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Evidence for Hantavirus disease in Slovenia, Yugoslavia.

In Slovenia, North-Western part of Yugoslavia, 17 clinically documented Hantavirus disease cases (HVD) were serologically confirmed so far. Previously HVD was reported in the Southern part of Yugoslavia. By the indirect fluorescent antibody test (IFA), the prevalence of IgG class antibodies against different Hantaviral antigens was demonstrated in human sera collected in Slovenia. Three different reactivity patterns were observed. Majority of the IFA-positive human sera were confirmed by the immunoblot method. The distribution of Hantaviral infections was examined in small mammals captured in two natural foci of HVD, where clinical documented cases were reported. Hantaviral antibodies and antigens were demonstrated in C. glareolus, A. flavicollis, A. sylvaticus, and M. musculus.

Animals↗

[A critical review of the drug field in Yugoslavia 1985-1988].

Developments in the drug field are presented under the following headings: 1. Drug approval. About 220 new drugs have been discussed (including new formulations and dosages). The number of drugs belonging to the group A (important) and those which should not, according to the author's opinion, have been approved (group D) is similar 6.3/9.1%. About 64% are clinical or generic repetitions (i.e. "me too" drugs). Considerable difficulties with pricing, which is haphazard, and performed in an unsatisfactory way, is the reason why the industry tries to introduce "new drugs" which are often not new and do not present an advance to pharmacotherapy. 2. Drug regulation got (up till now with modest success) an important impetus through Conclusions of the Federal Council of the Parliament of Yugoslavia asking the Federal Committee for Health to elaborate the Yugoslav Essential Drugs List and revise the list of drugs approved in the country--the Federal Institute for Health Protection to prepare diagnostic and therapeutic standards. 3. Drug legislation was "enriched" by the Regulation of Adverse Drug Reaction Reporting (which dos not exist in other countries) and controversial Regulation on Auxiliary Therapeutic Substances, the latter being greatly insufficient. Finally, the List of Essential (unavoidable) Drugs comprising 1/3 (= 336) of drugs approved in Yugoslavia has been accepted. It is hoped that this will improve the availability of drugs, which availability is essential. The greatest problem in the Yugoslav drug field remains irrational prescribing, inadequate pricing (linear increases without observing the grade of necessity of various agents) and consecutive repetitive deficit even of most needed therapeutic agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Industry↗

Eight red cell enzymes polymorphisms in the Slovakian ethnic group of Yugoslavia.

The polymorphisms of eight red cell enzymes were studied in 211 unrelated voluntary blood donors from the ethnic group of Slovakians (Yugoslavia). Only common phenotypes were detected, which are usually present in European populations. The allele frequencies found were: GLO1*1 = 0.410, ESD*1 = 0.887, AK1*1 = 0.962, PGM1*1 = 0.780, ACP1*A = 0.315, ACP1*B = 0.637, ACP1*C = 0.047, GPT*1 = 0.535, ADA*1 = 0.952 and PGD*A = 0.940. These findings are discussed in the context of other European populations and the population of Serbia, Yugoslavia.

Alleles↗

Edmonston-Zagreb strain of measles vaccine: epidemiologic evaluation in Yugoslavia.

According to epidemiologic data in Yugoslavia, a high level of immunity (95%) must be attained in the susceptible population between eight months and 30 years of age for the eventual eradication of measles (to cut off the seasonal peak and to prevent the epidemiologic wave). Where the vaccination rate produced a lower level of immunity (e.g., 85% and 67%), the cyclic wave did not disappear completely but was greatly reduced. Live measles vaccine prepared from a further-attenuated Edmonston-Zagreb strain was used for vaccination in Yugoslavia.

Adolescent↗

Communicable diseases in former Yugoslavia and in refugees arriving in the United Kingdom.

The war in the republics of former Yugoslavia has created the largest number of European refugees since the Second World War. Over 40,000 people from the republics arrived in the United Kingdom before visa restrictions were applied in September 1992, although not all of these were refugees. In November 1992, permission was given for about 4000 Bosnian ex-detainees and their dependents to come to the UK, about 700 of whom had arrived by the end of April 1993. The pre-war health care system in the republics is breaking down and the reporting and control of communicable diseases has been disrupted. Tuberculosis, lice and scabies are likely to affect refugees from former Yugoslavia. Suggestions are given for the management of refugees arriving in the UK, as well as travel health advice for aid workers and others going to the region.

