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PubMed1976

A comparison of flexible and nonflexible plastic cannulae for performing first trimester abortion.

The safety and effectiveness of flexible and nonflexible plastic cannulae used in vacuum aspiration abortion for patients at 6 to 12 weeks' gestation were evaluated in a study of 1100 physically healthy women in Ljublijana, Yugoslavia. To minimize study biases, each type of cannulae was randomly assigned to 550 patients. To minimize evaluator bias, a second physician who was kept unaware of which cannula was used for particular patient was responsible for evaluating patients after the procedures. Both groups of patients were similar with respect to age, parity, marital status, formal education and gestational age. Higher rates of retained tissue and cannula obstruction were obtained with the flexible cannula. The two types of cannulae were not significantly different with respect to other criteria of evaluation.

Abortion, Induced↗
PubMed1993

Use of recombinant nucleocapsid proteins of the Hantaan and nephropathia epidemica serotypes of Hantaviruses as immunodiagnostic antigens.

Hantavirus nucleocapsid protein has previously been identified as the major antigen recognized by the humoral immune response in hemorrhagic fever with renal syndrome (HFRS). It was therefore considered to be a suitable antigen for the development of rapid and reliable immunodiagnostic assays. Genes encoding the nucleocapsid proteins of two Hantavirus strains, one of the Puumala serotype [nephropathia epidemica virus (NEV)] and the other of the Hantaan serotype were expressed in E. coli, and the expression products were used as diagnostic antigens in solid-phase enzyme immunoassays. The assays were used to detect IgG- and IgM-antibodies in sera of HFRS patients originating from different geographic regions (China, Germany, Greece, Yugoslavia, Scandinavia). ELISA was highly sensitive and proved to be superior to the indirect immunofluorescence assay. Both antigens were necessary to diagnose all HFRS cases originating from the different countries. Most of the sera revealed a predominant reactivity with either 1 of the 2 antigens, allowing the characterization of the etiologic virus as Hantaan-like or NEV-like. The results of the analysis of sera obtained from China and Greece suggested that the Hantaviruses prevalent in these countries are closely related to the Hantaan serotype. In contrast, an NEV-like reactivity was observed in Central and Northern European patients. In the sera of Yugoslav patients both reactivity patterns were found, suggesting that both virus types occur in the Balkan region.

Antibodies, Viral↗
PubMed2001

Baia Mare accident--brief ecotoxicological report of Czech experts.

On 30 January 2000, following the breach in the tailing dam of the Aurul SA Baia Mare Co., a major spill of about 100,000 m(3) of cyanide and metal-rich liquid waste was released into the river system near Baia Mare in northwest Romania. The pollutants flowed via different tributaries into the Tizsa (Tisa) river and finally through the Danube river into the Black Sea. Along the way pollutants (especially cyanides) caused rapid death of aquatic organisms and animals living close to the poisoned rivers. Following request from the governments of Romania, Hungary, and the Federal Republic of Yugoslavia, United Nations sent international mission experts to the area of accident. The Czech team of four experts took very active part in this mission. Samples of surface water collected by this team 3 weeks after the accident showed high toxicity in the rivers on the Romanian territory. Due to this impact, water from the Szamos river and a large area of the Tisza river in Hungarian territory was still medially toxic. Improvement of this situation was detected only in downstream areas of the Tisza/Tisa river. The high toxicity of surface water from the locality of the Lapos river upstream of the accident indicated the possibility of toxic pollution from other sources in the area. Aquatic sediments were highly toxic only in the Aurul reservoir and its surrounding area. Rapid decline of their toxicity indicated more limited adverse impact of the "Aurul pollution" in comparison with surface water. From ecotoxicological results it is evident that there is an urgent need to start abatement activities in the Baia Mare area because the possibility of future accidents still exists (this hypothesis was proved by further accidents on 10.3.2000 and the beginning of May 2000).

Cyanides↗
PubMed1993

Inter-cohort differences in coronary heart disease mortality in the 25-year follow-up of the seven countries study.

