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Introduction: Massive internal displacement of Iraqi civilian in Autonomous Kurdistan led to humanitarian catastrophe. The aim of the study is to assess comparison of communicable to non-communicable diseases among the internally displaced in Autonomous Kurdistan. Patients and Methods: In an open cohort two arm study, children vs adults and communicable vs non-communicable diseases, the occurrence of infectious and non-infectious diseases were compared during the first 6 months of 2016. Within the selected population of refugees

Background: The aim of the survey was to assess antimicrobial resistance dynamics and reversibility in the group of children with AIDS in Cambodia in 2003 2015. Patients: Correlation between antimicrobial (ATB) resistances in commonest respiratory isolates among 140 children with AIDS on antiretroviral therapy was studied from 2003 to 2015 in 586 isolates. Original Articles 8 Clinical Social Work and Health Intervention Clinical Social Work and Health Intervention Vol. 7 No. 3 2016 Results: All but 3 (98%) children showed a sustained CD4 increase after introduction of antiretroviral therapy (ART) followed by a decrease of ATB resistance. In our group of children restoration of the immune system decreased the number of infection diseases episodes and the proportion of multi-resistant bacterial strains. Conclusions: Less frequent use of antimicrobial therapy probably led to the decrease of multi-resistance and restoration of susceptibility of studied respiratory bacterial isolates. Results and discussion Table 1 presents trends in ATB resistance in major respiratory isolates from October 2003 to December 2015 (total of 586 isolates). Penicillin resistance in pneumococci decreased from 25% to 2% in 2015 (P

Introduction: The aim of the study was to compare resistance rate against anti-retrovirals in two cohorts of children with HIV one perinatally infected from Cambodia and the other nosocomially infected in Kyrgyzstan. Patients and Methods: Two groups of HIV positive children were compared: Vertically infected Khmer children in Cambodia and nosocomially infected children in 3 hospitals in Kyrgyzstan. Results: Prevalence of S. aureus and other oral cavity comensual was much lower in Kyrgyz children in comparison to Khmer children in Original Articles 36 Clinical Social Work and Health Intervention Clinical Social Work and Health Intervention Vol. 7 No. 3 2016 Introduction Viral, parasitic, bacterial and fungal co-infections are very frequently present among HIV positive children and such conditions often require administration of antibiotics during their therapy (1-2). The spectrum of infections occurring in HIV positive children is wide and use of antibiotic prophylaxis can stimulate development of resistance (3-4). We aimed to evaluate the spectrum of infections among pediatric HIV patients receiving HAART (Highly Active Retroviral Therapy) and to assess resistance rates of those microorganisms in the two groups of children with HIV. Methods Samples obtained from 51 HIV-positive children from Osh, Bishkek, Jalal-Abad, Kara-Suu and Nookatsk, Kyrgyz Provinces who have been receiving HAART for 3 years, were included. During their previous hospital stays, children were frequently treated with ampicillin. Cultivations from samples were performed and antibiotic profiles were assessed. A group of 51 children from Kyrgyzstan was compared to 141 children from Phnom Penh and Sihanoukville. Cambodia has a 15 year follow-up program in HIV. Tab. 1 Spectrum of microorganisms colonizing the respiratory tract in Kyrgyz versus Cambodian children with HIV on HAART Species Kyrgyz children Khmer children P Neisseria catarrhalis 20.48% 51% p˂0,01 Moraxella catarrhalis AMP-R 7.23% 6.2% NS Streptococcus viridans PEN-R 20.48% 5.1% p˂0,01 Streptococcus pneumoniae PEN-R 9.64% 5.1% NS MSSA 10.84% 10.1% NS MRSA 2.41% 45.2% p˂0,001 CoNS Staphylococcus spp 8.43% 10.1% NS Candida albicans FLU-R 15.66% 10.1% NS Others* 4.82% 4.0% NS Notes: MSSA – methicillin-susceptible S. aureus MRSA – methicillin-resistant S. aureus Other: CoNS coagulase-negative staphylococci, *Escherichia coli (1), Proteus mirablis (1), Pseudomonas aeruginosa (1), Enterococcus faecalis (1) Cambodia due to type of treatment with HAART (inpatients versus outpatients). Conclusion: In inpatient setting of HIV positive children, ATB resistance is lower. 37 Original Articles Clinical Social Work and Health Intervention Vol. 7 No. 3 2016 Results and Discussion In 51 HIV positive children we found out Neisseria catarrhalis (20.48%), Streptococcus viridans (20.48%) and Candida albicans (15.66%) being the most frequent microorganisms. Interestingly, prevalence of staphylococci was not very high (1821.69%), and surprisingly, only 2 cases (2.41%) of MRSA were noticed (P˂0,01 – 0,001) Tab.1. Also, resistance rate among bacteria was really low, with clindamycin resistance acting as the most prevalent (5.6% of bacteria isolates), followed by ampicillin and erythromycin (4.9% and 2.8%, respectively). Resistance to 5-fluorocytosine was noted in one C. albicans isolate, with the rest of candida isolates being fully susceptible to all antifungals tested. Co-infection with 2 or 3 microorganisms was identified in 20 patients (39.22%).In Cambodian children, isolation of MRSA was significantly higher (P˂0.01 – 0,001) (Tab. 1) (6-7).

