Rabies infection in humans is still a major public health problem, causing upwards of 20,000 deaths per year. The prevalent vaccine is still the nerve-tissue vaccine, which, although improved, ...necessitates the use of long and painful application schedules and fails to provide safe and reaction-free protection. A new generation of low-cost, purified rabies vaccines released in the last 2 years promises a revolution in rabies immunization in less-developed, rabies endemic countries, providing protection comparable to that of human diploid cell vaccine at the cost of Semple-type vaccine. Devising an appropriate technology for human rabies immunization includes new regimens of administration, one of which, a revised intramuscular regimen requiring only four doses and three clinic visits, proved highly efficient for postexposure treatment.
Rabipur, a vaccine propagated on chick embryo fibroblasts, is one of the `second generation' rabies vaccines produced by cell culture techniques. It compares in tolerance, immunogenicity and efficacy ...with the human diploid cell culture vaccines and is significantly more economical to be produced. It has proven to be an excellent vaccine, particularly when employed by the 2–1–1 schedule vaccination. This approach combines economy of vaccine with increased safety of treatment. Rabipur was investigated in all immunological parameters and can be recommended as a vaccine of choice for postexposure rabies treatment.
Although elderly hospitalized patients, irrespective of the cause of hospitalization, are known to be at a high risk of subsequent development of pneumonia, some studies suggest the risk to be even ...higher in those hospitalized for pneumonia than in those hospitalized for other diseases. The aim of this retrospective study was to determine the association of hospitalization for pneumonia and some other diseases with subsequent pneumonia morbidity and mortality. The risk of recurrent pneumonia in patients hospitalized for pneumonia was investigated. Rehospitalization of pneumonia patients previously hospitalized for the same disease was followed-up and compared with rehospitalization of patients hospitalized for other diseases during the same study period. The study included patients aged overl8, initially hospitalized in 1998 for pneumonia (J12-J18), or for some particular gastrointestinal (K20-K31) and urogenital diseases (N10-N12, N30-N39). All rehospitalizations for pneumonia in nine Zagreb hospitals were followed-up during a 3-year study period (1998-2000). Out of 975 patients followed-up for rehospitalization, 227 (23.3%) had initially been hospitalized for pneumonia, and 748 (76.7%) for other diagnoses. During the 3-year period, 30 patients were rehospitalized for pneumonia, out of which number 22 had initially been hospitalized for pneumonia, yielding a statistically significant difference between the two study groups (chi2 = 34.780, p < 0.001). The mortality directly caused by pneumonia was also significantly higher in the group of patients with the initial diagnosis of pneumonia than in the group of patients with other diagnoses (chi2 = 15.82, p < 0.001).
Background and Objectives: Interlaboratory differences (and conflicting practices) in syphilis screening strategies (serial versus parallel test combinations) prompted us to determine an estimate of ...the diagnostic miss rate in the detection of (1) infected persons and (2) infected but untreated persons potentially affected by late active syphilis. Goal: We set out to establish the most efficient syphilis screening strategy for two routine tests (VDRL and Treponema pallidum hemagglutination assay TPHA) with regard to our tested public health population (average VDRL+ TPHA+ and VDRL- TPHA+ reactor ages being 59.9 years and 50.5 years, respectively. Study Design: Retrospective analysis covered the results of a routine parallel VDRL and TPHA testing on 24,863 persons done in four public health laboratories. Nosologic sensitivity of the VDRL test (18.32%) was determined using the TPHA test as reference. The percentage of VDRL nonreactors among infected persons (TPHA reactors) was considered as the VDRL false negative rate (81.68%). We estimated the proportion of persons infected but untreated with potential late active syphilis using our own Bayes theorem-based procedure. Results: The Bayes theorem-based estimate showed a significantly higher value for persons at risk of active late syphilis than the number of suspected cases obtained using the classical approach (25.1% versus 18.32%, or 83 persons versus 61 of the 330 infected). Conclusion: In screening an older population, the VDRL test alone (or as the first of a series with TPHA as a confirmation test) may produce a diagnostic miss rate higher than the syphilis detection rate. Another miss in such a population is detected by the Bayes theorem-based method.
