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PubMed1999

Surveillance for bloodborne infections.

At the close of the 20th century, the blood supply in the U.S. is among the safest in the world. Multifaceted and overlapping strategies that include comprehensive donor history-taking and screening (soon to include nucleic acid testing for HCV and HIV), and viral inactivation of plasma derivatives have resulted in significant declines in transfusion-transmitted infections. Nonetheless, we and our blood supply remain vulnerable to new or re-emerging infections as a consequence of changes in human behavior and demographics, improvements in technology and industry, economic development and land use, and microbial change. The second phase of CDC's strategic plan to improve our national capacity against emerging infectious diseases targets diseases transmitted through blood and blood products as one of its nine special focus areas. One of our mainstays against emerging threats must include surveillance, integrated with a multi-disciplinary approach that includes epidemiology and laboratory sciences. Enhanced surveillance can play an important role in helping to ensure the continued safety of blood and plasma products.

Biological Products↗
PubMedDate not supplied

[The principles, levels and sources of the financing for the medical care system under the new socioeconomic conditions (a review of the literature)].

A review is submitted of home and foreign literature on the state of financing of the medical industry. The data presented reveal modern principles, levels, and sources of financing of public health care systems in our country and abroad. The experience studied suggest that unification of scientific and practical achievements of Ukraine and economically developed countries, together with further improvements in financing of the medical industry might contribute to formation of national efficiently functioning public health care system.

Budgets↗
PubMed1999

[Analysis on the epidemic characterization and trend of AIDS in Fujian Province].

OBJECTIVE: To analysed the epidemic characterization and trend of AIDS in Fujian Province based on data obtained from HIV sero-survallance, HIV-1 subtyping and epidemiological survey. METHODS: Serum samples collected from people in high risk groups and specific subgroups were examined for antibody against human immunodeficiency virus (HIV). Epidemiological investigation was conducted toward people who were sero-positive. Clinical data on patients with AIDS were also collected. Peripheral blood mononuclear cells (PBMCs) obtained from HIV-1 infectious and patients with AIDS were used for DNA amplification between C2-V3 region by PCR. The amplified products were sequenced to identify HIV-1 subtypes. RESULTS: From January 1987 through the end of December 1997, a total number of 569,873 serum samples from high risk groups and specific subgroups including blood donors and people that travelling abroad frequently were examined for HIV antibody Seventy people with HIV-1 sero-positive were identified, accounting for 0.12/1000 of the total detected numbers. Among them, 21 patients with AIDS in which 18 cases had died. HIV/AIDS cases were mainly distributed along the coastal cities as Fuzhou, Quanzhou and Xiamen where economic development was growing rapidly. Most cases were infected abroad and spreading HIV to the country through sexual transmission. Clinical data showed that early syndromes and reversal fever of patients with AIDS were seen but survival time was short. Nucleotide sequencing showed that HIV-1 strains in the province were most subtype E. CONCLUSION: HIV epidemic in the province will mainly be spreading among people with sexually promiscuous behaviors.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Appropriate levels of cytotoxicity for genotoxicity tests using mammalian cells in vitro.

Among standard battery genotoxicity assays, the in vitro chromosome aberration test and the mouse lymphoma tk assay (MLA) yield about fourfold higher incidences of positive test results than the bacterial reverse mutation test or in vivo bone marrow tests. This is a result of experience with submissions of 335 new pharmaceuticals to the German Federal Institute for Drugs and Medical Devices. While all of the standard systems have their value in detecting relevant genotoxins, there is no supportive evidence for DNA reactivity for a considerable number of in vitro clastogens and MLA positives. In particular the clastogenic response of such compounds is often associated with high cytotoxicity. This may invoke the need to change the approach to test for clastogenicity in vitro. A combination of measures such as (1) a change in the upper limits of cytotoxicity that are currently given in International Conference on Harmonisation (ICH) and Organization for Economic Co-Operation & Economic Development (OECD) guidelines, (2) the creation of a common ground of understanding for interpretation of in vitro (positive) test results, and (3) lowering the upper limits of test compound concentration irrespective of cytotoxicity may prove useful to ensure a sufficient reliability of genotoxicity testing with mammalian cells in vitro.

Animals↗
PubMed2000

Public health implications or urban agriculture.

The article presents the case for stronger public policies in support of urban gardening as a means to improve public health. It considers several beneficial aspects of gardening, such as food security, economic development, exercise, psychological and community well-being, and environmental stewardship. It also considers some of the public health problems associated with urban agriculture and suggests policies to ameliorate them. In the balance, urban gardening has potential as an important element of urban public health.

Agriculture↗
PubMed2000

Psychotropic medications from natural products: a review of promising research and recommendations.