Sixteen cohorts of men aged 40-59 years at entry were examined with the measurement of some risk factors and then followed-up for mortality and causes of death for 25 years. These cohorts were located in the USA (1 cohort), Finland (2), the Netherlands (1), Italy (3), the former Yugoslavia (5), Greece (2), and Japan (2), and included a total of 12,763 subjects. Large differences in age-adjusted coronary heart disease (CHD) death rates were found, with extremes of 45 per 1000 in 25 years in Tanushimaru, Japan, to 288 per 1000 in 25 years in East Finland. In general, higher rates were found in the US and Northern European cohorts as compared to the Southern European and Japanese cohorts. However, during the last 10 years of follow-up large increases of CHD death rates were found in some Yugoslavian areas. Out of 5 measured entry characteristics treated as age-adjusted levels (serum cholesterol, systolic blood pressure, cigarette smoking, body mass index and physical activity at work), only serum cholesterol was significant in explaining cohort differences in CHD death rates. Over 50% of the variance in CHD death rates in 25 years was accounted for by the difference in mean serum cholesterol. This association tended to decline with increasing length of follow-up, but this was due to the great changes in mean serum cholesterol in the two Yugoslavian cohorts of Velika Krsna and Zrenjanin. When these two cohorts were excluded the association increased with time. Changes in mean serum cholesterol between year 0 and 10 helped in explaining differences in CHD death rates from year 10 onward. It can be concluded that this study suggests that mean serum cholesterol is the major risk factor in explaining cross-cultural differences in CHD.

Adult↗
PubMed1985

The frequency of the gamma chain variant A gamma T in different populations, and its use in evaluating gamma gene expression in association with thalassemia.

The occurrence of the A gamma T chain (i.e. A gamma 75 Ile----Thr) in different populations was evaluated through a study of 4250 cord blood samples and blood samples from more than 350 SS patients. High frequencies were observed in Italy, Yugoslavia, Turkey, Holland, but also in Japan, Vietnam, and India. The chain is (nearly) absent in the Black population of Ghana and Kenya, and low frequencies were observed in China and Australian aborigines. Only a few adult SS patients (18 out of 357) were A gamma T heterozygotes. The chromosomes with the A gamma T globin gene were mapped through an evaluation of the presence of 10 different restriction sites. The A gamma T chromosomes from different populations were closely related and had the same subhaplotypes of [- - + + T - +] (Hinc II 5' to epsilon; Xmn I 5' to G gamma; Hind III in G gamma and A gamma; Hinc II in and 3' to psi beta), quite different from the subhaplotypes seen for A gamma T negative chromosomes. This suggests a common ancestor which may have originated in Southern Europe. An evaluation of the gamma chain production by both chromosomes in SS patients and beta-thalassemia heterozygotes was possible for subjects with an A gamma T heterozygosity. It was concluded that in beta-thalassemia trait, the gamma chain synthesis is directed for about two-thirds by the thalassemic chromosome and for about one-third by the normal chromosome; the contribution by the normal chromosome decreases with a decrease in total gamma chain production.

Adolescent↗
PubMed1985

Hereditary triose phosphate isomerase deficiency: seven new homozygous cases.

Seven new homozygous cases of hereditary triosephosphate isomerase (TPI) deficiency have been detected in five unrelated families. Two of the families originate in France, the others from Algeria, Yugoslavia, and Morocco. Only the parents coming from Algeria and Morocco were first cousins. In the other parents no evidence of consanguinity was found. All seven patients exhibited the same symptoms, i.e. hemolytic anemia appearing very early after birth associated with progressive neuromuscular symptoms. Expression of the deficiency is heterogeneous; this had previously been pointed out in the previously reported cases of TPI deficiency. Red cell TPI activity was 3 to 4% of the normal mean in the patients and 50 to 60% in the parents. The latter did not exhibit any clinical symptoms. The levels of red cell glycolytic intermediates and the characteristics of the mutated TPI could be studied in four of the patients only. Substantial increases of red cell dihydroxyacetone phosphate and of fructose 1,6-diphosphate, normal Km of TPI for glyceraldehyde phosphate, and thermoinstability of the enzyme were found. In addition the electrophoretic pattern showed no significant modification of the mobility of the TPI bands, but abnormal decreased staining of the two more anodal bands.

