Cysticercosis in the Czech Republic

The authors report 10 cases of cysticercosis registered by the National Reference Laboratory for tissue helminthiasis. Six Czech citizens and four foreigners contracted the disease. Four of 6 Czech citizens were contaminated abroad. Six patients suffered from nervous manifestations of cysticercosis, 2 from muscular or subcutaneous cysticercosis and 2 patients had an asymptomatic course of the infection. The prerequisite of successful treatment with new anthelmintics is early diagnostics.     

Prevalence of osteoporosis in the Czech Republic

BACKGROUND: The objective of this study was to evaluate the prevalence of osteoporosis and osteopenia in Czech women and men aged 50 to 75 years. METHODS AND RESULTS: Bone mineral density was assessed in an age-stratified random sample of 713 women and 429 men from two cities (Prague and Litom?rice) in the lumbar spine, proximal femur and total body by dual X-ray absorptiometry and in the distal forearm by single X-ray absorptiometry. The proportion of women and men in each age group with bone density below specified levels at any of these skeletal sites was projected to the population structure of the Czech Republic. With advancing age, in women at 55 years and in men at 65 years of age the population with normal bone mineral density becomes smaller, and a greater proportion has osteopenia or osteoporosis. Overall, an estimated 428,000 women and 195,000 men over age 50 have osteoporosis and another 680,000 women and 435,000 men have osteopenia. CONCLUSIONS: The results of this first population-based cross sectional study in the Czech Republic document a high prevalence of osteoporosis and osteopenia which is comparable with that published for the Netherlands and the United States. The results offer a basis for economical considerations in diagnosis, treatment and consequences of osteoporosis.     

Education and health in the Czech Republic

An enzyme linked immunosorbent assay, specific for prothymosin alpha (ProT alpha) was developed using an antibody against the synthetic C-terminal peptide ProT alpha[101-109] and isolated bovine ProT alpha for the preparation of standard solutions and immunoplates. Due to the antibody used, the ELISA developed was capable of fully discriminating between ProT alpha, the naturally occuring and partially homologous peptide parathymosin alpha (ParaT alpha) and the peptide thymosin alpha1 (T alpha1), whose sequence is identical to the [1-28] sequence of ProT alpha, and its in vivo occurrence is under question. Moreover, due to its improved sensitivity, the ELISA was capable of directly determining ProT alpha concentration in human serum and tissue extracts, without any pretreatment of the samples. ProT alpha levels were directly measured in sera obtained from 48 apparently healthy individuals and 27 patients with diagnosed breast cancer and found to range from 0.67 to 2.34 microg/ml (mean value 1.27 +/- 0.49 microg/ml) and from 0.47 to 1.74 microg/ml (mean value 1.02 +/- 0.29 microg/ml), respectively. ProT alpha levels were also measured in four breast tumor and adjacent normal breast tissue extracts and found to be elevated in the tumor extracts.     

Clinical biochemistry in the Czech Republic today

A retrospective analysis of 160 cases of bladder tumors in females revealed that in 9 of these cases cancer in the bladder arose 1 to 22 years after radiation for uterine and breast cancer. This secondary tumor manifested in 2 females as dysuria, in one of them transition cell cancer of the bladder followed Brunno's cystitis 2 years after the cystitis diagnosis. The other patients had macrohematuria. Being a frequent complication of radiotherapy of pelvic cancer, dysuria and macrohematuria should not be considered as a sign of radiation-induced cystitis. Such patients should be carefully followed up with annual microscopic and cytological examinations of residual urine and cystoscopic control.     

Dialysis therapy in the Czech Republic in 1994

1. In 1994 were 81 haemodialysis centers in the Czech Republic (including 12 private ones, i.e. 7.7 p.m.p.). 2. The capacity of dialysis centres enabled an outstanding number of new patients to be accepted--120 p.m.p. (the European average was half that number). Majority of the new patients were from higher age groups and diabetics. The number of patients, who were not followed prior to renal replacement therapy, still remains one third of the newly accepted ones. 3. In 1994 there were 3592 patients on dialysis treatment--342 p.m.p. (the maximum number so far), but by December 31st 1994 there were 2691 patients--256 p.m.p. surviving on dialysis treatment. We have achieved higher number dialysed patients p.m.p. than any other country of the former Eastern bloc, including the GDR. Mortality was 14%. 4. Hepatitis B as well as C remains a major problem, although there has been a slight decline of HBsAg positive patients. 5. The technical facilities for dialysis treatment are not optimal. 6. A favourable trend continued in the development of peritoneal dialysis programme.     