Most psychotropic agents employed in allopathic medicine have limited efficacy and significant side effects. Although usually beneficial, synthetic psychotropics are unavailable to approximately 80% of the world's population. Improved understanding of appropriate and safe uses of naturally occurring substances as psychotropic agents will greatly contribute to global mental healthcare. Empirical validation of non-allopathic treatments to ensure safety and efficacy is important because increasing numbers of patients in economically developed countries are using natural substances as medicinal agents. Patients and clinicians often lack accurate information, resulting in poor treatment outcomes or the possibility of drug-drug interactions when herbal medications are used with synthetic psychotropic medications. An important objective of this paper is to distinguish compelling scientific evidence supporting the use of natural products in psychiatry from political or institutional biases that have been misrepresented as scientific arguments. Following an overview of historical, legal, and regulatory issues, this paper presents findings of a systematic literature review on natural products used to treat neuropsychiatric disorders. Significant recent research is reviewed, including emerging treatments of seizure disorders, schizophrenia, dementia and age-related cognitive decline, depression, anxiety states, and substance abuse. Substantial evidence is advanced for safety and efficacy of many natural products used to treat neuropsychiatric symptoms or disorders. Preliminary findings suggest that several treatments based on natural substances are as effective and safe as synthetic pharmaceuticals in current use. Additional studies are indicated to confirm these findings, to elucidate mechanisms of action, and to elaborate standards for safe and appropriate treatment indications. In conclusion, strategic approaches aimed at facilitating improved networking, accelerating promising research directions, and enhancing quality standards of ongoing investigations into putative psychotropic agents from natural sources are recommended.

Humans↗
PubMed1978

The dietary fibre theory and bile salt pattern in Nigerians.

The results of bile analysis showed differences in the bile salt pattern of Caucasians and Nigerians, whose dietary habits differ mainly in dietary fibre composition. The Nigerian bile appears to contain less deoxycholate, but more cholate and a larger total pool of bile salts. These findings would seem to lend biochemical support for the epidemiological evidence concerning the uncommon occurrence of cholesterol gallstones and large bowel cancer in Nigeria as, indeed, in the less economically developed contries, where the dietary habits have not undergone comparable revolutionary changes of Western civilization, which have removed cellulose fibre from the diet in the process of industrial refinery.

Adult↗
PubMed2000

[Malaria vaccines--which vaccines to whom?].

More than a third of the world's population is at risk of contracting malaria. It is estimated that 200 people, primarily children in Africa, die of malaria every hour of every day all year round. Malaria is one of the main obstacles to socio-economic development in Africa. Vaccines against malaria are considered to be the control tool most in need of development. Fundamentally there are three types of malaria vaccines: vaccines against the invading sporozoite or the parasite's development in the liver cells, vaccines directed against the parasite's invasion of and development in the red blood cells; vaccines directed against the fertilisation process in the mosquito. Each malaria vaccine has its own area of application. In spite of promising results in animals it has been difficult to reproduce the results in clinical trials in humans. Recently, however, an experimental vaccine containing a sporozoite protein coupled to a hepatitis B surface molecule with a new adjuvant has been tested in Gambia. The results of these tests are promising, but it is unlikely that the vaccine will be of use in endemic areas. Increased focus on one of the world's biggest health problems has to a certain extent promoted the funding of development work on malaria vaccines. Despite minimal interest from the pharmaceutical industry, a number of experimental vaccines for clinical phase I trials are on their way. However, it will take a huge increase in public financial resources to secure effective and safe malaria vaccines for those most in need of them: people in developing countries and particularly in Sub-Saharan Africa.

Adult↗
PubMed2000

[The dynamics and structure of neonatal mortality in Bulgaria in the period of 1989-1998].

