[The prevalence of viral hepatitis markers in patients hospitalized in infectious disease wards with a diagnosis of acute viral hepatitis]

According with Romanian public health surveillance system, the acute viral hepatitis is nominal reportable disease for what hospital admission is compulsory (Ord. MS 638/1978 and Ord. MS 386/1985); that why, for this condition controlling purpose, only the hospital admitted cases are reported. The acute viral hepatitis statistics do not reflect the morbidity in general population but in hospitalized population; these statistics are very dependent if ill people are hospitalized or not, and in the same time by the lack possibilities of laboratory diagnosis. The objective's study were: a) to describe the structure of laboratory-based diagnostics (using ELISA kits), b) to compare this one with diagnostics established for admitted ill people in infectious wards or clinics, using electroimmunodiffusion (EID) test. The most important findings reveal that from a total of 121 cases about three quarters has been identified as type B viral hepatitis, 20% as type A viral hepatitis and 8.3% were neither type A nor type B viral hepatitis (ELISA kits for hepatitis C diagnosis there was not available for us). According with our findings we think EID technique as etiologic diagnosis for acute viral hepatitis, have to be changed. We need instead a more sensitive and timeliness test; in the same time this has to be permissive from the financial point of view.

[The prevalence of viral hepatitis B in pregnant women in an area of southern Romania]

In Romania, the acute hepatitis B virus (HBV) infections are considered to be a public health problem. One of the most effective routes of transmission is from infected mothers to newborns both perinatal and in early childhood. That for, this study objective was to estimate the prevalence of hepatitis B în pregnant women. We used the cluster sampling method with a sample size of 1356 pregnant women. Finally our study was based on 1298 blood samples coming from 19 clusters (obstetrics wards/hospitals) selected from those 108 obstetrics wards/hospitals in the south of Romania. Overall, 31.8% (95% C.I. 27.3%-36.4%) of pregnant women admitted for birth in southern Romania had the evidence of past or current HBV infection (anti HBc, AgHBs). In a study done in 1990, Bradley A. Woodruff et al. has reported a prevalence of past or current HBV infection of 36.7% among pregnant women in northeastern Romania.

[An evaluation of the antidiphtheria protection in the general population]

The assessment of the antidiphtheria protection in healthy population is common for a surveillance system within any National Program of Immunization. Our study is intending to measure the antidiphtheria immunity level in apparently healthy peoples living in the southern Romania. Our study were carried out on 8594 healthy subjects. Sample were stratified by nine age groups being representative for the above mentioned area. The titration of diphtheria antitoxin in our laboratory were performed by passive hemagglutination assay (PHA) and in vivo neutralization test (NT). In our study, we had considered as "protective immunity level" an antitoxin titers equal or above 1/640. The overall prevalence of protected peoples was 88.1% (C.I. 95%: 87.4%-88.8%). The prevalence of protected people against diphtheria decrease by age from 94.5% (1-9 years of age) to 82.4% (60 years and over). We think that overall, our national strategy for diphtheria control is quite efficient, but need to be sustained by specific actions concerning some high risk population groups.

[The prevalence of viral hepatitis markers in the general population]

The study objective was to measure the characteristic serological markers prevalence for viral hepatitis A, viral hepatitis B and viral hepatitis Delta in a representative group from apparent healthy general population. Viral hepatitis infections represent through their frequency and gravity a public health problem, in our country. A total of 860 subjects from 13 districts sided in the south part of the country were investigated. The sample were distributed by 9 age group. By using a certain work algorithm we examined the following serological markers: HBs Ag, anti HBs, AgHBe/antiHBe, AgHD/antiHD. For the serologic investigation we used ELISA test with Wellcozyme and Sanofi Diagnostics Pasteur Kits. The results of our study confirm high prevalence values for HAV and HBV (65.8% respectively 44.9%). We could estimate that 73.5% from the population has passed through either HAV infection or HBV infection and 29.1% to 37.7% has passed through both infections. The study also proved a very high HBs Ag carriage (10.5% to 30.9%). The HBe Ag were detected only in HBs Ag carrier children (4.5% to 13%). The presence of anti HBe was 31.4%. From the investigated persons 10% had hepatitis Delta virus infection.

Spectrophotometric assay of the interaction between malaria erythrocyte lysates with methylene blue and neutral red dyes

Changes of oxidative processes induced in mouse erythrocytes by Plasmodium berghei were studied in the presence of methylene blue, neutral red or of both cationic redox dyes. The results are discussed in terms of redox and metachromatic modifications of the dyes which are produced by malarial and normal erythrocyte lysates.

[Personal experience with 2,500 closed heart mitral commissurotomies]

Between 1953 and 1976 a total of 2527 mitral commissurotomies have been performed in the Clinic for Cardio-Vascular Surgery of the "Fundeni" Hospital. This group included cases with pure mitral stenosis (predominantly following rheumatic disease), but also cases of mitral stenosis associated with other cardiac lesions in which the major hemodynamic element was the mitral obstruction. Criteria are discussed for surgery, the preoperative preparation of the patient, incidents, accidents and complications, as well as technical difficulties of the digital and/or instrumental mitral commissurotomies on closed heart, either carried out for the first time in the respective patient, or as iterative intervention. Comparing the results in relation with the functional stage of the disease (62.5% of the patients were classified in the III-IV evolutive degree, according to the NIHA classification), pulmonary hypertension (61.6% of the patients had medium or severe pulmonary hypertension), associated lesions (present in 17% of the cases--mitral failure predominated, together with tricuspid or aortic failures), it is appreciated that the technique of mitral commissurotomy on closed heart is an useful therapeutic method (88.6% very good and good results, a global death rate of 3.9%) that can be applied in a large category of patients, although there is a trend toward open-heart surgery, with all medico-economical major implications.

[Surgical treatment of interatrial septal defect]

On the basis of the authors' experience acquired between 1956 and 1973 (a total of 401 cases with inter-atrial communications and 234 cases of ostium secundum that have been operated by them), data are presented concerning the diagnostic means, the indications and the contra-indications of the surgical treatment, as well as the attitude to be adopted towards the associated lesions.