Carbohydrate Epimerases↗
PubMed1988

Limited polymorphism of both classes of MHC genes in four different species of the Balkan mole rat.

We analyzed the restriction fragment length polymorphism of class I and class II MHC genes in DNA from 20 individuals belonging to the four different species of the complex of species of Balkan mole rats Spalax leucodon captured at four different localities in Yugoslavia. All populations were tested with four restriction enzymes and one conserved mouse probe for each of the two classes of MHC genes. The probes employed detect either limited polymorphism of class I genes or lack of polymorphic bands containing class II genes. Of the two other subterranean rodents that have been studied, four karyotype forms of the Israeli mole rat show polymorphism in both classes of MHC genes similar to the one found in all other mammals (Nizetić et al. 1985), and the Syrian hamster shows limited polymorphism of class I genes and high polymorphism of class II genes (McGuire et al. 1985). Balkan mole rats belong to a new group in this respect, different from all mammals studied so far, since they apparently show limited polymorphism of both classes of MHC genes.

Animals↗
PubMed1985

Inter-laboratory quality control in neonatal screening for inborn errors of metabolism.

Screening of neonates for inborn errors of metabolism has been carried out on a national level since 1969 in the Federal Republic of Germany. To raise the reliability of these routine investigations, we introduced an external quality control in March 1982. Every 2 months ten filter paper samples were sent to the screening centres in West Germany. Some of these samples have a normal and others a slightly raised content of phenylalanine, leucine, methionine and galactose. The success of this external quality control is appraised on the basis of the number of false negative results. In the course of time, screening centres in France, Israel, Italy, Japan, Switzerland, Taiwan, Turkey and Yugoslavia have also participated in these inter-laboratory quality controls.

Diagnostic Tests, Routine↗
PubMed1994

Ointments and transdermal nitroglycerin patches for stable angina pectoris.

Nitroglycerin (NTG) ointment is used for the prophylaxis against angina pectoris, but there are no data to support its effectiveness during long-term therapy. Continuous, once-daily application of isosorbide dinitrate cream produces tolerance with complete loss of efficacy within 1 week. Nitroglycerin patches are very popular and continuous once-daily application is still claimed by some investigators to provide 24 hour antiischemic and antianginal efficacy. This claim is based on data from postmarketing studies in a very large number of patients and placebo-controlled studies in smaller groups of patients from Italy, Yugoslavia, Greece, and Germany. In contrast, studies from the United States, Canada, England, and some centers in Germany have failed to show superiority of patches over placebo during continuous therapy. This controversy was addressed by the NTG cooperative study group, in which a total of 562 patients who were responders to sublingual nitroglycerin were studied. Patients received either placebo or NTG patches delivering low (15-30 mg/24 hr), moderate (45-60 mg/24 hr), or large (75 and 105 mg/24 hr) amounts of NTG. Four hours after the initial application, NTG patches increased exercise duration compared to placebo, but this beneficial effect had disappeared by 24 hours. Furthermore, after 8 weeks of continuous therapy, none of the NTG patches were superior to placebo, whether patients were or were not taking concomitant beta-blockers. Therefore, current opinion is that continuous therapy with NTG patches produces pharmacologic tolerance and is ineffective.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗
PubMed1998

[Asylum seekers and refugees in the medical polyclinic: a comparison between the Basel, Bern and Geneva polyclinics].

