[Epidemiological assessment of morbidity and natural foci of TBE-CEE virus infection in Transylvania]. / Evaluarea epidemiologica a emergentei morbiditatii si focalitatii naturale cu virusul TBE-CEE in Transilvania.

UNLABELLED: In Romania, anthropozoonoses, and in this nosological context, human viral neuro-infections with incidental transmission by active vectors with natural foci, may be considered infectious diseases with endemic emergence. Since 1996, the form of manifestation of the epidemiological process by viral meningitis and meningoencephalitis, the etiological structure of morbidity and the problem of natural foci have required the implementation of an effective epidemiological survey strategy. This paper includes the results of an epidemiological survey and the general population seroepidemiological evaluation of acute and historic infections, identified as arboviral TBE-CEE neuro-infections. MATERIAL AND METHOD: In the interval 1999-2006, the following aspects were studied: an endemic episode of 37 cases of TBE-CEE neuro-virus infection in a rural population. The epidemiological inquiry was conclusive for the transmission of infection by goat milk from highly tick infested animals, in a habitat with identified natural sylvatic and peridomestic foci; an endemic-epidemic state with 17 cases of TBE-CEE neuro-virus infection, occurring within a short time interval, in a rural community. Recent history revealed tick infestation from a common natural area; the size and dynamics of territorial changes in natural foci by comparing the prevalence of historic TBE-CEE infections in 41 subjects at known occupational risk, 95 subjects from the domestic habitat of former patients with TBE-CEE neuro-infection, and 172 subjects from areas adjacent to natural foci. RESULTS: Specific serology was positive in 41.5%, 11.6%, and 5.8% of the investigated subjects (chi2 = 38.98); the prevalence of historic TBE-CEE infection in the general population was estimated at 0.6% (0.3-1.1%, CI = 95%) by the seroepidemiological investigation of a representative sample of the Transylvanian population (1669 subjects); the TBE-CEE etiology of acute viral meningitis/meningoencephalitis in the interval 2001-2006 (862 cases in the area) with a prevalence of 14.1% (10.9-17.8%, CI = 95%) of the cases, evaluated based on the etiological investigation of representative samples from 2 counties and on request from the territory (in total 397 investigated cases). Seroepidemiological tests validated by external quality control were performed using the ELISA technique, with standardized immune reagents (IgM and/or IgG specific). CONCLUSION: Based on the epidemiological survey performed, it may be concluded that the specific infection sources and the morbidity of human TBE-CEE virus neuro-infections have an endemic emergent course and natural foci are in full territorial expansion.

[Results of etiologic diagnosis in clinical syndrome consistent with acute and chronic borreliosis]. / Rezultatele diagnosticului etiologic in sindroame clinice compatibile cu borrelioza acuta si cronica.

UNLABELLED: Borreliosis is a multisystem infection, which in the absence of adequate diagnosis and clinical management, may develop towards various clinical forms of chronic pathology. Due to the heterogeneity of clinical manifestations it is known under more names: erythema migrans, Lyme disease, neuroborreliosis etc. MATERIAL AND METHOD: Taking into account the present interest and the weight in pathology of syndromes consistent with the suspicion of a Borrelia spp. infection, since 2002 we applied in current practice the investigation of this etiology. There have been investigated 481 subjects, clinically suspected of Borrelia spp. infection that had historical risk of tick bite and cases of serous meningitis, after exclusion of usual etiology. Tests were performed on ELISA kits with standardised immunoreagents and recently, for result validation, on Western immunoblot kits (WB). RESULTS: Our results revealed the Borrelia etiology in 32% of cases (27.96-36.29% CI = 95%) at the screening, value expressed by the persistent positivity of the specific immunoglobulins (Ig) IgM (80.5%) and IgM+IgG (19.5%). Historic infection, represented exclusively by IgG positivity, was present in 8.6% (5.87-11.98% CI = 95%) from the cases that were negative for IgM (68%, 63.71-72.04%, CI = 95%). This weight is superposable with the results obtained in investigating a comparable sample of healthy individuals (193 subjects with 6.74% historical IgG, 3.79-10.96%, CI = 95%). Based on these results, it can be considered that ELISA procedure is useful and of reliable prognosis value for screening the Borrelia spp. etiology, the next step, taking into account the higher sensitivity of WB, being WB procedure which is useful for confirmation of ELISA positive cases and for treatment efficiency surveillance. The results prove that Borrelia spp. infections are a public health issue, which due to the diversity of clinical manifestations and diagnosis difficulties need repeated and complex laboratory investigations.

Effect of modified eros centre on some reproductive parameters of the sow.

