[Clinical and epidemiologic considerations regarding the incidence and evolution of and possible remission in late poststreptococcal articular rheumatic manifestations].
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Biomedical subjects
Publications and source records attributed to A Ivan.
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Authors present some epidemiological aspects of medical and socioeconomic implications caused by group A beta hemolytic streptococcus (ABHS) infections and by their complications, assessed on 10948 inpatients with angina, 323 with scarlet fever, and 644 with erysipelas, hospitalized in the City of Galati, between 2000-2003. All these three major diseases determined by ABHS needed 79125 days of hospitalization, with an average period of 6.4 days for angina, 76 for scarlet fever, and 10.4 for erysipelas. The costs of the mere hospitalization of these inpatients (11915) amounted to 14,479,543,800 lei. This fact highlights how costly the infections caused by AHBS are.
Authors present the first laboratory and epidemiological results which reveal the circulation in a population of protozoan Blastocystis hominis and its implication in the determinations of some gastrointestinal troubles, with fever, diarrhea and constipation, intense intestinal meteorism, associated with abdominal pain and cramps. Out of the 3106 investigated patients, 9.7% presented B. hominis as a unique etiologic agent, with an increased prevalence in adults (74.3%) and women (65.3%). Blastocystis infection with clinical manifestations or its asymptomatic form is included among emergent diseases.
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The results of an epidemiological screening of 1,228 parents and 614 children, pupils in the V-XII forms of 12 schools of different types, are presented. It is suggested that when parents present elevated blood pressure values their children, although normotensive, are at high risk, especially in case more risk factors are present. The relation hypertensive parents--hypertensive offsprings was strongly significant. In the hypertensive children with normotensive parents the high frequency of some life-style dependent risk factors is discussed. The relationship between risk factors and morbidity by essential hypertension both in parents and their offsprings and the need of primary and secondary prevention programs for pupils are underlined.
The investigations revealed that in the interval 1978-1987 the mean incidence of viral hepatitis type B in children was 40 at 100,000 inhabitants as compared to 767 in the children from orphanages. In 27.5% of the cases, the children from orphanages, with or without HBs antigen, had viral hepatitis in their case history. The prevalence of AgHBs carriers was of 21.6%, the highest value (46.1%) being recorded in the children from orphanages in the age group 0-3 years. It was also found that 14.9% of the children had AgHBs when admitted to orphanage and 28.7% became carriers later on. It is suggested that in children homes there are conditions for an increased risk requiring special measures for viral hepatitis prophylaxis and control.
The results of the epidemiological investigations in industrial environment in view of demonstrating some relations between alcohol and salt consumption, tobacco smoking, over weight and prevalence of essential arterial hypertension are presented. The obtained data indicate that in 471 workers in smelting the prevalence of alcohol consumers (1-3 intakes/day of strong alcohol) was of 15% as compared to 28.4% in 559 workers in an unit for building equipment, 4% in the 1188 women, working in ready-made and knitted wear mills and 19.8 and 4.5% in men and women, respectively, working in administrative services. Both the prevalence of daily strong alcohol consumption and of the other considered factors are significantly increasing with age. An increased prevalence of alcohol consumption associated with tobacco smoking, salt consumption and over weight was found in the hypertensive subjects as compared to the controls. The obtained data are useful in elaborating primary prevention programs of essential arterial hypertension.
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7,917 pupils in schools, between 10-19 years old, of both sexes, were investigated within an epidemiologic screening, performed in the school milieu, for detecting the prevalence of some risk factors (RF) and of the AT modifications with a view to work out the programmes for the essential arterial hypertension (EAHT) primary prevention. 84.4% of all the pupils in the Vth--VIIIth forms and 93.9 pupils in the IXth--XIIth forms were included in the screening. 422 cases of labile arterial hypertension (LAHT) (5.1%) and 457 of benign arterial hypertension (BATH) (54%) were found. In the children with normal arterial hypertension (NAHT) the following were recorded: 46.5% increases only of the diastolic tension: 44.0% of the systolic-diastolic and 7.1% of the systolic tension respectively. Although present, the differences between the LAHT and BAHT prevalence in the gymnasiums (4.3% and 5.4%) and lyceums (5.5% and 6.4%) are not significant and might be functions of: age, sex, psychomotor development, structure of the respective collectivities, the momentary psychoemotional reactions, lability of the blood pressure, specific to the childhood, several screening difficulties etc. The observations made on the prevalence of the growth of the AT values were correlated with the occurrence at some significant levels of the RF, suggesting the measures to be taken for the steady improvement of the primary and secondary prophylaxis of EAHT in schools.
The investigations carried out in 92 patients with confirmed diagnosis of primitive hepatocellular carcinoma (HCC) have demonstrated that in almost half of them hepatitis was present in their antecedents, indicating the intervention of hepatitis virus in the etiology of this disease. In this context, the primary prophylaxis of primitive HCC is mainly based on the prophylaxis and control of viral hepatitis. As the interval detection-death was in most cases very short (1-2 month), the secondary prophylaxis consisting in performing more of the investigations recommended for the early diagnosis of primitive HCC is essential.
Based on an epidemiological screening of 6411 pupils from 7 schools of different types, the frequency and intensity of the association of 8 risk factors for essential hypertension in a series with increased blood pressure values and in a normotensive one was compared. The frequency of the various studied risk factors was significant especially in the pupils with increased blood pressure values. The average number of risk factors in the two series was unsignificant. The intensity of 2, 3 or 4 risk factors different associations was more marked in the pupils with increased blood pressure values than in the controls. Some risk factors proved to be more frequently involved in multifactorial associations. The importance of such studies for the elaboration of prevention programmes in underlined.
The statistical correlations between body weight, glycemia, total lipids, cholesterol in 200 patients with essential hypertension, especially borderline essential hypertension, followed up for 6 years indicate that the complex environmental factors in Slănic-Moldova Health Resort associated with balneotherapy may induce a return to normal values of the above mentioned parameters. Good results were also obtained in the patients with essential hypertension and non-insulin dependent diabetes mellitus, their treatment including reduction diets (1200-1400 calories/day).
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