AIM OF THE STUDY: To follow and analyse the state and the structure of neonatal mortality rate (NMR) in the last ten years in Bulgaria. MATERIAL AND METHODS: A retrospective study is fulfilled on the annual data of the National Health Statistic Institute concerning the NMR in a period of last ten years. Along to this the changes in the perinatal infant mortality rate (PIMR) including the stillbirth and the early NMR are studied. The results are analysed by a comparative method and presented graphically. RESULTS: The unfavorable trends in the social and economic development of Bulgaria in the last decade are associated with a constant increase of PIMR--from 10.8% in 1989 to 12.9% in 1998, and of its components respectively: the stillbirth--from 5.9% to 7.4% and of the early NMR--from 4.9% to 5.8%. The NMR has increased from 7.3% since 1989 to 8.3% in 1998, the highest level being in 1991--10.4%. Besides the level of prematurely has increased constantly for the recent ten years--from 6.5% to 9.6%. The leading causes of neonatal mortality in Bulgaria are: perinatal asphyxia, congenital malformations, neonatal respiratory distress syndrome (RDS) and perinatal infections. They have remained the same for the recent five years. From them only the mortality caused by perinatal asphyxia has decreased in 1998--to 41.3% in comparison with 1994--43.7% and by congenital malformations--from 29.4% to 23.4% in 1998, the highest reduction being of the malformations of the neural system (2 folds) and of the gastrointestinal system (5 folds). The NMR of the low-birth weight infants (birth weight < 2500 g) has been 58.1% in 1997 and of the very low birth weight infants (< 1500 g)--276.3%. The NMR of both groups premature infants has decreased in 1998, respectively--to 47.6% and 191.4%. The NMR of the term-born infants has been 13.2% in 1997 and 11.1% in 1998. CONCLUSIONS: The NMR in Bulgaria remains comparatively high, the larger part being on the account of the early NMR, and it has increased for the last ten years. The main causes of NMR have remained the same for the last five years in the leading place been the perinatal asphyxia, the congenital malformations and the neonatal RDS. There is a tendency to a decrease of the perinatal asphyxia and the congenital malformations as a course of NMR in the last five tears. The NMR of the premature infants has decreased in 1998 and is relatively low, but this may be due to the fact that a certain part of the deceased extremely low-birth weight infants (< 1000 g) has been still not registered.

Birth Rate↗
PubMed1996

Microbial diseases in Malaysia: recent experiences.

Microbial diseases continue to occur in Malaysia despite the marked socio-economic development that has been taking place in the country along with improvements in the medical, health, and environmental sectors. This paper highlights the continuing presence of the numerous microbial diseases including the emergence of new problems such as AIDS. Local publications dealing with work on several microbial diseases is reviewed to show that this group of diseases will pose challenges for a long while. Undoubtedly several other diseases that were relatively unrecognised in the past are increasingly being identified owing to recent availability of diagnostic facilities and equipments. The need for continued vigilance is emphasised.

Bacterial Infections↗
PubMed1996

Diabetic control among NIDDM patients in urban and rural areas in Malaysia.

Sixty three and fifty nine non-insulin dependent diabetes mellitus (NIDDM) patients in rural (land resettlement scheme) and urban areas respectively were studied to determine factors associated with diabetic control. The anthropometric and metabolic data (HbA1 and fructosamine levels) were analysed. After adjusting for gender, age, body mass index (BMI) and food intake, the fructosamine level which correlates with short term diabetic control, was significantly lower among patients in urban areas compared to patients in rural areas (p < 0.05). However, for longer term diabetic control (HbA1 level) the difference was not statistically significant (p > 0.05). The socio-economic status, level of education, BMI and types of food did not correlate with diabetic control in either group of patients. More diabetes education is needed together with socio-economic development and changes in lifestyles to enhance compliance towards health and dietary regimens and to achieve better metabolic control.

Body Mass Index↗
PubMed2000

[Latent membrane protein LMP-1 in Hodgkin's lymphoma].

The authors examined using the antibody against latent membrane protein (LMP-1) a group of 169 patients with Hodgkin's lymphoma (age 2 to 82 years). From the total number of 169 patients 48 (28%) patients were positive when tested with this antibody. In the whole group the following histological types were represented most frequently: type II (nodular sclerosis) 83 (49%) patients, and type III (mixed cellularity) 70 (41%) patients. Type I (lymphocytic predominance) was not represented. In type IV (lymphocyte depletion) there were three cases (1.7%). Type V (lymphocyte rich) was represented by 13 patients (7.6%). The frequency of positive cases was in these histological types as follows: type II 14 cases (17% of 83 cases), type III 28 cases (40% of 70 cases), type IV 2 cases (66% of 3 cases). type V 4 cases (30% of 13 cases). Distribution of positive cases by age: in children under 10 years a positive finding was recorded in 80%. In old people above the age of 80 years there was a 100% positivity (only two patients were examined). The smallest number of positive cases was in the third decade (of 26 patients 4% were positive). LMP-1 positivity was most frequent in male patients--in 37 (of 96 examined patients) and in 11 female patients (of 73 examined) The frequency of LMP-1 in Hodgkin's lymphoma is consistent with similar studies in economically developed countries. A markedly higher incidence of positive cases in the lowest and highest age groups and gender differences are striking and so far there is no unequivocal explanation for them.

Adolescent↗
PubMed2000

Caring for Oklahoma's children: the Department of Pediatrics and Children's Hospital of Oklahoma.

