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Blood levels of natural antioxidants in gastric and colorectal precancerous lesions and cancers in Slovakia.

A long-term sufficient intake of fruits and vegetables reduces significantly the risk of gastric and colorectal carcinoma. It is anticipated that natural antioxidants are involved in this effect in addition to other substances. The aim of this study was to determine levels of vitamins A, C and E, as well as beta-carotene, selenium, zinc and copper in blood of 249 patients with precancerous lesions (atrophic gastritis, gastric hyperplastic polyp, gastric, colonic and rectal adenoma, chronic ulcerative colitis) and in 96 individuals with gastric, colonic or rectal carcinoma and to compare these levels with the values of a control group of 130 healthy individuals. We have found that the frequency of average values of analyzed micronutrients in precancerous groups was decreasing in the order vit C > vit E/vit A > Se > beta-car. The average levels of vitamins and beta-carotene were significantly reduced in all carcinoma groups, while selenium level showed a decrease only in the gastric carcinoma group. Copper level was elevated in the ulcerative colitis group and in all groups with carcinoma. The results indicate a frequent insufficient saturation of organism by natural antioxidants in groups with precancerous lesions and carcinomas of stomach and colorectum. Therefore, it is necessary to increase the general consumption of fruits and vegetables in Slovakia as a part of primary prevention of malignant diseases in these organs. Chemoprevention may be recommended in individuals with precancerous lesions.

Adult↗

Mortality of the population in Slovakia: past and present.

This contribution presents an analysis of the health status of the Slovakian population using trends in overall mortality, death rates from major diseases, and of other health indicators. The health status of the Slovak population at the beginning of this century as well as at the time of the establishment of Czechoslovakia in 1918 was very bad. This situation is demonstrated by the extremely high infant mortality rate, short life expectancy and enormous mortality from infectious diseases, particularly from tuberculosis. Despite progress before the Second World War, only in the postwar period was the health status comparable with other developed countries of western Europe as there was a rapid improvement of health lasting until the middle of 1960s. This positive evolution resulted mainly from the extensive use of preventive measures against infectious diseases, contributing to the decline of infant mortality and the gradual prolongation of life expectancy. A simultaneous rapid increase of noninfectious, mainly chronic diseases, particularly of cardiovascular diseases and cancer was observed. Attempts to deal with this increase lead only to enlargement of treatment facilities. The whole health policy in prevention, including the pre- and postgradual education of physicians and paramedical personnel, remained in its traditional orientation against infectious diseases. This situation, together with low social and moral standard of the population, increasing consumption of cigarettes, alcohol and inadequate composition and superfluous food led to the rapid deterioration of the health status of the Slovakian population in the past three decades. The orientation of the health policy to the prevention of noninfectious, mainly chronic, degenerative diseases and, above all a change of the attitude of the inhabitants of this country to their own health, present the only way to the substantial and rapid improvement of the health status of the population of Slovakia.

Adolescent↗

Trends in the incidence of non-melanoma skin cancer in Slovakia, 1978-1995.

Non-melanoma skin cancer (NMSC) incidence in Slovakia in the period 1978-1995 was analyzed. A total of 38,629 microscopically confirmed NMSC cases (19,600 in males and 19,029 in females) were registered by the National Cancer Registry: 31,714 (82.1%) were basal cell carcinomas (BCC), 6,396 (16.6%) squamous cell carcinomas (SCC) and only 519 (1.3%) other NMSC. Age standardized rates of NMSC increased in the given period by 59.1% in males and 58.5% in females. The greatest increase was observed for BCC, 70.4% and 65.0% in males and females respectively, the smaller for SCC, 13.5 and 18.8%. In the period 1993-1995 age-standardized incidence rates per 100,000 were 38.0 for BCC, 6.7 for SCC and 45.5 for all NMSC in males and 29.2, 3.8 and 33.6, respectively in females. The observed marked increase of incidence with age was particularly pronounced for SCC. In both sexes, head and neck was the most common localization of BCC and SCC (84.2 to 74.7%), followed by trunk for BCC (17.0% in males and 10.8% in females) and by upper limbs for SCC (with 11.6% in males and 12.5% in females). Very fast increase of BCC incidence over time, its slower increase with age as compared to SCC incidence and body-site distribution suggest that BCC etiology is much more similar to melanoma etiology than SCC one. Registration of NMSC in relation to changes in possible risk factors (i.e. sun exposure/protection, ozone layer decrease) is important to study the mechanism of disease occurrence and to support public health interventions.

