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A simple, rapid new technique is described for the electrophoresis of hemo­globin when screening large human populations. The method uses a drop of finger tip's blood dried on a thick filter paper as the specimen. The simplicity of the sampling, tagging, transportation and electrophoresis, provides a reliable procedure for surveys of large population. In our hand 200 specimens were screened during a working day by two technicians with a very good resolution of hemoglobin band. Even small amount of fetal hemoglobin could be separated from normal adult hemoglobin by this technique. During last 8 months, 20,000 individua1s were screened by this technique and a number of known and unknown hemoglobin variants were detected which are reported elsewhere.

A total of 711 beta-hemolytic streptococci were isolated from throat cultures of patients during 1970-73. These strains were grouped in parallel by the precipitin and bacitracin paper disk method. The former method was estab­lished as the standard by which the bacitracin technique was compared. The difference in results was about 5.67%. The greatest error (5.4%) was seen with non-group A strains being sensitive to bacitracin. In spite of this, it was shown to be advantageous to use the bacitracin disk for primary isolation from throat cultures rather than to consider all beta-hemolytic streptococci isolated as group A, which would give a magnitude of error around 16%.

A total of 711 beta-hemolytic streptococci were isolated from throat cultures of patients during 1970-73. These strains were grouped in parallel by the precipitin and bacitracin paper disk method. The former method was estab­lished as the standard by which the bacitracin technique was compared. The difference in results was about 5.67%. The greatest error (5.4%) was seen with non-group A strains being sensitive to bacitracin. In spite of this, it was shown to be advantageous to use the bacitracin disk for primary isolation from throat cultures rather than to consider all beta-hemolytic streptococci isolated as group A, which would give a magnitude of error around 16%.

A Divisão de Combate a Vetores, da Secretaria da Saúde do Estado de São Paulo, Brasil, em trabalho anterior, apresentou os critérios que adota na passagem de áreas limpas do T. infestans, principal vetor da doença de Chagas na região, para uma fase mais adiantada do seu programa de contrôle, denominada de Fase de Vigilância Entomológica. Entre as áreas onde não se encontram mais exemplares de T. infestans, situa-se uma região de 2.007 km², com população estimada em 51.000 habitantes, compreendida por 6 municípios, situados na Região 7 - Bauru (Estado de São Paulo), onde foi instalada a "Área Piloto de Vigilância Entomológica". Nessa área, entre maio de 1969 e junho de 1970, foram desenvolvidas as seguintes atividades: Instalação e funcionamento de uma rêde de Postos de Informação de focos de triatomíneos; investigação de focos de triatomíneos; avaliação da infestação nas casas de barro, através das caixas-abrigo de triatomíneos (método de Gómez-Nuñez); levantamento sorológico RIF (imunofluorescência), em gôta de sangue colhida em papel de filtro, realizado entre menores de 8 anos; pesquisa e captura de triatomíneos realizada por uma equipe especial. Os resultados conseguidos mostram a inexistência de achados de exemplares do T. infestans na área e, por outro lado, assinalam o encontro esporádico de exemplares isolados ou de pequenos focos de outras espécies (R. neglectus e T. sordida) não infectados pelo T. cruzi. Conclui-se que foi correta a passagem dessa área para a Fase de Vigilância Entomológica e que os métodos empregados funcionaram satisfatòriamente. A vista dos resultados alcançados, essa área apresenta condições para transferir às Unidades Sanitárias locais, parte do contrôle da transmissão da doença de Chagas.In a previous paper, the Vector Control Division of the Department of Health of the State of São Paulo, Brazil, presented the adopted criteria for transference of cleaned Triatoma infestans areas, the main vector of Chagas' disease in the region to a more advanced phase of its control program, called "Entomological Surveillance Phase". Among the areas where T. infestans was not found any longer there is a region of 2007 km², with an estimated population of 51000 people including six counties located in Region 7 - Bauru (São Paulo. State - Brazil), where the Pilot Area of Entomological Surveillance was installed. In this area, between May 1969 and June 1970, the following activities were performed: installation and functioning of a network of information Posts for Triatominae foci; investigation of Triatominae foci; estimation of the infestation in mud cottages, through special boxes for Triatominae (Gomez-Nuñez method); RIF (immunofluorescence reaction) serological survey in blood drop caught in filtering paper, carried through less than 8 years old children; research and capture of Triatominae bugs. As results there was not found T. infestans bugs in the area. Beside this, only few isolated specimens or small foci of other species (R. neglectus and T. sordida) that were not found infected by Trypanosoma cruzi. So, it was concluded that the changing of this area to the Entomological Surveillance Phase was correct, and that the methods used were satisfactory. By there this area was considered in condition to transfering the Chagas' disease control to the local Sanitary Units.