The effect of a modified eros centre on weaning to oestrus interval, follicle size, ovulation and farrowing rate and total born litter size was investigated. In modified eros centre 94.4% and in group housing 79.1% of the sows (p < 0.01) expressed oestrus within 10 days post-weaning. Weaning to oestrus interval was shorter (p < 0.001) for sows kept in modified eros centre. The interval from onset of oestrus to the time of ovulation was longer for sows in group housing (p=0.05). The time of ovulation was negatively correlated (r=-0.50) with the interval from weaning to oestrus (p=0.005). The time of ovulation after onset of oestrus was significantly (p < 0.05) shorter for sows expressing oestrus within 2-4 days of weaning, compared with the animals that expressed oestrus between days 5 and 6 post-weaning and was shortest for sows expressing oestrus after day 6 post-weaning. Farrowing rate was not affected by a modified eros centre. Litter size tended to be smaller in group-housed weaned sows (p=0.10). The timing of last artificial insemination relative to time of ovulation did not affect litter size (p > 0.10). The implication of these results is that a modified eros centre may improve some of the post-weaning oestrous parameters of the sow.

[The effect of the histological condition of the endometrium on fluid absorption during trans-cervical endometrium resection]. / A méhnyálkahártya szövettani állapotának hatása a méhüri öblítófolyadék felszívódására transcervicalis endometrium-resectio alatt.

The aim of the study was to assess the effect of the number of endometrial and myometrial vessels on fluid absorption. Operative details and histology results (endometrium chips and myometrial biopsy) of fifty-four consecutive patients undergoing transcervical endometrial resection were analyzed. Thirteen of the 54 patients had hormonal pretreatment using 600 mg/day danazol (n = 11) or norethisterone 10 mg/day (n = 2) for four weeks before procedure. Simultaneous myomectomy were performed on 17 patients. A positive correlation was found between the number of endometrial vessels and volume of fluid absorption, although due to the small study population the result is not significant [p = 0.087, r = 0.29, CI (95%) for r: 0.218 to 0.377]. The correlation with myometrial vessels was found to be negative [p = 0.1, r = -0.39, CI (95%) for r: -0.527 to -0.262]. Patients with hormonal pretreatment absorbed less fluid, but not in a significant amount. Simultaneous myomectomy has no effect on absorption. There is only a poor correlation between fluid absorption during endometrial resection and the number of vessels in the endometrium and myometrium. The authors emphasize the importance of continuous monitoring of fluid dynamics.

[A prevalence study of serum markers in hepatitis virus infection in the epidemiological anamnesis of the population]. / Studiul prevalentei markerilor serici ai infectiei cu virusurile hepatitelor în anamneza epidemiologica a populatiei.

Pandemic of the infections with hepatitis viruses is a priority in public health. In Romania, the very high acute and chronic morbidity by viral hepatitis demands the rapid implementation of a feasible preventive program. In the population of 5 districts from Transylvania we conducted a sero-epidemiological survey in order to find the real and specific characteristics of the prevalence of the infections with hepatitis viruses. The study was a cross-sectional study on the anamnestic presence of the infections in the population. The evolution of the cumulative prevalence of infections with HAV (74.3%) and HBV (31.7%) are proving a high endemoepidemicity. For the infections with HCV (4.9%) and HDV (1.7%) we observed an active process of endemicity. The high rate of persistent infections following HBV acute infections (19.1%) suggests a growing-up tendency of chronic hepatic diseases. In actual epidemiologic conditions, the rate of exposure to a potential hepatic viral infections in the population we studied could be 1.68 infections/person, during a period equal to life expectancy at birth.

[Transcervical endometrial resection. A new surgical method for the management of metrorrhagia]. / Transzcervikális endometrium rezekció. Uj mütéti eljárás a metrorrhagia kezelésére.

The authors introduce to transcervical endometrial resection offered as an alternative operation for women with metrorrhagia. Their experience regarding to the introduction and results of the surgery of the first 10 patients are reported. There were no intraoperative complications. The benefit of the new technique regarding to the shorter hospital stay and recovery time is obvious.

Betaloc therapy in pregnancy-associated mild and moderately severe hypertension.

In a prospective study the effect of Betaloc therapy on pregnancy-associated mild and moderately severe hypertension has been examined. Besides the effects on the mother the changes of foetal heart rate were also observed. The antihypertensive therapy was performed with daily 3 x 100 mg (3 x 1 tab) oral doses of Betaloc in 30 pregnant women with 140-170 mmHg systolic and 90-110 mmHg diastolic blood pressure values at admittance. In the course of the examinations definite and statistically significant fall of systolic flood pressure could be observed following the onset of Betaloc therapy as early as on the first day of drug administration which could be maintained during therapy. Somewhat less definite but the same change was observed in the diastolic blood pressure. Maternal pulse rate was significantly higher before therapy than after finishing Betaloc therapy. Notable foetal bradycardia was not observed, in the course of Betaloc administration the decrease of foetal heart rate did not surpass the normal limit values. During the therapy no side-effect attributable to the drug was observed.