Communicable Diseases↗

[Epidemiologic characteristics of mortality in cancer of the tongue in Yugoslavia].

The paper contains mortality data about tongue cancer in Yugoslavia for the period from 1969 to 1988. Using descriptive epidemiologic method a demographic analysis was conducted on deceased from tongue cancer according to age and sex. The chronologic analysis includes the period of 20 years, while the topographic distribution of deceased includes six Yugoslav republics. Statistic models for studying standard mortality rates were used according the method of direct standardization as well as the specific mortality rates concerned with sex and age, equation of linear trend and proportion. The results of investigation show that the average standardized mortality rate concerning tongue cancer from 1969 to 1988 in Yugoslavia amounted to 0.62 in 100,000 inhabitants. These rates are considerably higher in males (1.17%ooo) than in females (0.17%ooo). The specific rates of mortality considering age continually grow with the increase of age. They are relatively low, up to the age of 44 (males), and up to 54 (females). The examination of epidemiologic situation concerning tongue cancer in our country on the basis of total mortality trend (y = 0.62 + 0.03x) indicates a slow growth, in males (y = 0.17 + 0.07x) as well as in females (y = 0.17 + 0.01x), which points to a need for research of possible risk factors and prompt realization of adequate preventive measures.

Adult↗

Humanitarian assistance: technical assessment and public health support for coordinated relief in the former Yugoslavia.

Since July 1992, the WHO Regional Office for Europe has been using epidemiological and public health assessment techniques to guide its interventions in the crisis in the former Yugoslavia. WHO field operations have evolved into the largest emergency relief operation ever undertaken in the European Region. The WHO programme of humanitarian assistance focuses on five major areas: public health, equipment, supplies and logistic support, support to war victims, primary health care for refugees and rehabilitation of the health care system. The main thrust of the programme is to implement the public health measures required for survival. The first step is to provide health intelligence for international humanitarian assistance programmes through health and nutrition monitoring. This leads to targeted intervention. While involved in all aspects of relief, WHO clearly justifies its presence by its technical focus, bringing its network of expertise and experience to bear on the assessment of need and the coordination of intervention. Three examples of this approach are given: the nutrition programme, which includes emergency food aid and health and nutrition monitoring, the winter protection programme in Bosnia and Herzegovina, and the medical kit programme, involving the design and use of special kits to cover basic emergency needs for medical supplies to the maximum number of people. In the former Yugoslavia, the WHO Regional Office for Europe has concentrated on technical situation analysis and sound public health grounding to guide and direct intervention.

Humans↗

[Physicians in former Yugoslavia build new bridges with Scandinavian support].

For the first time since the war started in former Yugoslavia physicians from the medical associations in Bosnia-Herzegovina, Croatia, Macedonia, Montenegro, Serbia and Slovenia met in Oslo, Norway, to establish a dialogue between medical professionals on issues related to humanitarian assistance, health and medical issues. The three days meeting was initiated by the Norwegian Medical Association's Committee on Human Rights and financed by the Norwegian Ministry of Foreign Affairs. The meeting was held in cooperation with the World Health Organization and the medical associations of all the Nordic countries. The meeting in Oslo started in tension but ended with a joint statement (page 303) from all eleven participating delegations to continue dialogue on issues related to humanitarian assistance to the people of former Yugoslavia and to find ways of moving forward in health and medical issues.

Delivery of Health Care↗

[Care of injured and ill patients in combat areas in the former Yugoslavia 1991-1992].

Large number of military and civilian physicians took part in war on the territory of former Yugoslavia during 1991/1992, managing the medical service or in medical units of Yugoslav Peoples' Army and civilian health institutions. Their vast war experiences were presented in their reports and numerous papers published in proceedings of congresses and meetings, held in the period from 1992 till today. This is an attempt to systematize those experiences and to draw out some conclusions significant for the further development of doctrinaire approach to the organization and functioning of the medical service of the Army of Yugoslavia at war.

Health Services↗

Health status of refugees from former Yugoslavia: descriptive study of the refugees in the Netherlands.

