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At least 1,261 records · Page 70Linked to original sources
PubMed1986

Time to conception after IUD removal: importance of duration of use, IUD type, pelvic inflammatory disease and age.

Some investigations of IUD use have demonstrated impaired ability to become pregnant after removal, while others have not. None of these studies, however, have adequately considered such potentially influencing variables as age and a history of pelvic inflammatory disease (PID). To study the effect of length of IUD use, IUD type and the modifying influences of age and PID history on time required to conceive, we followed women trying to become pregnant after removal of their IUD. Five hundred forty women in Ljubljana, Yugoslavia who were first fitted with an IUD between 1964 and 1972 and had their IUD removed in order to become pregnant were followed through 1980. We found no relationship between the duration of IUD use or type of IUD used, but increasing age and a history of PID each decreased the monthly probability of conception. These findings, along with other recent work, indicate that IUDs are a safe and efficacious contraceptive for women at low risk for sexually transmitted diseases.

Adult↗
PubMed1986

Yugoslavian experience with the contraceptive sponge.

A trial of the contraceptive sponge was conducted at two clinics (403 subjects) in Yugoslavia. Women were periodically followed up for 1 year. The 1-year method pregnancy rate (life-table) was 5.6 per 100 women. Rates of other events leading to discontinuation of sponge use were similarly low. There were no serious complications. The results of the study show that the contraceptive sponge may be successfully used by a population of women with limited experience with the use of vaginal contraceptive methods.

Administration, Intravaginal↗
PubMed1985

Whither the state in Yugoslav health care?

As part of their broader sociopolitical system of self-managing socialism, the Yugoslavs have attempted to create a health care system which is simultaneously destaticized, depoliticized, decentralized, democratized and economically and socially efficient. This paper provides a description and evaluation of the evolving self-managed health sector in post-World War II Yugoslavia. I argue that, despite repeated institution restructuring and innovation and some noteworthy accomplishments, the Yugoslavs have fallen short of their health objectives. After presenting alternative explanations for these shortcomings, I propose that they can best be understood in terms of the contradictions the Yugoslavs have encountered in their efforts to simultaneously pursue destatization, depoliticization, decentralization, democratization and social and economic efficiency. I conclude with an ideologically unpopular proposal that some form of continuous and legitimate central state coordination may be necessary to resolve current critical problems in Yugoslav health care (e.g. persistent deficits in health financing, shortages of basic medical supplies, duplication of expensive medical technology, unemployed health workers despite unmet health needs, persistent health inequalities).

Budgets↗
PubMed1992

Epidemiology of Balkan endemic nephropathy.

The first outbreak of Balkan endemic nephropathy (BEN) was reported between 1955 and 1957, initially in Serbia and soon afterwards in Croatia and in Bosnia and Herzegovina. The disease appears to be of a focal nature. In Yugoslavia at least six foci are known, generally along major rivers of the Danubian river basin, in areas that have often been flooded in the past and even today suffer from high ground waters. The prevalence rate of the disease is reported to be between 2 and 10%. In the endemic area of Croatia, a systematic survey of 'in-the-field' cases of the disease since 1975 has shown a prevalence between 0.5 and 4.4%. When suspected cases are also included the prevalence rises to 20% or more. Specific mortality (based on official statistics) during the period 1957-1984 averaged 1.54/1000 per annum, but some studies have shown that mortality is actually more than twice as high as this figure. More women are affected than men; women also more frequently die of BEN than men. Lethality is extremely high. A striking feature of BEN is the familial occurrence of the disease. Incidence does not seem to be connected with ethnic group differences. Immigrants into the endemic area may also contract the disease. An increased incidence of malignant tumours of the urinary tract has been recorded in populations living in endemic areas. Epidemiological characteristics suggest that the disease is contracted in the domestic situation, or possibly from other family members. Factors to be considered are food, water or long close contact. It is also possible that the disease is contracted outside the house, in connection with farming activities, since the affected persons are almost exclusively farmers.

Adult↗
PubMedDate not supplied

Consequences of lead exposure and iron supplementation on childhood development at age 4 years.

For a prospective study of lead exposure and early development, we recruited pregnant women from a smelter town and a nonlead-exposed town in Yugoslavia and followed them and their children through age 4. For 332 children seen at age 4, mean scores on the McCarthy Scales General Cognitive Index (GCI) in the exposed and nonexposed towns were 81.3 and 86.6, respectively; geometric mean blood lead concentrations (BPb) were 39.9 and 9.6 micrograms/dl, respectively. Potential confounders included the quality of the HOME environment; maternal age, intelligence, education, and language; birthweight and gender. These showed predictable associations with 4-year intelligence, accounting for 42.7% of the variance in GCI. Following adjustment for these variables and for concurrent Hgb, we found significant independent adverse associations between GCI and BPb's, measured at 6-month intervals since birth. At age 4, BPb accounted for an incremental 3.5% of the variance in GCI, such that the estimated loss in GCI associated with an increase in BPb from 10-25 micrograms/dl was 3.8 points. The Perceptual-Performance subscale of the McCarthy was most sensitive to Pb exposure, a result consistent with findings from prospective studies in Boston and Port Pirie.

