Interpopulation study of medical attendance aboard a cruise ship

The study carried out aboard a cruise ship in the years 1993 – 1998 involved ship passengers of various nationalities including 3872 Germans aged 23 – 94 years and 1281 Americans aged 25 – 94 years. Both nationality groups were divided into two age subgroups: till 64, and 65 – 94 years. The German younger age subgroup (mean age 53,2 years) consisted of 59% of the passengers, whereas the 65 – 94 years subgroup (mean age 72 years) was made up of 41% of the ship`s passengers. On the other hand, 73% of the Americans belonged to the 65 – 94 years subgroup (mean age 73,4 years), whereas 27% to the younger one (mean age 52,8 years). The number of onboard consultations and their causes were determined. The occurrence of chronic illnesses in both 65 – 94 years subgroups was assessed by means of a questionnaire. A higher frequency of consultations was found in the Germans (24,38%) than in the Americans (14,05%) (p = 0,001). The difference was particularly striking in the people over 65 years of age (30,87% of the Germans as compared with 14,22% of the Americans, p = 0,001).The Germans were nearly 4-times more frequently seen than the Americans for cardio-vascular diseases and almost 3-times more often because of gastrointestinal disorders. The discrepancies in the consultation rates were mainly caused by the different insurance systems of both nations. Chronic illnesses as estimated by means of the questionnaire prevailed in the German passengers. The statistically significant differences (13,3% versus 20%, p = 0,01 and 0,001) regarded the locomotor system, urinary tract diseases and a group of illnesses including neurological, ophthalmological, ear, skin, malignant diseases and diabetes

Difficulties in the diagnosis of schistosomiasis in patients of the Departament of Tropical and Parasitic Diseases of the MUG

Between 2002 and 2006 in the Department of Tropical and Parasitic Diseases of the Medical University of Gdansk 40 hospitalized patients were suspected of schistosomiasis on the basis of clinical manifestations, epidemiological data and positive serology tests (ELISA IgG). In spite of multiple tests, schistosoma eggs were not identified neither in stool nor in urine of the patients. Histopathological examinations of liver and colon or bladder mucosal biopsy have not revealed schistosoma eggs in chosen patients. Diagnosis confirmation in case of negative parasitic tests requires serologic tests for schistosomiasis. ELISA serology tests for antibodies class G were performed in all 40 patients. In some cases the results were dubious – index in the upper limit or only slightly elevated. In those cases, cross reactions with Plasmodium spp. were taken into account. In 10 patients, serologic index for schistosomiasis was elevated during or a few weeks after treatment for malaria. In control tests, 4-8 weeks after the first examination, serologic indexes for schistosomiasis were significantly lower or normal without specific treatment with praziquantel (Biltricide, Cesol). Seven patients were lost from follow up. Because of diagnostic difficulties confirmation tests with Immuno-Blot IgG were introduced to verify ELISA. After final clinical and serologic analysis, human schistosomiasis was diagnosed in 23 patients who were treated with success