Adolescent↗

[The prehospital phase in patients with acute myocardial infarct in Slovakia. A challenge].

Better management of patients with acute myocardial infarction during the prehospital phase is at present a challenge not only for health workers but for society as a whole. The authors pay attention to knowledge of the complex problem of the prehospital phase in patients with acute myocardial infarction which is a prerequisite for finding possible solutions for a favourable effect on their management. The authors analyzed 3,040 patients who were admitted to hospital alive within 96 hours after the development of complaints with suspicion of a first or repeated acute myocardial infarction. They focused attention in particular on prehospital time delay. They found that within a satisfactory time interval (within 2 hours) 29.8% patients were delivered and within a yet acceptable interval of 4 hours 51.6% patients (with respect to effectiveness of thrombolytic treatment). Similarly undesirable are also data on the patient time delay. Within the optimal first hour after development of complaints following the decision of the patient (subjects present) to ask for or seek medical assistance was the decision of 34% patients, during the first two hours 47.5% and within 4 hours 61.2% patients with acute myocardial infarction. The ratio of time delay of the patient in the total prehospital delay is 45.5% even in patients who were admitted during the first hour after development of acute myocardial infarction. In patients who were admitted 4 hours after development of complaints it is 79.5%. The patient is admitted to hospital most quickly if he calls the medical emergency service and latest when he decides to see a doctor. Physicians and other health workers contributed only in 16.4-20.9% patients with acute myocardial infarction to their early decision to seek medical assistance. Patients with an early decision (within one hour) call most frequently the medical emergency service and are taken to hospital by this service. The time delay due to transport is shortest in these patients. The late hospital admission of patients with acute myocardial infarction in Slovakia calls for reduction of the time interval from the development of complaints to hospital admission (total prehospital delay), in particular the time taken by the patient to make up his mind (patient time delay). Early calling of the emergency medical service and transport of the maximum possible number of patients with acute myocardial infarction to hospital by the emergency medical service will greatly improve the management of patients with acute myocardial infarction. Comprehensive implementation of the survival chain (24), the most comprehensive implementation of recommendations of the European Society of Cardiology and the European Resuscitation Council for in the management of patients with acute heart attacks during the prehospital phase (21) and early effective treatment which begins already in the prehospital phase has a favourable impact on the condition of patients with acute myocardial infarction and on their prognosis. Along with early and effective treatment of patients with acute myocardial infarction in hospital and their stratification these are the most important approaches to the development and control of sudden cardiac death. Knowledge of the complex problem of the prehospital phase in patients with acute myocardial infarction is the prerequisite for the elaboration of high standard prehospital management of patients with acute myocardial infarction.

Adult↗

Prevalence of antibodies to herpes simplex virus 2 among homosexual men either positive or negative for human immunodeficiency viruses in Slovakia.

We determined the prevalence of antibodies to herpes simplex virus 2 (HSV-2, HSV-2 antibodies) in sera of homosexual men either positive for human immunodeficiency virus 1 (HIV-1, HIV+, a group of 27 sera) or negative for HIV-1 and HIV-2 (HIV-, a group of 52 sera) in Slovakia. Antibodies to HSV-2 glycoprotein G-2 (gG-2, gG-2 antibodies) were determined by a double-antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA) and immunoblot analysis. We found that 40% of HIV+ and 23% of HIV- homosexual men were positive for the gG-2 antibodies, what is 3.6 and 2.1 times higher incidence, respectively, than that in the control heterosexual population (Bystrická et al., Acta Virol. 42, 319-324, 1998). Identification of individuals infected with genital herpes among HIV+ and HIV- homosexual men should be succeeded by antiviral therapy in order to prevent transmission of HSV-2 and HIV as well in this community.