The University of Oklahoma Department of Pediatrics was founded in 1930. Its history has mirrored the cyclic history of the state's economic development. The Department has maintained its commitment as a central resource for specialty care for sick children, training future physicians, and creating new information to improve children's health. The Department is currently in a stage of growth based on support from the College of Medicine and the community. Because the histories of the Department and the Children's Hospital of Oklahoma are intertwined, this article gives an overview of each.

Child↗
PubMed2000

Mapping international challenges for managed care.

The author in this presentation discusses the factors which he believes constitute the 5 mega-challenges confronting the global managed care industry; namely: Challenge One: Contest the bogus falsehoods and factual errors about managed care. Challenge Two: Engage the debate on the rightful place of private health care in the global economy. Challenge Three: Make the healthcare industry an integral part of every nation's economic development plan. Challenge Four: Lead the public policy debate on the side of safe, health, peaceful, caring communities. Challenge Five: Join with colleagues from pharmaceutical, medical device and information technology companies to promote a robust private health sector.

Global Health↗
PubMed2001

How two major health systems are employing 'doing more with less' and 'value-added' approaches to hospital security.

In efforts to achieve greater productivity from their security departments in the face of cutbacks, mergers, and other economic developments, a number of buzzwords have become popular recently that, in effect, call on security personnel to effectively provide additional services without increased funding or, in fact, with reduced budgets. Talking about such approaches is one thing, but achieving desired results is another. In this report, we'll present details on how security directors of two of the county's largest health operations have put concept into action.

Arizona↗
PubMedDate not supplied

Estimated costs of acute adenolymphangitis to patients with chronic manifestations of bancroftian filariasis in India.

In India, lymphatic filariasis persists as a major cause of clinical morbidity and as an impediment to socio-economic development. The direct costs incurred for the treatment of adeno-lymphangitis (ADL) episodes and the consequent indirect costs due to loss of income were determined from selected agricultural labour-intensive rural endemic pockets in Tamil Nadu. Information on the occurrence of ADL, its frequency and duration were collected using semi-structured questionnaire from randomly selected patients afflicted with chronic manifestations of bancroftian filariasis. Direct (treatment) cost per year per patient was found to range from Rs. 30 to 101 among patients with different manifestations. Income foregone (indirect cost) annually by each patient, which is a function of frequency and duration of ADL ranged from Rs. 182 to 702. ADL episodes among filarial patients alone cost a minimum of Rs. 4515 million for the nation every year. Cost benefit analysis of filariasis control programme in India showed that the benefits in terms of savings on treatment and work lost due ADL alone exceeded the cost by 24%. The per capita cost of the National Filaria Control Programme was calculated to be Rs. 2.6 per annuam.

Acute Disease↗
PubMed1997

Studies of primary angle closure glaucoma in China.

The recent researches on primary angle closure glaucoma (PACG) in China were reviewed. The prevalence of PACG (0.41%) in chinese is between the Caucasian and Eskimos, and chronic type is the dominant type in PACG. However, with the economic development and medical care improvements, the prevalence condition of PACG may change; several researches discovered that the mechanism of PACG, especially the chronic type, is not only because of pupil-blocking but also closely related to the mechanism of crowding of peripheral iris and the anterior location of the ciliary body. We supposed that PACG can be divided into several subtypes based on this mechnism. Also, we believe that the use of ultrasound biomicroscopy (UBM) and ophthalmic laser in China has promoted the research of PACG and improved the level of prevention and treatment of PACG.

Asian People↗
PubMed2000

Public health nutrition: results and research.

Public health nutrition is focused on the prevention of diet-related diseases and the attainment of good health, through policy, education and health promotion. It involves many sectors of the community, cooperating to improve the health and wellbeing of the population with emphasis on prevention, equity, wellbeing and improved quality of life. In the majority of western countries, an epidemic of coronary heart disease (CHD) began after World War One, reaching its peak in the 1970's. In Asia, the epidemic began after WW2 with the rapid economic development of the region. In western countries, of which Australia is a typical example, health promotion activities and improved hospital treatment have been effective in reducing the impact of the CHD epidemic. The life expectancy of the population has steadily grown to 75.6 years for males and 81.3 years for females. Despite major advances in the prevention and treatment of cardiovascular disease, it is still the leading cause of premature mortality and morbidity in Australia. Furthermore, cardiovascular disease shares common risk factors with other leading causes of death, including lifestyle behaviours (diet, physical inactivity, alcohol consumption, smoking), physiological states (obesity, hypertension, high blood cholesterol) and socioeconomic factors. For Asia, the challenge is to implement public health policies that will tackle the epidemic of chronic disease before it reaches its peak. Health Promotion policies will be important for all countries. The use of the disability adjusted life years (DALY) methodology to measure the association between the cause of disease and relate its occurrence to health outcomes will be an important public health planning tool.

Aged↗