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PubMed1996

[Epidemiologic and microbiologic aspects of mycobacteriosis in Slovakia. M. avium complex].

BACKGROUND: Mycobacteria belonging to M. Avium Complex (MAC) are strains very similar in structure and biochemistry but very different from the point of serology. OBJECTIVES: They are divided into 28 serotypes. The objective of the research is to describe the epidemiological situation in mycobacterioses caused by Mycobacterium Avium Complex in Slovakia and to compare it with the situation in the developed countries. METHODS: The study is methodologically based on the surveillance of tuberculosis and applied to the problem of mycobacterioses. RESULTS: During the period of 19 years we have registered in Slovakia 43 new cases caused by Mycobacterium Avium Complex. The number of new cases per year ranged from 0 to 4 cases. The majority of cases were males in permanent residence in Slovakia. 74.4% of them were from central and eastern Slovakia. CONCLUSIONS: Over the past 19 years the stabilized trend of incidence of mycobacterioses caused by Mycobacterium Complex has not changed. (Ref. 22.)

AIDS-Related Opportunistic Infections↗

PubMed1997

[Epidemiologic and microbiologic aspects of mycobacteriosis in Slovakia. M. fortuitum].

The purpose of this paper is to confront the knowledge about the epidemiology of this disease abroad with information obtained in Slovakia. The methodology of this paper is based upon surveillance of tuberculosis as applied on mycobacterioses. Pulmonary infections caused by M. fortuitum presents only 10% of pulmonary mycobacterioses caused by facultative pathogenic mycobacteria. Since the year 1979 were in the territory of Slovakia newly discovered 5 cases of mycobacterioses caused by M. fortuitum. 4 of them are men (age 61-77 years old) and 1 women (57 years old). 3 patients are from Eastern Slovakia and 2 patients are from Central Slovakia. All of them had pulmonary location of disease. Another 8 cases (5 men and 3 women) are suspect for mycobacterioses for the meantime. In each isolation of the agents was made 5-8 times but without verification of clinical activity. Findings of M. fortuitum in biological material even when repeated can mean contamination only. During the period of last 10 years 768 isolations of M. fortuitum from 496 persons were registered. (Ref. 36.)

Aged↗

PubMed1999

Incidence of Haemophilus influenzae type b meningitis among children less than 5 years of age in Slovakia.

Owing partly to a lack of disease burden data, Eastern and Central European countries have not introduced universal infant immunization against Haemophilus influenzae type b. To determine the incidence of Haemophilus influenzae type b meningitis among children less than 5 years of age, data were examined from eight districts in Slovakia that formed part of a national Haemophilus influenzae type b surveillance system. All invasive isolates of Haemophilus influenzae type b identified from these districts during 24 months (1996-1997) were sent to a single central laboratory for serotype confirmation. Thirty-five cases of confirmed Haemophilus influenzae type b meningitis were identified, for a disease incidence among children under 5 years of 17.3 per 100,000 population per year. Only 13 cases were identified during 1996, the first full year of the surveillance system. Records were available for review at six of the eight district laboratories and showed that, using World Health Organization definitions, almost half of the cases of probable bacterial meningitis were culture negative, suggesting that the true incidence of Haemophilus influenzae type b meningitis may be considerably higher than 17.3. The rate of Haemophilus influenzae type b meningitis among children less than 5 years of age in Slovakia is comparable to that found in Western Europe and North America during the prevaccine era. Thus, universal, publicly funded infant vaccination in Slovakia can be expected to have the same dramatic effect on Haemophilus influenzae type b disease morbidity and mortality as has been demonstrated in other countries that have adopted this approach.

Child, Preschool↗

PubMed2002

Alkaptonuria in Slovakia: thirty-two years of research on phenotype and genotype.