Anemia, Iron-Deficiency↗
PubMed1994

Why do our patients die of active tuberculosis in the era of effective therapy?

SETTING: All patients with tuberculosis as a primary or underlying cause of death who were autopsied at the Institute for Lung Diseases and Tuberculosis, Sremska Kamenica, in the former Yugoslavia, between 1981 and 1990 were investigated. OBJECTIVE: To study why people die of active tuberculosis in the era of effective chemotherapy and to identify factors contributing to death. DESIGN: In a retrospective investigation, this index group was compared with a control group consisting of patients who suffered from tuberculosis over the same period but who improved and were discharged from hospital. RESULTS: A significant difference in age (P < 0.05) was found between those patients who died with an antemortem-established diagnosis and those who died with unrecognised tuberculosis (median 49 and 60 years respectively). When it came to the index group, 28 patients (56%) had one or more risk factors and the frequency of alcohol abuse was significantly higher (P < 0.001). Antituberculosis treatment had been introduced in 27 cases (54%). The median duration of hospitalization before therapy was 2 days and the median duration of antituberculosis therapy was 7 days. Of the 23 untreated tuberculosis patients, 74% died within the first 4 days. CONCLUSION: Delay in the detection of tuberculosis was the main factor contributing to death in our patients.

Adult↗
PubMed2004

Examination of the health status of populations from depleted-uranium-contaminated regions.

During the NATO air strikes on the Federal Republic of Yugoslavia (Serbia and Montenegro) in 1999, depleted-uranium ammunition was used on 112 locations, mainly Kosovo, in the south of Serbia, and one location in Montenegro. Blood samples of residents from depleted-uranium-contaminated areas were gathered and blood cell and chromosomal aberrations were analyzed. During the last 3 years blood samples from 21 residents of Kosovo (Strpce), from 29 residents from the south of Serbia (the Vranje and Bujanovac regions), and from 19 technical television workers from the site of Pljackovica, in the vicinity of Vranje, were collected. Blood samples from 33 residents of central Serbia and 46 occupational workers exposed to X-rays were used as controls. All subjects studied were without any clinical symptoms of disease. The examinations included general clinical assessment; urine samples for alpha-and gamma-spectrometry analysis; complete blood counts; ratio-percentages of blood cells in stained (Giemsa) capillary smears, individual leukocyte line elements; morphological changes observed under a microscope; the presence of immature forms or blasts; and leukocyte enzyme activity [alkaline phosphatase leukocyte (APL)]. Chromosomal aberrations were evaluated in 200 peripheral blood lymphocytes in mitosis. An increased incidence of rogue cells and chromosomal aberrations was found in the blood of the residents of Vranje and Bujanovac, but this was below the incidence of chromosomal aberrations in individuals occupationally exposed to ionizing irradiation. Blast cells were not found. Blood counts were decreased in only a few samples, while morphological changes of both nuclei and cytoplasm were marked in individuals in south and central Serbia. Enzymatic activity (as measured by the APL score) was decreased in samples with chromosomal aberrations and cyto-morphological changes in subjects from the south of Serbia. The contamination level measured by this examination was low. Because of the presence of depleted uranium (uranium-238) in the soil and in plants, the prevention of consequences necessitates the identification of the initial biological effects on sensitive tissues. Early identification of serious blood cell changes is important for appropriate medical treatment.

Alkaline Phosphatase↗
PubMed2005

Radioactivity of the soil in Vojvodina (northern province of Serbia and Montenegro).

The widespread public belief that during the bombardment of Vojvodina (Yugoslavia) this region was contaminated by depleted uranium has recently raised public concern with respect to the potential contamination of agricultural products due to soil radioactivity. Based on the gamma-spectrometric analysis of 50 soil samples taken from the region of Vojvodina we concluded that there is no increase of radioactivity that could endanger the food production. Taking into account the transfer factors of 137Cs to plants, the measured activity concentrations of this isotope should not endanger the health safety of the produced food. No traces of depleted uranium have been found. The natural radioactivity levels are compared with the results form other countries.