Prevalence study of serious substance abusers in the Czech Republic

The exfoliated cell micronucleus (MN) assay using fluorescent in situ hybridization (FISH) with a centromeric probe is a rapid method for determining the mechanism of MN formation in epithelial tissues exposed to carcinogenic agents. Here, we describe the use of this assay to detect the presence or absence of centromeric DNA in MN induced in vivo by radiation therapy and chronic arsenic (As) ingestion. We examined the buccal cells of an individual receiving 6,500 rads of photon radiation to the head and neck. Exfoliated cells were collected before, during, and after treatment. After radiation exposure a 16.6-fold increase in buccal cell MN frequency was seen. All induced MN were centromere negative (MN-) resulting from chromosome breakage. This finding is consistent with the clastogenic action of radiation and confirmed the reliability of the method. Three weeks post-therapy, MN frequencies returned to baseline. We also applied the assay to exfoliated bladder cells of 18 people chronically exposed to high levels of inorganic arsenic (In-As) in drinking water (average level, 1,312 micrograms As/L) and 18 matched controls (average level, 16 micrograms As/L). The combined increase in MN frequency was 1.8-fold (P = 0.001, Fisher's exact test). Frequencies of micronuclei containing acentric fragments (MN-) and those containing whole chromosomes (MN+) both increased (1.65-fold, P = 0.07, and 1.37-fold, P = 0.15, respectively), suggesting that arsenic may have both clastogenic and weak aneuploidogenic properties in vivo. After stratification on sex, the effect was stronger in male than in female bladder cells. In males the MN- frequency increased 2.06-fold (P = 0.07) while the frequency of MN+ increased 1.86-fold (P = 0.08). In addition, the frequencies of MN- and MN+ were positively associated with urinary arsenic and its metabolites. However, the association was stronger for micronuclei containing acentric fragments. By using FISH with centromeric probes, the mechanism of chemically induced genotoxicity can now be determined in epithelial tissues.     

Parvovirus B19 in the Czech Republic. Seroepidemiologic study

Two rare cases of strabismus resulting from contracture of the extraocular rectus muscles after retrobulbar anesthesia for cataract surgery are described. Clinical signs in both cases suggested that the development of the impaired function of the lateral and superior rectus muscles followed the same pattern: initial stimulation followed by paretic and restrictive stages. Abnormal enlargement of the muscles was identified by computed tomography (CT) and magnetic resonance imaging (MRI). The data indicate that the strabismus was the result of direct injection of anesthetics into the rectus muscle.     

3 years of long-term home oxygen therapy in the Czech Republic

BACKGROUND: Long-term domiciliary oxygen therapy was introduced in the Czech Republic as a standard therapeutic method in patients with chronic respiratory failure in October 1992. As a source of oxygen almost exclusively oxygen concentrators are used which are allocated to the patients according to criteria elaborated by the European Respiratory Society. METHODS AND RESULTS: From October 1, 1992 to October 1, 1995 the mean number of installed concentrators is 10,24/100000 population. From a total of 1064 patients by October 1, 1995 3.8% were treated for three years, 20.7% for two years and 34.4% for more than one year. In the course of three years a total of 490 patients died. The mean survival period of patients treated for prolonged periods by domiciliary oxygen therapy was 8.88 months. The high mortality rate is due to the fact that patients in a very serious state are treated. On account of chronic pulmonary disease oxygen therapy was indicated in 93.4%, on account of interstitial pulmonary processes (KFA and other fibroses) in 3.9, on account of kyphoscoliosis in 2.4% and on account of cystic fibrosis in 0.3% of the group. The mean costs of treatment were 114.40 K?/day which is a third of the costs when the patient is hospitalized. CONCLUSIONS: Domiciliary oxygen therapy proved effective and economical in patients with chronic respiratory failure.     