The need of the society for medical and health care services and the question of training of physician and medical education program, are major problems which the health and education planners are faced with. The increasing tendency toward specialization in various branches of medicine, has created a significant gap between the rea1 medical need of the community, ie, primary comprehensive health care and what the medical profession offers at the time being; in other words the medical profession is gradually losing the social and humanitarian aspects of their services: In order to overcome these problems, there is an urgent need for the critical redefinition of the objectives of medical education and the training of physicians and as a consequence, a sound revision in medical education program. The present paper has tried to review some aspects of this very complex and important subject. In the present paper, the teaching of Public Health and Preventive Medicine in Medical Education and their p1aces in the medical curriculum are discussed. The aims and objectives, of medical education in general and for Iran, in particular, are reviewed. The principles governing the training of General Practitioner and development of a vide-spectrum medical, health and socio-economic know ledge and skill are pointed out: The contents of Public health and preventive medicine programmers and their distribution throughout the medical curricu1um (in pre-clinical and clinical periods) are detailed and exemplified, and the conditions to secure the proper implementation of such programmers are presented.

In the course of serological and parasitological studies of malaria, 1,018 persons were examined. They were from four different areas (A, B, C and D) in the region of Bandar Abbas and 1-1ina), southern Iran, where malaria is still endemic. For the serological examinations, the IFAT was used with P. falciparum and P.vivax antigens. Several FA-positive reactions were observed in young children, most probably due to congenital antibodies. In areas A, B, and particularly in area C, the sero-positivity rates indi­cate that malaria control measures have been relatively effective in recent years. The sero-positivity related to increasing age, and virtually negative in the young­er age groups. Parasitological findings how that more positives were found, by concentration technique than by the routine examination of thick blood films. This indicates that routine blood examination of fever cases is not able to show the real infection rate in areas where malaria is still endemic· A comparison between the serological readings obtained with extracts from 204 blood specimen on filter paper and those produced by genuine plasma samples has yielded practically identical results.

With the recent changes in the status of malaria and in the strategy of malaria eradication, and with more emphasis given to the planning of .the anti-malarial campaign within a coordinated health and socio-economic devel­opment plan; with the, betterment of methodology for comprehensive health planning and the refinement of administration and management techniques; and with rapidly increasing medical knowledge and technology; there is need for a revision of the programs for the training of the professional malaria staff, particu1arly the "malariologist".In the present paper, the above changes and developments as well as the experience gained are reviewed, the profile of an ideal epidemiologist malariologist is given, and the pattern of the program for the training of such a person, including basic, special and advanced training, is described and, wherever necessary, is exemplified.

O objetivo proposto foi verificar a prevalência de deficiência de ferro, num estrato de parturientes e recém-nascidos do município de São Paulo, de características sócio-econômicas bem definidas. O levantamento bioquímico constituiu-se de dosagens de concentração de hemoglobina, hematócrito, ferro sérico e capacidade de ligação de ferro. Os resultados desse levantamento mostraram uma prevalência de 52,3% de anemia em parturientes e de 21% de anemia em recém-nascidos. Concluiu-se que a ministração de sais de ferro, em serviços especializados de atendimento às gestantes pertencentes a classe sócio-econômica semelhante à essa estudada, seria uma medida profilática que poderia diminuir essas porcentagens de anemia.The present paper was planned to study prevalence of iron deficiency in a group of women at delivery and newborn children of comparable social and economic status. The biochemical survey included hemoglobin concentration, packed cell volume, serum iron and iron binding capacity. The results showed a prevalence of anemia of 52,3% for the women and 21,0% for the newborn. Iron administration, at specialized services would be a sound prophylactic measure.

Trabalho de caráter exploratório e informativo, teve como principal objetivo levantar dados sobre a migração internacional no Brasil, e a contribuição desse contingente imigratório para o crescimento da população brasileira. Nesse sentido construiu-se um índice que, pelo menos em primeira aproximação, proporcione estimativas da emigração de retorno, cuja ausência de dados prejudica a análise. Embora na introdução contenha elementos anteriores a 1872, considerou-se essa data como marco inicial por ser a do primeio censo nacional do Brasil. Analisou-se também, a partir de dados censitários, a distribuição espacial da população estrangeira por unidades da Federação.The present paper, exploratory and informative basically, had as main purpose, to put together data about International Migration in Brazil and the contribution of this migration to the growth of the brazilian population. For this matter an index that would proporcionate a first approximation for the estimatives of return emmigration, was build, once data on that matter is lacking. Despite the fact of the introduction having elements beyond 1872, this date was taken as inicial point, as it is of the first Brazilian National Census. It also has been analysed based on Census data, the spacial distribution by State, of the foreign population.

The significance and impact of the arthropods and other vectors, as diseases transmitting agents and human pests, on human health need not to be over emphasized. The Increasing changes of the total environment, accompanied with the climates in the ecology of vectors have made such impact a more complex and dynamic one. To meet the problems caused by these changes, a quantitative and qualitative knowledge of vector characteristics such as, presence or absence, species, densities, distribution and dispersal biting habit, infection rate, etc. are necessary. This information should be available on local, region, national and international basis. In the present paper, various aspects of such intonation system (surveillance) including network, personnel, methods etc., are reviewed in general. Examples from Iranian experiences in the cases of malaria vectors sandfiles, fleas and snails are also presented and illustrated.

