Prognosis of the dynamics and intensity of the epidemic process in viral hepatitis A

The article deals with approaches to the calculation of the annual morbidity rate in virus hepatitis A at the period preceding the season of maximum morbidity, necessary for planning the relevant prophylactic and antiepidemic measures in due time. The method for calculating the monthly levels of sporadic morbidity in virus hepatitis A is proposed. This method permits the detection of complications on the epidemic situation, which is necessary for the timely organization of antiepidemic measures. The proposed method for predicting annual and monthly morbidity levels can be used in the practical work of specialists at sanitary and epidemic stations.     

The definition of the forms of the epidemic process in intestinal infections]

A method for the identification of the forms of the epidemic process in dysentery (annual, seasonal and outbreak forms) has been worked out. The method is based on the calculation of the upper limits of annual and seasonal morbidity from the data on the period of several years with the use of the formulae of binomial distribution, serving as the mathematical model of alternative random values, such as morbidity. The comparison of actual morbidity for each year of the analyzed period with the upper limits of annual and seasonal morbidity helps identify the form of the epidemic process.     

Prognosis of the incidence of hemorrhagic fever with the renal syndrome in the Primorsk region]

A study was made of a possibility of prognostication of the number of patients (morbidity per 100 000 residents) with hemorrhagic fever with the renal syndrome in conditions of the Primorsk region. The main factors characterizing this disease were analyzed with the use of the "Minsk-22" computer; these were dynamics of the populations of murine rodents, metereological data, morbidity. A method of prognostication of the number of patients (morbidity) with hemorrhagic fever and a renal syndrome in the Primorsk region for the current year was elaborated.     

Methodological aspects of the evaluation of epidemiological safety in maternity hospitals

The distribution of morbidity and mortality in newborns, as well as morbidity of parturient women, in maternity hospitals of Moscow official have been analyzed according to statistical data for 1996-1999. The methods of cluster analysis (k-medium and tree classification by the method of the next door neighbours) were used. The evaluation of the stability of the distribution of morbidity and mortality in maternity hospitals was made with the use of chi 2 criterion. The specific features of the distribution of morbidity and mortality of newborns, as well as morbidity of parturient women, in the hospitals under study were detected. The methodological approach to the evaluation of epidemiological safety in maternity hospitals was proposed.     

Solitary lag screw osteosynthesis in the treatment of fractures of the angle of the mandible: a retrospective study

Various methods have been advocated for the treatment of fractures of the angle of the mandible, emphasizing the complexity of the problem. A functionally stable osteosynthesis can be achieved in such fractures with a solitary lag screw. This technique meets the principles of rigid internal fixation and achieves maximum stability with a minimum of implant material. It obviates the need for maxillomandibular fixation, as well as the morbidity associated with the conventional methods of treatment. A review is presented of 50 patients who were treated by this method. The data show that the procedure is an effective and predictable modality of treatment with a low rate of morbidity.     

Method of calculating the incidence of viral hepatitis B

The method for the calculation of actual hepatitis B morbidity and the formula for such calculation are proposed. The calculations presented in this work have demonstrated that the actual spread of virus B hepatitis is many times higher than the registered morbidity rate and that there are more than 30 undetected hepatitis patients per each manifest case of the disease. This requires additional approaches to the study of the epidemiology of virus B hepatitis, the ways and factors of its transmission.     

The possibility of using the demonstration of Shigella antigens in the study of the epidemic process in dysentery

The detection of Shigella antigens in feces in accordance with the results of the passive hemagglutination test is more effective than the bacteriological method for finding out persons infected with Shigella, especially in the absence of pronounced clinical manifestations of dysentery, and can be used in the study of the mechanism of the epidemic process. The examination of two groups, each consisting of permanent and temporary members, has revealed that the use of this method for detection of the antigen makes it possible to perform the epidemiological analysis of morbidity and, in particular, to determine the source(s) of infection.     

Advisability of carrying out mass prevention of infectious hepatitis with gamma globulin

In Vilnius 15,183 pupils in 20 schools were observed for two years; in October, 1966, gamma globulin prophylaxis of infectious hepatitis was carried out among all the pupils of these schools. 17.062 pupils in 27 schools, who received no gamma globulin, were used for control. At the end of the first year of observation morbidity rate among the immunized children was found to be considerably lower than among the school children of the control group. During the second year of observation morbidity rate among the children of the "old" immunized group increased 3.5-fold and did not significantly differ from morbidity rate among the children of the control group. The latter increased 1.8-fold. The authors have come to the conclusion that the effect of gamma globulin prophylaxis on the epidemic process depends on the method of such prophylaxis. The method of prophylaxis by introducing gamma globulin immunization with universal coverage, as the use of the former method is not followed by an increase in total morbidity (i.e. among both immunized and nonimmunized children) during the second year after immunization, which is observed after prophylaxis by universal immunization.     