Antibodies, Viral↗

[Health and economic benefits of mandatory regular vaccination in Slovakia. IV. Measles, rubella and mumps].

The epidemiological situation as regards measles, rubella and mumps in Slovakia before vaccination and after its introduction in 1996, is analysed. On the basis of model costs of treatment of these diseases before vaccination and costs of treatment in 1996 including costs of vaccination, the authors calculated the total saved costs (549.7 mil. Sk), cost-effectiveness (10,680 Sk), as well as the cost-benefit.

Child↗

[A model of development of the number of physicians in Slovakia].

The aim of this study was to work out a mathematical model of the anticipated development of the number of physicians in Slovakia during the period 2000-2025. The study is based on the current state of professionally active physicians employed by state and private health care organisations, their age structure, and the assumed number number of graduates of medical universities. This study is the first work trying to produce a model of this problem.

Adult↗

Smoking and some life-style changes in medical students--Slovakia, 1995-1999.

INTRODUCTION: The main goal of a questionnaire cross-sectional study was to compare the changes of smoking habits in medical students between 1995 and 1999. Beside this, other factors of life-style such as alcohol consumption, nutritional status [studied through body mass index (BMI)] and citrus consumption were studied. METHODS: Cross-sectional questionnaire study in 453 medical students of 1st to 5th academic years of the Jessenius Faculty of Medicine, Comenius University in Martin, Slovakia, carried out in October and November 1999. Data on smoking habit were compared with a similar study carried out in 1995. RESULTS: Prevalence of regular smoking (min. 1 cig/day) was 13.6% in men and 8.9% in women and did not change significantly in comparison with 1995. In women, prevalence of occasional smokers increased from 7.3% in 1995 to 19.8% in 1999 and almost reached men in the same year (21.8%). During this period significantly decreased proportion of respondents who have never smoked both in men (from 43.0 to 23.3%) and women (from 61.9% to 18.2%). Excessive drinking dominates in men, overweight (BMI > or = 25) had 16.0% of males and 2.0% of females and excessive underweight (BMI < or = 17.5) 1.0% of men and 2.8% of women. More than one half of respondents consumed less than 1 piece of citrus fruit per day. CONCLUSIONS: Smoking of men still predominates, however, the most apparent changes of smoking habit in regard to increasing proportion of smoking women, particularly occasional smokers. This indicates increasing social tolerance of smoking. In female a possibility of eating disorders deserve attention and a need for the improvement of diet is felt in both sexes.

Adolescent↗

[80th anniversary of the Slovak Medical Society in Bratislava (1920-2000), and its significance in the development of medicine in Slovakia].

The establishment of the Slovak Medical Society (SMS) in Bratislava on 13th June 1920 (until 1939, the society was included into the Czechoslovak Medical Society) represents one of the most important milestones in the modern history of Slovak medicine. It was founded in direct consequence of the establishment of the first faculty of the Comenius University, namely the Medical Faculty. SMS began to issue its own journal Bratislavské lekárske listy (Bratislava Medical Journal) which was the first medical journal published in Slovakia after the origin of the Czechoslovak Republic. Eighty years of the existence of SMS which by its 2500 members forms the largest medical association, prove that the share of this society and its contribution to the development of Slovak medicine are essential. For many years, the society has been the only forum for Slovak physicians and scientific workers of the Medical Faculty where they could meet and increase their expertise. The society has witnessed also the significant material and moral support and co-operation between Czech and Slovak physicians during the period of the first Czechoslovak Republic.

History, 20th Century↗

Epidemiological survey of human borreliosis diagnosed in Eastern Slovakia.