The paper contains the first report on the biology of snail-killing flies (sciomyzidae) in Khuzestan. It is based on field and laboratory studies conducted during November 1971 and April 1973, as well as field observations in May 1972, at the Dezful Medical Research Station. Additional biological information obtained during studies is given for Pherbellia fuscipes (Macaquart), P.grisescens (Meigen), Coremacera amoena (Loew), Knutsonia turkestanica (Hendel), Sepedon sphegea (Fabricius), S.s spinipes (Scopoli) and Colobaea iranica Knutson, together with their habitat distribution.

A series of DDT irritability tests with adult A. maculipennis typicus and A. superpictus were carried out in the Isfahan area in August-September, 1970. The observations on irritability were measured in accordance with the WHO method arid the natural populations of anopheline mosquitoes were used. The tests were carried out in a light intensity of approximately 8 foot candles. The engorged mosquitoes were captured in various villages that had not been treated with DDT since 1964. Note was taken of the number of take-off by anopheline mosquitoes from the impregnated filter paper during a period of 15 minutes. The temperature of the testing room was approximately 25°C.-27°C and the tests were carried out between 9 a.m. and 2 p.m. It was noted that there was a great difference in the average number of take-offs between the control mosquitoes and the mosquitoes exposed to DDT. The average number of take-offs for A. maculipennis exposed to 2% DDT was observed to be between 17.1 and 21, and for 4% DDT, between 25.95 and 26.8; for A. superpictus exposed to 2% DDT, it was between 17.8 and 21. The average number of take-cm-s, for the control group was between zero and one. The levels of irritability for the strains of A.maculipennis and A. superpictus were about the same with no statistically significant difference in irritability for 2% DDT. However, significant difference in irritability was observed with A. maculipennis exposed to 2% and 4% DDT.

O objetivo do trabalho é apresentar sugestões concretas visando a incentivar o desenvolvimento das ciências da conduta aplicadas à saúde, na América Latina. Para justificar essa necessidade e as sugestões propostas, é descrito e comentado o panorama geral da situação atual dessas ciências no âmbito latino-americano.The objectives of the present paper are to present concrete suggestions in order to encourage the development of Behavioural Sciences applied to health in Latin America. To justify this need and the suggestions presented, the author describes and comments the general situation of Behavioural Sciences in Latin America.

O presente trabalho objetiva estimar o número de professôres, prédios escolares e vagas no curso primário, necessários para o atendimento da população que a êle irá se dirigir, no Estado de São Paulo. Baseadas em tábuas de sobrevivência, foram feitas projeções populacionais até 1980, em períodos qüinqüenais, a partir de 1950. Através de algumas hipóteses concernentes às taxas de matrículas esperadas até aquela data, estimou-se o número de crianças que estarão matriculadas e as necessidades para seu atendimento.The purpose of this paper is to project the number of teachers and school-buildings required for the primary schools of the State of São Paulo. School-age population was projected since 1950 until 1980 based on life tables. In consequence of some hypotesis concerning the tendencies of school enrolmen, the number of pupils was estimated, and so was the number of teachers and school buildings, that would be necessary for them.

Ao lado da organização formal, reconhece-se hoje a existência de uma organização informal bastante influente nos destinos de qualquer instituição. Há uma série de semelhanças entre os dois tipos de instituição, merecendo destaque a estrutura de relacionamentos, os sistemas de contrôle e comunicação, a existência de pessoas com autoridade, a permanência relativa de seus membros e a possibilidade de representação gráfica. Como essa organização informal é indestrutível, recomenda-se seja ela utilizada pela formal, o que, além de viável, é altamente vantajoso para a instituição como um todo. São expostas algumas formas de estudo e utilização da organização informal.Beside the formal organization there exists the very powerful informal one. There is a series of similarities between them, of which the following stand out: a structure of relationships, a system of control, communication, persons with authority, perception of the consequences of an act, relative permanence of the members and possibility of graphic representation. Since the informal organization is undestructible, it is recommended that the same organization be used by the formal, which is viable, bringing general benefits. Some forms of informal organization study are presented in the present paper.

São relatadas as investigações que levaram a efeito o encontro de foco natural da Tripanossomose Americana, na área ocupada pelo bairro denominado Chácara Flora, na cidade de São Paulo. Esse foco conta com o concurso do triatomíneo Panstrongylus megistus, de gambás Didelphis marsupialis e de ratos domésticos da espécie Rattus norvegicus. A presença destes últimos permite admitir maior aproximação da infecção no sentido do ambiente humano. O encontro de um espécimen adulto fêmea de P. megistus sugando ativamente o homem dentro da habitação, aliado à revisão da literatura, permite supor que não se trata de subespécie ecológica. A presença de diferenças essenciais de comportamento no norte e sul do Brasil, no estado atual dos conhecimentos, seria resultante, preponderantemente, da ação de fatôres ambientais, entre os quais, as condições climáticas.A natural focus of American Trypanosomiasis was found in the city of S. Paulo. It was localized in a forest area preserved for residential purposes. In this focus the participation of triatomids bugs Panstrongylus megistus, marsupials of Diaelphis marsupialis species and domestics rats Rattus norvegicus was observed. Natural infection of all of them was observed. The ecotopes were found mainly in the pinus trees Cryptomeria japonica. Beside this, an adult female of P. megistus was found suckling actively humans inside the house. Some considerations are made in this paper concerning the distribution area of that species of triatomid. The sylvatic population found currently in South Brazil, represents probably the action of environmental factors limiting the bugs to its natural ecotopes. Nevertheless, these findings suggest that, from the epidemiological point of view, some approximation of the infection to the human environment was performed, at least, in urban areas.