This cross-sectional study describes the state of health of asylum seekers and refugees and the health services provided to them by the medical outpatient departments of three major Swiss university hospitals, Basel, Berne and Geneva. The comparison of outpatient departments differing in organisational structure facilitated the identification of positive and negative determinants of health service provision. Questionnaires have been filled in by all physicians of the three medical outpatient departments (Basel: 10, Berne: 1, Geneva: 36). All consultations of asylum seekers and refugees have been recorded during the study period (Basel: 42, Berne: 93, Geneva: 187). Interviews have been done with the physicians who coordinated the study. During the study period the majority of the patients originated from former Yugoslavia, Turkey, Sri Lanka, Somalia, Angola and Zaire. One of the most prominent features of the population investigated has been its diversity in respect to countries of origin, languages, ability to communicate and education. Diversity and low consultation rates per physician could explain many of the problems which have been observed, e.g. the lack of experience in specific approaches to these patients or difficulties to provide interpreters. To improve the health care for this group of patients in medical outpatient departments small teams of physicians should be selected. By these means adequate levels of experience could be achieved and organizational problems could be dealt with more effectively. In addition, the relationship between specific problems of asylum seekers and refugees and more general issues of the interaction between physicians and patients are discussed in view of tasks in research and training.

Adolescent↗
PubMed1998

[Asylum seekers and refugees in the emergency department].

This cross-sectional study describes the health problems and the health care of asylum seekers and refugees from the point of view of accident & emergency (A & E) physicians at the major hospital in St. Gallen, Switzerland. The physicians filled in a detailed questionnaire and documented all consultations of asylum seekers/refugees and of a control group of patients during eleven weeks (2 x 98 consultations). 76% of these asylum seekers/refugees originated from former Yugoslavia. The distribution of the main ICD-coded diagnoses did not differ between asylum seekers/refugees and the control group after correction for age. In comparison with the asylum seekers and refugees attending GPs, injuries were much more common in the A & E department attenders (37% vs. 8%). Asylum seekers/refugees and the patients in the control group did not differ in respect to being classified as an emergency case (58% vs. 65%). There were also no differences in hospitalisation rates (29% vs. 36%). Asylum seekers/refugees who were registered with a GP attended the A & E department more often during the night than during the day compared to patients who were not registered with a GP. Consultations which have been classified as emergencies occurred more frequently during the day than at night time. The time of residence in Switzerland was negatively associated with the registration with a GP and with being classified as an emergency case. A lack of experience in caring for asylum seekers and refugees and of specific training in this field has been the major complaint by the A & E physicians. Asylum seekers should be introduced to the tasks and functions of the various sectors of the national health care system as early as possible. Registration with a GP in the community should be promoted.

Adolescent↗
PubMed1995

Twenty-five year mortality from coronary heart disease and its prediction in two Croatian cohorts of middle-aged men.

Two cohorts of men aged 40-59 in geographically defined areas of Croatia, former Yugoslavia, were enrolled in 1958 and cardiovascular risk factors were measured. The cohort of Dalmatia, on the Adriatic coast, was made up of 671 men (participation rate 98%), that of Slavonia, in the inland plain, of 696 men (participation rate 91%). Similar examinations were repeated 5 and 10 years after the entry one. A complete follow-up for vital status and causes of death was run for 25 years. Death rates in 25 years from coronary heart disease (CHD) were 90 per 1000 in Dalmatia and 148 per 1000 in Slavonia where also all other major causes of death and all-cause mortality rates were higher (642 vs 465 per 1000 in 25 years). Univariate and multivariate analysis relating ten risk factors to CHD mortality, showed that age and systolic blood pressure were significant predictors in Dalmatia; age, subscapular skinfold and body mass index (inverse) in Slavonia; and age, systolic blood pressure and subscapular skinfold in a multivariate model with lumped cohorts, where dummy variables identifying cohorts indicated a large unexplained extra-risk in Slavonia. In the pooled analysis cigarette smoking and serum cholesterol carried non significant coefficients. Blood pressure change in the first 10 years of follow-up added predictivity to a model exploring the delayed CHD morality occurring between year 10 and 25 of follow-up. Among the base-line measurements only serum cholesterol was significantly different between the two groups (188 mg/dl in Dalmatia and 199 mg/dl in Slavonia).(ABSTRACT TRUNCATED AT 250 WORDS)

Cohort Studies↗
PubMed1985

[Tetanus immunity in an urban population: gaps in the vaccination of senior citizens and foreign guest workers].

