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PubMed1997

The impact of sociodemographic variables on immunization coverage of children.

The dependence of immunization coverage of children in the municipalities of Vienna and Klagenfurt on the sociodemographic variables of their parents is investigated. According to the Austrian vaccination program, the following vaccinations are recommended: diphtheria/tetanus (DT), measles/mumps (MM), poliomyelitis (oPV), tickborne encephalitis (TBE), tuberculosis (BCG) and whooping cough (P). The aim of the study is to identify risk groups, as are children that are not well covered. A cross-sectional study using vaccination certificates of second grade schoolchildren in Vienna and Klagenfurt was performed. A multivariate logistic regression model is used. In Vienna a representative sample of second grade schoolchildren (n = 585) was investigated, in Klagenfurt all second grade schoolchildren (n = 824). The investigation took place during the 1993/1994 schoolyear. In Vienna 34.8% of the children have all the vaccinations recommended, in Klagenfurt 59.6%. Children of Austrian mothers have the best immunization coverage, followed by children whose mothers are from 'other countries', 'not stated', and 'former Yugoslavia'. The immunization rate increases with the mother's increasing age. It is lower if the father is unemployed. The effects of the variables age and unemployment are not dependent on nationality. Children from Klagenfurt are more often completely immunized than children from Vienna. The mother's education does not have a significant influence. The Austrian immunization program is not sufficient to provide a high level of herd immunity. The immunization program recommends vaccinations but does not include a system for finding and recording riskgroups (non-immunized). To improve the situation eight steps needed for a setup of surveillance and containment system are recommended.

Austria↗
PubMed1998

Skin diseases in immigrants seen as out-patients in the Institute of Dermatology of the University of Rome 'La Sapienza' from 1989 to 1994.

In the Institute of Dermatology of the University of Rome 'La Sapienza' (IDURLS) from 1989 to 1994, 2198 immigrants from countries outside the European Community were seen as out-patients. Their personal and pathological data were collected by a particular software 'Questio', set up together with colleagues of the Interdepartimental Center for Scientific Calculous (ICSC) of the University of Rome 'La Sapienza'. The number of patients has been increasing from 326 in 1989 to 436 in 1994. Most of the people were coming from Africa, but from 1989 to 1994 the number of patients from the regions of ex-Yugoslavia has been increasing. About one third of the immigrants were unemployed, whereas 40% of them had a job (worker or employee), and the remaining 20% was composed by students and housewives. Most immigrants (1474 patients) were 20-39-year-old. Their data were compared with those of a control group composed by 2100 Italian people of the same age and sex, seen as out-patients in IDURLS in the same period. The most frequent skin disorders observed in immigrants were skin infectious or parasitic diseases, above all scabies. Excluding people with scabies, both immigrants and Italian patients shared the same skin diseases typical of young adult people: many fungal infections, many contact dermatitis and very few skin malignant tumors.

Adolescent↗
PubMed2000

Acute myeloid leukaemia and exposure to organic solvents--a case-control study.

The objective was to study the relation between exposure to organic solvents and the risk of developing acute myeloid leukaemia (AML) in Caucasians aged 18 years and more. Ninety-eight cases of AML were diagnosed from September 1986 to March 1990 in Novi Sad, Yugoslavia, and in two London hospitals from September 1988 and May 1994 and from July 1992 and July 1994, respectively. Two controls were matched to each case by hospital, year of admission, gender and 5-year age group. Information on solvent exposure was collected by interview. Odds ratios (ORs) were derived with conditional logistic regression. The degree of solvent exposure was determined by three experts blind to the status of the subject with good agreement between them (the kappa coefficient ranged between 0.52 and 0.86). The response rate for cases was 80%. Exposure to solvents was associated with the increased risk of AML (OR: 2.52; 95% CI: 1.45-4.39; p = 0.001) and those with probable exposure to solvents were found to have an odds ratio of AML over three times greater than non-exposed. We also found an elevated OR for exposure to oils (OR: 1.56) but this was not statistically significant. There is no clear pattern of increasing risks with increasing duration of employment but a significant risk was found for exposures of 10 years or less. An induction period of less than 10 years or more than 30 years was associated with a significantly raised OR. There was a significant excess of machinery mechanics and fitters among the cases.

