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PubMed1960

A report on the laboratory assays carried out at the Lister Institute of Preventive Medicine on the typhoid vaccines used in the field study in Yugoslavia.

The results of the laboratory assays of the Yugoslav typhoid vaccines used in the field trials at Osijek are disappointing when compared with the results of the field trials.The tests carried out at the Lister Institute in England, the Central Institute of Hygiene in Zagreb, Yugoslavia, and the Walter Reed Army Institute of Research in the USA indicate that, except for the agglutination tests for H antigen, there is little or no demonstrable difference in the potency of the two Yugoslav vaccines in either active immunization tests or passive protection tests.Although only a relatively small number of assays were carried out using the intracerebral route of challenge, the results indicate that there is no advantage in this method over the more usual intraperitoneal route. Since there was a difference between the potency of the vaccines in the field trails, it must be concluded that the mouse is not a suitable animal for typhoid assay or that the proper way of testing the mouse has not yet been found. The great variation in detail in nominally identical tests made in different laboratories and the differences in the results emphasizes the essential importance of at least one common assay, identical in detail between collaborating laboratories, in a study of this kind.

Agglutination Tests↗
PubMed1962

A controlled field trial in Yugoslavia of the efficacy of griseofulvin in the mass treatment of tinea capitis.

The introduction of the orally administered antibiotic griseofulvin has wrought a dramatic change in the prospects for controlling ringworm of the scalp. With the assistance of the World Health Organization, a field trial was carried out in Yugoslavia to determine the most suitable schedule of dosage with this drug for mass treatment and to ascertain what measures are necessary to reduce the reservoir of infection to a level where the disease ceases to be a public health problem. The value of supplementing griseofulvin administration by local treatment of the scalp was also investigated.In the endemic area selected for the trial, 495 cases of tinea capitis due to infection with Trichophyton violaceum were detected and treated among a total population of 4106. It was found that a relatively low dose (25 mg of griseofulvin per kg of body-weight, given once a week for 4 weeks) was sufficient to produce clinical cure, confirmed by microscopy, in some 95% of cases, as determined at a resurvey 6 months after the end of the treatment period. Treatment of household contacts of infected persons had no significant influence on the rate of cure. Local treatment of the scalp, on the other hand, did significantly enhance the recovery rate.An unexpected finding was that patients treated in the field trial showed consistently better recovery rates than patients given similar treatment in hospital. A controlled trial to test this finding is planned.

Griseofulvin↗
PubMed1960

Susceptibility of body-lice to DDT in a heavily treated area of Yugoslavia.

Body-lice collected in the Kosohovo-Metohia area of Yugoslavia, an area with a long history of epidemic typhus and one which had been treated with DDT since 1947, were tested for their susceptibility to that compound by the standard WHO test and showed an average mortality of 99% to 1.0% DDT and 96% to 0.1% DDT. Freshly fed insects showed 100% mortality at both concentrations. Tests with DDT-impregnated cloth indicated that the LD(50) had tripled between 1955 and 1958.In sleeve tests the body-lice appeared to tolerate 15 times as much DDT as in tests not involving the use of the human arm. Tests were also made to ascertain the effect of lowered temperature on reducing mortality from DDT, and the speed of kill with DDT was compared with that with BHC and pyrethrins.

Animals↗
PubMed2003

Trends and patterns of tuberculosis: interpretations and prospects of tuberculosis control in Vojvodina, Yugoslavia, 1987-2000.

AIM: To assess the trends and pattern of tuberculosis in Vojvodina, Yugoslavia. METHODS: Using a retrospective design, data on 393 diagnosed TB cases were investigated for the years 1987, 1993 and 2000. RESULTS: TB case notification has been increasing in Vojvodina. The number of reported TB cases was 146 in 1987, 101 in 1993 and 146 in 2000; cases were predominantly in the age group 20-39 years (44.5%) in 1987, compared to the 40-59 year age group in 1993 and 2000 (38.6% and 45.9%, respectively). The majority of patients belonged to lower socio-economic groups. Manifestations of TB such as cough, weight loss and exhaustion were common. With the increasing trend of alcoholism from 1987 to 2000, delays in reporting were noticed. TB-related mortality was 1.4% in 1987 and 4.1% in 2000. Resistance to TB drugs among previously treated cases was 2.7% in 1987, 0.9% in 1993 and 2.7% in 2000. With respect to the increasing resistance, the levels of detection and surveillance were poor. The implementation of the DOTS strategy remained fairly low. CONCLUSION: TB is a chronic problem in Vojvodina. Prompt community-oriented actions need to be taken to improve case detection and cure rates through DOTS.

Directly Observed Therapy↗
PubMedDate not supplied

Some epidemiological and socio-medical peculiarities of pulmonary tuberculosis (pTB) among individuals from war affected areas (WAA)--experiences and results from north-west Yugoslavia (NWYU).

