Tool for decision-making regarding general evacuation during a rapid river flood.

OBJECTIVES: To propose a simple and effective tool for decision-making regarding general evacuation during a rapid river flood. STUDY DESIGN: Virtual testing of a tool in a real event. METHOD: A four-component tool was applied to build an alternative scenario of the catastrophic river flood in Obrenovac, Serbia, on May 2014. The components of this tool are: (1) the amount of precipitation above the 95th percentile of all previous measurements; (2) upstream river discharge above the 95th percentile of all previous measurements; (3) upstream river level above the 95th percentile of all previous measurements; and (4) worsening of the hydrometeorological situation in the following 48 h. RESULTS: In the early morning of 16 May 2014, a rapid river wave flooded 80% of the Obrenovac territory. There were 13 deaths due to drowning. Application of the study tool shows that these lives could have been saved, as the score to recommend general evacuation was reached 1 day before the flooding. The application of this tool to two previous great floods in Serbia shows that the score to recommend general evacuation was reached either 1 day before or on the onset of flash flooding. CONCLUSIONS: Due to its simplicity, this tool is universally applicable to facilitate decision-making regarding general evacuation during a rapid river flood, and it should be further tested in future similar catastrophes.

Evidence of Aujeszky's disease in wild boar in Serbia.

BACKGROUND: Aujeszky's disease is a viral disease of suids caused by Suid Herpesvirus 1. The disease has worldwide distribution with significant economic impact. In Serbia, there is neither an Aujeszky's disease eradication nor national vaccination programme of domestic pigs. Since clinical symptoms of Aujeszky's disease are not specific, it is important to establish a link between clinical signs and presence of ADV active infection in wild boars. The aim of this study was to investigate the possibility of active infection within wild boar showing signs of ADV and also to examine relationship between isolates from domestic pigs and wild boar. Having in mind that virus has not been previously isolated from wild boars in Serbia, we report the first isolation of Suid Herpesvirus 1 from this species in Serbia. RESULTS: Tissue and serum samples from 40 wild boars from eastern Serbia were examined for evidence of Aujeszky's disease (AD). Suid Herpesvirus 1 (SHV1), the cause of AD was isolated on PK15 cell line from three tissue samples, inducing cytopathic effect (CPE) with syncytia forming, and viral genome was detected by polymerase chain reaction (PCR) in eight samples. Genetic analysis of us4, us9 and ul49.5 partial sequences showed high homology between ADV isolates from wild boars and between isolates from wild boars and domestic animals. Neutralizing antibodies were not detected by virus neutralisation test (VNT) in sera from four out of eight PCR positive wild boars suggesting recent infection in those animals. CONCLUSIONS: This is the first demonstration of Aujeszky's disease virus (ADV) in the wild boar population in Serbia although seroconversion has been detected previously.

Unusual epidemic events: a new method of early orientation and differentiation between natural and deliberate epidemics.

OBJECTIVE: To develop a model for quick and accurate evaluation of unusual epidemic events (UEE), based on the original model of bioterrorism risk assessment. METHODS: A new scoring system was developed for quick differentiation between a biological attack and other epidemics, using eight qualitative and six quantitative indicators. RESULTS: A new scoring system was applied to three UEEs: (1) a spontaneous outbreak of a new or re-emerging disease ('swine flu'); (2) a spontaneous outbreak following accidental release of a pathogen (Sverdlovsk anthrax); and (3) a spontaneous natural outbreak of a known endemic disease that may mimic bioterrorism or biowarfare (Kosovo tularaemia). The disease agent was found to be the most important and the most informative UEE component of the scoring system. CONCLUSIONS: This new scoring system may be useful for public health institutions and federal civil and military officials responsible for bio-attack investigations.

Bioterrorism--types of epidemics, new epidemiological paradigm and levels of prevention.

Biological attacks can cause both an epidemic of infectious disease and of fear and panic. Epidemiological triangle chain models can be used to present both these types of epidemic. By merging these two triangles we suggest a new four-sided pyramidal model of bioterrorism attack and appropriate levels of prevention. Primordial prevention of biological attacks should comprise the impeding of access of both terrorists and biological agents to the territory. The primary prevention level should comprise internal surveillance of potential sources of agents and terrorists. Secondary prevention activities should be directed toward breaking both the epidemic of infectious disease and that of fear and panic. Tertiary prevention should include measures for repair following the attack. This is a task mainly for mental health professionals, curing and rehabilitating those affected by the epidemic of fear and panic. The suggested epidemiological model can be implemented into training programmes for detecting and responding to bioterrorist attacks around the world.

Diet and bladder cancer: a case-control study.