Introduction: The aim of this situation analysis was to compare two phases, acute and post-acute, of disease epidemiology among refugees in the first 6 months (i) and a second 6 months post-acute (ii) period after displacement to an UNNCR camp within the Slovak Field Clinic. Patients and Methods: All together, 3,503 refugees appeared before an humanitarian team at a Mobile Clinic in Dohuk and Sinjar close to the transit border in Northwestern Kurdistan where about 1 million people were displaced after ISIS took over Mosul with its 3 million inhabitants. Results: In the post-acute period, only 18 cases of diarrhea in four camps is a sign of safe water and high health food standard safety in the designated (UNHCR) camps. Conclusion: Typical infectious in overcrowded camp populations such gastroenteritis, diarrhea, Hepatitis A, were absent in our group of refugees and migrants. Original Articles 43 Clinical Social Work and Health Intervention Clinical Social Work and Health Intervention Vol. 7 No. 3 2016 Introduction The aim of this situation analysis was to compare two phases, acute and post-acute, of disease epidemiology among refugees in the first 6 months (i) and a second 6 months post-acute (ii) period after displacement to an UNNCR camp within the Slovak Field Clinic. Patients and Methods The 3,503 visits appeared before a three person humanitarian team at a Mobile Clinic in Dohuk and Sinjar close to a transit border in Northwestern Kurdistan. There are about 1 million people displaced after ISIS took over of Mosul with its 3 million inhabitants. The spectrum of disease was compared in acute and post-acute periods with a chi-square-test (EpiInfo, CDC) in a univariate analysis. Results and Discussion In the post-acute period, that only 18 cases of diarrhea were found in four designated UNHCR camps in Sinjar is a sign of safe weather and food safety and high public health standards in the camps. Pneumonia (40 vs. 32 cases P˂0,07) was more commonly represented, less than 5% in both periods; as well as upper RTI despite seasonal weather (242 vs. 110 cases). This difference was significant (P˂0,01) showing surprisingly more RTI in winter (postacute) versus the autumn (acute) period. From other infectious diseases only scabies was represented in several cases in both periods. Of interest was that vaccination status for all patients was complete and well documented. Therefore, after the first case of diphtheria only a surveillance alert was given; in the second period (2 of 1,798 vs. 1 of 1,705, P=NS) with no severe emergency clinical course, no health alert (8-10) was necessary to declare. Conclusions Due to good sanitary infrastructure supply and safe water (i) and food safety (ii), diarrheal diseases are surprisingly sporadic. The majority of visits were due to upper respiratory tract infections. Scabies from ectoparasitis, was the commonest in this group of displaced refugees in North Kurdistan.

The aim of this study was to prospectively investigate 120 cases of viridans streptococcal bacteraemia (VSB) in 117 patients in major university hospitals in Slovakia in 2000-2002 (3 y) for antibacterial susceptibility, risk factors and outcome. From 127 episodes, 16 (13%) of VSB were caused by PEN-R strains and 13 (10%) by ERY-R strains. 32 cases had cancer as underlying disease (20 haematological), 41 had endocarditis and 35 were elderly (65 y of age) patients. Concerning mortality, 29 of 127 patients died (24%). There were several risk factors associated with mortality. Solid tumour as underlying disease (p0.02), stroke (p0.002), concomitant lung infection (p0.01), endoscopic procedure (p0.036), intubation (p0.0008), ventilatory support (p0.002), and coma (p0.009) were associated with more deaths. A comparison of 115 bacteraemias to 13 bacteraemias caused by erythromycin-resistant strains of Streptococcus viridans was performed. There were no significant differences in underlying disease, risk factors and mortality. Erythromycin resistance in bacteraemias caused by S. viridans did not have significant impact on outcome of the patients, nor did it show specific relation to analysed risk factors in our study. 14.5% of VSB were cause by PEN-resistant viridans streptococci. Risk factors for penicillin resistance were ventilatory support (p0.01), intubation (p0.001) and resistance to other antibiotics: 8 of 16 (50%) of PEN-R VSB were resistant also to erythromycin or cotrimoxazole or tetracycline compared with 9% of PEN-R VSB (p0.005). Endoscopic procedures in the upper respiratory system were at risk for development of PEN-R VSB. There was also difference in outcome; 71% vs 22.5% (p0.0002) of cases infected with PEN-R VSB died compared to PEN-S VSB. PEN-R is therefore clinically significant in VSB.