Transcutaneous fine needle aspiration biopsy of the preepiglottic space

OBJECTIVE: To evaluate transcutaneous fine needle aspiration biopsy of the preepiglottic space for staging supraglottic squamous cell carcinoma. STUDY DESIGN: We studied 28 patients who underwent total or horizontal supraglottic laryngectomy as their main therapy modality due to supraglottic squamous cell carcinoma, followed in some cases by adjuvant radiation therapy. All the patients underwent transcutaneous fine needle aspiration. RESULTS: The cytopathologic examination of the material obtained by aspiration was compared to the histopathologic analysis of the laryngectomy specimens; the efficiency was 96.4%. The method did not cause any morbidity. CONCLUSION: Transcutaneous fine needle aspiration biopsy of the preepiglottic space is useful for preepiglottic space evaluation, with a high correlation with histopathologic results and no morbidity.     

Nosogeography of viral hepatitis in the Ukraine over the last 25 years (1952-1976)]

For 25 years of observation the morbidity rate of viral hepatitis in the Ukraine was irregular. In individual regions the morbidity level fluctuated within 2 to 3-fold range. Regions with invariably high or low morbidity levels for viral hepatitis were distributed over the territory of the republic not chaotically, but in zones: a zone with invariably high morbidity rate (western), a zone with morbidity rate corresponding to the average level for the republic (south-western), and a zone with an invariably low morbidity rate (north-eastern). The expediency of dividing the territory into epidemiological areas in respect of viral hepatitis on a regional or republican level is discussed.     

A method for assessing the efficacy of using bifidumbacterin for the prevention of suppurative-inflammatory diseases in the newborn

A method has been developed for the evaluation of the effectiveness of bifidumbacterin in different quantitative morbidity characteristics in purulent inflammatory diseases of newborns in risk groups. This method requires a limited number of observations. In purulent inflammatory infections bifidumbacterin can be used as an effective remedy for the prophylaxis of hospital infections. The proposed method may be used for the analysis of the effectiveness of other antiepidemic measures, e.g. the sanitation of carriers.     

Reconstruction of the burned ear using a temporalis fascial flap

A case report is presented in which a temporalis fascial flap is used to reconstruct a burned ear complicated by full-thickness skin loss with exposed cartilage. The method provides a simple, reliable means for covering exposed auricular cartilage with readily obtainable vascularized tissue. Donor-site morbidity is minimal because the scar lies within the hairline.     

Analysis of the dynamics of typho-paratyphoid infection morbidity over the years in the USSR]

Statistical materials of recording the number of patients and of the typhoid-paratyphoid infections morbidity level in Russia and the USSR from 1891 to 1976 was studied. A stable tendency to reduction of this morbidity was noted. In analysing the empirical and flattened--by 3 and 5 points--curves of the number of patients and the morbidity level a regularity of declining morbidity rises was revealed. Elevation periodicity persisted, despite the reduction of morbidity level. The mean duration of the whole cycle constituted 12 years. The period of increasing morbidity from minimal to maximal in each cycle constituted 4 years, and of the declination period--8 years. Formalized empirical series of the number of patients and of the morbidity level deviated from 1908 to 1956 not more than by 1 year from the formalized basic curve. Cyclic changes of typhoid-paratyphoid infections morbidity should be taken into consideration in determining the efficacy of prophylatic measures, particularly of mass vaccination.     

Causal inference for non-mortality outcomes in the presence of death

Evaluation of the causal effect of a baseline exposure on a morbidity outcome at a fixed time point is often complicated when study participants die before morbidity outcomes are measured. In this setting, the causal effect is only well defined for the principal stratum of subjects who would live regardless of the exposure. Motivated by gerontologic researchers interested in understanding the causal effect of vision loss on emotional distress in a population with a high mortality rate, we investigate the effect among those who would live both with and without vision loss. Since this subpopulation is not readily identifiable from the data and vision loss is not randomized, we introduce a set of scientifically driven assumptions to identify the causal effect. Since these assumptions are not empirically verifiable, we embed our methodology within a sensitivity analysis framework. We apply our method using the first three rounds of survey data from the Salisbury Eye Evaluation, a population-based cohort study of older adults. We also present a simulation study that validates our method.     

深圳市南山区西丽人民医院辖区2005-2009年麻疹疫情分析

为了掌握深圳市南山区西丽人民医院辖区内麻疹病毒流行现状,评价该院辖区麻疹疫苗接种效果,为今后制订麻疹预防控制策略提供依据。采用回顾性调查方法,将2005-2009年间的麻疹发病情况作了分析。2005、2007两年发病人数最多,发病率较高,随着麻疹疫苗强化免疫活动的开展,使疫情有了较大的下降趋势。结果表明,接种麻疹疫苗是最有效地预防麻疹疫情的手段。     

Analysis of the seasonality of acute intestinal diseases with regard to the detection of dysentery by antigen indication

Coincidence in the seasonal changes of the registered morbidity in dysentery and in other acute intestinal diseases is observed. The occurrence of Shigella antigens, detected with the use of erythrocyte diagnostic reagents, in the excreta of patients with the clinical diagnosis of dysentery and patients with other acute intestinal disease has a seasonal character, its peak coinciding with the period of increased morbidity in bacteriologically confirmed dysentery. The correction of monthly morbidity levels in dysentery and in other acute intestinal diseases with due regard for the proportion of Shigella antigens in the findings, made in the groups of patients with the clinical diagnosis of dysentery and with the diagnosis of other acute intestinal diseases for the corresponding month, has revealed that the actual morbidity in other acute intestinal diseases has a less pronounced seasonal character in comparison with the registered morbidity. This fact substantiates the statement that in the group of patients with other acute intestinal diseases a large proportion of such diseases is, actually, of a noninfectious nature.     