Cesium Radioisotopes↗
PubMed2000

Partial left ventriculectomy: which patients can be expected to benefit?

BACKGROUND: Although some patients with end-stage heart disease will benefit from a partial left ventriculectomy, no criteria have been found for identifying this group preoperatively. Our experience with partial left ventriculectomy at two institutions-the Texas Heart Institute in Houston, TX, USA, and Dedinje Cardiovascular Institute in Belgrade, Yugoslavia-showed a higher survival rate and better postoperative myocardial function in the Yugoslavian patients. METHODS: We reviewed data from 42 patients (21 at each center) who had idiopathic cardiomyopathy, a left ventricular end-diastolic dimension of more than 70 mm, wall thickness of 1 cm or greater, and New York Heart Association class III or IV symptoms. The only significant difference in preoperative status between the two groups was duration of symptoms. Histologic specimens, blinded as to origin, were graded with regard to myocyte hypertrophy, cytoplasmic vacuolation, and fibrosis. Computer-assisted myocyte and nuclear morphometry was also performed. RESULTS: Immediately postoperatively, there were no significant intergroup differences in the reduction in cardiac dimension or in corrections of mitral regurgitation. During 6-month follow-up, however, the Texas Heart Institute patients had a lower cardiac index (1.8 versus 3.0 L x min(-1) x m(-2); p = 0.001) and left ventricular ejection fraction (24% versus 34%; p = 0.006) than the Dedinje Cardiovascular Institute patients. The Texas Heart Institute patients differed from the Dedinje Cardiovascular Institute patients in the degree of severe or moderate changes in myocyte hypertrophy (90% versus 29%; p = 0.0003) and fibrosis (71% versus 29%; p = 0.006), as well as in the measurements of median myocyte diameter (35 +/- 7 microm versus 27 +/- 4 microm; p = 0.0002) and median nuclear size (15 +/- 4 microm versus 12 +/- 2 microm; p = 0.0029). CONCLUSIONS: In the Texas Heart Institute patients, the significant intergroup difference in clinical outcome may have been related to increased myocyte hypertrophy and fibrosis. Further studies should be performed to determine the usefulness of these criteria in selecting patients for partial left ventriculectomy.

Adult↗
PubMed2002

Supracondylar missile fractures of the femur.

We present the results of the surgical treatment of 50 supracondylar missile fractures of the femur in 48 patients wounded in the territory of the former Yugoslavia in the period June 1991-October 1995. The injuries were caused by bullets in 28 (58.3%) patients and by fragments of mines or other explosive devices in 20 (41.7%) patients. In nine (18.0%) missile supracondylar fractures there were associated fractures of articular surfaces in the knee-joint. Neurovascular bundle injuries were present in 19 (38.0%) and vascular injuries alone in 17 (34.0%) limbs. Bone fragments were stabilized by external fixation in 43 (86.0%) and by plaster of Paris in five (10.0%) limbs. Primary reconstruction of large blood vessel was necessary in 16 (32.0%) limbs. In total eight (16.0%) above knee amputations were done. Coverage of soft tissue defects was required in 19 (38.0%) limbs. Early and late postoperative complications occurred in 26 (52.0%) limbs. Additional surgical procedures were necessary in 15 patients. Definitive results showed a large number of limb shortenings, nerve paralyses and contractures of the knee-joint.

Adult↗
PubMed1999

Primary surgical treatment of war injuries of major joints of the limbs.

We present the results of primary surgical treatment of war injuries of major joints in 339 patients, wounded in the territory of the former Yugoslavia in the period June 1991-October 1995. The total number of surgically treated joints was 358. The injuries were inflicted by the fragments of explosive devices in 176 (51.9%) patients and by bullets in 125 (36.9%) patients. A single wound was present in 160 (47.2%) and several wounds in 176 (51.9%) patients; 276 (77.1%) patients had injuries of articular bone. The most frequently injured joints were knee joint 167 (46.6%) and elbow joint 72 (20.1%). Associated neurovascular injuries were present in 68 (18.9%) patients. Postoperative bone fragment stabilization was required in 254 (70.9%) joints. Stabilization was by plaster of Paris in 148 (58.2%) and external fixation in 85 (33.4%) patients. Postoperative course was uneventful in 262 (77.3%) while postoperative complications occurred in 77 (22.7%) patients. Amputations were performed in 15 (4.4%) patients. After the primary surgical treatment 254 (74.9%) patients were discharged and directed to rehabilitation or home care and 81 (23.9%) patients required additional reconstructive surgery for bone and soft tissue defects.

Adult↗
PubMed2000

Primary surgical treatment of war injuries of the foot.