439 sera of patients from eastern Slovakia suspected of Lyme borreliosis were examined for anti-Borrelia IgG and IgM antibodies by ELISA (Ezygnost, Dade Behring, Germany). Out of the total number of 64 sera, e.g. in 14.6% found anti-Borrelia antibodies were. Among seropositive patients, 54.7% were women and 45.3% men. The highest incidence of the disease was diagnosed in the group of women aged 55-64 and men aged 45-54. Out of 29 positive sera of men, 55.2% had IgG antibodies, 27.6% IgM antibodies and 17.2% both types of antibodies. Out of 35 positive sera of women, 48.6% had IgG antibodies, 40.0% IgM antibodies and 11.4% both types of antibodies. Erythema Chronicum Migrans--ECM (31.3%) and arthritis (25.0%) prevailed among clinical symptoms, in contrast with only 7.8% of neurological cases. In men, arthritis most frequently occurred (27.6%), while in women erythema migrans forms (37.1%). Other manifestations of the disease appeared in 13 patients (20.3%), and 10 patients (15.6%) had no record of clinical manifestations. As shown by patients' records, 32.8% reported attachment of tick, 20.3% insect bites and 29.7% were not aware of being bitten by vectors. Seasonal dynamics of diagnosed cases reached three peaks with the highest numbers in February, May and October.

Adolescent↗

Influence of geomedical factors on Guillain-Barré syndrome incidence in the region of western Slovakia.

During 5-years of follow-up we identified 58 cases of the Guillain-Barré syndrome in the Western Slovakia (approximately 1,300,000 inhabitants). The incidence of this disease fluctuated between 0.4-1.9 cases per 100,000 persons likewise mentioned in the literature. It was interesting to analyse the influence of bioclimatic conditions. We found that while higher altitude, cold and humidity increased the incidence of the GBS, warm weather had the opposite (beneficial) effect. This phenomenon might be related to a higher incidence of upper respiratory tract infections, which probably induce the autoimmune related disease. (Tab. 1, Fig. 4, Ref. 12.)

Climate↗

Pharmacoeconomic analysis of conservatively treated patients with nephropathies in western Slovakia regions.

UNLABELLED: The prevalence of patients with chronic nephropathies leading to the end stage of renal failure (ESRF) is increased. The conservative therapy of patients in the phase of ESRF as well as the performance of hemodialysis represent an extensive burden on health care budgets. AIM: The aim of the study was to evaluate the financial expenses for medications in group of conservatively treated patients with nephropathies. PATIENTS AND METHOD: One hundred and two patients (56 females, 46 males) aged 21-84 years with nephropathies collected from three out-patient departments of nephrology in the regions of Bratislava and Nitra (Western Slovakia) were enrolled into the study. RESULTS: The total financial expenses represented 2,889,778 Sk The average expense per 1 patient/1 year was 28,331 Sk and that of 1 patient/1 day was 77.6 Sk, respectively. Antihypertensive therapy represented 1st position (29.4%) of the total financial cost followed by keto-analogs (27.5%), hypolipideamics (14.8%), drugs for disorders of calcium metabolism (14.4%) and antianaemics (6.2%), respectively. The group of "other" drugs represented 7.7% of total costs. CONCLUSIONS: Results show that the financial expenses for pharmacotherapy in conservatively treated patients with nephropathies are high, but significantly less expensive in comparison with hemodialysis (700,000-1,000,000 Sk/year/patient). The prevention and the slowing down of the progression of renal disease seem to be crucial in the management of nephropathies. The therapeutic approach in conservatively treated patients with renal diseases was rational and up to date. (Tab. 1 Fig. 5, Ref. 12. )

Adult↗

Creutzfeldt-Jakob disease with E200K mutation in Slovakia: characterization and development.