Immunity against tetanus in an urban population: gaps of immunity among elderly persons. In a sero-epidemiological survey we investigated the immunity against tetanustoxoid in an urban population. Children and adolescents born in Germany (n = 193) showed an excellent immunity, negative findings being the exception. Among soldiers of the army (n = 136), negative findings were rare too. In these both groups the antibody titiers averaged 4,5 IU/ml. It is generally agreed that an antibody titer of 0,01 IU/ml protects against tetanus. Adults born in Germany (n = 295) had a good immunity: 84% showed antibody - titers against tetanus. Among elderly persons, however, above 60 years of age (n = 1576) there was a striking incidence of negative findings: in 1043 persons (65%) no antibodies could be detected. The remaining 533 persons with positive findings (35%) had antibody-titers in the lower range (average 0,482 IU/ml). Also among foreigners and immigrant labourers from mediterrean countries (Greece, Turkey, Yugoslavia) the frequency of negative findings was high: 183 persons were examined, 70 (39%) were negative 113 (61%) were positive. The incidence of negative findings was highest among women from the mediterrean countries. Several small studies published in Switzerland show a similar tendency. Our paper will encourage further seroepidemiological studies.

Adolescent↗
PubMed1999

Environmental factors, health-related habits, and serum selenium levels in cancer patients and healthy controls.

Previous studies conducted in Yugoslavia indicated that the concentration of selenium in soil, food items, and serum of the population is very low. The aim of the study was to investigate the possible relationship among environmental, health-related habits, nutrition, and selenium serum levels in cancer patients and the healthy population. The case-control study included a group of cancer patients and a matched group of healthy controls: 57 cancer patients and 41 healthy controls living in Stari Grad (an urban area of Belgrade), as well as 17 cancer patients and 13 healthy controls living in Barajevo (a rural community in the vicinity of Belgrade). The healthy controls were matched to cancer patients in sex and age; they were not blood related. The selenium serum levels were measured by atomic absorption spectrophotometry. Health-related habits and relevant dietary factors ("food frequency" method) that may influence the selenium serum levels were assessed by questionnaires. The differences in average values of selenium serum levels between the cancer patients and healthy controls were not significantly different, but both were below the lowest recorded in referential studies. A significant difference between the values obtained from urban and rural subgroups was noted. The most important factors that influenced the level of selenium included the residence place in the region with selenium deficiency (Barajevo), age, associated chronic diseases, and some dietary factors potentially related to the intake of selenium. The results obtained in this investigation pointed out that use of selenium supplementation in this area should be seriously considered.

Aged↗
PubMed2001

Diabetes incidence in children of different nationalities: an epidemiological approach to the pathogenesis of diabetes.

AIMS/HYPOTHESIS: Incidence studies of children with Type I (insulin-dependent) diabetes mellitus and different ethnic backgrounds are known to provide important insights into the pathogenesis of the disease. For this reason, we compared the incidence rate in Baden-Württemberg, Germany, of children who were not of German descent with that of German children as well as with the reported incidence rates pertaining to the countries of origin of the children who were not of German descent. METHODS: Our study was based on the Baden-Württemberg incidence register, part of the EURODIAB TIGER network, which includes 2,121 children aged 0-14 years, diagnosed as having Type I diabetes between 1987 and 1997. The study covered a population at risk of 1.8 million children, which represents 13.3% of the total number of children in Germany. RESULTS: The total incidence rate was found to be 12.5 per 100,000 per year (95 %-CI 12.0-13.0); for German children alone it was calculated as 13.5 (95%-CI 12.9-14.1) and for children who were not of German descent it was significantly lower at 6.9 per 100,000 per year (95%-CI 5.8-8.0). The percentage of children who were not of German descent with Type I diabetes (8.3 %) is smaller than that among the general population (15.2%). Children from former Yugoslavia, Italy and Greece had incidence rates closer to their countries of origin than to the incidence rate of German children. CONCLUSION/INTERPRETATION: Our findings indicate that genetic factors play a predominant role in the pathogenesis of Type I diabetes. However, the influence of certain aspects of life-style, which remain constant even after immigration, cannot be excluded.

