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Subsets of childhood acute lymphoblastic leukaemia in Croatia.

As a contribution to epidemiological studies on distribution of acute lymphoblastic leukaemia (ALL) subsets in different countries, we investigated blast cell immunophenotype in 54 children with ALL from the western part of Yugoslavia. The subtype incidences were: common, 75.9%; null, 7.4%; T, 11.1%; B, 1.9%; and unclassifiable, 3.7%. This resembles the ALL pattern registered in developed countries. Hence, differences in socioeconomic status between our population and developed European countries do not result in an appreciably altered incidence of childhood leukaemia subtypes.

Burkitt Lymphoma↗

Historical processes and biological structure of the populations. Example from the Island of Korcula.

The importance of geographical distance as a determining factor of the population's biological and socio-cultural structure was studied on the island of Korcula, Yugoslavia. Migrational kinship coefficients, biological and linguistic distances were analysed in respect to isolation by distance, using Malecot's model. The fit of the model is highly significant for migrational kinship, linguistic, anthropometrical and physiological distances, while for morphometrical distances of metacarpal bones and dermatoglyphic distances, it is not adequate. The major conclusions reached through this analysis are in concordance with the known historical events in the entire region.

Anthropology, Physical↗

Are we treating enough patients for hypertension?

International comparisons indicate a two- to three-fold overall difference in the therapeutic intensity with antihypertensive drugs. In the District of Novi Sad in Yugoslavia, the use of antihypertensive drugs is among the lowest. The differences cannot be explained from the prevalence of hypertension. The evaluation of the existing practice in the treatment of hypertension was studied in a community of 6017 inhabitants with 756 hypertensive patients within the District of Novi Sad. The intensity of antihypertensive medication expressed in defined daily doses per 1000 inhabitants per day was compared with the number of hypertensive patients requiring drug therapy. Patients requiring therapy were classified into two groups: those having blood pressure above the age adjusted border levels and those who received at least the minimum daily therapeutic dose of antihypertensive medication. It is concluded that the volume of prescribed antihypertensive drugs, although lower compared to Nordic countries, might still be almost sufficient to meet the needs of patients who need drug therapy according to the criteria defined (if borderline hypertension is not treated).

Adult↗

The central role of the general practitioner in the treatment of periodontal disease.

This paper is based on experience of periodontal practice in Yugoslavia, Bosnia and Herzegovina respectively. Factors of relevance to the multidisciplinary approach to periodontal therapy are the level of development of public health, the teaching curricula in periodontology in dental schools, the organization of public dental health services (demand only or systematic oral care services) including the target groups and the dentist to population ratios. Quantification of periodontal treatments, the Community Periodontal Index of Treatment Needs (CPITN) and the recent analysis of the American Academy of Periodontology on periodontics in the twenty-first century are also of great relevance. Periodontology is a higher level discipline of public as well as dental health. The specialist periodontist carries out all the treatments in periodontology undertaken by the general dental practitioner and more specialized treatments not usually performed by the generalist.

Adolescent↗

[Epidemiology, diagnosis and treatment of the house-dust-mite allergy in asthmatic children].

Authors introduced as the first in Yugoslavia the method of isolation and classifying Dermatophagoides pteronyssinus out of house dust using the first the help of Spieksma, Cunnington and Araujo, later on by themselves in new established laboratory. In house dust of 290 houses of asthmatic children in 88 (30,8%) through of cases mites were found, mostly Dermatophagoides pteronyssinus. 212 asthmati children who did not react well to specific hyposensitisation with standard house dust extract showed an allergy to house dust mites in 76 (35,8%), who were successful treated with allergen extract Dermatophagoides pteronyssinus with the cutaneous method of hyposensitisation. House dust mites allergy has clinical importance in asthmatic children for pathogenesis of asthma bronchiale in childhood as well in adults. IgE values in the serum after the radioimmunological method in asthmatic and healthy children has been estimated. In asthmatic children we found statistical significant higher of IgE values in the serum as in healthy children, this is probably caused by the infestation from Ascaris lumbricoides. Asthmatic children were significant stengher infesteds the healthy children.

Asthma↗

Similar serum concentrations of thyroid hormones in two geographically separate populations on disparate iodine intake.

Serum thyroid hormones were measured in Montreal, Canada (urinary iodine 446 +/- 164 micrograms/day) and Zagreb, Yugoslavia (urinary iodine 108 +/- 32 microgram/day). The serum concentrations of thyroxine and triiodothyronine in the two populations were almost identical. We conclude that dietary iodine, within accepted normal limits, is not a factor in determining serum thyroid hormone levels. The wide differences in reported serum triiodothyronine concentrations are related to methodological problems.