Acute Disease↗
PubMed2002

CTG repeat polymorphism in DMPK gene in healthy Yugoslav population.

OBJECTIVES: Myotonic dystrophy type 1 (DM1) is caused by large expansions of cytosine-thymine-guanine (CTG)-repeats in myotonic dystrophy protein kinase (DMPK)-gene. This gene is highly polymorphic in healthy individuals. It has been proposed that expanded alleles originated from the group of large sized normal alleles. If this is correct, one should expect a positive correlation between the frequency of large sized normal alleles and a prevalence of this disorder in a population. In this paper we determined the distribution of alleles of DMPK gene in healthy Yugoslav population. MATERIAL AND METHODS: A sample of 235 healthy individuals of Yugoslav origin have been genotyped for the alleles of DMPK locus. RESULTS: We found 22 different alleles, ranging in size from 5 to 29 repeats. Among 470 chromosomes studied, 41 chromosomes had more than 18 repeats (8.72%). CONCLUSIONS: Relatively high frequency of large sized normal alleles found in our population, suggest that prevalence of DM1 in Yugoslavia should not be different from the prevalence in other European populations.

Cytosine Nucleotides↗
PubMed1999

Beliefs about health and illness essential for self-care practice: a comparison of migrant Yugoslavian and Swedish diabetic females.

In a multicultural society the frequency of contact with migrant diabetic individuals will increase, as well as the need for knowledge about their beliefs about health and illness, which have rarely been studied. The aim of the present study was to explore beliefs about health and illness among migrant Yugoslavian and Swedish diabetic subjects that might affect their self-reported self-care practices and care-seeking behaviours. The study design was explorative, and a purposive sampling procedure was used. Fifteen females born in Sweden and 13 in former Yugoslavia, aged 33-73 years, with previously known diabetes mellitus were recruited from primary health care centres in southern Sweden. Median time of residence in Sweden was 5 years (range 2-30 years). Eight of the Yugoslavians had their diabetes diagnosed in Sweden. Focus-group interviews including scenarios of common problems related to diabetes mellitus were held. Yugoslavian females in general gave less tangible examples concerning beliefs about health and illness. Yugoslavians were orientated towards feelings related to their migratory experiences, enjoyed life by making deviations from dietary advice and retaining former traditions, and were less inclined towards self-monitoring and preventive foot care. They also expressed a passive role, depending on health care personnel, and discussed the influence of supernatural forces. Swedes expressed themselves in terms of medicine and a healthy lifestyle, took active part in their self-care and let self-monitoring guide their actions. Self-care was mainly practised to restore health when ill in both groups, and when help was needed it was sought in the professional sector (nurse or physician). Yugoslavians expressed higher confidence in physicians and used more natural cure medicine, side by side with biomedicine, while Swedes more frequently used alternative medicine. Demonstrated dissimilarities illustrate that beliefs about health and illness differ between migrant Yugoslavian and Swedish diabetic individuals, and are essential for self-care practice and care-seeking behaviour and must be considered when planning diabetes care.

Adult↗
PubMed2002

Personality dimensions of sexually transmitted disease repeaters assessed with the Millon Clinical Multiaxial Inventory.

OBJECTIVE: To assess the personality characteristics of patients with repeated sexually transmitted diseases (STD). METHOD: A case-control study comparing 101 STD repeaters (subjects with a lifetime history of three or more STDs) with 182 controls who had no history of STD. All subjects attended the City Department for Skin and Venereal Diseases in Belgrade (Yugoslavia) from June 1997 to April 1998. Personality characteristics was assessed by the Millon Clinical Multiaxial Inventory (MCMI). RESULTS: The analysis of MCMI test showed that STD repeaters had higher scores on narcissistic, antisocial and paranoid scales. The difference between STD repeaters and the controls was significant on antisocial, psychotic thinking and psychotic delusion scales, although scores on clinical syndromes were low for both cases and controls. Discriminant analysis showed that antisocial personality was predictive for STD repeaters. CONCLUSIONS: This study support the hypothesis that STD repeaters are different from controls in terms of their psychological characteristics. The behaviour of STD repeaters is ego-syntonic, which makes the treatment of their personality difficult and emphasizes the importance of work on primary and secondary prevention of STD.

Adult↗
PubMed1998

[Strongyloides stercoralis infection in a patient with AIDS and non-Hodgkin lymphoma].