Research on alkaptonuria (AKU; OMIM # 230500) in Slovakia started in 1968 by the Research Laboratory (later on the Institute) for Clinical Genetics at Martin. Its first stage was focused on clinical, biochemical, genetic and epidemiologic questions and on the reasons for the high prevalence of AKU in Slovakia. Based on a screening programme of now over 611,000 inhabitants (509,000 newborns) the world-wide highest incidence of AKU (1 in 19,000) was recorded, and a total of 208 patients (110 children) were registered. Extensive genealogical studies (sometimes over two centuries) resulted in the fusion of several "unrelated" nuclear families into larger pedigrees and enabled tracing most AKU ancestors to their original geographic localities, predominantly in remote mountain areas. A likely founder effect was detected among the shepherd population of the so-called Valachian colonization that resulted in a high degree of inbreeding and persisting genetic isolation. These epidemiologic data formed the basis for molecular studies in collaboration with the Würzburg group. The AKU locus was mapped to human chromosome 3q2 by orthology to the mouse locus aku. Following the cloning of the homogentisate-1,2 dioxygenase (HGD) genes from human and mouse, nine different mutations were identified in 21 AKU index patients. These include 4 missense, 2 splice-site, 2 single-base insertion and 1 deletion mutation. The most frequent mutations among the 42 AKU chromosomes of the index cases are c.648G > A (Gly161Arg; 42.9%), and c.1278insC (Pro370fs; 19.1%). To date, the genotypes of 29 patients and of 74 gene carriers from 21 families have been established. The highest prevalence and allelic heterogeneity were observed in the Kysuce district with five different mutations. Molecular epidemiology studies by haplotyping were carried out to uncover the original geographic localities of all AKU index chromosomes. This strongly suggests that several founders have contributed to the HGD gene mutation pool. While there is no straightforward explanation for the clustering of independent mutations, the genetic isolation in the past is likely to be responsible for the high prevalence of AKU in Slovakia.

Alkaptonuria↗

PubMed1998

Crohns disease in Slovakia: prevalence, socioeconomic and psychological analysis.

The need for a basic epidemiological study, according to international standards, of the prevalence of IBD in Slovakia was increased by the dissolution of Czechoslovakia. This paper presents the results of CD prevalence to 30 April 1994 in Slovakia. To evaluate the statistical data of the prevalence of the disease according to age, sex, regions and districts, the authors employed the multi-dimensional Kruskal-Wallis test and cluster analysis and determined that the prevalence of CD in Slovakia is 6.75/100.000 inhabitants. The distribution differences indicate the need for further investigations of environmental differences. The socio-economic and psychological evaluation of the patients examined revealed some interesting associations. The psychological reaction to the disease is neurotic and depressive and a higher occurrence of affective symptomatology was observed in patients with permanent partnership and with children. On the other hand, the educational level and knowledge concerning the disease on the part of the patient had a positive influence on the reaction to the disease.

Adolescent↗

PubMed2001

Epidemiology of testicular tumors in Slovakia (1993-1997): preliminary report.

Worldwide increase of the incidence of testicular tumors was also reflected in the increasing number of these malignancies in the Slovak Republic. Lack of the accurate information about the occurrence of testicular tumors in Slovakia has helped to create a new multicentric retrospective study based on occurrence, histology, risk factors, diagnosis and treatment of this malignancy in Slovakia. The analysed study group consists of 1010 patients with testicular cancer, diagnosed from the beginning of 1993 to the end of 1997. Identification and histological data about the patients were obtained from the heads of departments of urology in Slovakia. In this study considerable differences were found between information obtained from departments of urology and information published by the National Cancer Register of the Slovak Republic. Ascertained information is higher than the one published by the National Cancer Register from the last five officially concluded years.

Adolescent↗

PubMed1995

Surveillance of tuberculosis caused by Mycobacterium bovis in Slovakia.

The elimination of tuberculosis (TB) among cattle was claimed in Czecho-Slovakia in the middle of the sixties. Experiences from some countries which eliminated TB among cattle earlier than Czecho-Slovakia indicated a sporadic occurrence of TB caused by M. bovis. A long-term investigation of the occurrence of this 'diminishing zoonosis' has been carried out by a special group of experts (epidemiologists, clinicians, bacteriologists, epizootiologists and veterinary surgeons) on the whole territory of Slovakia. During the period of years 1972-1990 there were discovered 68 new cases of TB in humans caused by M. bovis. This paper analyses the results of the epidemiological investigation of this group of patients from several aspects: eg age, sex, occupation and geographical distribution.

Adolescent↗

PubMed2007

Prevalence of permanent neonatal diabetes in Slovakia and successful replacement of insulin with sulfonylurea therapy in KCNJ11 and ABCC8 mutation carriers.