AIM: 1. To find out the differences between patients (pts) from WAA and the general population (GP) suffering from pTB. 2. To evaluate the proportion and characteristics of pts from WAA in pulmonary TB (pTB) hospital mortality rate. 3. To evaluate how many refugees (RE) and displaced persons consider TB as a social "stigma". METHODS: 1. Analysis of the medical files of pts with pTB--137 from WAA and 212 from the GP. 2. Analysis of clinical data of pts who died of pTB from 1990 to 1999. 3. A questionnaire about knowledge and social attitude towards TB. RESULTS: 1. The main characteristics of pts with pTB from WAA (both those who were dismissed from hospital and those with fatal outcome) are: male dominance, prolonged hospital treatment, high prevalence of relapses, very extended forms of the disease and presence of cavernous lesions on chest X-ray. 2. Deterioration of life conditions, impoverishment, demographic changes, shortage of anti-TB drugs and supplies for diagnosis led to increase hospital mortality rate of TB between 1990 and 1999 in NWYU (36% of all pts who died of TB in the mentioned period originated from WAA). 4. RE from former Yugoslavia consider TB more as a social "stigma" than the GP. CONCLUSION: The prevention, treatment and follow up of pts with pTB from WAA must be a priority in the Yugoslav national TB programme.

Adult↗
PubMed2004

Treating posttraumatic stress in post-conflict countries and countries that accepted refugees. Report on the STOP-study, a multi-site study on treatment seeking and treatment outcome in people suffering from posttraumatic stress following war and migration in former Yugoslavia.

War and migration in the Balkans caused traumatic experiences in great parts of it's population. About four million people living in former Yugoslavia as well as about 100,000 refugees living in different European countries are estimated to suffer from on-going and severe psychological symptoms of post-traumatic stress. Although in need of treatment, many of these people do not seek treatment. Given the fact that, if untreated, post-traumatic stress reactions tend to persist for many years, often resulting in impairment and disability secondary to the symptom complex, offering appropriate care is a special challenge to health services. With regard to this context, an EC-funded multi-centre study including partners from Belgrade (SCO). Dresden (D), London (UK), Rijcka (HR), Sarajevo (BIH), and Zagreb (HR) aims (a) to provide an empirical basis for designing care programmes for people suffering from post-traumatic stress following war and migration in the Balkans who currently do not seek treatment, and (b) to improve the cost-effectiveness of treatment programmes for those patients who are cared for in specialised treatment centres. The paper presents the aims and the design of the STOP study. The first results of the study will be available in 2005.

Europe↗
PubMed1991

Geographical distribution of arboviruses in Yugoslavia.

Studies of arboviruses started in Yugoslavia in 1953 following the isolation of TBE virus which caused a severe epidemic that year. Until now the following viruses have been proven to circulate in the country: tick-borne encephalitis (TBE), Crimean-Congo hemorrhagic fever (CCHF), Bhanja (BHA), sandfly fever (SF), Tahyna (TAH), Calovo (CVO), West Nile (WN), dengue (DEN), Jug Bogdanovac (JB), and Hantaviruses. TBE virus is endemic in the north-west part of the country, causing also epidemics in cyclical intervals. Its typical clinical picture is aseptic meningitis, but severe cases with paralysis have also been described. The bite of ticks is confirmed in about 80% of cases. CCF caused a small epidemic with ten clinical cases in Macedonia in 1976. Bhanja virus was isolated on the Dalmatian island of Brac in 1977, the antibody rate there, determined by the HI method, being about 31%. The first human disease in the world was caused by the Yugoslav Bhanja virus strain. Sandfly fever is still active in the country. The Naples type is prevailing and has proved hazardous for newcomers. Hantaviruses have been studied since 1980. They caused severe epidemics (1967, 1980, 1989) and sporadic cases all over the country. Three different strains are in circulation. Further studies are needed for the rest of the above mentioned viruses to learn more about their significance in human pathology.

Arbovirus Infections↗
PubMed1991

Characterization of a noncyst-forming isolate of Trichinella from a wild boar in Yugoslavia.

An isolate of Trichinella obtained from a wild boar in Yugoslavia did not form cysts in the musculature of its natural host. Subsequent inoculation into experimental hosts demonstrated that some larvae became encysted only after extended time periods, whereas others remained unencapsulated. Histological staining of larvae in the musculature demonstrated no deposition of collagen typically seen for Trichinella spiralis spiralis, Trichinella spiralis nativa, or Trichinella spiralis nelsoni. The Yugoslavian isolate, given the name of Zagreb isolate after the University where it was first studied, had low infectivity for pigs and mice. Isozyme analysis demonstrated greater homology with T. s. nelsoni than with other subspecies of Trichinella. Restriction fragment length polymorphisms and dot blot analyses further demonstrated the distinctive nature of this isolate. These results suggest that lack of cyst formation might be characteristic of isolates other than those designated Trichinella pseudospiralis and that this character might be important in the classification of Trichinella.