Fazem-se algumas considerações sobre o problema da rubéola no município de São Paulo. São apresentados os 287 casos de rubéola notificados de 1951 a 1966. A distribuição sazonal destes casos parece indicar que a maior ocorrência dá-se nos meses de setembro e outubro, correspondentes à primavera, conforme têm sido descrito para outros países. O aumento do número de casos notificados em 1955 e 1962 pareceria mostrar que os ciclos de maior incidência de casos nesta comunidade também guardam o intervalo de 7 anos, embora se apresente nôvo aumento em 1966. São feitas recomendações sôbre a necessidade de se realizar inquéritos sôro-epidemiológicos para um melhor conhecimento da distribuição desta doença no município de São Paulo.The present paper considers some problems related to rubella in the city of São Paulo, S.P., Brazil. The cases reported over the period of 1951 to 1966 (287) are presented and analysed. Seasonal distribution shows a higher incidence during September and October, that is, during Spring, agreeing with what has been observed in other countries. The increase in incidence in 1955 and 1962 seems to suggest that 7 year cycles present themselves here too, although there was also an increase in 1966. Epidemiologic surveys based on serum examination are recomended so that a better knowledge of the distribution of rubella may be achieved in our city.

Após caracterizar a importância dos dados de estatística vital em Saúde Pública, quando esta planeja, executa e avalia suas atividades assistenciais e sanitárias, são feitos comentários sôbre êstes dados no município de São Paulo, demonstrando que êsses dados devem ser coletados, apurados e analisados segundo o critério sanitário. Sòmente assim poderão ser integralmente úteis às autoridades sanitárias. Isto não ocorre no município em tela. Portanto, sugere-se que no futuro as autoridades passem a colher esses dados segundo aquêle critério; e, para isso, propõe-se, em virtude das razões apontadas no decorrer do trabalho, que o Serviço de Centros de Saúde da Capital venha a se encarregar desse mister, para o que, aliás, já foram tomadas as primeiras providências.After characterizing the importance of vital statistics in Public Health when this last one plans, performs and estimates its sanitary and assistance activities, he comments these data in the county of São Paulo, Brazil. In his comments he shows that these data showed be collected, tabulated and analyzed according to the sanitary criterion, because only in that way can they be totally useful to sanitary officials. This does not happen in the county of São Paulo. Therefore, he suggests that in the future the health officials collect these data using that criterion and, in order to reach that goal - because of the reasons mentioned on this paper - he suggests that the S. Paulo Health Centers Service showed take charge of this task and - by the way - the first steps have already been taken.

No presente trabalho foi estudada a biologia da estabilização aeróbia de resíduos da extração industrial de amido e farinhas, das raízes de «mandioca brava» (Manihot esculenta), planta nativa do Brasil e de grande importância econômica dado seu alto valor nutritivo. Os resíduos líquidos dessa extração apresentam elevado teor de matéria orgânica proteica e possuem ácido cianídrico, sendo inconveniente, por essas razões, seu lançamento aos rios sem prévia estabilização. Essa estabilização tem sido obtida, satisfatoriamente, por intermédio de instalações de valos de oxidação. Os objetivos almejados com o estudo da biologia do sistema eram, principalmente: 1. Conhecer a composição biológica e a estrutura microscópica dos flocos formados por aeração; 2. Determinar as causas e, eventualmente, o processo de correção do fenômeno do intumescimento do lôdo («bulking») que freqüentemente ocorre nessas instalações; 3. Determinar a seqüência de populações microbiológicas que se desenvolvem no decorrer do processo de estabilização, de modo a possibilitar o controle microscópico da eficiência do sistema de tratamento. Através da aeração do resíduo, em laboratório e comparando os resultados da análise microscópica com os dados que permitiam verificar a evolução do processo de estabilização, foi possível obter-se os seguintes resultados: 1. Os flocos são constituídos de uma massa biológica em que predominam fungos filamentosos (Fig. 2). 2. Êsses flocos, sendo pouco compactos, originam o fenômeno do intumescimento. 3. A adição de fósforo ao sistema produz modificação radical na biologia e na estrutura dos flocos, determinando predominância de bactérias, formação de flocos compactos e desaparecimento do fenômeno de intumescimento (Fig. 1; Fig. 2c). 4. Foi estabelecida a seqüência de microrganismos bem como as suas relações de natureza ecológica com as distintas etapas na evolução do processo de estabilização de modo a permitir o reconhecimento microscópico dessas etapas e controle do funcionamento e eficiência do sistema (Fig. 3).In the present paper, the biology of aerobic stabilization of proteinaceous wastes from starch extraction and manioc meal manufacture from "mandioca brava" roots is studied. "Mandioca brava" (Manihot esculenta) is a native plant of great economic importance in Brazil. Wastes from this manufacture have high concentration of organic matter and cyanide and so they are improper to be discharged into rivers without previous stabilization. This stabilization has been achieved successfully through oxidation ditches treatment. The main purposes to be attained with these biological studies were: 1. to know the biological composition and the microstructure of the floes obtained by aeration; 2. to determine the causes and eventually the process of correcting the bulking which often appears in these systems; 3. to know the sequence of microbiologic populations which appear during the stabilization process in order to make possible the use of microscopy to control effectiveness of the treatment. Aeration of the waste was done in the laboratory and results of the microscopic examination were compared with the data as: pH, odor, amount of sludge and relative stability as indicators of the stabilization process evolution. The following conclusions are attained: 1. The floes are formed of a biological mass where filamentous fungi and yeast cells predominate (Fig. 2) ; 2. These floes are loose and so, responsible for the bulking: 3. Addition of phosphorus to the system produces complete biological modification and changes the microstructure of the floes. It produces more favorable conditions to bacteria growth and a heavier floe results (Fig. 1, Fig. 2c) ; 4. The sequence of microscopic organisms as well as their ecological relation with different steps of the process are stablished. So it was possible to recognise those steps by microscopic examination and to control the effectiveness of stabilization (Fig. 3).