Characteristics of the manifest and latent components of the hepatitis A epidemic process in cities of Russia

Seroepidemiological study of hepatitis A (HA) morbidity was carried out in three Russian cities, with different levels of HA morbidity. The study included the analysis of HA morbidity for 22 years, the determination of antibodies to HA virus (anti-HAV) in 2,958 healthy persons aged 0-12 months to 40 years and older. In one of the cities 7 isolates of HA virus were obtained from unrelated sources and the genotypes of the virus were determined. The study revealed that the frequency of seropositive cases among persons of different ages correlated with the level and prolonged dynamics of HA morbidity. According to the occurrence of anti-HAV, such cities as St. Petersburg, Rostov-on-Don and Yakutsk may be at present classified as territories, moderately endemic in HA. At the same time in the 90 s the epidemic situation in HA was more favorable in Rostov-on-Don than in two other cities. The suggestion was made that a high proportion of seropositive persons among the population of St. Perersburg was linked with an almost twofold rise in HA morbidity in 1993-1995 caused by genotype 1 of the virus. Seroepidemiological studies in HA during the period of a drop in morbidity acquire special importance in the surveillance and control system of this infection.     

Catheter-mediated subselective intracoronary gene delivery to the rabbit heart: introduction of a novel method

BACKGROUND: Recent studies suggest that gene therapy using replication-deficient adenoviruses will benefit treatment of cardiovascular diseases including heart failure. A persistent hurdle is the effective and reproducible delivery of a transgene to the myocardium with minimal iatrogenic morbidity. In this study, we sought to design a relatively non-invasive percutaneous gene delivery system that would maximize cardiac transgene expression and minimize mortality after intracoronary adenovirus injection. METHODS: Adult rabbits received a left circumflex coronary artery (LCx) infusion of 5x10(11) total viral particles of an adenovirus containing the marker transgene beta-galactosidase (Adeno-betaGal) via either a continuous infusion method utilizing an oxygenated, normothermic, physiologic pH Krebs solution driven by a Langendorff apparatus (n=12) or a timed bolus and set concentration at a constant infusion rate to the LCx (n=12). Six rabbits underwent global transgene delivery via an invasive method involving intraventricular delivery and aortic root cross-clamping. The efficacy of transgene expression via these three distinct delivery methods was determined in the left ventricle at 5 days by histological staining and colorimetric quantification assay. RESULTS: While the open-chest, aortic cross-clamping method provides the highest level of gene expression throughout the heart, the morbidity of this procedure is clinically prohibitive. Percutaneous LCx delivery of Adeno-betaGal using the Langendorff apparatus was associated with the lowest morbidity and mortality while still supporting significant myocardial gene expression. CONCLUSIONS: Percutaneous delivery of an adenovirus solution using a continuous infusion of oxygenated Krebs solution via a Langendorff apparatus appears to be a gene delivery modality offering the best compromise of gene expression and clinical utility to maximize any potential therapeutic outcome.     

Development of morbidity in hemolytic disease of the newborn after the introduction of immune prophylaxis at the Rostock blood exchange center from 1970 to 1980

The development of morbus haemolyticus neonatorum morbidity is demonstrated by referring to the example of the "exchange centre" in Rostock after using anti-D-immunprophylaxis for more than 10 years. The level achieved is compared with findings in international studies. The main cause for rest morbidity consists in omitting indicated immunoprophylaxis. Further progress in reducing the morbidity of morbus haemolyticus neonatorum can only be achieved by keeping physicians informed about the deleterious consequences of anti-D-immunisation having occurred.     

Immunomorphologic features of experimental allergic encephalomyelitis induced by the administration of tryptophan peptide

Three patterns of EAE with different morbidity and mortality rates were induced in the guinea pigs inoculated with various doses of tryptophane peptide (TP) and complete Freund's adjuvant. TP-sensitized animals manifested the delayed type hypersensitivity (DTH) reactions to TP and circulating anti-TP and -BPF antibodies were not found, polypeptide fraction of myelin basic protein (BPF while a A correlation was revealed between the DTH-reactions and EAE development. Intracutaneous TP and BPF injections at the early period before the EAE onset resulted in reduction of morbidity rate from 90 to 50 per cent. For the first time with the help of modified Marchi method demyelination has been shown to be highly marked in CNS tissue process in CNS can be caused by cell-mediated immune of animals given TP. It is supposed that the demyelinating reaction to encephalitogenic fragment of BP molecule. The data indicate a possibility of EAE inhibition by means of TP and BPF injections in saline solution.