Animals↗
PubMed1991

Ventilatory parameters in healthy nonsmoking adults of Adriatic islands (Yugoslavia).

Forced expiratory volumes and flows (forced vital capacity (FVC), forced expiratory volume in one second (FEV1) peak expiratory flow (PEF), maximal expiratory flow at 25% (MEF25%), 50% (MEF50%) and 75% (MEF75%) of the FVC) have been measured in 909 healthy nonsmoking men and women, ranging in age from 18-86 yrs, who live on Eastern Adriatic islands (Yugoslavia). This area is essentially free from air pollution. The results have been analysed in terms of age and height and regression equations for each sex were derived. The equations for FVC and FEV1 were reliable and those for forced expiratory flows were not. Comparisons were made with prediction equations derived for other populations, especially with those which are commonly used in daily medical practice.

Adolescent↗
PubMedDate not supplied

[Iodine levels in salt for human consumption and aspects of iodine prophylaxis in Yugoslavia].

Iodine content of iodinated salt intended only for human consumption was eyamined in samples from all domestic manufacturers (salt mines in: Tuzla, Pag, Ulcinj, Ston, Nin, Seca-Portoroz). Sampling was made from commercially available packs (1 kg) or from food industries (large packs). It was established that iodine content of examined samples (57) varied considerably and ranged from 1.8 to 12.2 mg iodine/kg salt. Iodinated salt from the Tuzla and Pag salt mines contained iodine within the prescribed limits in both small and large packs. Similar finding of iodine content was in the small packs of the Ulcinj salt mines, however, their large packs (10 kg) had a markedly low level of iodine (1.8-4.7 mg). Lower iodine content was also noted in salts (1 kg) from the Nin, Ston and Seca-Portoroz mines. Of the 57 examined samples in 70% iodine content was lower than the prescribed dose (7.6 mg). In addition, some mines had low iodine content in all of the 100% of their respective samples. Ever since iodine prophylaxis was introduced in Yugoslavia a number of factors influenced the decrease of iodine intake by the organism to a considerable degree. The results of our investigations and some epidemiological data indicate that the issue of increasing the amount of iodine from the present 7.6 to 15 mg iodine/kg salt should be reconsidered. Besides, it is necessary to arrange the systematic quality control of iodinated salt.

Goiter↗
PubMedDate not supplied

[Characteristics of primary blast injuries at the beginning of armed conflict in Yugoslavia in 1991].

At the beginning of combat operations in Yugoslavia among 290 wounded members of the Y.P.A. and Territorial Defence sent to the treatment at the Military Medical Academy, 60 (20.7%) were with explosive mine wounds. In the group of 12 wounded with rupture of one or both tympanic membranes or with traumatic hearing impairment of various degrees, the chest x-ray was also performed. Radiologic signs characteristic of primary blast injury of the lung were found in a high percentage (42%). A possible relationship of primary auditory and primary nonauditory blast injury was discussed, and it has been concluded that more severe rupture of the eardrum in the injured by mine explosion can suggest the presence of primary blast injuries.

Adult↗
PubMed1991

Epidemiology of swine trichinellosis in Yugoslavia.

Intensive epidemiological and seroepidemiological studies of Trichinella spiralis infection in swine have been carried out in the borough of Kladovo, one of the four regions in Yugoslavia where trichinellosis is endemic. A high prevalence (4.7%) of trichinellosis was discovered in three neighboring parishes adjoining the bank of the river Danube. Both geographically and epidemiologically these three parishes constitute a very unique condition that is very vulnerable to T. spiralis infection. Studies of 7,409 swine showed that the ELISA test for the detection of specific antibodies to T. spiralis in swine was highly reliable.

Age Factors↗
PubMed1991

[Epidemiologic study of laryngeal cancer in Yugoslavia].

In Yugoslavia cancer of the larynx has an important position in the group of malignant tumours, especially among the malignomas of the respiratory system. According to the data on mortality, laryngeal cancer accounts for 2.67% of all tumours and 11.59% of all respiratory tract tumours during the period from 1977 to 1988. In that period the average age-adjusted mortality rate of laryngeal cancer was 3.09 per 100,000 population, much higher in mean--6.29%(000) than the women--0.53%(000). The linear trend in laryngeal cancer mortality from 1977 to 1988 points to a slight increase (y = 2.97 +/- 0.02x), in men (y = 6.03 +/- 0.04x), while in women it shows a decrease (y = 0.60--0.01x). Age specific mortality rates of laryngeal cancer are low in the age groups to 39 years in men and 49 years in women. It augments steadily from 40 and 50 years of age respectively, with the highest rates in patients above 70 years of age (39.66%(000) for men and 4.05%(000) for women).