HISTORY AND CLINICAL FINDINGS: The patient, now 50 years old, an immigrant miner from the former Yugoslavia who was known to have AIDS, was in 1992 found to have non-Hodgkin lymphoma of the oesophagus and given five cycles of multiple chemotherapy (CHOP) with complete remission. Subsequently he complained of retrosternal pain, dysphagia, dry cough and upper abdominal discomfort. On admission he had slight fever of 39.1 degrees C, but physical examination was unremarkable. LABORATORY TESTS: Blood count revealed an eosinophilia of 41%. IgE concentration was raised to 432IU/ml. The CD4+ T-cell count was reduced to 10/microliter, that of CD8+ to 89/microliter. ADDITIONAL TESTS: Blood culture, fecal and sputum samples and bronchoalveolar lavage demonstrated Mycobacterium avium intracellulare. TREATMENT AND COURSE: Treatment of the disseminated atypical mycobacterial infection was started with clarithromycin, rifabutin, ciprofloxacin and ethambutol. There was no improvement of the upper abdominal discomfort, but the fever subsided. Oesophagogastroscopy excluded recurrence of the lymphoma. Biopsy and examination of the duodenal juice revealed worms and larvae of Strongyloides stercoralis. Stool samples contained no mycobacteria, but strongyloides larvae were demonstrated. Albendazole was given (2 x 400 mg daily for 6 days, followed by a maintenance dose of 1 x 400 mg daily). Repeat endoscopy and stool sample after a month no longer showed any parasites. CONCLUSION: Even in Western Europe, persons coming from endemic areas who, as this patient, have various risk factors that may facilitate the occurrence of strongyloidiasis. With early diagnosis and treatment albendazole is an efficacious drug.

AIDS-Related Opportunistic Infections↗
PubMed1975

The occurrence of mercury in amphibia.

Studies have been made of the distribution of mercury and its occurrence as methylmercury in the organs of amphibia collected from different sites mainly in Slovenia, Yugoslavia, including the area around the mercury mine at Idrija. Liver accumulates the highest amounts of mercury, up to 2 ppm in apparent background areas, with values up to 0.5 ppm in muscle, where virtually all mercury is present in the methyl form. Results are reported for some other trace elements in liver. Amphibia may provide useful monitors of the occurrence and spread of mercury contamination.

Amphibians↗
PubMed1989

Brucellosis contracted during foreign travel.

Brucellosis, a bacterial infection, is rarely seen in the United States. It occurs mostly in people who work with domestic animals and animal products. However, this patient became infected while in Yugoslavia, and diagnosis was delayed by the gap between appearance of symptoms and positive results of serologic tests. Brucellosis should be suspected in a patient with unexplained fever, especially if he or she has traveled to a country where unpasteurized dairy products are common.

Brucellosis↗
PubMed2006

The Balkan Piedmont: male suicide rates pre-war, wartime, and post-war in Serbia and Montenegro.

The epidemiology of suicide in Serbia and Montenegro from 1989 to 2003, a period of civil war, is presented. Following the break-up of former Yugoslavia, Serbia and Montenegro underwent a period of war from 1991-1994 and another in 1999. During the war years, the number of suicides increased, reaching its peak in 1993. Male suicides outnumbered female suicides by a ratio of 2:1. Male suicides decreased slightly after the war of 1991-1994 only to rise in 1997 and continue at this higher level throughout the nineties. In Serbia alone, male suicide reached its peak in 2002 (nearly 29/100,000). The methods of suicide changed significantly, with the use of firearms doubling during and after the war years. Speculations are offered about the findings, many consistent with Durkheim's classical hypothesis concerning suicide and unpopular wars.

Demography↗
PubMed2005

The impact of country of birth and time in Sweden on overweight and obesity: a population-based study.