Adolescent↗
PubMed2004

Two point mutations identified in emmer wheat generate null Wx-A1 alleles.

In this report, the Wx-A1 mutations carried by a Triticum dicoccoides line from Israel and a Triticum dicoccum line from Yugoslavia are characterized. A single nucleotide insertion in the T. dicoccoides null allele and a single nucleotide deletion in the T. dicoccum null allele each cause frameshift mutations that induce premature termination codons more than 55 nucleotides upstream of the last exon-exon junction. In both mutants, Wx-A1 transcripts were detectable in 10 day post-anthesis endosperm by relative RT-PCR. However, transcript levels of the T. dicoccoides and T. dicoccum null alleles were reduced to approximately 6.5 and 1.5% of wild-type, respectively. Therefore, the lack of Wx-A1 protein in the mutants appears to be largely due to nonsense-mediated mRNA decay. The two mutations described here arose independently, and are not related to either of the Wx-A1 mutations identified in common wheat.

Alleles↗
PubMed2005

SSR allelic diversity changes in 480 European bread wheat varieties released from 1840 to 2000.

A sample of 480 bread wheat varieties originating from 15 European geographical areas and released from 1840 to 2000 were analysed with a set of 39 microsatellite markers. The total number of alleles ranged from 4 to 40, with an average of 16.4 alleles per locus. When seven successive periods of release were considered, the total number of alleles was quite stable until the 1960s, from which time it regularly decreased. Clustering analysis on Nei's distance matrix between these seven temporal groups showed a clear separation between groups of varieties registered before and after 1970. Analysis of qualitative variation over time in allelic composition of the accessions indicated that, on average, the more recent the European varieties, the more similar they were to each other. However, European accessions appear to be more differentiated as a function of their geographical origin than of their registration period. On average, western European countries (France, The Netherlands, Great Britain, Belgium) displayed a lower number of alleles than southeastern European countries (former Yugoslavia, Greece, Bulgaria, Romania, Hungary) and than the Mediterranean area (Italy, Spain and Portugal), which had a higher number. A hierarchical tree on Nei's distance matrix between the 15 geographical groups of accessions exhibited clear opposition between the geographical areas north and south of the arc formed by the Alps and the Carpathian mountains. These results suggest that diversity in European wheat accessions is not randomly distributed but can be explained both by temporal and geographical variation trends linked to breeding practices and agriculture policies in different countries.

Alleles↗
PubMed2006

Patterns of inpatient care for immigrants in Switzerland: a case control study.

BACKGROUND: Migration has become a major political and social concern in West European societies. METHODS: A case-control method was used to analyse the utilisation of inpatient mental health services by immigrants from a catchment area in Switzerland over a 7-year period. RESULTS: Compared to natives, immigrants had fewer psychiatric hospitalisations, but more emergency and compulsory admissions. During inpatient treatment, they received less psycho-, ergo- and physiotherapy. Other therapies as well as compulsory measures were at comparable rates, as was the frequency of irregular discharge. They spent shorter periods as inpatients and the rate of psychiatric readmissions was significantly lower. Comparison of different countries of origin revealed that only patients from West and North Europe were comparable to natives regarding type of referral, inpatient treatment, and longitudinal measures of service utilisation. Even after accounting for effects of social class, immigrants from South Europe, former Yugoslavia, Turkey, East Europe and more distant countries spent significantly shorter time in inpatient treatment, compared to Swiss control patients. CONCLUSIONS: Results of this study clearly point to an underutilisation of inpatient facilities among immigrants with mental disorders, and to disadvantages in psychiatric inpatient care. This, however, does not pertain to all foreign patients to the same extent: inequalities of mental health service use are particularly pronounced in immigrants from more distant countries.

Adolescent↗