[Impact of the conclusions of the 14th Congress of the Communist Party of Czechoslovakia of public health in Czechoslovakia].
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Communism↗
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[Gustatory using phenylthiocarbamide and endemic goiter in Czechoslovakia 1967-1971. I. Demographic study on the relation of taste distinction of PTC (Phenylthiocarbamide) to the quantity and quality of goiter in 61,490 subjects in Czechoslovakia].
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Adolescent↗
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↗
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↗
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↗
Contribution to the issue of essential drugs in Czechoslovakia.
OBJECTIVE: To determine the ratio represented by essential drugs (EDs) in the total consumption of drugs in Czechoslovakia in 1989. DESIGN: Retrospective analysis of the assortment and consumption of EDs in 1989. SETTING: Department of the Organization and Management of Pharmacy, Faculty of Pharmacy, Bratislava. MAIN OUTCOME MEASURES: Consumption of drugs and/or pharmacotherapeutic groups, expressed by the number of formulations, number of units, and in financial terms. RESULTS: EDs constitute approximately one-third of the total consumption of drugs in Czechoslovakia (both in terms of volume and finances); almost 60 percent of EDs have dosage forms and concentrations identical to those shown in the World Health Organization Model List of Essential Drugs (Sixth List). CONCLUSIONS: The results obtained indicate that there is need for a regular updating of the drug policy within the public health branch of the government to more effectively regulate the production and import of drugs.
Chemistry, Pharmaceutical↗
Czechoslovakia's changing health care system.
Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.
Communism↗
[The quality of demographic development in Czechoslovakia from the European viewpoint].
Forty years of a totalitarian regime imply economic, cultural and moral devastation. Statistical analyses reveal, however, also demographic devastation in particular in the sphere of health and social aspects. This means that the basic indicators of the quality of demographic development in Czechoslovakia during the last 25 years are remarkably close to the indicators of the former socialist system and that they deteriorate and lag behind when compared with other countries, in particular developed industrial countries. This trend can be also called "balkanization" because Czechoslovakia which belonged before the war among the eight most highly developed industrial countries dropped at the end of the eighties to the level of demographic indicators of Bulgaria, Jugoslavia, Hungary, Roumania etc. In the submitted investigation the authors demonstrate these facts based on the analysis of selected coefficients of quality of the demographic development such as infant mortality, specific mortality of the male and female population aged 55-59 years and the mean life expectancy of men and women at birth, on the background of the general European demographic situation. For analyses only the latest data published by UNO were used.
Adult↗
Psychosomatic medicine in Czechoslovakia: history, present state and perspectives.
The history and present state of psychosomatic medicine in Czechoslovakia are described in detail. At the present time, a concept of Z.J. Lipowski is spreading. Since the formation of the Section for Study of Psychosomatic Medicine, a part of the Czech Psychiatric Association in 1975, several teams of physicians and clinical psychologists have started work in various fields of psychosomatic medicine. Some inpatient and outpatient psychosomatic wards and units were opened. Pre- and postgraduate training in psychosomatics and behavioral medicine have started. Future developments of psychosomatic health care in Czechoslovakia will require the integration of the psychosomatic approach and the bio-psychosocial model of disease into primary health care and other bio-medical disciplines. Psychosocial theory must be incorporated into prevention, diagnosis, treatment and rehabilitation of all diseases using the method of liaison psychiatry, along with the further institutionalization of psychosomatic care.
Cross-Cultural Comparison↗
[Nosocomial infections in surgical and orthopedic departments in Czechoslovakia].