To investigate possible relationships between diet and risk for bladder cancer in Serbia, the hospital-based case-control study was carried out. This study included 130 newly diagnosed bladder cancer patients and the same number of controls matched by sex, age (%+/-%2 years) and type of residence (rural or urban). Dietary information was obtained by using a food frequency questionnaire. Initial case-control comparisons were based on tertiles of average daily intake of control group. The odds ratios (ORs) were computed for each tertile, with the lowest tertile defined as the referent category. All variables (food items) significantly related to bladder cancer were included in multivariable logistic regression analysis. According to this analysis, risk factors for bladder cancer appeared to be consumption of liver (OR=6.60, 95%CI=1.89-23.03), eggs (OR=3.12, 95%CI=1.10-8.80), pork (OR=2.99, 95%CI=1.16-7.72), and pickled vegetable (OR=3.25, 95%CI=1.36-7.71). A protective effect was found for dietary intake of kale (OR=0.21, 95%CI=0.06-0.73), cereals (OR=0.19, 95%CI=0.06-0.62), tangerines (OR=0.21, 95%CI=0.07-0.68), cabbage (OR=0.27, 95% CI=0.11-0.68), and carrots (OR=0.15, 95%CI=0.05-0.41). The study indicated a potentially important role for dietary fat and pickled vegetables in bladder carcinogenesis. An inverse association was recorded between consumption of fruits, vegetables and cereals, and the development of bladder cancer.

[Diet in bladder cancer ethiopathogenesis].

The aim of this paper is to show influence of different foods on bladder cancer appearance, as well as possible consequent ways of prevention. Consuption of food rich in animal fat and cholesterol, fried foods, especially several times used cookin oil for frying, processed meat with additives (nitrates, nitrites, azo-colourrs) can influence bladder cancer occurrence. Regularly, continous consumption of fermented milk products, which contains come types of milky--acids bacterias, is considered as protective factor in developing bladder cancer. Reports that fruit and vegetable are protective food items are pretty consistent. Data about mineral intake and bladder cancer are obscure.

Fluid intake and bladder cancer. A case control study.

To examine the relation of the total intake of fluids and the types of beverages to the risk of bladder cancer, we conducted a hospital based case-control study with 130 newly diagnosed bladder cancer patients and the same number of matched controls. Information of total fluid intake was derived from the reported frequency of consumption of the different types of beverages on the food frequency questionnaire. Univariate and multivariate logistic regression analyses were performed in statistical analysis. There was no statistically significant difference between the cases and the controls in total daily fluid intake. Multivariate logistic regression model showed consumption of: soda (OR=8.32; 95%CI=3.18-21.76), coffee (OR=1.46; 95%CI=1.05-2.01) and spirits (OR=1.15; 95%CI=1.04-1.28) as statistically significant risk factors, while mineral water (OR=0.52; 95%CI=0.34-0.79), skim milk (OR=0.38; 95%CI=0.16-0.91), yogurt (OR=0.34; 95%CI=0.12-0.97) and frequency of daily urination (OR=0.27; 95%CI=0.18-0.41) were statistically significant protective variables. In our study no statistically significant association was observed for total fluid intake. The findings suggest consumption of soda, coffee and spirits were indicated as a risk factors for bladder cancer, while mineral water, skim milk, yogurt and frequency of urination as protective factors for bladder cancer.

Tap water colonization with Pseudomonas aeruginosa in a surgical intensive care unit (ICU) and relation to Pseudomonas infections of ICU patients.

Water faucets on a surgical intensive care ward were examined prospectively as a source of Pseudomonas aeruginosa infections. All water outlets harbored distinct genotypes of P aeruginosa over prolonged time periods. Over a period of 7 months, 5 (29%) of 17 patients were infected with P aeruginosa genotypes also detectable in tap water.

[Risk factors for urinary bladder cancer]. / Faktori rizika za nastanak raka mokracne besike.

A matched case control study was conducted in order to assess possible relationships between some habits and risk of bladder cancer. The study included 130 newly diagnosed bladder cancer patients and the same number of controls matched with respect to sex, age (+/- 2 years) and type of residence (rural-urban). According to multivariate logistic regression analysis, risk factors of bladder cancer were smoking habits (OR = 3.15), consumption of animal fats (RR = 2.10) and pickled food (RR = 21.28). Higher level of educational (RR = 0.51), frequent urination (RR = 0.21), consumption of greens (RR = 0.10), cherry (RR = 0.03) and tangerines (RR = 0.02) had a protective effect.

Risk factors for Graves' disease.

A case-control study of 100 newly diagnosed patients with Graves' disease and the same numbers of controls matched with respect to sex, age (+/- 2 years) and type of residence (rural-urban) was carried out. According to the matched analysis (McNemar's test and 6 test) seventeen variables recognized as risk factors were included into the model of multivariate conditional logistic regression. The following factors were significantly associated with the occurrence of Graves' disease: change in time spent on work-much overtime work, second job, much less work than usual (RR = 6.62; CI = 2.08-21.01), lack of readiness of relatives and friends to help the subjected (RR = 1.48; 95% CI = 1.14-1.93), increased arguments with spouse (RR = 14.12; 95% CI = 1.63-121.87), unemployment for at least one month (RR = 9.80; 95% CI = 1.13-85.02), and family history of Graves disease in the first degree of relation (RR = 7.20; 95% CI = 0.85-60.70).

[Risk factors for allergic bronchial asthma]. / Faktori rizika za nastanak alergijske bronhijalne astme.

