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PubMed1990

[Ethnic genetics: ethnogeographic diversity of the gene pool of human populations around the world].

The study was undertaken to estimate a degree of genetic differentiation in human all-world population at the ethnic level of its structure. The genetic information for this work came from well-known A. Mourant's et al. world-wide survey on human genetic polymorphisms and from regional survey on the same polymorphisms of the USSR peoples. The data were grouped into 9 regional populations studied for 49 alleles and haplotypes belonging to 20 polymorphic loci. Average genetic distances from the all-world human gene pool to each of regional one, and from these to gene pools of ethnic groups within regions were estimated and compared. An unexpected result of this within-between-region comparative analysis is the shortest genetic distance between gene pools of the USSR peoples as a whole on the one hand, and all-world peoples on the other. At the same time, a considerable part of the total human genetic polymorphism is persisted in the USSR region.

Americas↗

PubMed2006

[Tuberculosis in the world, and in Japan].

Tuberculosis situation in a certain country or area is decided by 1) tuberculosis prevalence of the past during around 40 years, 2) socio-economic situations of the country, and 3) tuberculosis control program. The trend of tuberculosis situation is changing forming "tuberculosis spiral" shown in Fig 1. TB situations of the several countries in the world were discussed to show the factors influencing on them from the standpoint of view mentioned above. The trends of TB epidemiology of the 47 prefectures in Japan were analyzed more deeply. The 47 prefectures were divided into the following 3 groups. The first group consists of rural prefectures where TB incidence is not so high and decreasing rather rapidly. TB was not so prevalent in the past 40 years or more, compared with other prefectures belonging to the other group. The second group is composed of intermediate prevalent prefectures because of rather high prevalence of tuberculosis in the aged, due to the rather high prevalence of tuberculosis in the past. The big cities and prefectures near by are forming the third group. Prevalence of tuberculosis among the young, jobless, homeless, foreign-born and so on is high, and tuberculosis is decreasing slowly. Divergence of tuberculosis epidemiology between these three groups is becoming wider recently. The spiral of tuberculosis, mentioned above, could be observed clearly by the analysis of the trend of tuberculosis in these 42 years in 47 prefectures. The author is considering that tuberculosis control program in the world has developed as follows. After the World War 2nd, classical tuberculosis control program had been carried out in the world (the classical TB control period, 1948-1963), new realistic tuberculosis control program had been launched in 1964 according to the 8th Experts Report of WHO (the realistic TB control period, 1964-1990). However tuberculosis did not decrease as expected, and the simple and clear tuberculosis control program aiming 85% or more cure rate, later by DOTS strategy (DOTS period, 1991-1999). And to expand and strengthen tuberculosis control program more and more, the Stop TB Partnership has been started in 2000 (the Stop TB period, 2000-). In Japan, tuberculosis control program has been carried out by Anti-Tuberculosis Law enacted in 1951, revising according to the situations. However, remainder of the classical tuberculosis control program, such as high rate of hospitalization, long duration of hospitalization and so on, is still existing. The author concluded that it is important to improve tuberculosis control program according to the epidemiological situation of the area, because tuberculosis situation is different by area to area and will become more profound in the future.

Adult↗

PubMed1990

Current status of nuclear power in the United States and around the world.

Nuclear energy's share of the world electricity market has been growing over the past 35 years. In 1989, eight generating units entered commercial operation abroad and three new units were licensed in the U.S. In early 1990, Mexico became the 26th country to produce electricity from nuclear power. Currently the 426 operating reactors supply one sixth of the world's total electrical capacity. Fourteen countries have now operated nuclear plants for 20 or more years. Since 1980, France has been the leader in the use of nuclear power and currently generates three quarters of its electricity from 54 nuclear plants. The U.S. has 112 nuclear plants, the largest number of any country in the world. These plants satisfy almost 20 percent of U.S. electrical energy requirements. Last year Three Mile Island, the would-be icon for everything that is wrong with the nuclear industry was rated as the most efficient nuclear plant in the world. The worldwide trend toward acceptance of nuclear is improving slightly, but many political and societal issues need to be resolved. Whereas recent polls indicate that a majority of the people realize nuclear must be a major contributor to the energy mix of the future, many are reluctant to support the technology until the issue of waste disposal has been resolved. Fears of another Chernobyl, lack of capital, and a new anti-nuclear campaign by Greenpeace will keep the nuclear debate alive in many countries. Additional stumbling blocks in the U.S. include the need to develop a new generation of improved reactor designs which emphasize passive safety features, standardized designs and a stream-lined federal licensing process. Nuclear power is really not dead. Even environmentalists are starting to give it another look. A nuclear renaissance will occur in the U.S. How soon or under what conditions remain to be seen. The next crisis in the U.S. will not be a shortage of energy, rather a shortage of electricity.(ABSTRACT TRUNCATED AT 250 WORDS)