Foi demonstrada a presença da toxina do C. diphtheriae, através de prova de hemaglutinação passiva, usando-se hemácias sensibilizadas com antitoxina diftérica, na lesão da garganta de 47,7% dos casos suspeitos de difteria examinados no presente trabalho. De 53,0% dos mesmos pacientes pôde ser isolado bacilo diftérico toxígeno. A prova de hemaglutinação passiva foi a única positiva em 13,0% dos casos e a cultura, a única positiva em 18,9%. Em 42 crianças normais ou portadoras de faringite ou amigdalite sem nenhuma característica clínica de difteria, a prova de hemaglutinação passiva foi negativa. O processo descrito, de execução muito simples, pode acusar o resultado em menos de 2 horas e oferece grande possibilidade de aplicação vantajosa no diagnóstico da difteria.The presense of C. diphteriae toxin was demonstrated in throat lesions of 47.7 per cent of case with probable diagnosis of diphtheria, by passive hemagglutination test using erithrocytes previously sensitized by diphtheria anti-toxin. From 53.0 per cent of the same patients toxigenous bacilli were isolated. Hemagglutination test was the only positive one in 13.6 per cent of cases and cultivation in 18.9 per cent. The passive hemagglutination tests performed on 42 children, normal or with pharyngitis or tonsillitis but without clinical characteristics of diphtheria were all negative. The procedure described in this paper, of very simple execution can show results in less than two hours and offers great possibility of advantageous application in the diagnosis of diphtheria.

Foram relatados os recursos médicos e para-médicos existentes na região do Grande São Paulo, em 1966, último ano em que os dados foram disponíveis. Em relação ao pessoal médico, o número de habitantes encontrados por médico variou de 1008 a 17 732 pessoas, respectivamente para os municípios de São Paulo e Itaquaquecetuba. Para a região do Grande São Paulo, como um todo, constatou-se a existência de 5 290 médicos, contrastados com 5 074 encontrados no município de São Paulo, o que permitiu a relação de 1286 habitantes por médico para esta Região. Adotando-se como satisfatória a proporção de um médico por cada 1000 habitantes, com exceção do município de São Paulo, "todos os outros municípios que compõe a área do Grande São Paulo, apresentaram-se abaixo do número ideal de médicos. Dos 38 municípios componentes da área de estudo, 12 não possuem nenhum médico, o que faz com que 102322 habitantes, teoricamente, estejam descobertos por este tipo de profissional. Quanto ao pessoal para-médico, constatou-se a sua grande concentração nas áreas mais urbanizadas e desenvolvidas economicamente, que é o município de São Paulo, chamando a atenção o reduzido número de enfermeiras diplomadas, nutricionistas, técnicos de laboratório e outros profissionais afins em tôda a área do Grande São Paulo. Cêrca de 50% ou mais dos municípios da área de estudo não apresentaram nas unidades hospitalares e para-hospitalares nenhum dêstes tipos de profissionais.This paper refers to the medical and paramedical resources existing in the area of the "Greater São Paulo", Brazil, in 1966, the last year on which there were available data. Considering the medical personnel, the number of inhabitants per each doctor was found to be 1008 to 17732, in the counties of São Paulo and Itaquaquecetuba, respectively. With respect to the area of the "Greater São Paulo", as a whole, there existed 5290 doctors, while for the county of São Paulo the number was 5074, which gives 1286 inhabitants per each doctor in this region. It the proposion of one doctor per 1000 inhabitants can be considered satisfactory, all the other components of the "Greater São Paulo" area except for the county of São Paulo, present an unsatisfactory level. Of those 38 components of the studied area, 12 have no doctor at all, which causes a total of 102322 inhabitants to be without medical assistance. As to the auxiliar health personnel, it was found to exist in greater concentration in the more urbanized and economically developed area, i.e., the county of São Paulo. It should be taken into account the reduced number of graduate nurses, nutricionists, laboratory technicians, and other related professionals in the area of the "Greater São Paulo". Approximately 50% of the counties in this area have not any kind of these professionals in their hospitals and parahospital units.

