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[Incidence of phagotypes of Mycobacterium tuberculosis in Czechoslovakia and East Germany and of Mycobacterium bovis in Czechoslovakia and Argentina].

The following study gives review of the results of the phagetyping of M. tuberculosis strains in different localities of Czechoslovakia and German Democratic Republic (165 strains from Czechoslovakia and 102 strains from GDR) and the comparison of the occurrence of phage subgroups of M. bovis strains in two different localities of Czechoslovakia (62 strains) and Argentina (93 strains). The results of the phagetyping of the Czechoslovak M. tuberculosis strains show that this group comprises all the 6 phage subgroups and agree very well in subgroups Ax, A2, B and C with the M. tuberculosis strains from GDR. Both groups of strains differ in subgroups A2 (9) and D. The results with the fresh isolated Argentinian M. bovis strains show that this group has only subgroups Ax and D in comparison with the old laboratory strains of M. bovis which have subgroups Ax, A2(9), and D. The phagetyping of the M. tuberculosis and M. bovis strains was undertaken with the help of 11 international mycobacterial phages. The use of mycobacterial phages in 1 RTD (Routine Test Dilution) and 10 RTD concentrations (in contrary to the 1 RTD and concentrated phage suspensions used previously) decreased the number of the "unspecific" reactions.

Argentina↗

Cardiovascular drugs in Czechoslovakia--registration and consumption data.

Data on registration and consumption of cardiovascular drugs in Czechoslovakia were sorted from the computerized Drug Information System (DIS) for a detailed analysis. Cardiovascular drugs (including antiarrhythmics, cardiac glycosides, diuretics, antihypertensive agents and vasodilators) represent at present 10% of all registered drugs in Czechoslovakia with an ever increasing trend over the last ten years. For economical analysis of consumption of cardiovascular drugs, three methodological approaches (expenditure figures, material units--number of packages and DDD (Defined Daily Dosis), as a technical unit of measurement) were chosen. In the period of 7 years (1980-1986) all three methodologies confirmed the increasing trend of cardiovascular drugs consumption in Czechoslovakia. However, an international comparison of consumption data between Czechoslovakia and Sweden revealed lower levels in Czechoslovakia in this respect.

Cardiovascular Agents↗

Different trends in cardiovascular mortality and food consumption in Austria and in former Czechoslovakia.

The life expectancy of the male and female population immediately after World War II was similar in the former Czechoslovakia and in Austria. However, the situation has changed radically over the past 30 years. In 1991 the life expectancy in Czechoslovakia was 4.9 years less for males and 3.6 years less for females than in Austria due to the two-fold higher premature mortality from cardiovascular diseases and some further causes. The reasons for the 200% difference in cardiovascular mortality between Austria and Czechoslovakia are unknown. The prevalence of traditional risk factors (i.e. smoking, hypertension and hypercholesterolemia) was only moderately different in both countries. On the other hand, very different trends in food consumption were observed: in Austria the consumption of milk and milk products, vegetable oils, fruits, some kinds of vegetables and nuts was significantly higher, whereas the consumption of butter, sugar, eggs, cereals and concentrated spirits was lower. The consumption of pork, beef, poultry and fish was very similar in the two countries. The intake of antioxidant vitamins and probably also of folic acid, which affects the level of homocysteine, was lower in Czechoslovakia. The psychosocial load in totalitarian Czechoslovakia was undoubtedly higher. Epidemiological research of Central European populations living on both sides of the former Iron Curtain might bring new information on the role of less known non-traditional risk factors (i.e., psychosocial stress, nutritional factors such as chronic deficiency of antioxidant vitamins and a low intake of folic acid) in the etiology of cardiovascular diseases.

Adult↗

[Utilization of cardiac glycosides in Czechoslovakia--does it correspond to need?].