Objectives To compare the clinical and radiographic results for locked intramedullary (IM) nails and plates used in the treatment of humeral diaphyseal fractures. Design Prospective randomization by sealed-envelope technique of eighty-four patients into two study groups: those treated by intramedullary nailing (IMN group; n = 38) and those treated by compression plating (PLT group; n = 46). Setting Patients admitted consecutively to a university-affiliated Level I trauma center. Patient/participants All skeletally mature patients admitted to Harborview Medical Center with acute humeral shaft fractures requiring surgical stabilization. Fractures of the diaphysis were defined as being at least three centimeters distal to the surgical neck and at least five centimeters proximal to the olecranon fossa. Intervention Treatment with locking antegrade intramedullary humeral nails (Russell-Taylor design [Smith and Nephew Richards]) or with 4.5-millimeter dynamic compression and limited contact dynamic compression plates (AO design [Synthes]). Main outcome measurements Clinical outcome measurements included fracture healing, radial nerve recovery, infection, and elbow and shoulder discomfort. Radiographic measurements included fracture alignment, time to healing, delayed union, and nonunion. Results Follow-up averaged thirteen months. Forty-two fractures (93 percent) in the PLT group were healed by sixteen weeks versus thirty-three fractures (87 percent) in the IMN group (p = 0.70). Shoulder pain and a decrement in shoulder range of motion (ROM) were significant associations with IMN (p = 0.007 for both variables) but not with PLT. A decrement in elbow ROM was significantly associated with PLT (p = 0.03), especially for fractures of the distal third of the diaphysis, whereas elbow pain was not (p = 0.123). The sum of other complications demonstrated nearly equal prevalence for both treatment groups. Conclusions For patients requiring surgical treatment of a humeral shaft fracture, intramedullary nailing and compression plating both provide predictable methods for achieving fracture stabilization and ultimate healing.

Objective To determine patterns of nasopharyngeal colonisation in HIV-positive children. Methods Nasopharyngeal, nasal and ear swabs were prospectively taken from all children living in two paediatric nursing homes for HIV-positive orphans in Cambodia from 2004 to 2011. Results A total of 882 swabs were taken, of which 586 tested positive for bacteria. Staphylococcus aureus was the most frequently isolated species (178 isolates; 30.4%) followed by Streptococcus pneumoniae (103 isolates; 17.6%) and Klebsiella pneumoniae (99 isolates; 16.9%). The rate of S. pneumoniae decreased in 2009 when a vaccination programme was introduced. Conclusions The respiratory tract of HIV-positive children receiving highly active antiretroviral therapy is commonly colonised by S. aureus and S. pneumoniae, while other species normally found in the respiratory tract, such as Moraxella catarrhalis, are far less frequent. Objectif Determiner les profils de colonisation du rhinopharynx chez les enfants VIH-positifs. Methodes Des prelevements par ecouvillons du rhinopharynx, du nez et des oreilles ont ete prospectivement effectues chez tous les enfants vivant dans deux centres de soins infirmiers pediatriques pour orphelins VIH-positifs au Cambodge, de 2004 a 2011. Resultats 882 prelevements ont ete effectues, dont 586 ont ete trouves positifs pour des bacteries. Staphylococcus aureus etait l'espece la plus frequemment isolee (178 isolats; 30.4%) suivie de Streptococcus pneumoniae (103 isolats; 17.6%) et Klebsiella pneumoniae (99 isolats; 16.9%). Le taux de S. pneumoniae a diminue en 2009 quand un programme de vaccination a ete introduit. Conclusions Les voies respiratoires des enfants VIH-positifs recevant un traitement antiretroviral hautement actif est generalement colonises par S. aureus et S. pneumoniae, tandis que d'autres especes normalement presentes dans le tractus respiratoire, telle que Moraxella catarrhalis, sont beaucoup moins frequentes. Objetivo Determinar los patrones de la colonizacion nasofaringea en ninos VIH positivos. Metodos De forma retrospectiva se recogieron frotis nasofaringeos, nasales y de oido a ninos viviendo en dos orfanatos para huerfanos VIH positivos en Cambodia, entre 2004 y 2011. Resultados Se tomaron 882 frotis, de los cuales 586 dieron positivo para bacterias. Staphylococcus aureus era la especie mas frecuentemente aislada (178 aislados; 30.4%), seguida por Streptococcus pneumoniae (103 aislados; 17.6%) y Klebsiella pneumoniae (99 aislados; 16.9%). La tasa de S. pneumoniae disminuyo en el 2009 cuando se introdujo el programa de vacunacion. Conclusiones El tracto respiratorio de ninos VIH positivos recibiendo terapia antirretroviral de gran actividad normalmente esta colonizado por S. aureus y S. pneumoniae, mientras que otras especies normalmente encontradas en el tracto respiratorio, como Moraxella catarrhalis, son mucho menos frecuentes.

