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[Improving ambulatory services for children in the foci of tuberculosis with special reference to the factors of increased risk of infection].

The paper deals with the results of the examination of certain factors that increase the risk of children's contamination in tuberculosis infection foci. It has been established that primary infection takes place more frequently in children under 6 years of age (1.3-fold), in children who do not attend preschool establishments (2-fold), in those having inappropriate BCG vaccination and revaccination (2.4-fold) and in the foci where patients abuse alcohol (2.2-fold). These children comprise a group of especially high contamination risk. It is expedient to check up them 3 times a year, performing a tuberculin test in children showing an uncertain response, to conduct clinical and X-ray examinations in accordance with the indications and to strictly controlled chemoprophylaxis. The proposed scheme of children's medical examination is one of the pattern to make better therapeutic and preventive measures in tuberculosis infection foci.

Adolescent↗

[Disorders of glucose tolerance and ischemic heart disease].

The incidence of impaired glucose tolerance, the relation of blood glucose levels to the prevalence of risk factors for coronary heart disease (CHD) and to myocardial infarction morbidity and mortality were studied over 15 years among males aged 45-59 years, excluding patients with diabetes mellitus. The data analysis was made in quintils of glucose levels. Impaired glucose tolerance was detected in 20.6% of the males. In the fifth versus the first quintil, there was an increase in the prevalence of systolic and diastolic arterial hypertension (p less than 0.001), obesity (p less than 0.001), low physical activity and hypercholesterolemia (p less than 0.05). As compared with the first, the fifth quintil showed higher total mortality rates and higher myocardial infarction morbidity and cardiovascular disease and CHD morbidity rates. But for age, and major risk factors, the risk for CHD, total and cardiovascular mortality increase at low and high blood glucose concentrations.

Age Factors↗

[Amino acid composition and biological value of pastries with protein-rich additives].

The authors studied amino acid composition of confectionery (bisquits) enriched with dry fat-free milk, dried buttermilk, dry whey and soya bean flour. The biological value of the products was estimated by the sum of essential amino acids, by the ratio of essential amino acids and total nitrogen, by the chemical score and the variation coefficient of the amino acid score. It has been established that confectionery enriched with dry fat-free milk and dried buttermilk contain more lysine than those enriched with soya bean flour. The balance of amino acids is improved in the products enriched with dry fat-free milk and dried buttermilk. To improve the amino acid balance and increase protein content in food products it iz recommended that by-products of milk manufacturing be mildly used.

Amino Acids↗

[3 cases of viral carriage detected during screening for HIV antibodies].

The results of screening more than 23,000 serum samples from persons belonging to risk groups, as well as those not belonging to such groups, in Moscow, Vilnius and Klaipeda are presented. Screening was carried out with the use of an assay system manufactured by the Scientific and Industrial Amalgamation "Antigen" (USSR). In this screening 3 HIV carriers were detected; of these, 2 were foreign students from two African countries.

Acquired Immunodeficiency Syndrome↗

[Diagnosis of the degree of neuroticism using psychological methods].

Three Herck-Hess questionnaires (BFB-A, BFB-B and VFB), the MMPI test, color Lüscher's test (short form) and EEG investigation were employed to compare the diagnostic value of different methods during primary determination of neuroticism in 80 practically healthy persons. There were 43 women and 37 men. The Herck-Hess questionnaires applied at a time turned out the most suitable for individual diagnosis of neuroticism, which was proved on a statistical basis with the aid of the mean profiles of the MMPI test. On analogous checking by the MMPI test Lüscher's test appeared unreliable in neuroticism determination. No relationship was established between neuroticism and EEG alterations.

Adult↗

Laboratory standardizatin in an international study: the Kaunas--Rotterdam intervention study (KRIS).

