Biomedical subjects
Publications and source records attributed to L Strnad.
In the paper lying before the authors estimate changes of pH-values of the Calcium hydroxide (Calxyd) after contact with a zinc oxide phosphate cement (Adhesor), a polyacrylate cement (Adhesor-Carboxy) and a zinc oxide eugenol cement (Caryosan). The last shoved to be best qualified for over capping of pasty preparation with calcium hydroxide.
Czechoslovakia is contemporarily ranged between the countries with mostly unfavourable indicators of national health. The life expectancy (LE) values at birth as achieved by 1988 in men were 67.85 years and 75.42 years in women, respectively. In Czechoslovakia this indicator is averagely 4 and more years lower than that of industrially developed countries. Such a low czechoslovakian LE value is conditioned with mainly higher mortality to the ischemic heart disease, vascular brain disease as well as malignancies and traumas. In men, the mortality due to the ischemic heart disease (IHD) is accounted for the Le decrease to 3.23 years, and 2.57 years in women, respectively. Similarly, there is a LE decrease to 3.05 years in men, and to 2.54 years in women due to the malignancies. When the IHD mortality decrease may be achieved up to 30% against the status of 1985-87, it may be resulted in LE prolongation to 0.84 in men, and 0.66 in women, respectively. The similar decrease in mortality to vascular brain disease and atherosclerosis may have resulted in LE prolongation to 0.51 in men, and 0.72 years in women. The mortality decrease to cancers for 30% may have been resulted in LE prolongation for 0.84 years in men, and for 0.73 years in women, respectively. The attempt on how to prolong the LE is resulting in fast and responsible measures of primary prevention and partly in those of secondary prevention.
Problems related to the optimization of diagnosis making are scrutinized. Applied immunological tests for diagnosis of ovarian cancers are used as an example of ROC curve calculation. Moreover, sensitivity and specificity grades are computed in order to obtain the optimum of diagnostical robustness. The ROC analysis is supplemented with application of Bayes diagnostical algorithm. The analysis is given also of other problems concerning with implementation of quantitative characteristics in the course of diagnostical decision making.
The quality of treatment of dental defects with amalgam is closely associated with the preparation of the cavity and its filling as well as with completion of the filling and its finish. Strict adherence of a correct working procedure improves markedly the standard of treatment and makes it possible to make use of the positive properties of amalgam from which the filling is prepared.
The significance of individual risk-factors associated with the ischaemic heart disease is known to be estimated differently in various stages. In this account, still more screening and evaluation of mentioned factors is continuously needed in facing different social, economical, demographical and geographical conditions. The analysis has been made of such risk-factors which are generally precluded as decisive ones (age, sex, blood lipid levels, cigarette smoking, higher blood pressure, obesity, diabetes mellitus). The majority of these factors and their interrelations may be influenced. Of special author's concern were different dependencies between the selective groups of coronarographied patients and the groups defined with mainly clinical symptomatology. Authors suggest that the analysis of proper group may be supportive in order to formulate such a complicated topic and outline the appropriate trends of secondary prevention also in their conditions.
The attherosclerosis risk-factors occurrence is studied in the present paper and compared with that of abnormal coronarogram in 376 male subjects. As an abnormal coronarogram is estimated this with at least one of coronaries having more than 50% of lumen obstructed. The abnormal coronarogram occurred significantly with more frequently in male patients with hyperlipoproteinemia an in smokers (p less than 0.001). In a total of male subjects with positive coronarographic findings, the significantly higher averaged levels of total cholesterol (p less than 0.01) have been stated. Authors detected the levels of total cholesterol higher than 6.72 mmol/l and those of triglycerides higher than 1.80 mmol/l are significantly exerting the influence on the value of coronarographic score. Of particular interest is a fact that no significant relation of abnormal coronarogram to the occurrence of systemic hypertension has been detected as well as to the disorders of glycide metabolism and obesity. However, mathematically significant relation has been determined between the smoking and hyperlipoproteinemia (p less than 0.001). The cigarette smoking was stated to enhance hyperlipoproteinemia as 4 %. Smokers have been found to represent pathologically increased both triglyceride and total cholesterol levels. It is to be said that the group of smokers has values of body mass index (BMI) lower ones than the group of non-smokers. Authors also revealed the disorders of glycide metabolism were related with higher occurrence of hyperlipoproteinemia in men as 1-2%. Although no significantly frequent occurrence of glycide metabolic disorders has been proved in men with abnormal coronarogram, the more detailed analysis showed those with glycide metabolic disorders were significantly higher in coronarographic score (p less than 0.05) in contrast with the group compared, and showed significantly higher occurrence of hemodynamically important stenoses than the controls. The results of the present work are believed to enlarge the knowledge about the relations between the atherosclerotic changes, their clinical manifestations and risk-factors estimated in conditions which are completely different from those of routine epidemiological studies. The necessity of primary prevention is confirmed and possible secondary measures are indicated.