CONTEXT: Mutations in the KCNJ11 and ABCC8 genes encoding the pancreatic beta-cell K(ATP) channel have recently been shown to be the most common cause of permanent neonatal diabetes mellitus (PNDM). Information regarding the frequency of PNDM has been based mainly on nonpopulation or short-term collections only. Thus, the aim of this study was to identify the incidence of PNDM in Slovakia and to switch patients to sulfonylurea (SU) where applicable. DESIGN: We searched for PNDM patients in the Slovak Children Diabetes Registry. In insulin-treated patients who matched the clinical criteria for PNDM, the KCNJ11 or ABCC8 genes were sequenced, and mutation carriers were invited for replacement of insulin with SU. RESULTS: Eight patients with diabetes onset before the sixth month of life without remission were identified since 1981, which corresponds to the PNDM incidence in Slovakia of one case in 215,417 live births. In four patients, three different KCNJ11 mutations were found (R201H, H46Y, and L164P). Three patients with the KCNJ11 mutations (R201H and H46Y) were switched from insulin to SU, decreasing their glycosylated hemoglobin from 9.3-11.0% on insulin to 5.7-6.6% on SU treatment. One patient has a novel V86A mutation in the ABCC8 gene and was also substituted with SU. CONCLUSIONS: PNDM frequency in Slovakia is much higher (one in 215,417 live births) than previously suggested from international estimates (about one in 800,000). We identified one ABCC8 and four KCNJ11 mutation carriers, of whom four were successfully transferred to SU, dramatically improving their diabetes control and quality of life.

ATP-Binding Cassette Transporters↗

PubMed1999

Short report: simultaneous occurrence of Dobrava, Puumala, and Tula Hantaviruses in Slovakia.

The prevalence of antibody to hantaviruses in Slovakia (serum panel n = 2,133) was lower in the western part (0.54%) and higher in the eastern part (1.91%) of the country and was found to be significantly enhanced in a group of forest workers from eastern Slovakia (5.88%). One-third of the IgM-negative convalescent phase sera from patients with hemorrhagic fever with renal syndrome exhibited antibodies reacting predominantly with Puumala virus antigen, while two-thirds had antibodies directed mainly against Hantaan virus antigen. Fine analysis of two Hantaan virus-reactive sera by a focus reduction neutralization test showed that Dobrava hantavirus was the source of these human infections. Initial results of rodent screening indicated the circulation of Dobrava virus in populations of striped field mice (Apodemus agrarius) in eastern Slovakia.

Animals↗

PubMed1999

Genetic studies in Medzev, a village in south-eastern Slovakia. 3. Morphogenetic traits.

Eleven anthropometric traits, five indices and eight anthroposcopic and behavioural traits have been studied in the population of Medzev, which is located in the region Spis in South-Eastern Slovakia. An attempt has been made to compare the results of the present study with other population groups in Slovakia, particularly with an ethnogenetically related population from North-Eastern Slovakia (Chmel'nica). Barring zygomatic breadth in males, biogonial breadth in females, biacromial breadth und jugomandibular index in both sexes, hair pigmentation, ear lobe attachment and arm folding, the remaining traits show no significant differences between the Medzev and Chmel'nica population. On the whole, these two populations are closer to each other than to any other Slovakian group.

Adult↗

PubMed2000

[Epidemiologic and microbiological aspects of mycobacteriosis in Slovakia--Mycobacterium szulgai].

The first case of mycobacteriosis caused by M. szulgai in the territory of Czechoslovakia was discovered in the year 1979 in southern Slovakia and was published in our and foreign literature in the year 1981. The purpose of this investigation is to describe the epidemiological situation of the diseases caused by M. szulgai in Slovakia and to compared it with the experiences in chosen developed countries, especially focused on the localization of the disease, factors of transmission, mechanism of transmission and other epidemiological characteristics. The methodology of this paper is based upon surveillance of tuberculosis applied on mycobacterioses. During the period of last 20 years two cases of the disease without mutual epidemiological connection were discovered. In contradiction to other mycobacterioses, diseases caused by M. szulgai, have not the tendency to endemic occurrence. The most often transmission factors are contaminated water and soil. Both cases of M. szulgai in Slovakia suffered from pulmonary diseases. Other localization reported in other countries, for example: olecranon bursitis, skin infections, cervical adenitis, osteomyelitis and renal disease were not reported in our country up to now. (Ref. 23.)

Humans↗

PubMed2002

[Orofacial clefts in western Slovakia].

Orofacial clefts are relatively frequent inborn developmental defects. The objective of our study was to reveal the actual frequency of orofacial clefts in western Slovakia. From 390 404 liveborn children in Bratislava and the western Slovakian region in 1985-1999, 629 children with orofacial clefts were operated at a specialized department--the Clinic of Plastic and Aesthetic Surgery of the Medical Faculty, Comenius University Bratislava. The authors assessed the total incidence of orofacial clefts from the records of the above department and reported data. For statistical evaluation of differences they used the chi 2 test. The total incidence during the years of investigation in western Slovakia was 1.611/10(3) liveborn children whereby in Bratislava town the incidence was higher than in the western Slovakian region. Between individual districts these values had a wide range from 1.20-2.04/10(3) liveborn infants. As regards different types, the authors found the highest incidence of orofacial clefts of the primary and secondary palate. The frequency in males was significantly higher. As regards the risk of possible birth of an infant with this congenital developmental defect in western Slovakia, the authors found a discrepancy between data on their records--1 child/620 liveborn infants, and notified cases--1 child/756 liveborn children.