Apresentaram-se os resultados obtidos na pesquisa de anticorpos fixadores de complemento para o vírus respiratório sincicial e adenovírus, assim como de anticorpos inibidores da hemaglutinação para os vírus parainfluenza dos tipos 1, 2 e 3, num grupo de 972 crianças de idade compreendida entre 3 meses e 14 anos. A técnica de colheita de sangue foi a de embebição em papel de filtro. Do total de crianças examinadas, considerando o conjunto de todas as idades, 34,6% apresentavam anticorpos para o vírus respiratório sincicial; as porcentagens com anticorpos para adenovírus, parainfluenza 1, parainfluenza 2 e parainfluenza 3, foram respectivamente 47,7%, 46,8%, 54,1% e 66,6%. Foram estudadas as distribuições dos anticorpos em função da idade, do sexo e da localização do domicílio. Em relação aos dois últimos atributos obtiveram-se os seguintes resultados: dos indivíduos do sexo masculino, 32,3% apresentavam anticorpos contra o vírus respiratório sincicial, 49,2% contra adenovírus, 60,1%, 65,1% e 78,3%, respectivamente, contra os vírus parainfluenza 1, 2 e 3; nas crianças do sexo feminino as porcentagens de positividade encontradas foram, respectivamente, 37,4%, 45,9%, 31,1%, 41,2% e 52,9%; em relação à localização do domicílio, 44,8% do total de crianças da zona rural mostraram possuir anticorpos contra o vírus respiratório sincicial, 70,1% contra adenovírus, 43,8% contra vírus parainfluenza 1 e 46,8% e 65,4% contra os vírus parainfluenza dos tipos 2 e 3; as porcentagens de positividade na zona urbana foram, respectivamente, 30,5%, 38,7%, 47,9%, 57,1% e 67,1%.The author presents the results of a survey for respiratory syncytial virus and adenovirus complement fixing antibodies and parainfluenza viruses 1, 2, 3 haemagglutination inhibition antibodies in a group of 972 chidren between 3 months and 14 years of age. The filter paper method of collecting whole blood was used. Altogether, the percentage of children with complement fixing antibodies against respiratory syncytial virus and adenovirus were respectively 34.6% and 47.7%; 46.8%, 54.1% and 66.6% possessed haemagglutination inhibition antibodies against parainfluenza vírus types 1, 2 and 3. A study on the distribution of the antibodies according to different age groups was also conducted. The present study was undertaken, in order, to examine the distribution of antibodies according to sex and home localization. The following results were obtained: 32.3% of the boys possessed antibodies against respiratory syncytial virus, 49.2% against adenovirus and 60.1%, 65.5% and 78.3% against parainfluenza viruses 1, 2,3 respectively; percentages in girls were 37.4%, 45.9%, 31.1'%, 41.2% and 52.9% respectively. In the rural area 44.8% of the children possessed antibodies against respiratory syncytial vírus, 70.1% against adenovirus, 43.8% against parainfluenza vírus type 1 and 46.8% and 65.4% against parainfluenza viruses 2, 3; in the urban area the percentages observed were, respectively, 30.5%, 38.7%, 47.9%, 57.1% and 67.1%.

Se realizaron tentativas de inhibir la producción de las enterotoxinas estafilocóccicas por las cepas ATCC 13565, ATCC 14458, S 6 y S 100 con los antibióticos penicilina y estreptomicina. Los resultados obtenidos parecen demonstrar que la penicilina no impide la formación de proteínas enterotóxicas, siendo que por otro lado la estreptomicina a partir de la dosis de 500 myg por ml de medio impide en casi todas las cepas la producción de enterotoxinas. Con la dosis de 1000 myg/ml no se pudo demonstrar presencia de enterotoxina en ninguno de los cultivos realizados con las diversas cepas. Se indican las posibles explicaciones para estos resultados.An attempt to inhibit Staphyloccoci enterotoxin production of strains ATCC 13565, ATCC 14458, S6 and S100 was made with penicillin and streptomycin. Results suggest that penicillin does not prevent enterotoxic protein synthesis, while streptomycin, in doses of 500 mug/ml prevent it in almost all strains. With doses of 1.000 mug/ml the presence of enterotoxin was not detected in any of the strains under study. Possible explanations for such results are suggested in this paper.

A construção das tábuas de sobrevivência vem sendo, recentemente, simplificada através da pressuposição de constância da força de mortalidade para cada grupo etário. Neste trabalho, mostram-se vantagens adicionais de tal suposição, tanto de caráter conceitual como de cálculos.Life tables construction has been simplified through the assumption of a constant force of mortality in each age group. In this paper further advantages are shown, concerning both the conceptual nature and simpler calculations derived from that assumption.