Asia↗

PubMed1988

Man, apes, and Old World monkeys differ from other mammals in the expression of alpha-galactosyl epitopes on nucleated cells.

The study of the expression of alpha-galactosyl epitopes on various mammalian cells is of particular interest, since as much as 1% of circulating IgG antibodies in humans interact with this carbohydrate residue. This natural antibody, designated "anti-Gal," was previously found to bind to terminal Gal alpha 1----3Gal beta 1----4GlcNAc-R on biochemically defined glycolipids (Galili, U., Macher, B. A., Buehler, J., and Shohet, S. B. (1985) J. Exp. Med. 162, 573-582; Galili, U., Buehler, J., Shohet, S. B., and Macher, B. A. (1987) J. Exp. Med. 165, 693-704). The expression of anti-Gal binding epitopes on nucleated cells from various mammalian species was studied by immunostaining with this antibody. The binding of anti-Gal to various cells was correlated with the binding of the lectin Bandeiraea (Griffonia) simplicifolia IB4 (BS lectin). The BS lectin also interacts with alpha-galactosyl residues and particularly with high affinity with Gal alpha 1----3Gal beta 1----4GlcNAc residues. We observed a striking evolutionary pattern in the expression of these epitopes on mammalian nucleated cells. Fibroblasts, epithelial cells, endothelial cells, smooth muscle cells, and lymphoid cells of nonprimate mammals, prosimians, and New World monkeys readily bound both anti-Gal and BS lectin. However, no such binding was detectable on cells of Old World monkeys, apes, and humans. Measurment of the binding of radiolabeled BS lectin to the various nucleated cells suggests that cells binding anti-Gal express 10(6) to 3.5 x 10(7) alpha-galactosyl epitopes, most of which, based on the anti-Gal specificity, seem to have the structure of Gal alpha 1----3Gal beta 1----4GlcNAc-R. The absence of these epitopes from human cells results from diminished activity of the enzyme alpha 1----3 galactosyltransferase, which catalyzes the following reaction. Gal beta 1----4GlcNAc-R + UDP-Gal(alpha 1----3-galactosyltransferase)----Gal alpha 1----3Gal beta 1----4GlcNAc-R + UDP This enzyme, which participates in the glycosylation of cell membrane glycoconjugates in nonprimate mammals, prosimians, and New World monkeys, appears to have been suppressed in Old World primates as a result of evolutionary events which occurred 20-30 million years ago. It is argued that an anomalous activity of this enzyme in man may result in initiation of autoimmune diseases because of the de novo expression of Gal alpha 1----3Gal beta 1----4GlcNAc-R epitopes recognized by anti-Gal.

ABO Blood-Group System↗

PubMedDate not supplied

Short-term medical service in the developing world.

Medicine as it is practiced in the developing world is far removed from medicine as we know it in the United States. It is the authors' opinion that the developing world offers a stimulating environment medically, culturally, and ethically. Those physicians who devote some portion of their careers to practicing in the developing world reap significant rewards. The authors describe how they found and selected medical situations in the developing world and the experiences they had delivering health care in those situations.

Developing Countries↗

PubMed1993

Child health in the Third World.

Malnutrition, immunisable illness and diarrhoeal diseases are the main causes of morbidity and mortality in Third World children. War and other disasters, rapid social change and AIDS add to these problems, and the debts of Third World countries cripple their efforts to deal with them. The World Summit for Children formulated an ambitious set of goals for the world's children by the year 2000 and there are signs that improvements in basic child health services can be achieved in this decade.

Child Health Services↗

PubMedDate not supplied

[An agenda to debate: the World Bank report Investing in Health].