Cleft Lip↗

PubMed2003

The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial in Slovakia.

OBJECTIVES: We described the baseline characteristics of a cohort of patients who are a part of a large prospective study and compared with those characteristics of patients enrolled globally. BACKGROUND: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) is a double-blind, randomized, multinational, multicenter, prospective, parallel group study. The primary objective of VALUE trial is to assess the effect of the angiotensin II (AT1 receptor) antagonist valsartan on the reduction of cardiac morbidity and mortality in patients 50 years of age or older with essential hypertension and a high risk of cardiovascular events. METHODS: A total of 15314 patients from 31 countries were randomized. In Slovakia 103 patients were randomized. We compared baseline characteristics of patients enrolled in Slovakia with those of patients enrolled globally. Statistic analysis was made with F-test, t-test, chi-square test and binomial test. RESULTS: The Slovak group had of fewer men (40.8%) and more patients of Caucasian race (99.0%). A higher proportion of patients treated for hypertension for at least three months was found in the Slovak group (99.0%), however the mean values of sitting systolic and sitting diastolic blood pressures remained similar in both groups. The value of serum creatinine >150 micromol/l did not occur in the Slovak group. The coronary heart disease was more prevalent in the Slovak group (77.7%) and the mean value of hemoglobin was lower in the Slovak group (138.0 g/l). CONCLUSIONS: The baseline characteristics of the 103 patients enrolled in VALUE trial in Slovakia indicate that the target population of patients with essential hypertension and a high risk of cardiovascular events was achieved. (Tab. 1, Fig. 6, Ref. 21.).

Aged↗

PubMed2003

Initial experience with lung transplantation in Slovakia--an example for successful bilateral cooperation between countries.

OBJECTIVE: To review initial experiences, results of single lung transplantation (SLT) and double lung transplantation (DLT) on the basis of bilateral cooperation between Slovakia and Austria. PATIENTS AND METHODS: During the period between July 1998 and January 2003 ten patients from Slovakia underwent lung transplantation in Vienna, Austria. There were 7 males and 3 females with an age range from 21 to 48 years. Eight patients underwent double lung transplantation, two patients had single lung transplantation. Indications were: pulmonary fibrosis in 2, cystic fibrosis in 2, emphysema in 2, primary pulmonary hypertension (PPH) in 4 cases. In the PPH patients (n = 4) and in the patients with cystic fibrosis (n = 2), bilateral lung transplantation under ECMO support was performed. One patient (n = 1) with postradiative pulmonary fibrosis and intracardial myxoma underwent bilateral lung transplantation under cardiopulmonary bypass. Only three patients (e.i. the two with emphysema and one with pulmonary fibrosis) underwent lung transplantation without any intraoperative circulatory support. RESULTS: No perioperative mortality was recorded. Two patients died in late postoperative period: one due to multiorgan failure on 93rd day after DLT, the other one--on a liver failure caused by cirrhosis after 2.5 years after LTX. All the remaining eight patients, but the two ones who underwent LTX several days ago, are with improved functional status in full work activity. The follow up period for all patients ranges between 10 days and 54 months. CONCLUSION: Both unilateral and bilateral lung transplantations are accepted treatment modalities in patients with end-stage pulmonary disease. Bilateral cooperation for such countries as Slovakia (with limited possibilities) offers a unique example of possible and successful way how to deal with such demanding procedures. (Tab. 3, Fig. 2, Ref. 19.).

Adult↗

PubMed2003

[Antibiotics in ambulatory practice in Slovakia 1999-2001].

Evaluation of the consumption of antimicrobial drugs is an important component of antibiotic policy and provides a picture of rationality of treatment. In the present paper, the authors analyzed the consumption of antibacterial agents of the ATC group J01 for systemic use in out-patient practice in Slovakia in 1999-2001. The data were taken from materials of all Slovak insurance companies provided by the Ministry of Health of the Slovak Republic. The paper evaluated the total out-patient consumption of antimicrobial agents and the financial costs of antibiotic therapy, analyzed the consumption of the individual groups of antibiotics and the consumption of individual agents, and compared the found out-patient consumption with that of Finland. The DDD values in the period under study gave evidence of a high but stable consumption of antibiotics. The analysis according to the groups of antibiotics revealed the dominance of penicillins with wider spectra, penicillins sensitive to beta-lactamases, and macrolides. The evaluation of individual antimicrobial agents showed a positive tendency of the growth of amoxicillin consumption, compensated by a decrease in the consumption of less advantageous ampicillin. The comparison of the Slovak and Finnish consumptions of macrolide antibiotics showed a prevailing consumption of roxitromycin and klaritromycin in Slovakia, and azitromycin in Finland. As far as cephalosporins are concerned, the preparations of the first generation dominated in Finland, and those of the second generation in Slovakia.