São apresentadas as necessidades de unidades sanitárias a médio e a longo prazo, correspondente aos respectivos anos de 1975 e 1990. Tal estudo integrou o Plano Urbanístico Básico de São Paulo (PUB) e as unidades propostas sempre obedeceram o critério de unidades integradas ou polivalentes. Para definição dos padrões propostos levou-se em conta o tamanho da população, densidade demográfica, tamanho da área, raio de atendimento e classe sócio-econômica. As unidades sanitárias foram divididas em três tipos e definidos, os seus programas de acôrdo com as respectivas atribuições propostas. A responsabilidade funcional foi definida para o setor público municipal, estadual e previdenciário.This paper refers to the demand of sanitary unities, at short and long run, for the years of 1975 and 1990, respectively. This study was part of the "Plano Urbanístico Básico de São Paulo (PUB)", and the proposition always followed the criterium of integrated or polivalent unities. In the definition of the proposed patterns it was considered the size of population, demographic density, size and extension of the area and socio-economic classes. The sanitary unities were divided into three types, and their programs established according to their purposes. The "municipal" authorities are responsible for their functioning, as well as the state and welfare agencies.

O trabalho procura discutir os conceitos de demanda e de necessidades em saúde e sua importância para o planejamento. Conceituando saúde como o estado de melhor adaptação do indivíduo ao ambiente em que vive e "necessidade em saúde" como tudo o que contribui para tal adaptação, o trabalho chama a atenção para o fato de que "demanda" é um conceito histórico particular a um determinado tipo de economia e ligado a poder aquisitivo individual. Conclui recomendando aos técnicos em planejamento de saúde a substituição da "demanda" por "necessidades" nas técnicas atualmente utilizadas.The paper is concerned with health planning in a market economic system. The author after discussing the concepts of "demand" and "necessity" related to health planning stresses the importance of considering such problems in the current techniques of health planning.

Trachoma, especially its complications, is more prevalent in females than in males. In some of the rural areas of Iran, the use of "Surmeh" is a preva­lent practice. A biological test was carried out to determine the benefit of using this social custom by means of medicated surmeh for the control of trachoma and other infectious eye disease. Surmeh is smoked carbon powder, with a little oil added, which is used for beautifying the eye-lashes and eye-lids of women. Surmeh could transmit bacterial eye diseases, but its effect on the transmission of trachoma is not yet proven. In preparing medicated Surmeh almond oil is used, but other cheap, non-allergiant oils may be substituted. Seventy tests for three kinds of medicated surmeh were performed, i.e., 1. surmeh plus 1% aureomycin; 2. surmeh plus 3% aureomycin; 3. surmeh plus about one-thousandth methylene blue. The biological test is the same as the usual bacterial sensitivity test, i.e., a stock isolated sensitive staphylococcus is cultured on blood agar plate and round disc papers ,with eye secretion are put on the plate. The tests showed that all three medicated surmeh were effective and have considerable residual effects up to 8 hours. In few occasions the residual effect was lasting even up to 16-23 hours. The residual effects of medicated surmeh are nearly the same as those of antibiotic eye ointments. Medicated surmeh may be used for the treatment of blepharitis. It seems that medicated surmeh is also effective in trachoma control, especially for the prevention of trichiasis. Medicated surmeh can be prepared in the field by making a condensed oil suspension of the effective drug and mixing 2-3 drops in each of the women's surmeh pots. Health education is needed for the proper use of surmeh in areas where its use is common, and precautions must be taken to prevent the spreading of this social custom.

With the recent changes in the status of malaria and in the strategy of malaria eradication, and with more emphasis given to the planning of .the anti-malarial campaign within a coordinated health and socio-economic devel­opment plan; with the, betterment of methodology for comprehensive health planning and the refinement of administration and management techniques; and with rapidly increasing medical knowledge and technology; there is need for a revision of the programs for the training of the professional malaria staff, particu1arly the "malariologist".In the present paper, the above changes and developments as well as the experience gained are reviewed, the profile of an ideal epidemiologist malariologist is given, and the pattern of the program for the training of such a person, including basic, special and advanced training, is described and, wherever necessary, is exemplified.

Patients with pulmonary cavities are usually exposed to other pulmonary infections, especially of fungus origin, such as Asnprgillosis and Coccidiomycosis. They are manifested by the formation of fungus ball in these cavities, which is completely resistant to anti-fungal therapy. In these circumstance the best method of treatment is removing of the ball by surgery, in this paper a case of pulmonary aspergilluma, secondary to T.B. cavity is reported which has been operated in Isfahan University Hospital.

In the course of serological and parasitological studies of malaria, 1,018 persons were examined. They were from four different areas (A, B, C and D) in the region of Bandar Abbas and 1-1ina), southern Iran, where malaria is still endemic. For the serological examinations, the IFAT was used with P. falciparum and P.vivax antigens. Several FA-positive reactions were observed in young children, most probably due to congenital antibodies. In areas A, B, and particularly in area C, the sero-positivity rates indi­cate that malaria control measures have been relatively effective in recent years. The sero-positivity related to increasing age, and virtually negative in the young­er age groups. Parasitological findings how that more positives were found, by concentration technique than by the routine examination of thick blood films. This indicates that routine blood examination of fever cases is not able to show the real infection rate in areas where malaria is still endemic· A comparison between the serological readings obtained with extracts from 204 blood specimen on filter paper and those produced by genuine plasma samples has yielded practically identical results.