The 1993 World Bank Development Report analyzes the world health situation from an economic perspective. In spite of the fact that many of the discussed topics are controversial, the report accomplishes an interesting review of different health and socioeconomic indicators. The experts of WHO and the World Bank elaborated a new measurement of the global burden of disease, the Disability-Adjusted Life Years (DALYs). It's an indicator that summarizes the health status of a population, combining mortality, morbidity and disability data. We think that the development of this new indicator is the most novel and positive aspect of the report. This indicator stimulates comparisons between countries and facilitates decision making processes in the health field. The present work summarizes and analyses the most interesting and controversial aspects of the World Bank Development Report.

Financing, Organized↗

PubMed1995

The anal world of a six-year-old boy.

Clinical material from the psychoanalysis of a 6-year-old boy is presented which manifests the creation of an anal psychic world--a psychic world which is blatantly anal in content and characterised by the formal qualities of de-differentiation and interchangeability, which are linked to anal experience and the level of cognitive maturation typical during the anal phase. This case demonstrates the existence at an earlier developmental level of perverse qualities which have previously been identified in adults. In particular, similarities are noted with the fantasies of adult perverts and the Marquis de Sade. Psychodynamic antecedents which have previously been extrapolated from investigation of these adults are confirmed in statu nascendi in this child. Like adult perverts, this boy appears to have created his anal world to defend against acknowledgement of sexual and generational differences. His anal world play is conceptualised as an example of a perverse play style.

Child↗

PubMed1996

The ethics of managed care--part 2 diagnosis: the world as it is....

A warped vision of the world is demiurgic: it helps distort the world in its own image. Ethics is about correcting one's self-exculpatory vision so as to see the world clearly as it is in the hope that it can be improved. This essay summarizes the world-as-it-is in health care today.

Choice Behavior↗

PubMed1996

Health status assessment via the World Wide Web.

We explored the use of the World Wide Web to collect health status information for medical outcomes research. The RAND 36-Item Health Survey 1.0 (RAND-36), which contains the 36 multiple-choice questions of the Medical Outcomes Study SF-36 "Short Form" and differs only in its simplified scoring scheme, was made available for anonymous use on the Internet. Participation in the survey was invited through health-related Internet news groups and mailing lists. Participants entered data and received, their scores using the World Wide Web protocol. Entries were recorded from 15 June 1995 to 14 June 1996 (1 year). The survey was completed anonymously by 4876 individuals with access to the World Wide Web. Two-thirds completed the survey within 5 minutes, and 97% did so within 10 minutes. The item-completion rate was 99.28%. Values of Cronbach's alpha of 0.76 to 0.90 for the scoring scales matched the high reliability found in the Medical Outcomes Study. The World Wide Web provides a method of rapidly measuring individual health status and may play an important role in advancing health services research and outcomes-based patient care.

Computer Communication Networks↗

PubMed1997

Middle digestive cancers in Texas Hispanics: a New World syndrome?

To test the hypothesis that middle digestive cancers in Texas Hispanics follow the patterns predicted by the New World Syndrome (1984), cancer incidence rates and relative risks for middle digestive cancers were estimated for 1944-1992. The relative risk for all middle digestive cancers is significantly elevated in Texas Hispanics compared with Anglos, and this risk has increased over time. Elevated risks of these cancers in Texas Hispanics have been explained as resulting from the evolutionary history of Native Americans (American Indians), their genetic relation to Texas Hispanics, and a changing diet and lifestyle. Recent Texas cancer incidence data add further support to the hypothesis. Other current disease prevalence data in Texas Hispanics, percent of the population which is diabetic and percent which is overweight, are also consistent with the New World Syndrome. Expected patterns of disease in males vs females are also confirmed. Factors that do not support the New World Syndrome hypothesis and can be examined by future studies are described. This is the first report since the original describing and updating patterns of middle digestive cancers in Texas Hispanics as resulting from the New World Syndrome. Application of these findings to contemporary medical practice and to cancer prevention are reviewed.

Asian People↗

PubMed1997

A research agenda for AIDS prevention in the developing world.