The data are given on the consumption of cardiac glycosides (CD) in the CSSR over the past 18 years (1970-1987). Consumption expressed in terms of defined daily doses (DDD) permitted to construct time series of the consumption of this group of pharmacotherapeutic agents as a whole as well as individual CG and to compare the data thus obtained with similar data from abroad. The results indicate that the consumption of CG as a whole culminated in Czechoslovakia in 1983 (27.6 DDD per a population of 1000 per day = 27.6 DDD/1000/d) and that there has been a slow decline ever since. Compared with foreign data, Czechoslovakia's quantitative consumption of CG is roughly between countries noted for traditionally high consumption (GDR 84.8 DDD/1000/d) and those with low consumption (Scandinavian countries with the exception of Sweden, about 10 DDD/1000/d). Unlike Czechoslovakia, however, all other countries with well established CG consumption have been exhibiting a relatively steep and lasting decline in CG consumption since the late 1970s. This reduction reflects modern trends of CG pharmacotherapy, especially stricted consideration of the uses as distinct from the risks of CG administration, as well as some of the recent efforts to terminate long-term CG treatment particularly in vaguely indicated cases. As for individual CG consumption, Czechoslovakia, similarly as other countries, has been favouring more rational prescription of oral digoxin at the expense of the oral form of lanatoside C, while parenteral digoxin has for all practical purposes become a substitute for strophantin.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Glycosides↗

Development of gentamicin resistance in gram-negative bacteria in Czechoslovakia and correlation with its usage.

Widespread use of gentamicin in Czechoslovakia began in 1975 when it became more available, although its use remained restricted until 1986. Starting in 1980 a remarkable increase in gentamicin resistance was observed in Pseudomonas aeruginosa, Klebsiella, Enterobacter and several Proteus species, especially Proteus rettgeri. A large proportion of gentamicin-resistant strains came from the urine of hospitalized patients. In spite of infection control measures and restrictive antibiotic policy, gentamicin resistance has increased over the last years. In 1985 gentamicin resistance of bacteria in Czechoslovakia represented 18.2% and was higher than in Austria or the Federal Republic of Germany, for example, but lower than in Hungary, France, Greece and Italy. The usage of gentamicin has also increased. During the years 1982-1987 gentamicin usage in Czechoslovakia increased by one-half. In a representative collection of 69 gentamicin-resistant Gram-negative strains from seven regions of Czechoslovakia, the mechanisms of resistance to gentamicin, netilmicin, tobramycin and amikacin were studied. Production of acetyltransferases (AAC) and adenylyltransferases (ANT) was observed in 84% of strains. The majority of isolates produced AAC(3) enzymes (55%); production of ANT(2") represented the second most observed resistance mechanism (35%); only 14% of isolates produced AAC(6'). This resistance pattern correlates with patterns reported recently for Central and Southern Europe. Due to dissemination of plasmids coding for the AAC(3)-II enzyme, the majority of Czechoslovak gentamicin-resistant Gram-negative strains were also tobramycin- (87%) and netilmicin-resistant (68%). Amikacin remains the most effective aminoglycoside against multiresistant bacterial strains.

Acetyltransferases↗

Impact of diffuse nitrate pollution sources on groundwater quality--some examples from Czechoslovakia.

In several regions of Czechoslovakia with intensive agricultural production, the correlation between the amount of nitrogen fertilizer applied and the nitrate content in groundwater has been recognized. Nitrate pollution of groundwater is considered to be the most serious source of nonpoint pollution in Czechoslovakia. A program of research into the effects of farming activities on groundwater quality in Czechoslovakia is under way on experimental fields (20 to 30 hectares) and, simultaneously, in regions in which shallow, vulnerable aquifers occur. The importance of the soil organic matter's stability for maintaining the groundwater quality is emphasized. Research based on nitrogen and organic carbon balance has shown that the restoration of a soil-groundwater system is a complicated process that usually requires changes in the extent and intensity of agricultural activities and consistent attention to the effects produced by natural conditions. Regional investigation of the impact of farming on shallow aquifers in the fluvial deposits of the Elbe River in Bohemia has proved the hydrochemical instability and vertical hydrochemical heterogeneity of these aquifers. The WASTEN deterministic model was used for modeling the transport and transformation of various types of inorganic fertilizers. The input data is based on laboratory and field measurements. Special topics are the verification of model calculations and the time and spatial variability of input data with respect to the unsaturated zone. The research results are being used for making regional and national agro-groundwater managerial schemes more precise, as well as for decision-making.