Laboratory results obtained in different laboratories over lengthy periods of time usually are difficult to compare. In cooperative long-term studies where such results must be pooled, thorough standardization of methods is vital. We describe a program in which comparable plasma cholesterol and glucose analyses have been obtained, by simple methods. In the Netherlands and the Soviet Union in close collaboration with the Center for Disease Control, Atlanta, Ga., U.S.A. The two laboratories produced glucose values (direct o-toluidine reaction) within 2% of the target reference values and cholesterol results (direct Liebermann-Burchard reaction) with a consistent 6-8% positive bias over the reference method values. Intralaboratory precision was subject to preset acceptance limits. The use of common control materials, exchange of patient samples, and on-site comparison of all details of laboratory procedures are vital tools in standardization efforts. A laboratory protocol that included quality requirements and rejection criteria was developed and proved to be indispensable. The experience gained should be useful in standardizing inter-laboratory results in similar studies.

Blood Glucose↗

[The therapeutic problems of medicine in catastrophes].

There are lack of principle differences between the problems of medical aid during the military and civil disasters, and therefore one can draw a conclusion concerning the validity and necessity of using the experience of military medics in disaster medicine during peace-time. The following aspects are discussed: organization of therapeutic caring of the victims during Chernobyl's AES disaster, earthquake in Armenia and accident in chemical enterprise "Nitrogen" in Jonava. Requirements to the teams for emergency medical service have been formulated with determination of Principles of putting them into practice; the further directions of therapeutic aid improvement are outlined.

Accidents↗

[Health status of childbearing population of women in regions with different levels of infant mortality].

Under conditions of present demographic situation in the USSR with a view of scientific substantiation of priority directions in the development of regional programmes of medico-social activities in the field of maternal and child health the major importance is being given to the valid information on the health status of mothers and factors of social environment determining the conditions for intrauterine development of foetus and the formation of child health at early stages of life under conditions existing in specific regions. For this purpose simultaneously in Panevezhis, Lipetsk and Fergana which are representatively reflecting the specificity of regions with low, average and high infant mortality, on the basis of unified methodology a complex socio-hygienic survey of three cohorts of children of 1986 year of birth and their mothers during the present period of pregnancy and delivery was conducted. The data suggested the rise in the level of pathology identified during pregnancy and delivery among Fergana women as compared with Lipetsk and especially Panevezhis women.

Adult↗

[General risk factors of chronic non-infectious diseases among schoolchildren in Kaunas and Moscow].

Representative samples of 16-year-old school-children including 126 children from Kaunas and 124 children from Moscow were surveyed by one and the same team consisting of researchers from Kaunas and Moscow. The survey indicated a statistically valid higher level of systolic blood pressure among Kaunas schoolchildren as compared to Moscow schoolchildren of the same age group. Diastolic blood pressure was somewhat higher among Moscow schoolchildren. Moscow schoolchildren smoked statistically valid more often and more intensively. During leisure time boys from Kaunas and girls from Moscow were less physically active. A higher level of arterial blood pressure was found among schoolchildren with high rates of IMT and among non-smoking boys. There was no dependence between the duration of physical activity in leisure time and the level of arterial blood pressure. The established correlations between levels of general risk factors for chronic noninfectious diseases (CNID) among Kaunas and Moscow schoolchildren are important for the evaluation of the effectiveness of CNID integrated prevention programme.

Adolescent↗

[Improving the organizational forms of early detection of arterial hypertension].

Within scientific and practical integral programme of chronic noninfectious diseases prevention and control scientifically substantiated prevention procedures are being developed and introduced into applied public health with the object of reducing morbidity and mortality in the republic from leading non-infectious diseases. Proceeding from the assumption that each fifth or sixth adult inhabitant of the republic has elevated arterial blood pressure and during recent years the indices of effectively controlled arterial hypertension are not improving, the search for new forms of arterial hypertension control is quite timely. The results of work of the prevention unit established at the regional department store suggests great opportunities for increasing the volume of screening for arterial hypertension, increasing population's awareness of the necessity of arterial hypertension correction. Enlisting medical students and sometimes senior pupils from secondary school to work in the prevention units established at non-medical institutions serves as an example of using additional resources for the control of arterial hypertension at the community level.

Adolescent↗