BACKGROUND: In the developing world, HIV is spreading in many epidemiologic patterns, ranging from slow spread in limited segments of the population to exponential growth to mature epidemics. These differences are superimposed on widely varying cultures and patterns of behavior, creating unique challenges for prevention in each setting. Local prevention research is continually necessary to respond appropriately and effectively to local prevention needs and to best use scarce resources. THE RESEARCH AGENDA: We propose a research agenda for AIDS prevention in the developing world, consisting of three main components: epidemiologic and behavioral surveillance; enhancing local understanding of HIV risk behavior; and testing interventions. We review examples of each. This 'bottom-up' research is contrasted with 'top-down' research conducted in the developing world by scientists from developed countries to answer questions of general interest. RESULTS: The articles published in this volume exemplify the scope and importance of AIDS prevention research in the developing world. They also show what can be accomplished through international collaboration directed towards meeting local needs.

Acquired Immunodeficiency Syndrome↗

PubMed1997

[Veterinary medicine in the modern world].

Present veterinary medicine is the result of a global scientific effort. Unknown are ideological or national barriers. However, the conditions for its realization vary from country to country with a changing clientele as well. The number of farm animals is increasing, as well as interest in the health of animals not in the care of man. There are about 600,000 veterinarians in the world, globally unevenly distributed. Relatively speaking, the least are in areas with greater agricultural population, and the most, in societies of the postindustrial age. In recent years many regions of the world have been going through an avalanche of changes. Even though the concepts of these consequence to the health care of animals far from agree, the direction of veterinary responsibility is shifting from public to private sector. In this regard the care of animal health on an international, national or regional level has been repeatedly analyzed and intricately evaluated from the early '80s. A generally accepted policy has been that in the care of animal health both sectors, public and private, play a significant role. However, under discussion are their relative proportions which differ in various parts of the world. The market is increasingly permeating into health care. In our country up to now the critical break in the development of veterinary medicine has not been objectively evaluated. We are still too concerned with the past, passing on disinformation, persisting in old dogmas and moss-grown myths. The way into a world of new priorities and the hierarchy of values in today's turbulent times is uneasy, all the more to be tentaciously sought.

Animal Diseases↗

PubMed1998

Trends in childhood cancer mortality as indicators of the quality of medical care in the developed world.

BACKGROUND: Mortality from childhood cancer in general and childhood leukemia in particular has sharply declined in economically developed countries over the last 30 years, whereas the incidence of these diseases has remained essentially unaltered. Therefore, childhood malignancies can be used as tracers of accessibility to and effectiveness of medical care. The objective of this study was to compare the reduction of mortality from childhood cancer in general, and childhood leukemia in particular, in four economically developed areas of the world, to assess accessibility to and effectiveness of technologically advanced medical care. METHODS: The authors used data from the World Health Organization to compare the evolution over time of gender specific, age-adjusted mortality from childhood cancer in general and childhood leukemia in particular in the childhood (birth to age 14 years) populations of North America, western Europe, Japan, and Australia and New Zealand during the period 1960-1993. They assessed the evolution over time and the cumulative percentage representing the decline in mortality from childhood cancer and childhood leukemia in the four aforementioned areas of the world. RESULTS: The decline in mortality from both the disease entities considered and for both genders has been more pronounced in North America than in other economically developed areas of the world. CONCLUSIONS: When disease control depends on technologically advanced medical care, as in the case of cancer, the North American population is benefited by earlier and effective introduction of new therapeutic approaches. This conclusion does not apply to other childhood diseases, the incidence of which is higher among low-income groups and control of which depends on prevention rather than treatment.

Adolescent↗

PubMed1998

Patterns of death in world leaders.

This study presents an analysis of the mortality patterns of people who become world leaders. Using information in the public domain, we identified 261 world leaders who died between 1965 and 1996. Of these, 118 died while in office, 44% violently, often by assassination. Of the 143 leaders who died after leaving office, 11% died violently. The violent deaths occurred worldwide but most frequently in the Middle East/South Asia and sub-Saharan Africa regions. The most frequent natural causes of death among world leaders were heart disease, cancer, and stroke. Mortality patterns reveal that the longevity of those leaders who died of natural causes could have been predicted by U.S. life tables. This study suggests that world leaders are neither biologically "tougher" nor more vulnerable to disease than others; however, their odds of dying violently while in office are high.

Aged↗

PubMed2026

Timing matters: Impact of covalent BTK inhibitor dose modifications on outcomes in chronic lymphocytic leukemia/small lymphocytic leukemia-A 7-year real-world study.

