Latin America. Macrolide resistance was greatest in Europe and the United States. Gatifloxacin appears to be a promising new fluoroquinolone for clinical use in respiratory tract infections commonly caused by S. pneumoniae.

Anti-Infective Agents↗
PubMed1996

Epidemiology of AIDS dementia complex in Europe. AIDS in Europe Study Group.

The aim of the study was to describe the epidemiology of AIDS dementia complex (ADC) in Europe and to assess the possible role of zidovudine therapy in preventing or delaying its occurrence. We used an inception cohort, with data collected retrospectively from patients' clinical records from 52 clinical centers in 17 countries across Europe. The subjects were 6,548 adult people with AIDS consecutively diagnosed from 1979 to 1989. The main outcome measures were codiagnosis of ADC at the time of AIDS diagnosis and ADC-free time after AIDS diagnosis. ADC was reported in 295 patients (4.5%) at the time of AIDS diagnosis and during follow-up in a further 402 of the 5,160 patients (7.8%) who were diagnosed with AIDS based on diseases other than ADC. Whether at the time of AIDS diagnosis or later, the occurrence of ADC was significantly associated with age, transmission category, and CD4+ cell counts. The risk was greater in older patients (14 and 19% greater, at AIDS diagnosis and after, respectively, for a 5-year difference in age), in i.v. drug users than in homosexual and bisexual men (89 and 60% greater, at AIDS diagnosis and after, respectively), and for people with lower CD4+ cell counts (14 and 30% greater for a reduction of 1 on the natural log scale). Risk was almost double for women than for men. A significant reduction, of approximately 40%, was found in the risk of developing ADC after AIDS diagnosis for patients receiving zidovudine therapy, but this effect was present only during the first 18 months of treatment, irrespective of whether treatment began before or after AIDS diagnosis. In conclusion, an increase in the risk of developing ADC either at the time of AIDS diagnosis or thereafter is associated with increasing age, i.v. drug use, and decreased CD4+ cell count. Women tend to have a higher risk of ADC at the time of AIDS diagnosis. Zidovudine therapy appears to have a definite, but time-limited, effect of protecting patients against ADC development after AIDS diagnosis.

AIDS Dementia Complex↗
PubMed1999

Legal and ethical perspectives on delivery of reproductive and sexual health services in the countries of eastern Europe and the CIS (countries with economies in transition, Europe).

International human rights conferences have repeatedly declared that reproductive and sexual health and choice are human rights entitled to protection and respect. This is no less true in the countries of Eastern Europe and the New Independent States (NIS). It was widely believed that the dissolution of the former Soviet Union and of Communist rule in Eastern Europe would lead to conditions of greater freedom, health and prosperity and to a time of greater respect for reproductive health and rights of choice. In fact, that has not happened; in some respects, the situation in these countries is now worse than before. This article examines the current state of reproductive and sexual health in these countries and several of the reasons why conditions, generally speaking, have not improved since the transition. It closes by identifying some suggestions for positive change and some resources for reproductive health advocacy in these countries.

Adolescent↗
PubMed2000

[Assurance and assessment of quality education in occupational medicine in selected countries of western Europe and in the United States. 1. Western Europe].

The author discusses the studies undertaken with the general aim to provide education in occupational medicine and assure and assess its quality in some countries of Western Europe advanced more than Poland in this area. It becomes quite evident that despite a widespread interest in quality of education, there is a lack of basic systemic solutions. A gap between basic theoretical and methodological guidelines and a large number of dispersed reports on concrete analytical and evaluation studies can be still observed. In addition to the presentation of an inside view of research activities carried out in some countries of Western Europe and the United States, based on selected professional publications, the author formulates general conclusions on how the assurance and quality assessment of education in occupational medicine function in those countries.

Education, Medical↗
PubMed2002

Water and health in Europe. A joint report from the European Environment Agency and the WHO Regional Office for Europe.