Creutzfeldt-Jakob disease (CJD), the most important human prion disease, occurs in sporadic, iatrogenic and familial form. Except Slovakia and Israel, the recorded familial cases have never exceeded 10-15%. In the Slovak CJD group 95 out of 136 CJD cases (74.2%) carried a CJD-specific mutation in the prion protein gene (PRNP) at codon 200 (mutation E200K). All CJD(E200K) patients carried a heterozygous E200K mutation within the alelle with methionine at codon 129. No more than 53.7% were typical familial cases. The penetrance of the E200K mutation in 1975-2000 was 59.5%. The distribution of codon 129 polymorphism showed 78.6% of methionine-homozygous and 21.4% of methionine/valine-heterozygous patients. Genetic analysis performed on 278 CJD patient relatives demonstrated the E200K mutation in 97 (34.8%) of healthy relatives tested. The E200K mutation carriers were methionine-homozygous in 64% and methionine/valine-heterozygous in 36%. The relatives without the mutation showed a 54.9% methionine homozygosity, 10.4% valine homozygosity and 34.7% methionine/valine heterozygosity. Analysis ofthe E200K carriers provided evidence that the methionine homozygosity is a CJD risk factor, more efficient in CJD patients than in asymptomatic relatives. Th influence of both the E200K mutation and methionine homozygosity at codon 129 was evident in the duration of the clinical stage of CJD and in the immunoreactivity pattern of PrP resistant to proteases (PrP(res)). In the CJD(E200K) methionine-homozygous patients the mean duration ofthe disease was significantly shorter (3.7 +/- 2.0 months) than in the methionine/valine-heterozygous patients (7.84 +/- 7.3 months). Comparison of the PrP(res) positivity in the cerebellum of familial and sporadic CJD using specific polyclonal and monoclonal antibodies (MAbs) to PrP showed less conspicuous immune reaction in CJD(E200K) cases. Methionine-homozygous CJD patients were characteristic mainly by synaptic pattern of staining, while methionine/valine-heterozygous patients by PrP(res) granules and plaque-like structures. Most of numerous plaque-like PrP(res) deposits were found in sporadic valine/valine-homozygous cases. Potential professional risk was excluded in health facility workers. The percentage of professions related to farming was significantly higher in CJD(E200K) (48%) and sporadic CJD (44%) cases as compared to the employed population (9%).

Amino Acid Substitution↗

International migration in the Czech Republic and Slovakia and the outlook for East Central Europe.

This article "is devoted to the international migration issue in the Czech Republic and Slovakia (Czechoslovakia). Besides the contemporary trends, the international migration situation is briefly traced back to the communist era. The probable future scenario of international migration development--based especially on migration patterns that Western Europe has experienced--is also sketched, whilst mainly economic, social, political, demographic, psychological and geographical aspects are mentioned." Some consideration is also given to other countries in Eastern Europe. The different types of migration are analyzed, including illegal migration, labor migration, and refugees and asylum seekers.

Behavior↗

Seroprevalence of anti-Borrelia burgdorferi antibodies in sheep and goats from mountainous areas of Slovakia.

In the present study, domestic animals such as sheep and goats from eastern Slovakia were screened for the presence of anti-Borrelia antibodies. Seroprevalence in 181 sheep and 65 goats were carried out in 1999 and 2000. Modified ELISA method was used for detection of anti-Borrelia IgG antibodies. Seroprevalence obtained was 15.8% and 17.5% in 1999 and 2000 respectively in sheep, whereas in goats it was 17.2% and 19.4% respectively. The results suggest that these domestic species have potential to transmit the disease to other animals. Though the role of sheep and goats in Lyme disease has not yet been documented, there is great possibility of transmission of the causative agent via co-feeding to human beings.

Animals↗

Study of the content of heavy metals related to environmental load in urban areas in Slovakia.