In both the Czech and Slovak Republic since 1982 several prevalence investigations nosocomial infections were made. In the present work the authors submit an analysis of the most frequent nosocomial infections in surgical and orthopaedic departments in Czechoslovakia. They recorded a 11.7% prevalence of nosocomial infections in surgical departments in Czechoslovakia (14.0% in the Czech Republic and 8.1% in the Slovak Republic) and 8.0% in orthopaedic departments, both in the Czech and Slovak Republic. Almost 7% of the revealed nosocomial infections were wound infections, 13.5% were infections of the urinary pathways and 13.6% respiratory infection. In some 10% of the patients the wounds were suppurative. After a so-celled clean operations the wound was suppurative in 7.3%, in orthopaedic departments in 5.9% of the patients. The incidence of infections of clean surgical wounds above 2.0% should be "the reason for deeper interest in an epidemiological investigation".
Cross Infection↗
Some epidemiological characteristics of pneumonia in Czechoslovakia and several neighbouring countries from the aspect of mortality rates.
The authors evaluated the dynamics of mortality rates due to pneumonia in Czechoslovakia and several neighbouring countries over the period of 1974 to 1985. The relative risk of death and proportional mortality rates were calculated and epidemiological curves plotted using data provided by the World Health Organization. It is concluded that during the period in question there was no positive change in the dynamics of mortality rates in Czechoslovakia. Particular attention should be paid to persons in the age group of 75 and more years, where the relative risk of death is at least 4 times greater than in the general population.
Aged↗
Contribution of clinical pharmacology to a rational use of cardiac glycosides in Czechoslovakia.
In Czechoslovakia, drug utilization studies showed that oral forms of digoxin and lanatoside C are traditionally the most prescribed cardiac glycosides. Our study of the relative bioavailability of the oral form of lanatoside C revealed that the drug has a low and irregular bioavailability making use of this frequently prescribed drug non-rational. The above data definitely contributed to a sharp decrease in the use of the oral form of lanatoside C in our country, which is in agreement with consumption trends in other European countries. However, the use of only drug forms with a good bioavailability is one aspect of new approaches applied in pharmacotherapy with cardiac glycosides resulting in gradual decrease of their consumption as a pharmacological group. Clinical pharmacological evaluation of individual drug forms and postgraduate education in clinical pharmacology of cardiac glycosides contribute significantly--apart from other regulatory measures--to a more rational use of cardiac glycosides in Czechoslovakia.
Biological Availability↗
Some epidemiological outlooks on cancer mortality in Czechoslovakia.
Study of the total mortality evolution of the population in Czechoslovakia indicated the steadily increasing and recently 20% participation of the malignant neoplasms and their leading, second position among main causes of deaths. The crude cancer mortality rates of all sites showed in the period 1946--1975 substantial increase more expressed in males, while the pattern of age-adjusted mortality rates of men were lower and in the women remained quite stable during the whole evaluated period. Cancer mortality in this period was characterized also with increasing overmortality of men. Analysis of age-specific death rates revealed not only higher mortality of males but also the shifting of the peaks to older age groups in both sexes. The malignant neoplasms of lung, stomach, prostate and rectum in men and the tumors of breast, stomach, colon, rectum and of genital organs in women were the most important individual sites. Finally, the actual cancer mortality rates of all sites in Czechoslovakia were compared with those of some European countries.
Adolescent↗
Protozoan parasites of carp (Cyprinus carpio L.): a comparative study of their occurrence in Bulgaria and Czechoslovakia, with the description of Trichodina perforata sp.N.
In the course of a long-term study of protozoan parasites of carp (Cyprinus carpio L.), a total of 27 protozoan species were discovered in Czechoslovakia and 26 species on the Bulgarian territory. Their list is supplemented with remarks on their pathogenicity, frequency of occurrence and morphology. There is no essential difference in the constituents of protozoan parasitofauna of carp between the two territories studied; a very similar fauna of protozoans can be anticipated on carp in other European regions. A new species, Trichodina perforata sp.n. is described from carps on Bulgarian territory; it is absent in Czechoslovakia. It is characterized by very thin, obliquely set thorns of denticles and by perforations in denticel blades. Throughout the area of the present distribution of the carp, records of its protozoan parasites include a total of 76 determined species, 6 parasites determined only to the generic level and 8 facultatively parasitic ciliates. Attention is drawn to several pathogenic species, which constitute a potential threat to carpiculture in Europe.