The occurrence of atherosclerosis risk-factors has been studied in comparison with the rate of abnormal coronarogram in 63 female subjects. As an abnormal coronarographic finding the obstruction of more than 50% lumen of at least one of coronaries was estimated. Female subjects with hyperlipoproteinemia (p less than 0.001) and hypertension (p less than 0.05) showed significantly more frequent abnormal coronarographic findings. Coronarographically positive women revealed significantly higher levels of total cholesterol (p less than 0.05). No relationship was detected between the pathological coronarogram and glycide metabolic disorders. Of particular interest is a fact that the disorders of glycide metabolism are conditioning the occurrence of hyperlipoproteinemia in women of our group as far as 15-16% (p less than 0.001), whereas in men only as 1-2 % (p less than 0.05). These results are supporting the opinion of those authors who point on the interaction between the disorders of glycide metabolism and hyperlipidemia estimating disorders of glycide metabolism in women to be more significant risk-factor of coronary atherosclerosis than in men. Our findings are confirming specificity of profile of atherosclerotic risk-factors in women. In accord with them, the importance of hyperlipidemia and hypertension is estimated to be the most significant risk of atherogenesis. The implementation of principles of primary and secondary prevention of ischemic heart disease is carried through the common approaches in both men and women.
The total of 376 male and 63 female subjects is concerned. As an abnormal coronarogram, such a finding is estimated where at least one of coronaries showed more than 50% lumen obstruction. The occurrence rates of atherosclerotic risk-factors, angina pectoris and myocardial infarction have been studied with regard to the abnormal coronarograms. A special concern in male group is almost simultaneous occurrence of angina pectoris along with positive coronarogram. The occurrence of both studied factors shows an increase with more age. The percentage of IM occurrence is practically the same in all age groups studied regardless to the value of coronarographic score. However, the male subjects with both clear and suspected IM (especially in the age group up to 40 years) are stated to show higher occurrence of normal coronarographic findings (32 %). This is in agreement with the suggestion that also other factors are involved than the atherosclerotic affection of coronary bed, what demonstrates the complexness of pathophysiological mechanisms of IM genesis.
The present paper characterizes the health care systems in several chosen capitalistic countries with developed industries. The health care systems are referred to in USA, Sweden, Japan and Great Britain. Mentioned countries are now able to subsidize their public health care with 6.5 to 11% gross national products and about 1,000 dollars for 1 citizen a year in average. The health care tends to be provided generally from governmental sources, though in lesser extent in USA, being still covered there with almost 50% from national budget. Nowadays a certain trend is manifested in providing better health care as well as health status of population without rising costs. This was notably achieved in Sweden. In industrially developed countries, no straight relation has been found between the cost-expenditure of the health care and the level of health status achieved as measured with the use of population health characteristics. The extent of health investments is directly dependent of country's economical level and that of national budget which is created there.
During the last two decades, the economic aspects of health care acquired an outstanding attentiveness in all developed countries. Simultaneously, the methods have been searched for a more intensive and perfect application of internal health sources, i.e. manpower, materials and money. New approaches in evaluating health care efficacy (conception of health provision as a branch of national economy) have been made. In accord with them, the efficiency of either individual or partial health actions such as health care programs, preventive measures, diagnostical and curative procedures etc.) is measured. All these questions are the up to date topic for Health care of Czechoslovakia which now is far to dispose of sources comparable with the majority of economically developed countries in Europe. At present, they are approximately similar in supplying 1 person health care needs with 500-1000 dol. a year and even more in several countries, whereas Czechoslovakia spends about 200 dol. on health needs of 1 inhabitant a year. This fact is closely connected with relatively low efficacy of our economy incapable to produce the sufficient sources for providing health care on one hand, and on the other it is due both to the budgetary politics as practiced now and the conception of national product division. The shortage in Health care sources is manifested mainly in retardation of material and technical base of health service altogether with low levelled renumeration of health workers consequential in psychologic, social and political problems. The consequences of this condition are reflected negatively in a level of health service provision. This is as far important as the czechoslovac population health status viewed from the so-called strategic health indices (averaged life expectancy, specific mortality, occurrence of cardiovascular diseases and malignancies etc.) is not favourable due to a number of factors, and its improvement will require considerable efforts from both the health workers and community as a whole. Besides the needful enlargement of sources, these complicated questions are resolvable in observing unity of medical, organizational and economical rationality on all levels of health service management and in all health institutions. This is also the way how to improve the efficiency of health care. The term of efficiency in relation to the health services. In economics, the efficiency is the ratio between the achieved result (effect) and the expenditure of a specified amount of resources. Mathematically, this ratio is expressed as follows: efficiency = end-result/costs Linked to the Health care, the efficiency may be understood also differently from its economic term.(ABSTRACT TRUNCATED AT 400 WORDS)
Explore the source record for details and available documents.
The informational efficacy is evaluated of diagnostic tests that are employed in both screening programs and clinical routine. The main data concerning with the decision making theory are summarized and may be successfully applied in order to obtain diagnoses in practical conditions. Various diagnostic algorithms are demonstrated on practical examples. The attention is focused on such diagnostic methods which are issued from binary input data, ROC curve, the use of information theory and Bayes formula. Also the problem related to the statistical induction in evaluating diagnostic tests is treated.
The paper deals with theoretical problems associated with the evaluation of medical, social and economic effectiveness, and the authors mention different approaches to the evaluation of provision concerning the health of some population groups and provisions concerning the population as a whole. Attention is also focused on information problems of effectiveness. In the paper formulae and methodological aspects are given which can be used for the calculation of the economic effect of various prosions which reduce the morbidity, which help to save human lives or lead to an increased productivity of labour. In the conclusion methodological recommendations are given for the approach in investigations of the effectiveness of health care.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.