AIM: To describe the health status of formally recognized refugees from the former Yugoslavia in the Netherlands, and analyze the relationship between experienced traumatic events and health status. METHODS: A random sample of refugees was taken from randomly selected municipalities. One hundred and two persons received a postal questionnaire. Forty percent filled out the questionnaire completely. Well-validated self-assessment scales were used to measure six dimensions of health status. Traumatic experiences were assessed by the Harvard Trauma Questionnaire. Physical aspects of health status were measured by the three dimensions of the Medical Outcome Study (MOS) Short-form General Health Survey (SF-20) which consisted of the dimensions "physical functioning", "subjective health", and "pain". Social health was measured by the two dimensions of the SF-20, "role fulfilling" and "social functioning". RESULTS: The refugees showed vulnerable health. A significant group had an accumulation of health problems. These were mostly unrelated to sociodemographic variables. Many of the refugees experienced several traumatic events. These experiences were clearly related to all health problems. CONCLUSIONS: The refugees from the former Yugoslavia scored low on standardized health measurement scales. This was primarily due to their traumatic experiences in combination with their refugee status. There is a need for health services to prevent the accumulation of (future) health problems.

Adult↗

[Epizootiologic situation of rabies in 1997. Urbanization of sylvatic rabies in Yugoslavia].

The Federal Republic of Yugoslavia is situated on the border of a great sylvatic rabies epizootics occurring in central and eastern Europe. That is the reason why a relatively small number of rabid animals have been registered. In 1997, 124 rabid animals, mainly red foxes, were identified. In recent years red fox rabies epizootics in Yugoslavia has annually spread 15-20 km to the south. Rabies in domestic animals, especially dogs, was characterized with furious clinical forms and dog-to-dog transmission typical of urban rabies. Sylvatic rabies has been almost completely eradicated in some countries of western Europe in the last years, mostly due to the method of oral vaccination of foxes-the main vector of rabies.

Animals↗

A survey of ergonomics in Yugoslavia.

The writer conducted a survey of ergonomics in Yugoslavia during the month of December 1982. This survey was made possible by the scientific exchange programme between the National Academy of Sciences of the USA and the Council of Academies of Yugoslavia. The writer met with engineers and scientists in academic, research and public health institutions to develop an overview of historical developments, the compostion of the ergonomics community, current research interests and methodologies, academic training programmes and future trends. The schedule of visits, which spanned four of the six Yugoslavian republics, is summarised in Table 1. The present study is a sequel to earlier surveys of ergonomics or human factors in Eastern Europe (Seminara, 1975; 1976; 1979a; 1979b; 1979/80; 1980; 1982; 1983).

Journal Article↗

Psychiatric and cognitive effects of war in former yugoslavia: association of lack of redress for trauma and posttraumatic stress reactions.

CONTEXT: Although impunity for those responsible for trauma is widely thought to be associated with psychological problems in survivors of political violence, no study has yet investigated this issue. OBJECTIVE: To examine the mental health and cognitive effects of war trauma and how appraisal of redress for trauma and beliefs about justice, safety, other people, war cause, and religion relate to posttraumatic stress responses in war survivors. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional survey conducted between March 2000 and July 2002 with a population-based sample of 1358 war survivors who had experienced at least 1 war-related stressor (combat, torture, internal displacement, refugee experience, siege, and/or aerial bombardment) from 4 sites in former Yugoslavia, accessed through linkage sampling. Control groups at 2 study sites were matched with survivors on sex, age, and education. MAIN OUTCOME MEASURES: Semi-structured Interview for Survivors of War, Redress for Trauma Survivors Questionnaire, Emotions and Beliefs After War questionnaire, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS: The mean (SD) age was 39 (12) years, 806 (59%) were men, and 339 (25%) had high school or higher level of education. Participants reported experiencing a mean of 12.6 war-related events, with 292 (22%) and 451 (33%) having current and lifetime posttraumatic stress disorder (PTSD), respectively, and 129 (10%) with current major depression. A total of 1074 (79%) of the survivors reported a sense of injustice in relation to perceived lack of redress for trauma. Perceived impunity for those held responsible for trauma was only one of the factors associated with sense of injustice. Relative to controls, survivors had stronger emotional responses to impunity, greater fear and loss of control over life, less belief in benevolence of people, greater loss of meaning in war cause, stronger faith in God, and higher rates of PTSD and depression. Fear and loss of control over life were associated with PTSD and depression (odds ratio [OR], 2.91; 95% CI, 2.27-3.74 and OR, 2.30; 95% CI, 1.75-3.03, respectively), and emotional responses to impunity showed a relatively weaker association with PTSD (OR, 1.53; 95% CI, 1.16-2.02) and depression (OR, 1.39; 95% CI, 1.02-1.91). Appraisal of redress for trauma was not associated with PTSD or depression. CONCLUSIONS: PTSD and depression in war survivors appear to be independent of sense of injustice arising from perceived lack of redress for trauma. Fear of threat to safety and loss of control over life appeared to be the most important mediating factors in PTSD and depression. These findings may have important implications for reconciliation efforts in postwar countries and effective interventions for traumatized war survivors.