Agriculture↗

Trends in mortality rate from malignant skin melanoma and other malignant skin neoplasms in Czechoslovakia during the period 1921--1970.

Mortality from malignant skin melanoma (172 ICD) has an ascending trend in Czechoslovakia (CSSR) the rate being higher after the year 1960 in Bohemia (CSR) than the Slovakia (SSR). Mortality from other malignant neoplasms of the skin (173 ICD) declines; this decline for the whole of Czechoslovakia has been statistically influenced mainly by the lower death rate from this cause in Bohemia, for in Slovakia this mortality rate has risen, although significantly only in women. The proportion of deaths from malignant skin melanoma (172 ICD) out of the total number of deaths from malignant skin neoplasms (172 + + 173 ICD) is relatively low in Czechoslovakia--lower in Slovakia than in Bohemia.

Adolescent↗

[Heart surgery in Czechoslovakia].

In 1985, the cardiovascular Section of the Society of Surgery decided to start a registry of cardiac surgery procedures. Since then, basic data on surgical treatment of patients with heart disease have been collected each year. The following conclusions have been drawn from the data available: 1. The situation in cardiac surgery in Czechoslovakia is catastrophic. Czechoslovakia ranks among nations with the lowest numbers of operations per population in Europe. The most critical situation exists in IHD. 2. The standard of care provided to patients in individual areas of Czechoslovakia is about the same. 3. The critical lack of funds led to a decrease in the number of operations performed in 1990. 4. Organization of health care is poor, as indicated by length of hospital stay longer than that in the industrialized nations. 5. It is crucial to allocate more money to departments of cardiac surgery.

Cardiac Surgical Procedures↗

Monitoring regional performance in general hospital psychiatry: England, Wales and Czechoslovakia.

The purpose of this article is to consider how the regional performance of general hospital psychiatry may be adequately monitored using routine information. Limitations on the types of information available for monitoring regional performance are discussed, in the context of the main functions which a routine information service may be expected to fulfill. English and Welsh routine data are used in a study of the utilisation of general hospital psychiatric beds, and then compared with similar data for Czechoslovakia. The findings suggest that regional equity in the provision of beds: as measured by the coefficient of variation of the bed supply rate, and national performance, as measured by the 'marginal throughput' of these beds; is superior in Czechoslovakia despite recent additions to such beds in England and Wales. The model of utilisation, which was used to assess national performance, may be used to identify the regions whose performance is substandard when compared to other regions or countries. Finally, the relevance of these proposals for monitoring Health Service performance generally is discussed.

Czechoslovakia↗

Alcohol and drug problems in Czechoslovakia.

The authors describe the current drug and alcohol scene in Czechoslovakia, with references to historical developments. Drug abuse is divided into nine groups: from drugs most frequently abused (opiates and speed) to illegally cultivated hemp (hashish and marijuana). In 1985 there were 9,900 registered drug addicts and 720 are added to this number annually. There are approximately 15 nonregistered drug addicts for every registered one. In the consumption of alcoholic beverages, Czechoslovakia holds 13th place in the world (average annual per capita consumption is in the vicinity of 9.5 litres of 100% alcohol). In 1985 there were 239,385 registered alcoholics (of this number, 18,746 were women). In conclusion the authors describe the Czechoslovak system of treatment of addictions: detoxification departments, outpatient treatment, and institutional care, as well as treatment for prisoners and forced treatment. They also mention the effectiveness of these treatment programs.

Alcoholism↗