This paper is a brief review of what has been carried out on the epidemiology of coetaneous Leishmaniasis in Mashad Research Station during the period 1964 through 1967. According to these studies; nine different foci of the disease exist in the province of Khorassan. The disease is of urban type in the city of Mashad and of rural type in Sarakhs and Lotfabad areas. The epidemiological type of the disease is not yet known in other foci. In the urban focus of Mashad, the main reservoir of the disease is dog and its vector Ph. Sergenti. Average duration of disease is about one year. The prevalence is about the same all the year round. The incidence in highly infected areas reaches 138 per thousand per year. In the rural foci, the main reservoirs of the disease are gerbils (Rhombomys oplmus and Meriones libycus erythrbumus its vectors are Ph. papatasi and sand-flies of the coucasious group. Average duration of the disease is about. 6 months. The prevalence differs according to the season, being maximum in December and almost zero In May. The incidence of the disease had been 86 per thousand per year during the study period. There exist 18 species of Phlebotomus and 11 species of Sergentomyia in the province of Khorassan. In Mashad and Lotfabad sandflies all active from late May through early October and they are susceptible to DDT and Dieldrin.

The significance and impact of the arthropods and other vectors, as diseases transmitting agents and human pests, on human health need not to be over emphasized. The Increasing changes of the total environment, accompanied with the climates in the ecology of vectors have made such impact a more complex and dynamic one. To meet the problems caused by these changes, a quantitative and qualitative knowledge of vector characteristics such as, presence or absence, species, densities, distribution and dispersal biting habit, infection rate, etc. are necessary. This information should be available on local, region, national and international basis. In the present paper, various aspects of such intonation system (surveillance) including network, personnel, methods etc., are reviewed in general. Examples from Iranian experiences in the cases of malaria vectors sandfiles, fleas and snails are also presented and illustrated.

A series of DDT irritability tests with adult A. maculipennis typicus and A. superpictus were carried out in the Isfahan area in August-September, 1970. The observations on irritability were measured in accordance with the WHO method arid the natural populations of anopheline mosquitoes were used. The tests were carried out in a light intensity of approximately 8 foot candles. The engorged mosquitoes were captured in various villages that had not been treated with DDT since 1964. Note was taken of the number of take-off by anopheline mosquitoes from the impregnated filter paper during a period of 15 minutes. The temperature of the testing room was approximately 25°C.-27°C and the tests were carried out between 9 a.m. and 2 p.m. It was noted that there was a great difference in the average number of take-offs between the control mosquitoes and the mosquitoes exposed to DDT. The average number of take-offs for A. maculipennis exposed to 2% DDT was observed to be between 17.1 and 21, and for 4% DDT, between 25.95 and 26.8; for A. superpictus exposed to 2% DDT, it was between 17.8 and 21. The average number of take-cm-s, for the control group was between zero and one. The levels of irritability for the strains of A.maculipennis and A. superpictus were about the same with no statistically significant difference in irritability for 2% DDT. However, significant difference in irritability was observed with A. maculipennis exposed to 2% and 4% DDT.

The paper contains the first report on the biology of snail-killing flies (sciomyzidae) in Khuzestan. It is based on field and laboratory studies conducted during November 1971 and April 1973, as well as field observations in May 1972, at the Dezful Medical Research Station. Additional biological information obtained during studies is given for Pherbellia fuscipes (Macaquart), P.grisescens (Meigen), Coremacera amoena (Loew), Knutsonia turkestanica (Hendel), Sepedon sphegea (Fabricius), S.s spinipes (Scopoli) and Colobaea iranica Knutson, together with their habitat distribution.

Iran is a large country with a total area of 1,645,000 square kilometers. The country’s population is estimated at about 31 millions. There is an uneven distribution of the population, varying from 2 to 50 per square kilometer. Sixty per cent of the total population (18 millions) is living in nearly 66,000 small and large village’s scattered throughout the country. A total of 10,000 physicians provide the main source of medical manpower, however more than 40% of these physicians are located in the capital city of Teheran. The physician to population ratio for the country is about 1 per 3,000 and the figure reaches 100,000 in some rural areas. Each year a total of 600 graduates is added to the health manpower , but technical and socio-economic handicapping factors make the rural and low-income areas less attractive to the new graduates. In this paper the reconstruction of health services around the concept of Primary Medical Care has been reposed for the country’s health development. Taking into consideration the country’s special geographical and demographic features, two levels of primary care workers have been suggested; the first group with 4 year’s training in curative and preventive services, and the second group at grade 9 level in education. It is foreseen that the two afore-mentioned groups will form a network of auxiliaries to the physicians in extending health services to the remote areas of the country.

A survey on the cause of blindness in Iran was carried out among 870 blinds from all parts of the country. 305 people with the same cause, 27 with different causes were blind from both eyes and 538 were blind from one eye. In present paper the first ten causes of blindness is pointed out and these causes are compared in the three different zones of ten countries, also the cause of blindness in different age groups are described. 36/1% of blindness is due to contagious conjunctivitis and trachoma, (In 1956 these diseases were 56.3% as the cause of blindness.), cataract 14.6%, physical agents 13.6% and glaucoma 10% are some of the other important causes.