Presented are the results of primary surgical treatment of war injuries of the foot in 250 patients wounded in the territory of former Yugoslavia in the period June 1991-October 1995. Total number of feet treated was 275. Aetiologically, the most frequent injuries were those inflicted by the effect of mine blasts (65.2%) and by bullets from firearms (30.8%). Injuries to a single foot were present in 140 (56.0%), combined injuries in 107 (42.8%) and associated with burn injuries in three (1.2%) patients. Soft tissue injuries were present in 25 (9.1%) and injuries to bone structures and joints in 250 (90.9%) feet. Injuries resulting from solid blasts were found in nine (3.2%) feet. Postoperative bone fragment stabilization was required in 115 (41.8%) feet. Stabilization was by plaster of Paris in 87 (75.6%) and by external fixation in 23 (20. 0%) feet. Amputations were performed in 73 (26.5%) feet. Covering of soft tissue and bone defects was required in 84 (33.6%) patients.

Adolescent↗
PubMed2001

Integrated natural radiation exposure studies in stable Yugoslav rural communities.

The results of field investigations of natural radiation exposures of the general population in two stable rural communities in Yugoslavia are presented. The principal emphasis was on exposures to contemporary indoor radon, but measurements of external penetrating radiation absorbed dose rates in air were carried out in the majority of cases. In addition, in a limited number of dwellings, measurements of thoron gas concentrations were made. By means of making a series of sequential 3-month radon measurements, both seasonal variations and annual average radon levels in the dwellings were determined. Using passive alpha track detectors, individual radon and thoron indoor concentrations as high as 9591 Bq m(-3) and 709 Bq m(-3), respectively, were detected while absorbed dose rates in air in the dwellings as high as 430 nGy h(-1) were recorded. On the basis of these different types of measurements, assessments could be made of the integrated natural radiation exposures being received by the populations. In addition to contemporary radon measurements, retrospective radon exposure assessments in most of the dwellings were made on the basis of measurements of 210Po concentrations in both surface (glass) traps and in volume (porous materials) traps. A description is given of the sampling strategies and protocols used in this field work. It is shown that at least one stable rural community receiving high natural radiation exposures, has been clearly identified and plans for future health investigations of the population there are outlined.

Air Pollutants, Radioactive↗
PubMed2001

Trace and major element pollution originating from coal ash suspension and transport processes.

Coal ash obtained by coal combustion in the "Nikola Tesla A" power plant in Obrenovac, near Belgrade, Yugoslavia, is mixed with water of the Sava river and transported to the dump. In order to assess pollution caused by leaching of some minor and major elements during ash transport through the pipeline, two sets of samples (six samples each) were subjected to a modified sequential extraction. The first set consisted of coal ash samples taken immediately after combustion, while the second set was obtained by extraction with river water, imitating the processes that occur in the pipeline. Samples were extracted consecutively with distilled water and a 1 M solution of KCl, pH 7, and the differences in extractability were compared in order to predict potential pollution. Considering concentrations of seven trace elements as well as five major elements in extracts from a total of 12 samples, it can be concluded that lead and cadmium do not present an environmental threat during and immediately after ash transport to the dump. Portions of zinc, nickel and chromium are released during the ash transport, and arsenic and manganese are released continuously. Copper and iron do not present an environmental threat due to element leaching during and immediately after the coal ash suspension and transport. On the contrary, these elements, as well as chromium, become concentrated during coal ash transport. Adsorbed portions of calcium, magnesium and potassium are also leached during coal ash transport.

Coal↗
PubMed2003

Depleted uranium residual radiological risk assessment for Kosovo sites.

During the recent conflict in Yugoslavia, depleted uranium rounds were employed and were left in the battlefield. Health concern is related to the risk arising from contamination of areas in Kosovo with depleted uranium penetrators and dust. Although chemical toxicity is the most significant health risk related to uranium, radiation exposure has been allegedly related to cancers among veterans of the Balkan conflict. Uranium munitions are considered to be a source of radiological contamination of the environment. Based on measurements and estimates from the recent Balkan Task Force UNEP mission in Kosovo, we have estimated effective doses to resident populations using a well-established food-web mathematical model (RESRAD code). The UNEP mission did not find any evidence of widespread contamination in Kosovo. Rather than the actual measurements, we elected to use a desk assessment scenario (Reference Case) proposed by the UNEP group as the source term for computer simulations. Specific applications to two Kosovo sites (Planeja village and Vranovac hill) are described. Results of the simulations suggest that radiation doses from water-independent pathways are negligible (annual doses below 30 microSv). A small radiological risk is expected from contamination of the groundwater in conditions of effective leaching and low distribution coefficient of uranium metal. Under the assumptions of the Reference Case, significant radiological doses (>1 mSv/year) might be achieved after many years from the conflict through water-dependent pathways. Even in this worst-case scenario, DU radiological risk would be far overshadowed by its chemical toxicity.