Shortage of water may be most urgent health problem currently facing some European countries. Climate change is predicted to influence water availability, especially in coastal areas. The extend of provision of piped drinking-water supplies to households varies across Europe and between urban and rural populations. The utilization of water for irrigation and for industry exerts pressure on water resources. Changes in populaton distribution and density are key factors influencing the quality of water resources. Outbreaks of waterborne diseases continue to occur across Europe, and minor supply problems are encountered in all countries. Inadequate sewerage systems are a significant threat to public health. Numerous chemicals are found throughout the aquatic environment. Eutrophication is a major threat to European surface waters. Considerate evidence has accrued linking the quality of bathing water with minor illnesses. Additional efforts are required to sustain the European Region's water resources and to provide safe water. Partnerships and cooperation are needed between the environment and health sectors at al levels of government to disseminate technology, to improve management and to provide financial and institutional support to ensure access to safe water and sanitation for all.

Climate↗
PubMed2000

Miospores from the Frasnian-Famennian Boundary deposits in Eastern Europe (the Pripyat Depression, Belarus and the Timan-Pechora Province, Russia) and comparison with Western Europe (Northern France).

A zonal subdivision of the Frasnian-Famennian transitional deposits in the Pripyat Depression and Timan-Pechora Province, based on a detailed palynological study, has been completed. The data obtained on miospores and conodonts from the Timan-Pechora Province enable a correlation to be made with the Standard Conodont Zonation. The lateral extent of the palynozones in Eastern Europe and the correlation with Western Europe are discussed. The following previously published new combinations are validated: Auroraspora speciosa (Naumova) Obukhovskaya, comb. nov., Corbulispora viminea (Nekriata) Obukhovskaya and Nekriata, comb. nov., Cristatisporites imperpetuus (Sennova) Obukhovskaya, comb. nov., Cymbosporites acanthaceus (Kedo) Obukhovskaya, comb. nov., Grandispora subsuta (Nazarenko) Obukhovskaya, comb. nov., and Verrucosisporites evlanensis (Naumova) Obukhovskaya, comb. nov.

Journal Article↗
PubMed2000

Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE).

Although cerebral palsy (CP) is the most common cause of motor deficiency in young children, it occurs in only 2 to 3 per 1000 live births. In order to monitor prevalence rates, especially within subgroups (birthweight, clinical type), it is necessary to study large populations. A network of CP surveys and registers was formed in 14 centres in eight countries across Europe. Differences in prevalence rates of CP in the centres prior to any work on harmonization of data are reported. The subsequent process to standardize the definition of CP, inclusion/exclusion criteria, classification, and description of children with CP is outlined. The consensus that was reached on these issues will make it possible to monitor trends in CP rate, to provide a framework for collaborative research, and a basis for services planning among European countries.

Cerebral Palsy↗
PubMed1997

Cytomegalovirus retinitis in patients with AIDS in Europe. AIDS in Europe Study Group.

The incidence of cytomegalovirus (CMV) retinitis and risk factors associated with the condition were studied in patients with the acquired immune deficiency syndrome (AIDS) in a multicenter retrospective cohort study of 6458 patients from 52 centers in 17 countries in Europe. Cytomegalovirus retinitis was diagnosed in 154 patients (2.4%) at the time of AIDS diagnosis, the probability of this diagnosis being significantly higher for those with CD4+ cell counts of < 100/mm3 (3.4%) than with counts of 100-200/mm3 (1.3%) or > 200/mm3 (0.8%). The rate of developing CMV retinitis after AIDS diagnosis was 9.4 per 100 patient years of follow-up. Multivariate analysis showed that risk behavior was significantly associated with the risk of developing CMV retinitis: lower for intravenous drug users [relative risk (RR) 0.47] and those engaged in "other risk behavior" (RR 0.58) than for homosexual men. The risk of developing CMV retinitis after AIDS diagnosis was significantly associated with CD4+ cell count at the time of AIDS diagnosis: for counts < 100/mm3 (RR 2.90) and from 100 to 200/mm3 (RR 2.13), there was a higher risk than for counts > 200/mm3. Patients with Pneumocystis carinii pneumonia, toxoplasmosis, or extraocular CMV infection at time of AIDS diagnosis exhibited an increased risk of developing CMV retinitis. Patients treated with zidovudine exhibited an increased rate of CMV retinitis: RR was 1.75 during and 2.87 after the second year of treatment as compared to those who had not received zidovudine. Median survival after CMV retinitis at time of AIDS diagnosis was eight months.

AIDS-Related Opportunistic Infections↗