Ambulatory Care↗

PubMed2003

[Liver biopsy in Slovakia].

INTRODUCTION: Liver biopsy is the most specific diagnostic modality in hepatology, but information about its application in Slovakia is rather obscure. METHODS: The authors performed a correspondence study with the aim to find out how many biopsy examinations has been done in Slovakia in 2001, for which indications, what kind of techniques have been applied and which small or great complications were encountered. RESULTS: It was established that in the year 2001, 400 biopsies for diffuse liver diseases were performed. There were 296 percutaneous biopsies, 82 laparoscopic biopsies and 22 trans-jugular biopsies forming the survey. Acute viral hepatitis was the most frequent indication, whereas non-alcohol steatohepatitis was a rare indication in spite of the high prevalence. The frequency of great complications was 0.00025%. No death associated with this procedure was reported. CONCLUSION: Liver biopsy has been done in Slovakia in indications, ways and with the frequency of complications, which were comparable with data from literature.

Biopsy↗

PubMed2004

[Nijmegen breakage syndrome in Slovakia].

BACKGROUND: The autosomal recessive Nijmegen breakage syndrome (NBS) is a DNA repair disorder due to a mutation in the NBS1 gene on 8q21. Hyperradiosensitivity and high risk for lymphoreticular malignancy are important reasons for early diagnosis and prevention by avoidance of ionisation. The frequency of NBS heterozygotes of the mutation 657de15, which is predominant in the Slavic population was estimated to be in the range of 1:90-1:314 in different parts of Poland, and 1:128-154 among Czech newborns, born 20 years ago. METHODS AND RESULTS: Lower prevalence of affected homozygotes born in Czechoslovakia in the period 1969- 1992 (24 among 5.2 million newborns corresponds to 1:271000) than expected on the basis of carrier frequency is explained to be due to underdiagnosing because the rate of prenatal lethality in the NBS families is not increased or it is even lower than in the general population. The underdiagnosing of NBS is emphasized also by the mean age at diagnosis (7.5 years) although severe microcephaly is present at birth. The possibility to offer effective prevention of primary and secondary malignancies becomes the motivation for interdisciplinary collaboration with paediatricians, neurologists, immunologists and clinical geneticists. A decrease of the mean age down to 6 months at diagnosis among the 11 newly recognized patients has been achieved in the previous 4 years. The occurrence of homozygotes was relatively higher in Slovakia with 5 million inhabitants (14 patients in 11 families) than in the Czech Republic with a population of 10 million (21 patients in 14 families), and therefore the frequency of NBS heterozygotes was studied among 2996 newborns born in 2002-2003 in 12 maternity hospitals of west, middle and east Slovakia. Surprisingly, only 3 heterozygotes were found. CONCLUSIONS: This discrepancy of heterozygote frequency and the number of homozygotes shows that due to traditional subisolates the population is not in the genetic equilibrium. It explains the high prevalence of alcaptonuria in Slovakia in the middle of last century, which is a rare disorder in other countries.

Abnormalities, Multiple↗

PubMed2005

Cleft lip and palate in Western Slovakia in the years 1985-2000.

Orofacial clefts are common congenital anomalies. The aim of this study was to assess the incidence in Western Slovakia. The study material were the case records of infants from the Bratislava and Western Slovakia regions, born between 1985 and 2000, and operated on in the Department of Plastic Surgery, Faculty of Medicine, Commenius University, General Hospital Ruzinov, in Bratislava. Of 409,205 live births in this period, 670 children were born with OC (orofacial clefts) and operated in the above-mentioned department. This study found a total incidence of 1.64/1000 live births. Compared to the Western Slovakia region, the incidence was higher in Bratislava. Of the different types of OC, CLP was the commonest, with a male preponderance of OC at the rate of 1.16:1. The available data showed significant differences of clefts in some of the studied districts, which could be a base for an intensive follow-up of endemic (genetic and exogenous) factors.

Cleft Lip↗