Adolescent↗

Repetitive health examinations as an intervention measure.

A cohort of 107 men aged 51-53 years with borderline levels of blood pressure, serum cholesterol, or glucose tolerance was recruited from a general population in central Zagreb, Yugoslavia, and randomized into two groups; one was treated with drugs and the other observed in a similar fashion but not treated. Ninety-five men appeared regularly for the check-ups over a 2-year period. Levels of systolic blood pressure, cholesterol, and glucose showed a substantial decrease over a period of 2 years in both treated and control groups. The possible effect of repeated check-ups and their implications are discussed.

Blood Glucose↗

Studies on vaccination against bacillary dysentery. 6. Protection of children by oral immunization with streptomycin-dependent Shigella strains.

A field trial of oral streptomycin-dependent mutant Shigella vaccines in five hyperendemic areas of Yugoslavia in 1969 confirmed the findings of earlier studies by demonstrating the effectiveness of these vaccines against dysentery. For the first time, a high degree of protection was demonstrated in children. The vaccines induced serotype-specific immunity against Shigella flexneri 1 and 2a and S. sonnei. Postvaccinal reactions were minor and consisted of vomiting or diarrhoea, or both, in a small proportion of children within several hours of the administration of the vaccine. These reactions, seen mainly after the first dose, were dose-dependent and could be decreased by reducing the number of live organisms. Reactions to subsequent doses were much fewer. Pretreatment with sodium bicarbonate was necessary. Under the conditions of this study, the vaccines proved to be stable with no evidence of reversion of the mutant strains to the virulent parent.

Administration, Oral↗

The Balkan endemic nephropathy and urinary tract tumors.

Topographical distribution of the Balkan endemic nephropathy and tumors of urinary organs was investigated in the most affected region -- Central Serbia (Yugoslavia). The data expose that there is an association of endemic nephropathy and tumors of the pelvis and ureters, but not of the bladder. Disagreement related to the kind and degree of correlation of endemic nephropathy and tumors of the urinary organs is explained by insufficient knowledge of the problem rather than by influence of different ecological factors.

Disease Reservoirs↗

Studies on vaccination against bacillary dysentery. 3. Effective oral immunization against Shigella flexneri 2a in a field trial.

In May 1963 a live vaccine prepared from streptomycin-dependent Shigella flexneri 2a was administered to 355 soldiers stationed in an area of Yugoslavia in which bacillary dysentery was hyperendemic. Five oral doses were given every third day. 382 unvaccinated soldiers from the same unit served as controls. Both groups were closely followed up until 16 September.Examination of 1637 rectal swabs from the vaccinated and control groups indicated that vaccination did not affect the carrier rate. The morbidity from shigellae of serotypes not contained in the vaccine was the same in the two groups; but Sh. flexneri 2a caused dysentery in 5.5% of the control group but in none of the vaccinated soldiers-a statistically significant difference.A similar vaccine, given in a much lower dose, was also tried among soldiers of another unit; the dose was insufficient to confer protection.The authors conclude that the results of these field trials justify further studies with live Shigella vaccine.

Adult↗

A controlled field trial to evaluate the protective capacity of a single dose of acetone-killed agar-grown and heat-killed broth-grown typhoid vaccines.

In a strictly controlled field trial among schoolchildren a study was made of the protective capacity of single doses of 2 typhoid vaccines: a heat-killed broth-grown sorbed dried vaccine made in the USSR (vaccine G-66) and an acetone-killed agar-grown dried vaccine (vaccine K-66) made in Yugoslavia. The latter vaccine was supplied by the World Health Organization.A single dose of these preparations exerted a statistically significant protective effect during the first 10 months of observation. The protection afforded by the acetone-killed and heat-killed sorbed vaccines was similar in duration and intensity to that resulting from single doses of other types of typhoid vaccines that had been evaluated earlier in the USSR. The data obtained confirm once again that successful immunization against typhoid is possible with a single dose of vaccine.The absence of any substantial difference in morbidity between the groups concerned indicates that the heat-killed broth-grown and acetone-killed agar-grown vaccines exert a roughly similar protective effect.

Adolescent↗

Changes in serum angiotensin I converting enzyme activity due to carbon disulfide exposure.

The activity of serum angiotensin I converting enzyme (ACE) was determined in 50 workers from a viscose factory in Banja Luka, Yugoslavia, and in 50 control subjects. Activity of serum ACE was significantly lower in workers exposed to carbon disulfide than in the control group. No correlation was found between a decrease of serum ACE in exposed workers and duration of exposure. These findings indicate that the serum ACE may be influenced by carbon disulfide, but the mechanism of these changes remains to be elucidated in this case.

Adult↗

The Matas/Soubbotitch connection.