Adult↗

Additional upper Pleistocene human remains from Vindija cave, Croatia, Yugoslavia.

This report presents a morphological description of ten hominid skeletal fragments found at Vindija cave, northwestern Yugoslavia, in 1980-1981. Eight of the specimens (seven cranial fragments and one complete hand proximal phalanx) were excavated from level G3, a stratum correlated to the Lower Würm stadial and containing Mousterian lithic elements. The salient morphological features of these new specimens are similar to those of previously described hominids from this same stratum, indicating that the new specimens are also remains of archaic H. sapiens (Neandertals). One parietal fragment was excavated from the stratigraphically more recent F complex. The F complex contains Upper Paleolithic lithic elements, and the new hominid specimen from this complex appears to exhibit features similar to other early modern H. sapiens in southcentral Europe.

Bone and Bones↗

Isolation by distance in Middle Dalmatia-Yugoslavia.

Parameters of Malécot's isolation-by-distance model are estimated for biological (anthropometric head and body dimensions, morphometric dimensions of metacarpal bones, quantitative and qualitative dermatoglyphic traits, and physiological/cardiorespiratory/variables) and linguistic distances and migrational kinship on the island of Korcula and the Peljesac peninsula in Middle Dalmatia, Croatia, Yugoslavia. Resulting parameters and the fit of the model are compared, for both regions, as well as with results of similar analysis in other parts of the world. The fit of the model is highly significant for migrational kinship and linguistic distances and less so for biological traits. Differences between these two populations, which live under basically similar ecological conditions, are explained by variation in biological and sociocultural history.

Adult↗

Organisational issues and effectiveness of the health sector in the Republic of Slovenia, Yugoslavia.

The republic of Slovenia is one of the six republics of the Socialist federal republic of Yugoslavia. The article deals with the health situation over the period from 1975 to 1988. Illness and hospitalisation data are shown in Slovenia for the year 1988, and the movement of common illnesses shown over the period 1980-1988. The health infrastructure is presented for the year 1986, and the stock of cadres of health worker i.e. doctors, dentists, pharmacists, nurses, is shown in tabular and graphic form, together with changes in the composition of that stock over the last fifteen years. These data are then used to develop trends, and a commentary on progress made. Finally, the level of financing of health care is shown, and movements in the share of the social product (GNP) from 1975 to the present time. Over that period, the share has remained constant, though significant fluctuations have taken place from year to year.

Demography↗

Respiratory syncytial virus infections in SR Croatia, Yugoslavia.

The prevalence of respiratory syncytial virus (RSV) infection was studied during three consecutive annual outbreaks (1983-1986) in SR Croatia, Yugoslavia. A total of 1,238 subjects were examined, using RSV isolation and immunofluorescent (DTFA) methods, with 1,042 showing the signs of respiratory infection and 207 of these having a positive RSV finding. Generally, the prevalence of mild upper respiratory infection (URTI) was 18%, reaching a peak of 30% at 1 year of age. The prevalence of severe lower respiratory tract infections with bronchiolitis, pneumonia, and croup accounted for 51, 34.4, and 28.3% respectively. The highest incidence of RSV infection among respiratory cases was observed in the first 6 months of life (49.4%), being particularly high at the second month among those with URTI, bronchiolitis, pneumonia, and croup (76.2%). Both sexes were equally susceptible to RSV infection (20.51% females, 19.03% males). RSV infections, seasonal incidence ranged from 25.55 to 30.31% in 1983/84 and 1984/85 respectively and dropped sharply to 8.93% in 1985/86.

Adolescent↗

On the origin of mass casualty incidents in Kosovo, Yugoslavia, in 1990.

In March 1990, a mysterious outbreak of illness spread suddenly among thousands of ethnic Albanian high school students in Kosovo (Yugoslavia). It was an unprecedented event on the worldwide scale both in terms of the number of cases and in terms of controversies concerning the aetiology. A retrospective analysis indicated that the epidemic consisted mainly of cases who felt ill in the absence of exposure to any physical agent. It is suggested that in an atmosphere of severe tension between the two ethnic groups living in Kosovo an increased frequency of respiratory infections may have triggered mass sociogenic illness.

Adolescent↗