Background: Because both hepatitis A and typhoid vaccination are frequently indicated in the same traveler, a prospective, randomized controlled study was performed to evaluate the feasibility of ...simultaneous administration of hepatitis A and typhoid fever vaccines in adult volunteers. Methods: Two groups of 25 subjects received either separate injections of hepatitis A (Havrixtrade mark, SmithKline Beecham Biologicals) and typhoid fever (Typhim Vitrade mark, Pasteur-Mérieux) vaccines in opposite arms, or a syringe-mixed combination of both vaccines as a single injection. A booster dose of Havrix was given at 6 months. Results: The immune response to hepatitis A tended to be higher in the mixed-injection group, but this difference was significant (p=.048) only following the booster dose. Adverse reactions were generally mild with no differences between the two groups. Conclusion: A combined formulated vaccine against both typhoid fever and hepatitis A is feasible and offers more convenience without added adverse reactions to travelers who have appropriate indications for both vaccines.
Promatrajući rad i sadašnju organizaciju javno-zdravstvene službe Republike Hrvatske moramo zaključiti da one ne udovoljavaju ni vremenu, ni prostoru, ni zahtijevima pučanstva Hrvatske.Također ne ...udovoljuje ni strogim normama zapadne Europe koje su preduvijet za ulazak u zajednički «EUROPSKI GOSPODARSKI PROSTOR». Snagom inercije međuratna organizacija javno-zdravstvene službe, s kozmetičkim promjenama zadržana je u iskrivljenom obliku do današnjih dana. Osoblje naših javno-zdravstvenih ustanova, premda brojčano stalno povećavamo, ograničeno je negativnom selekcijom, stručnim neznanjem, radnom nedisciplinom i financijskom nemotiviranošću.
Potaknuti demokratskim procesima u Hrvatskoj i ne mireći se s postojećim «funkcioniranjem» javnog zdravstva u Hrvatskoj državi, predlažemo novu organizaciju javno-zdravstvene službe Republike Hrvatske.
Although elderly hospitalized patients, irrespective of the cause of hospitalization, are known to be at a high risk of subsequent development of pneumonia, some studies suggest the risk to be even ...higher in those hospitalized for pneumonia than in those hospitalized for other diseases. The aim of this retrospective study was to determine the association of hospitalization for pneumonia and some other diseases with subsequent pneumonia morbidity and mortality. The risk of recurrent pneumonia in patients hospitalized for pneumonia was investigated. Rehospitalization of pneumonia patients previously hospitalized for the same disease was followed-up and compared with rehospitalization of patients hospitalized for other diseases during the same study period. The study included patients aged over18, initially hospitalized in 1998 for pneumonia (J12–J18), or for some particular gastrointestinal (K20–K31) and urogenital diseases (N10–N12, N30–N39). All rehospitalizations for pneumonia in nine Zagreb hospitals were followed-up during a 3-year study period (1998–2000). Out of 975 patients followed-up for rehospitalization, 227 (23.3%) had initially been hospitalized for pneumonia, and 748 (76.7%) for other diagnoses. During the 3-year period, 30 patients were rehospitalized for pneumonia, out of which number 22 had initially been hospitalized for pneumonia, yielding a statistically significant difference between the two study groups (x2=34.780, p<0.001). The mortality directly caused by pneumonia was also significantly higher in the group of patients with the initial diagnosis of pneumonia than in the group of patients with other diagnoses (x2=15.82, p<0.001).
Iistraživane su različite kombinacije uvjeta rasta i sastava peptonske vode, kao osnovnog tekućeg medija za razmnožavanje bakterija Vibrio cholerae i Vibrio metschnikovii obzirom na pH, ionsku ...jakost, te temperaturu i vrijeme inkubacije sa svrhom da se utvrde značajke koje najviše pridonose razlikama u rastu spomenutih mikroorganizama. Svrha je bila odvojiti dvije navedene bakterijske vrste, tj. odrediti kombinaciju uvjeta kultivacije (obzirom na gore navedene pokazatelje) koja bi omogućila selektivno razmnožavanje V. cholerae (ljudskog i životinjskog patogena) uz supresiju rasta V. metschnikovii. Ovaj potonji vibrio pravi smetnje pri vizuelnoj identifikaciji V. cholerae iz okolišnih i životinjskih uzoraka za analizu - pri upotrebi standardnog krutog selektivnog TCBS medija za kultivaciju. Preliminarna provjera mogućih metoda (tj. novih kombinacija gore navedenih uvjeta kultivacije i svojstava medija za kultivaciju) u dnevnoj rutini (u našem slučaju pri bakteriološkoj analizi otpadnih voda) je pokazala da bi kombinacija uvjeta za kultivaciju koja uključuje produženje inkubacije na 22 sata pri povišenoj temperaturi od 41 °C mogla omogućiti brzu i jednostavnu izolaciju V. cholerae, pri čemu bi njegova definitivna identifikacija i kvantifikacija mogla biti obavljena već i vizuelno.
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