Slovak Foundation: Education in Immunogenetics (SF EDI) has been founded one August 14,1995 in Bratislava, Slovak Republic, as non-profit privat non-govermental foundation. It is ruled by the articles No. 19-1, No. 20b and by the Loyal Civil Law No.47/1992 of the Slovak Republic.

Hashimoto’s thyroiditis (HT) is a typical organ-specific autoimmune disease characterized by the presence of high titer of antithyroidal antibodies and firm goiter. It has bee found that the minimal occurence rate of HT is 5.2% in girls and 1.2% in boys in Slovakia Caucasian population [1] Family and population studies suggested an HLA-linked gene controlling the susceptibility to HT. However, several different HLA-class II alleles were reported to be associated to HT: they are DR3, DR4, DRS, DR53, DQ7, DQB1*0201 or DQB1*0602 [2] in different ethnic groups. Moreover it was found, that the Japanese population show HLA-A2 and HLA-DR53 positive association with HT and HLA-DR13-DQB1*0604 haplotype negative associtation to HT [2].

The Ontario Cancer Institute/ Princess Margaret Hospital, Bone Marrow Transplant and Leukemia Service, Toronto, Canada, Dr. J. H. Lipton, asked our new HLA-DNA typing laboratory at University Hospital in Olomouc for typing of bone marrow donor for its patient N.L. suffering from chronic myelogenous leukemia. We have found her brother P.P. He was willing to collaborate with us. We analyzed his blood for HLA specificities and we obtained the same HLA-DNA typing results like Ontario Cancer Institute from their patient N.L. We used the PCR-SSP typing technique.

The HLA-DR2 specificity occurs with the high frequency in Caucasian and other populations, too, and its occurence induce many clinical con­sequences. The HLA-DR2 specificity has the important function in the control of immune responses, in transplantation immunology, and also in susceptibility to autoimmune and infection diseases [1, 2, 3, 4, 5].

Background: The World Health Organization (WHO) has identified hepatitis B (HB) as a major global health problem, estimating that globally there are 2 billion people who have been exposed to hepatitis B virus (HBV) infection (WHO, 2012). Healthcare workers (HCWs) are at an increased risk of being infected with HBV since they may be exposed to blood and blood by-products. It is therefore highly recommended that they should be vaccinated against HBV. But even though the Gauteng Department of Health and Social Development have published interim protocols (IPs) recommending that HCWs should be vaccinated, this is done on a voluntary basis and previous studies have shown that the uptake of the HBV vaccine is low among Gauteng HCWs. This study aimed to investigate the HB vaccination coverage of HCW’s at CHBH. This was a quantitative descriptive study which made use of a self-administered questionnaire with closed ended questions, distributed to 400 HCWs (100 doctors and 300 nurses) at Chris Hani Baragwanath Hospital (CHBH), Johannesburg, Gauteng Province. Methods&Materials: Thiswas a quantitative descriptive study which made use of a self-administered questionnaire with closed ended questions, distributed to 400 HCWs (100 doctors and 300 nurses) at CHBH hospital. Results: The overall response rate was 86.3% (345/400). Of the respondents, 55.7% (192/345) had received at least one dose of HB vaccine, andonly15.4% (53/345)were fullyvaccinatedwith threeor more HB vaccination doses. Most HCWs were not fully vaccinated, with 15.4% (53/345) having received three or more doses. A higher proportion (26.7% [23/86]) of doctors than nurses (11.6% [30/259]) had received three or more doses. Of those who had received at least one dose of HB vaccine, the majority (80% [154/192]) had not received 3 doses of HB vaccination. Conclusion: The Department of Health and Social Development in Gauteng Province highly recommends that HCWs should be vaccinated against HBV unfortunately vaccination is done on a voluntary basis. It is strongly recommended that HB vaccination for HCWs should be legislated in SA in order to increase vaccination coverage for the benefit of both the patient and HCW.