Adolescent↗
PubMed1991

[Mortality in malignant hemopathies in Yugoslavia].

The authors have analysed the mortality of malignant haemopathies in Yugoslavia from 1978 to 1987. The standardized rate of mortality among all malignant haemopathies was from 6.5 to 7.2%000. These rates were higher in males (7.8-8.8%000), than in the females (4.8-5.9%000). The mortality of this group of malignant tumors shows a decreasing tendency, which is more evident in females than in males. Since Hodgkin's disease and lymphoid leukemia participate with about 50% in the structure of mortality from all malignant hemopathies, and for that reason, mortality from these two diseases is especially analysed. The standardized rate of mortality from Hodgkin's disease was between 1.7-2.5%000 (males 2.1-3.2%000; females 1.3-2.0%000). Mortality from this malignant haemopathy has a tendency of decreasing, which is approximately of the same intensity in both sexes. Mortality from lymphoid leukemia in the period between 1978 and 1987 was from 0.7 to 1.2%000 (males 0.9-1.7%000; females 0.5-1.0%000). The mortality trend from lymphoid leukemia shows a similar slight decrease in males and females.

Female↗
PubMed1990

Population structure of the Peljesac Peninsula, Yugoslavia.

We gathered serogenetic and parent-offspring migration data from 604 residents of 7 villages on the Peljesac peninsula in southern Yugoslavia. A variety of population genetics and multivariate statistics models and procedures give a concordant picture of the population structure of this region. Extensive migration is the dominant microevolutionary force patterning the variation seen today. Multiple population bottlenecks have also occurred over the past few centuries as a result of disease, famine, war, economic failure, and founder events, making it likely that genetic drift has been an important factor in the history of this population system.

Adult↗
PubMed1990

Drug trials on healthy volunteers in Yugoslavia.

Ninety-seven healthy volunteers who participated in different clinical trials (phases III and IV) in a clinical pharmacology unit were interviewed over the period December 1988-February 1990 using questionnaire method. The aim of the investigation was to analyze the examinees' occupational distribution, the degree of insight in the trials they participated in, their opinion about the remuneration they get and their estimate of the importance or inconveniences of numerous trial elements. Only 39 volunteers (40.2%) were members of medical staff: 17 (17.5%) physicians, 17 (17.5%) medical students and 5 (5.2%) nurses. The volunteers assessed the importance of different elements related to the trial marking them from 1-5. They were more afraid of possible adverse drug reactions (ADR) occurring during the trial (median 3.87) than of those that might occur afterwards (2.94). Significant was their concern about the kind of investigated drug (3.49). "Potential contribution of the trial to the medicine and society" (3.30) and "length of time spent in the laboratory" (3.17) followed. The conduct of clinical trials on healthy volunteers in Yugoslavia and legal regulations are discussed at the end of the paper.

Adult↗
PubMedDate not supplied

[Lyme disease in Yugoslavia].

Presented are results of the last five-year period study of the lyme disease in Yugoslavia. On the basis of published papers and professional communications over 2500 cases of lyme disease.were detected in our country within this period. Presented are common epidemiologic and clinical features of the disease and particularly cases diagnosed in Belgrade. Since 1987 a group of various specialists has been working on the research project in collaboration with many centres in the country. Indirect immunofluorescence test as the diagnostic laboratory technique has been introduced in the Military Medical Academy in Belgrade in 1987. First species of Borrelia burgdorferi from ticks Ixodes ricinus have been isolated and cultivated in May and June 1990. Current problems concerning research work, medical and epidemiological aspects of the lyme disease are presented.

Adolescent↗
PubMedDate not supplied

Human exposure to ochratoxin A in areas of Yugoslavia with endemic nephropathy.

Ochratoxin A is a mycotoxin with pronounced nephrotoxic potency in all species of single-stomach animals studied; it is a major disease determinant of porcine nephropathy and a disease occurring endemically in several countries. This disease is comparable with Balkan (endemic) nephropathy, suggesting a common causal relationship. Ochratoxin A has been found in foodstuffs in many countries, but the highest frequency of ochratoxin A contamination in foods (10.3% of 1,553 samples of foodstuffs) was encountered in an area of Yugoslavia, where Balkan (endemic) nephropathy is prevalent. Detection of ochratoxin A in human blood samples confirmed the prevalent exposure to this food contaminant. Relative risk calculations indicated a tendency to an association between this mycotoxin and Balkan (endemic) nephropathy, supporting the hypothesis of a causal role of ochratoxin A in this disease.

Balkan Nephropathy↗