The paper deals with the current data on aetiological factors of allergic bronchial asthma. The cause of allergic bronchial asthma is unknown. In general, endogenous and environmental factors are though to play a certain role in its development. Early contact with allergic agents, air pollution, tobacco smoking and infective agents (viruses), are considered to be environmental factors. Endogenous factors are heredity of allergic diseases and special susceptibility for bronchial asthma.

Stressful life events in the pathogenesis of Graves' disease.

A case-control study was conducted in order to assess possible relationships between life events and Graves' disease. The study included 100 newly diagnosed patients with Graves' disease and 100 controls matched with respect to sex, age ( +/- 2 years) and type of residence (rural, urban). Paykel's Interview for Recent Life Events (a semistructured research interview covering 61 life events) was administered to each subject. In comparison with controls, the patients claimed to have had significantly more life events in the 12 months preceding the diagnosis (p = 0.0001). The following eight life events were significantly more prevalent among patients than controls: change in time spent on work (much overtime work, second job, much less work than usual) (McNemar = 12.04; RR = 7.00; 95%CI = 2.35-20.80; p = 0.0001), unemployment for at least 1 month (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), arguments with one's superior at work or a co-worker (McNemar = 4.50; RR = 3.50; 95%CI = 1.10-11.08; p = 0.031). change in the work conditions (new company division, new chief, large reorganization) (McNemar = 4.26; RR = 4.00; 95%CI = 1.07-14.92; p = 0.035), increased arguments with spouse (McNemar = 6.75; RR = 11.00; 95%CI = 1.82-66.44; p = 0.006), increased arguments with fiancé/fiancée or a steady date (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), hospitalization of a family member for serious illness (McNemar = 3.76; RR = 3.25; 95%CI = 1.01-10.68; p = 0.049) and moderate financial difficulties (McNemar = 8.50; RR = 3.25; 95%CI = 1.47-7.16; p = 0.003). Our findings indicate that life events may be a risk factor for Graves' disease.

[Social support and family relations in Graves-Basedow disease]. / Socijalna podrska, odnosi u porodici i Grejvs-Bazedovljeva bolest.

An anamnestic study encompassed 100 new patients with Graves-Basedow's disease and 100 controls matched according to sex, and age (+/-2 years) and place of living (rural/urban). The patients were treated in an out-patient clinic of the Clinical Center of the Medical Faculty, Clinical hospital center "Zvezdara" in Belgrade and in Special institution "Zlatibor" on Zlatibor in the period from May 1st, 1993 to November 1st, 1993. The aim of this study was to estimate the influence of family relationship and social support on the development of Graves-Basedow's disease. The diseased more often lived in an environment of family disharmony (McNemar's test = 3.76; relative risk (RR) = 3.25; 95% confidence limits CL = 1.01-10.68; probability (p) = 0.049) while the controls more often described themselves as nostalgic persons (McNemar's test = 4.96; RR = 0.38; CL (95%) = 0.16-0.89; p = 0.026). The possibility to discuss their personal problems with their relatives and friends (t = 2.29; DF = 99; p = 0.024), the relatives' and friends' interest for their problems and their readiness to help (t = 2.29; DF = 99; p = 0.004) and possibility of the patients to ask for help in case of financial problems (t = 2.78; DF = 99; p = 0.007) were more often present in persons from the control group.

[Risk factors in Graves's-Basedow's disease]. / Faktori rizika za nastanak Grejvs-Bazedovljeve bolesti.

The paper deals with the current data on aetiological factors of Graves's disease. The cause of Graves's disease is unknown. In general, endogenous and environmental factors are thought to play a certain role in its development. Stressful life, infective agents, lithium therapy, therapeutical radiation in the neck area and smoking, are considered to be environmental factors. Heredity and ethnic origin are endogenous factors.

[Mortality in Serbian males from the most common malignant tumors]. / Smrtnost muskaraca u Srbiji od najcescih malignih tumora.

The frequency and distribution of mortality of men in Serbia caused by the most frequent malignant tumors in the period from 1982. to 1991., were shown. Data were taken from the Republic Statistic Center. For the evaluation of the situation the descriptive epidemiological method was used. In that period men mostly died from lung, stomach, prostate, liver, rectum, pancreas, larynx, colon, brain and urinary bladder cancer. In the same period the mortality increase was observed in lung cancer, rectum, pancreas, colon, urinary bladder, brain, larynx and liver. For the cancer of prostate and stomach the decrease of mortality was noticed.

[Mortality in the most common malignant tumors in women in Serbia]. / Smrtnost od najcescih malignih tumora zena u Srbiji.

The incidence and mortality rate due to the most common malignant tumors in women in Serbia 1982-1991 were presented. Records from the Republic Institute of Statistics were used as the source of data. Descriptive method was used in epidemiological analysis. Within the period 1982-1991, women in Serbia had died most frequently due to malignant tumors of breast, lung, cervix, rectum, liver, colon, ovary, pancreas and uterine body. Tendency towards increased mortality rate due to the cancer of the breast, cervix, ovary, pancreas, rectum and colon has been registered in this period. Reduced mortality rate was observed in the cancers of uterine body, liver and stomach.