Computer Simulation↗
PubMed2002

Reproductive rights and the state in Serbia and Croatia.

The global reproductive rights movement arose in the late 1980s and early 1990s as a challenge to the population control paradigm that has dominated family planning policy for almost half a century. The essence of the challenge is to place women into the center of population discussions as subjects, not objects of policy, and to reorient family planning and health programs toward meeting the broad reproductive health needs of individuals, rather than the narrow population control objectives of states. Reproductive rights advocates argue that the use of family planning programs for developmentalist-oriented population control objectives is illegimate, and inevitably relegates women to the status of depersonalized policy "targets". The cases of Croatia and Serbia, the two dominant partners in the former Federal Republic of Yugoslavia, offer interesting twists on these reproductive rights issues. In Croatia and Serbia, unlike in many nations, the governments are deliberately seeking to increase rather than decrease fertility levels. Moreover, the objective concerns identity politics, more so than development: the governments have encouraged increased fertility to safeguard the survival of their nations and to strengthen national power amidst threatening internal and external environments of ethnic conflict. In this paper, we examine the dynamics of pro-natalist fertility policy in Croatia and Serbia. We do so with a view to explaining why, despite similarities, the two have followed divergent paths. While reproductive rights violations have occurred in both nations, they have been markedly higher in Serbia than Croatia. To explain this divergence we look at a series of sociopolitical factors, including the space available for groups to mobilize in each political system; the degree of nationalistic extremism present in the discourse of central political leaders; and perceptions of threats and opportunities in external geopolitical environments. In conducting this analysis we seek to drive home the point that a nation's reproductive rights situation and prospects cannot be understood divorced from its sociopolitical context. We also raise an additional impetus for promoting the reproductive rights agenda--one largely unexplored in the family planning literature-that emerges from low fertility nations facing identity issues. Women's bodies must be protected not only against those states seeking to use their reproductive capacities for developmentalist-oriented fertility control, but also against those wanting their bodies for nationalistic-oriented fertility promotion.

Authoritarianism↗
PubMedDate not supplied

Contribution of maternal smoking during pregnancy and lead exposure to early child behavior problems.

Maternal smoking during pregnancy elevates risk for later child behavior problems. Because prior studies considered only Western settings, where smoking co-occurs with social disadvantage, we examined this association in Yugoslavia, a different cultural setting. Mothers enrolled in pregnancy as the low-exposure group in a prospective study of lead exposure were interviewed about health, including smoking history. A total of 199 children were assessed on the Child Behavior Checklist (CBCL) at ages 4, 4 1/2, and 5 years. Average cumulative blood lead (BPb) was determined from serial samples taken biannually since delivery. Longitudinal analyses were derived from 191 children with available data on behavior and covariates. Smoking was unrelated to social adversity. Controlling for age, gender, birthweight, ethnicity, maternal education, and Home Observation for Measurement of the Environment (HOME) Acceptance, smoking was associated with worse scores on almost all subscales; BPb concentration was related to small increases in the Delinquency subscale. Daughters of smokers received significantly higher scores on Somatic Complaints compared to daughters of nonsmokers, consistent with other work relating biological factors and internalizing problems in young girls. Because the present smoking/child behavior associations persist after control for individual and social factors also related to behavior problems, possible biological mediators are considered.

Adult↗
PubMedDate not supplied

Military assistance in complex emergencies: what have we learned since the Kurdish relief effort?

After the success of relief efforts to the displaced Kurdish population in northern Iraq following the Gulf War, many in the US military and the international relief community saw military forces as critical partners in the response to future complex emergencies (CEs). However, successes in subsequent military involvement in Somalia, Rwanda, the former Yugoslavia, and other CEs proved more elusive and raised many difficult issues. A review of these operations reinforces some basic lessons that must be heeded if the use of military forces in humanitarian relief is to be successful. Each CE is unique, thus, each military mission must be clearly defined and articulated. Armed forces struggle to provide both security and humanitarian relief, particularly when aggressive peace enforcement is required. Significant political and public support is necessary for military involvement and success. Military forces cannot execute humanitarian assistance missions on an ad hoc basis, but must continue to develop doctrine, policy and procedures in this area and adequately train, supply, and equip the units that will be involved in humanitarian relief. Militaries not only must cooperate and coordinate extensively with each other, but also with the governmental and non-governmental humanitarian relief organizations that will be engaged for the long term.

Africa, Central↗