AIMS: A study was undertaken to investigate the relationship between country of birth, time in Sweden, and overweight and obesity. METHODS: Approximately 4,000 people aged 20-80 participated in a cross-sectional survey in 1994. The ethnic differences in overweight and obesity were analysed in a multivariate logistic regression analysis adjusting for age and education. The effect of number of years spent in Sweden on overweight and obesity was assessed for some of the ethnic groups compared with the Swedish-born group. RESULTS: Men from Yugoslavia and Arabic-speaking countries were overweight/obese (BMI 25.0-) and obese (BMI 30.0-) to a significantly higher extent than men born in Sweden. Women born in Poland, Arabic-speaking countries, and all other countries were overweight/obese and obese to a significantly higher extent than women born in Sweden. Both Arabic men and women who had immigrated to Sweden in 1989 or earlier had an increased risk of overweight/obesity and obesity compared with the participants born in Sweden, while no increased risk was observed for the Arabic group that immigrated after 1989. CONCLUSIONS: There were significant differences in overweight and obesity between the country of birth groups. The findings follow the patterns of low leisure time physical activity among certain ethnic groups reported in a previous study, which has implications for public health measures directed to decrease differences in overweight and obesity by country of birth.

Adult↗
PubMed1991

Evaluation of the epidemiology of hepatitis B virus cross-infection in a maternity hospital.

OBJECTIVE: To determine the hepatitis B infection risk in a university hospital of obstetrics and gynecology. SETTING: The University Hospital of Obstetrics and Gynecology, The University of Sarajevo, Yugoslavia. DESIGN: Staff members were divided into three groups: 73 doctors, 184 medical technicians working in delivery rooms, and 55 medical technicians working with postnatal care. The patients were 63 women, aged 17 to 39 years (mean = 26.11 years), pregnant for the first time and in the first stage of labor. Participants all had a negative history of hepatitis B and no known contact with the hepatitis B virus. RESULTS: The incidence of hepatitis B infections among physicians, technicians, and postnatal care technicians was 1.36%, 3.8%, and 3.6%, respectively. The incidence among patients was 4.76%. The daily infection risk varied between 1% and 17% of all deliveries. CONCLUSIONS: The risks of transmission of the hepatitis B virus to hospital workers in this setting is indeed high enough to make a case for hepatitis B vaccination in susceptible staff members. Even if vaccination of staff members is carried out, hygienic measures to prevent the transmission of bloodborne infection between patients and from patients to staff are of the utmost importance.

Adolescent↗
PubMed1984

Sodium in man and the assessment of radiation dose after criticality accidents.

Recent observations on the sodium content of the human body, both total and exchangeable, using isotope dilution methods and activation of sodium by whole-body irradiation with neutrons in the course of clinical research, suggest that ICRP Reference Man is a misleading guide to the sodium content of the body and of the skeleton and its parts. They also show that reasonable predictions of body sodium content can be made from body weight, height and age, or even from body weight alone. Mean sodium in the average man is about 1.04 g per kg and in the average women about 0.98 g per kg in British and N. American populations. Within each sex mean tissue concentration is inversely related to body weight. Review of the dosimetry for the criticality accident at Y-12 Oak Ridge shows that dose estimates should be increased by about 10% because whole blood values of 24Na were relied on instead of plasma values. Taking account of body build reduces the range of dose amongst the four most heavily irradiated subjects. The absorbed doses reported for the subjects exposed at the criticality accident at Vinca, Yugoslavia, need to be increased by about 30% because the normal sodium content of the body was grossly overestimated. The more severe clinical picture at Vinca than at Y-12 is now more easily understood in terms of differences in dose. These changes are solely the result of improved information about sodium in the body. Other uncertainties in the dosimetry at Y-12 and Vinca are unaltered.

Accidents, Occupational↗
PubMed1989

Food consumption patterns in the 1960s in seven countries.

At the end of the 1950s the Seven Countries Study was designed to investigate the relations between diet and cardiovascular diseases. Sixteen cohorts were selected in Finland, Greece, Italy, Japan, The Netherlands, United States, and Yugoslavia. During the 1960s food consumption data were collected from random samples of these cohorts by use of the record method. In Finland the intake of milk, potatoes, edible fats, and sugar products was very high. A similar but lower intake pattern was observed in The Netherlands. Fruit, meat, and pastry consumption was high in the United States; cereal and alcoholic drink consumption was high in Italy; and bread consumption high in Yugoslavians except for those in Belgrade. In Greece the intake of olive oil and fruit was high and the Japanese cohorts were characterized by a high consumption of fish, rice, and soy products. These differences in food consumption patterns have lessened during the past 25 y.

Adult↗
PubMed1981

A virologically studied epidemic of type A hepatitis in a school for the mentally retarded.