BACKGROUND: Covalent BTK inhibitors (cBTKis) are the cornerstone of chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL) therapy, yet real-world data on dose modifications and their differential impact on long-term outcomes remain incompletely defined. This study investigated the incidence, timing, and the effectiveness of drug switching in a real-world CLL cohort. METHODS: In this 7-year retrospective real-world study, 324 CLL/SLL patients treated at a specialized Shanghai outpatient clinic (April 2018-April 2025; median follow-up, 42 months) were analyzed. Dose modifications were classified as dose interruption (DI) or dose reduction (DR). Their prognostic impact on progression-free (PFS) and overall survival (OS) was assessed by Kaplan-Meier analysis and multivariate Cox regression. RESULTS: The 42-month PFS rate was 70.2%. Of 324 patients, 229 (70.7%) experienced dose reductions or interruptions; infections were the predominant cause (61.9%). The full-dose (FD) group (n = 90) demonstrated superior 4-year PFS (93% vs. 58%, p < .001) and OS (98% vs. 76%, p = .007). Early modifications (0-3 months) were independent predictors of inferior PFS (hazard ratio [HR], 3.93, p = .008) and OS (HR, 3.29, p = .014). Prolonged DI (>14 days) was associated with inferior PFS (HR, 2.64) and OS (HR, 2.15), whereas DR and short DI (≤14 days) had negligible impact. Early (0-3 months) prolonged DI was devastating (3-year PFS, 41.2%; HR, 3.84, p < .001). cBTKi switching (n = 82; 100% nonprogression-driven) shortened DI (median, 6 vs. 14 days) and was independently associated with superior OS (HR, 0.34, p = .018) and PFS (HR, 0.36, p = .022). CONCLUSIONS: Early prolonged DI is the dominant adverse prognostic factor in cBTKi-treated CLL/SLL. Proactive switching minimizes treatment gaps and improves survival, supporting a timing-aware, DI- versus DR-informed approach to dose management.

Humans↗

PubMed1993

On the role of the World Health Organization in the development of Sabin vaccines.

The World Health Organization has played a major part in the development, surveillance and distribution of attenuated poliovirus vaccines. At a time when most of the United States' efforts concerned the introduction of Salk-type vaccines, WHO initiated studies that set standards and permitted the large scale trials of Sabin and other attenuated vaccines. Independent expert review validated studies in countries such as the U.S.S.R. which helped lead to the adoption of Sabin vaccines for worldwide usage. Surveillance by WHO Collaborative Centres established the safety of Sabin vaccines and identified issues of reversion primarily concerning type 3 viruses, initiating studies which have elucidated the molecular mechanism of reversion. Efforts by the Biological Unit of the World Health Organization have ensured worldwide acceptable standards to control the safety and manufacture of vaccines. Revision of neurovirulence test methods has ensured adequate safety testing of vaccine lots, reduced the costs of such studies and the numbers of primates needed, important ethical and conservation issues. Finally, the World Health Organization has played a major part in the worldwide supply of vaccines at affordable prices and has been the repository of, and had the exclusive license, to Sabin vaccines since 1972.

Animals↗

PubMed1989

Rational use of diagnostic imaging in paediatrics. The report of a World Health Organization Study Group.

The World Health Organization (WHO) is the agency of the United Nations with primary responsibility for international health matters and public health. Through the exchange of the knowledge and experience of health professionals from 165 nations WHO promotes comprehensive health services worldwide. As a part of this effort WHO has in recent years been concerned with improving the availability and utilization of diagnostic imaging, especially as it relates to health services in developing countries. Having devised and specified suitable basic radiographic equipment (the WHO BRS) a WHO Scientific Group was convened in 1982 to study the utilization of radiographic procedures and to to recommend their more efficacious and rational use. Then in 1984, recognizing the implications of newer imaging technology on world health, a second WHO Scientific Group considered the design, impact and future use of ultrasonography and computed tomography in developing countries. The findings of these scientific groups were published as part of the WHO Technical Report Series which makes available the recommendations of such international groups of experts. Although some of the needs of children were considered in these previous Technical Reports, WHO felt that the size and socioeconomic importance of the paediatric population worldwide warranted a further study and report to address the particular technical and clinical problems of diagnostic imaging in the paediatric age group. Thus a third WHO Scientific Group met in Geneva from 18 to 24 November 1985 to review established practices and experience in paediatric imaging throughout the world; and to recommend rational guidelines for diagnostic imaging for children to age 14 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