Animals↗
[Detection and dispensary care of groups of persons at increased risk of bronchogenic cancer disease in Czechoslovakia].
Epidemiological and clinical studies organized by the Tuberculosis and Respiratory Diseases Research Institute, Prague, revealed that the main high-risk factors associated with the incidence of lung cancer in Czechoslovakia are as follows: are and sex, heavy cigarette smoking, persistent cough, expectoration and other symptoms of chronic respiratory disease, and lung lesions of tuberculosis or probably tuberculosis origin. The methods used in Czechoslovakia for lung cancer detection include photofluorography, which has been combined in some investigations with a standard questionnaire eliciting smoking habits and symptoms of respiratory disease. Cytological sputum investigation in suspicion to lung cancer was found to be a useful contribution to the diagnosis. The systematic dispensary control of persons with bronchogenic carcinoma or at high risk for this disease is provided by polyclinic Departments for Tuberculosis and Respiratory Diseases of the District Institutes of National Health in collaboration with general physicians, oncological and other specialized departments. Further studies on methods for detection and dispensary control of lung cancer high-risk groups represent an important research task.
Adolescent↗
[Development of the tuberculosis situation in Czechoslovakia in 1966--1974 (author's transl)].
There were declining trends of main epidemiological indices of tuberculosis in Czechoslovakia from 1966 to 1974 (Fig. 1 and 2). The smallest average yearly decrease of 4.9% was in the incidence of newly detected cases of active tuberculosis, the largest one of 21.6% in the prevalence of "tuberculous chronics" excreting tubercle bacilli in the last two years or longer. The total of newly detected cases of active tuberculosis and relapses per 100,000 inhabitants of corresponding groups of sex and age decreased in 1966--1974 in nearly all age groups of both sexes, the highest rates being in persons aged 45 years and over (Fig. 3). The participation of corresponding groups of population in BCG vaccination procedures was very high at the national scale during 1966--1974. The highest relative number of active cases of respiratory tuberculosis newly detected by photofluorography per 100,000 examinees of the appropriate group was found in persons with "fibrotic" lung lesions, less in persons investigated for their symptoms, still less in contacts with tuberculosis cases and least in persons not registered for lung lesions and investigated in mass X-ray examinations. The number of beds in institutions for special care of tuberculosis and respiratory diseases per 1,000 population by the end of the corresponding year decreased in Czechoslovakia from 1.1 in 1966 to 0.8 in 1974. The decrease of rates of tuberculous patients was accompanied by a decrease of the number of cases under ambulatory chemotherapy of tuberculosis. At the same time there was an increase in the number of cases treated for nontuberculous respiratory diseases in out-patients' and in-patients' departments of tuberculosis and respiratory diseases. In spite of the favourable epidemiological development of tuberculosis there remain large groups of the population -- especially in middle and higher age groups -- infected with tuberculosis in the past in which new cases of active tuberculosis may appear.
Adolescent↗
Alkaptonuria in the Trencín District of Czechoslovakia.
For several years the Clinical Genetics Research Laboratory at Martin, Czechoslovakia, has been studying alkaptonuria (AU) in the northern part of the District of Trencín in Slovakia. These affected individuals are part of a group of 103 alkaptonurics originated mostly in the mountainous parts of Slovakia. We report results of pedigree analyses; population and affected-family biochemical urine screening; estimation of inbreeding coefficient, of exogamy rate and of average marital distance and of calculation of the frequency of the AU allele, and of homozygotes and heterozygotes in this portion of the Trencín District. Twelve homozygotes were found, but seven originated from a single hamlet in which a founder effect - genetic drift and inbreeding - are thought to account for the high prevalence of AU.
Alkaptonuria↗