The occurrence of hepatitis A virus (HAV) infection in a small boarding school for mildly to moderately mentally retarded children in Umka, Yugoslavia, in the spring of 1979, six years after the last recognized occurrence, provided an opportunity to study the spread of the agent among 79 classroom and dormitory contacts. Only 51% of those who had entered subsequent to the prior outbreak had detectable antibody (anti-HAV) with immunoglobulin G predominance, and the proportion within the first six years of training did not vary. Both findings suggest a lack of endemicity during the interval. The outbreak ended spontaneously just before the summer vacation with an anti-HAV prevalence of 90%. The ratio of silent to overt cases was approximately 2:1. HAV was found in fecal samples from susceptible residents with inapparent infection as well as those with hepatitis. Among those with prior experience, there were no significant anti-HAV increases to suggest HAV reinfection in this group. Overall, 32% were seropositive for markers of past or chronic hepatitis B virus (HBV) infection, but this status did not correlate with sex, year of training, or HAV experience. Only one instance of HBV transmission was observed in the same interval as the 26 HAV infections.

Adolescent↗
PubMed1985

Serum cholesterol and cancer mortality in the Seven Countries Study.

In the Seven Countries Study, carried out in Finland, Greece, Italy, Japan, The Netherlands, the United States, and Yugoslavia, among 11,325 "healthy" men aged 40-59 years in 15 years, there were 594 cancer deaths. Among 477 cancer deaths five years after cholesterol measurement, there was a significant excess of lung cancer deaths in the bottom 20% of the cholesterol distributions in the populations. Age, blood pressure, smoking habits, occupation, and relative body weight did not help explain this. A U-shaped relationship between cancer and cholesterol was not seen in any population. Trend analysis with various cutting points indicated increasing risk of lung cancer death at cholesterol levels under 170 mg/dl. The 45 men dead from cancer in the first two years had lower cholesterol levels than their compatriots who died from cancer later but they did not differ in relative weight or fatness. In contrast to relationships for individuals within populations, the highest cancer death rates were in northern Europe, where the general level of cholesterol was also highest. Other characteristics of the populations--age, relative weight, smoking habits, blood pressure, physical activity, and vitamin A and ascorbic acid in the diet--did not help in the attempt to understand the regional differences in cancer mortality. There is no evidence that any of the observed cancer-serum cholesterol relationships among or within the populations involve an effect of serum cholesterol concentration on oncogenesis or cancer mortality but the possibility of such an effect cannot be denied.

Adult↗
PubMed1992

Combined effects of body size, parity, and menstrual events on breast cancer incidence in seven countries.

A biologically motivated breast cancer incidence rate function was fit to data from a published case-control study conducted in countries whose incidence is high (Wales and the United States), moderate (Brazil, Greece, and Yugoslavia), and low (Japan and Taiwan). The data include personal characteristics of 3,925 breast cancer cases and 11,327 controls interviewed in selected hospitals in 1964-1968. Parameters in the function specify the dependence of age-specific breast cancer incidence rates on age at menarche, age at menopause, occurrence and timing of full-term pregnancies, and body mass. Parameters were estimated separately for high-, moderate-, and low-risk countries. Examination of residuals provided little evidence of inadequacy of the fitted function in describing combined effects of the characteristics studied. The following patterns were seen in all three risk groups: 1) Incidence rates jump to a higher level after first childbirth, but then increase with age more slowly thereafter. 2) Rates increase with age more slowly after menopause than before. 3) Rates change quadratically with body mass index among all women, although the main trend varies: Rates decrease with body mass among premenopausal women in high-risk countries, but increase with body mass in all other groups of women. Similarities of parameter estimates across countries suggest that reproductive events and body fat exert similar effects on all women, regardless of breast cancer rates in their country of residence.

Adult↗
PubMed1986

Psychopharmacology of schizophrenia: a European view.

This article describes how psychopharmacological therapy is applied in Yugoslavia and other countries in Central Europe. The first part of the article summarizes experience and customary use of psychopharmacological substances in relation to clinical syndromes, course of disease, and dominant symptoms. In the second part of the article, the experience obtained in treatment with combinations of drugs and in prolonged pharmacotherapy of schizophrenia is described. Finally, the last section of the article addresses the social implications of psychopharmacological treatment and presents some of the problems and disadvantages that accompany this form of treatment.

Acute Disease↗