The Southern Association for Vascular Surgery, as one of the recently developed major regional vascular societies, has recognized the outstanding accomplishments of one of the vascular pioneers in the United States, Rudolph Matas, by including his profile in the Association logo. Although the contributions in vascular surgery by Matas are well known by all who have an interest in vascular surgery, the contributions of V. Soubbotitch have not been recognized widely in the English-speaking world. Matas proclaimed in an International Surgical Congress in London in 1913 that Soubbotitch had achieved clinical success that was unparalleled by repairing injured arteries and veins. Soubbotitch, Senior Surgeon, Belgrade State Hospital, Serbia (now part of Yugoslavia) and a Lieutenant Colonel in the Serbian Army Reserve during the Balkan Wars (Serbo-Turkish and Serbo-Bulgarian) initiated one of the first clinical programs that emphasized repair, rather than ligation, of injured arteries and veins. Surgeons from the capitals in Europe visited his clinic to assist in this effort, and the 1913 presentation in London included the experience of managing 77 injured large blood vessels, which resulted in 32 vascular repairs--19 arteriorrhaphies and 13 venorrhaphies. It is ironic that nearly 40 years passed before similar successful efforts were achieved during the latter part of the Korean Conflict (1952 to 1953). In this brief review we emphasize the connection between two outstanding surgical pioneers who shared mutual interest in the repair of injured vessels and in international surgical exchanges, Matas and Soubbotitch.

History, 19th Century↗

[Factors, which may influence breast feeding (author's transl)].

The case histories of 2197 mothers, who delivered at the 1st Department of Obstetrics and Gynecology of the University of Vienna in the years 1976 and 1977 were evaluated by the computer. 14 different parameters, which could have an influence on the incidence and duration of breast feeding were investigated. Our results suggest, that the incidence of breast feeding is declining with advancing years of the mother. An early reintegration into professional life after delivery has an effect on the duration of nursing. The family status and parity of the mother had no influence on the incidence and duration of breast feeding. Foreigners, as well as non-Roman Catholic mothers, who are represented mainly by guest workers from Yugoslavia and Turkey had a distinctly higher frequency of breast feeding of 74,6%, respectively 78,5% than average (67%). Also the duration of breast feeding of foreign mothers was above average. Women of higher socioeconomic classes had a higher incidence of breast feeding, as well as women, who had abortion or interruption or those using oral contraceptives. Operative delivery under narcosis and premature birth were accompanied by a significantly lower frequency of breast feeding. The rate of mastitis is at 1,4% in the group of breast feeding mothers.

Adult↗

[Legal statutes on sterilization].

Sterilization in Yugoslavia is no population policy measure. Decision about the birth of children is free, a private problem of any individual, a basic right guaranteed by the Constitution. However, according to certain laws in Slovenia and Croatia, sterilization is allowed as a family planning method in persons over 35 year old. Only exceptionally can sterilization be applied in persons younger than 35 years: according to the Slovenian law, in cases when a person lacks the capacity of reasoning and also when there are medical indications, and according to the Croatian law, when there are medical and eugenic reasons (if the child is supposed to be born with negative congenital properties).

Adult↗

Serum thyroid hormones in two Yugoslav districts with different iodine intake.

Serum thyroid hormones were measured in two areas of Yugoslavia, one with relatively low iodine intake, Zagreb (urinary iodide 111 +/- 36 microgram/g creatinine), and the island of Brac with higher iodine intake (247 +/- 76 microgram/g creatinine). The serum concentration of T4 and T3 in two groups were not different. These data confirm previous findings that iodine intake within accepted normal range, is not a factor in determining serum thyroid hormone levels.

Adult↗

Clinical and epidemiological aspects of allergic alveolitis.

Clinical and epidemiological aspects as well as classification of allergic alveolitis were discussed. Clinical features were divided into three stages: initial, chronic and terminal. Each stage was described with clinical signs, radiological, angiographical and with lung functional aspects. Epidemiological data of allergic alveolitis in Yugoslavia were given.

Alveolitis, Extrinsic Allergic↗

[Undergraduate and graduate education in surgery].

In the world as well as in our country various branches of surgery have been developing at an unexpected rate over the past decades. Training and education of staff have been lagging behind, however, and there has been no parallel development of regulations concerning this field of education. This is partly due to inadequate cooperation and support od the part of professional organizations for surgery. As the highest professional and public body the Congress of Yugoslav Surgeons should take over the responsibility of analysing at each of its future conventions the state of education in the field of surgery in our country. These problems are not only local, regional and republic in nature but concern Yugoslavia as a whole. Under selfmanagement socialism the possibilities of self-management agreements and social compacts should therefore be employed to the utmost extent.

Education, Medical, Graduate↗