UNLABELLED: It is natural for the man to take care of his environment so the negative influences of intensification of industrial and agricultural production and the entire process of pollution are kept at minimum or eliminated as early as possible. However, they must first be identified. BACKGROUND: companion animals, for example dogs, are a very good indicator of the pollution load on the environment. They inhabit the same space as humans and are exposed to the action of the same pollutants. The most important role in contamination of the environment with heavy metals is played by emissions of different origin. For that reason it is appropriate and advantageous to evaluate the load on the man by parallel evaluation of the heavy metal load on dogs, particularly in large town agglomerations. MAIN PURPOSE: the aim of the study was to compare and evaluate the content of three heavy metals, cadmium, arsenic and lead, in the hair of dogs from two largest town agglomerations of Slovakia, Bratislava and Kosice. In addition to that, an effort was made to compare the environmental load in Bratislava and Kosice by using the dog as a bioindicator of environmental pollution with heavy metals and to quantify the content of heavy metals in dog' hair. METHODS: The generally low level of heavy metals in biological material makes it impossible to use common analytical methods. In our study the samples of dog hair were analysed using the method of atomic absorption spectrometry. The measurements were carried out on a Perkin-Elmer spectrometer, model 5000, using the following wavelengths: 228.8 nm for Cd, 193.7 nm for As and 283.3 nm for Pb. The results of analyses are presented as means. The concentrations of Cd, As and Pb are expressed in microg/kg dog hair. Statistical evaluation of results was carried out by means of Student's t-test. RESULTS: The mean values of heavy metals in the set of dogs from Bratislava reached the following levels: 38.09 microg/kg for Cd, 111.07 microg/kg for As, and 729.59 microg/kg for Pb. The set of dogs from Kosice allowed us to detect the following mean values: 22.21 microg/kg for Cd, 79.87 microg/kg for As, and 542.49 microg/kg for Pb. The mean values for the entire Slovak territory reached 27.39 microg/kg for Cd, 90.06 microg/kg for As, and 601.96 microg/kg for Pb. The comparison of the first two experimental sets of data with the Slovak mean values showed highly significant differences in arithmetic means (p < 0.01) for Cd and significant (p < 0.05) for As with the Bratislava set reaching higher values. No statistically significant differences were observed with regard to Pb. CONCLUSION: The study confirms the need for further research in this area with the dog as a bioindicator involving also other environmental loads not only that resulting from heavy metals. It indicates the importance of risk assessment in relation to environmental pollution. As the studies on animals are applicable also to the human population it appears very appropriate to use also this indirect way to point out to the negative impact of the polluted environment. Lead, cadmium and arsenic are the heavy metals that raise particular concern because of their wide-spectrum negative influences on live organisms. (Tab. 4, Fig. 5, Ref 28.)

Animals↗

Identification and enumeration of Fusarium species in poultry feed mixtures from Slovakia.

Thirty-three samples of poultry mixed feeds collected in the region of Nitra (Slovakia) from August 2001-April 2002 were assayed for the incidence of Fusarium Link: Fr. species. In tested samples, the total frequency of isolated fusaria was determined to be 48 % (16 samples) and their counts ranged from 0.2 x 10(2) to 2.4 x 10( 4 ) CFU per g of the sample on Dichloran Chloramphenicol Peptone Agar (DCPA). Of the total amount of Fusarium isolates (609), the highest part (i.e. 584 isolates) was represented by Fusarium proliferatum (Matsushima) Nirenberg, being isolated in all the samples tested. Fusarium subglutinans (Wollenw. et Reinking) Nelson, Tousson et Marasas (in total 24 isolates) was found in 3 positive samples (9%) and Fusarium oxysporum Schlecht. Fr. (a single isolate) was found in one positive sample only (3%). Data of these significant mycotoxin producers found in examined samples with particular mycotoxins as well as their habitats were summarised briefly. The results refer to a large incidence of the potentially toxinogenic Fusarium species, mainly F. proliferatum, in the feeds of Slovakian origin which represent entry components of the food chain. The study also points out a potential risk of feed contamination with hazardous toxic compounds, especially by carcinogenic fumonisins and cardiotoxic moniliformin. From the hygienic point of view, it will be necessary to continue monitoring and evaluating this occurrence.

Animal Feed↗

Serological screening of occurrence of antibodies to Encephalitozoon cuniculi in humans and animals in Eastern Slovakia.

Encephalitozoon cuniculi is one of the mamalian microsporidian pathogens that can affect a number of different species of animals as well as humans. The presence of specific serum antibodies to Encephalitozoon cuniculi was studied in a group of animals and humans from Eastern Slovakia by the indirect immunofluorescence of antibodies (IFA). 456 people, 571 rabbits, 457 mice, 193 dogs, 72 cats, and 59 sheep were examined. Specific anti-E. cuniculi antibodies were found in 26 out of 456 human sera examined (5.7%). The highest occurrence of antimicrosporidial antibodies was found in the group of immunodeficiency patients - 37.5%. In the group of animals, the highest positivity was observed in rabbits - 41.7%, and in dogs - 37.8. The relative high prevalence, especially in rabbits and dogs as potential sources of microsporidial infection for humans, indicates the importance of performing the screening examinations in animals with aim of reducing or halting the spread of this disease.

Animals↗