Urinary and fecal incontinence in geriatric facilities in the Czech Republic

BACKGROUND: Incontinence represents one of the common problems in long-term care geriatric facilities and nursing homes. However, in the Czech Republic data on prevalence, severity and incontinence-associated factors for nursing home residents are not available. The aim of the study was to report the prevalence of urinary (UI) and bowel incontinence (BI) in different geriatric facilities and to identify factors positively associated with incontinence. METHODS AND RESULTS: In a sample of 1162 residents of 18 long-term care facilities UI has been found in 684 residents (63.3%). Health and social care facilities did not differ significantly (60.7 vs 65.6%). Of the incontinent 294 residents (27.2%) suffered from permanent/daily incontinence, 390 (36.1%) from occasional transitory UI. Prevalence of BI reached 54.4%, as well as double incontinence (45.9%). Cognitive impairment, self-care ADL and/or mobility dependency and bed rest are factors significantly associated with UI (for all P < 0.001). However, age, gender and urinary tract infection did not reach the statistical significance (P = 0.280-0.069). Risk adjustment/stratification for UI revealed the prevalence of 33.0% in the low risk group. In the high risk group (high ADL dependency and severe cognitive impairment) the prevalence came up to 96.0%. CONCLUSIONS: Our study presents the first results focused on incontinence problem in long-term care geriatric institutions in the Czech Republic. High prevalence of this condition makes incontinence an important medical, nursing and economical yet neglected problem.     

Present status of minimally invasive surgery in children in the Czech Republic

In an effort to assess the contemporary position of miniinvasive surgery in children the authors addressed a total of 10 departments. They received replies from nine. The report includes thus all important Czech departments concerned with child surgery incl. miniinvasive operations. The group comprises a total of 1,191 laparoscopic operations and 30 thoracoscopies performed between 1994 and February 1997. The total number of complications was 1.1%. The mean percentage of conversions was 3.1%. The authors did not record any major complications with serious harm to the patient.     

Environmental specimen banking in the Czech Republic: a pilot study

In recognition of the importance of environmental specimen banking (ESB) as an important component of the described ongoing real-time environmental and health-related monitoring programmes, a proposal for a planned ESB pilot study in the Czech Republic is presented. Selection of biomonitors, analytes, sampling techniques and sites is discussed, especially with regard to the possible harmonization with ESB already operational abroad. Availability of validated analytical techniques for determination of up to 30 elements using nuclear and spectroscopic techniques, including speciation of several metals, and of the most important organic pollutants employing various chromatographic techniques in biological and environmental samples is demonstrated.     

The occupational disease and injury compensatory system in the Czech Republic

Clinical manifestations of neonatal echovirus type 18 infections include a nonspecific febrile illness, diarrhea, and meningitis with or without exanthem. We report a successful outcome in a case of neonatal sepsis with shock caused by echovirus type 18, a complication not previously associated with this serotype.     

Incidence of renal agenesis in the Czech Republic from 1961 to 1995

An outbreak of cryptosporidiosis occurred at a veterinary hospital, involving multiple species, including humans. The index case was an infected dairy calf that presented with diarrhea. Several other cases of cryptosporidial diarrhea subsequently developed during a 1-month period. The key features of this outbreak were the multiple species affected, the increased morbidity in immunocompromised neonates, and the failure of implemented control measures to contain the disease.     

Increasing social variation in birth outcomes in the Czech Republic after 1989

OBJECTIVES: This study investigated social variation in birth outcome in the Czech Republic after the political changes of 1989. METHODS: Routinely collected records on singleton live births in 1989, 1990, and 1991 (n = 380,633) and 1994, 1995, and 1996 (n = 286,907) were individually linked to death records. RESULTS: Mean birthweight fell from 3,323 g to 3,292 g (P < .001) between 1989 and 1991 and then increased to 3,353 g by 1996. The gap in mean birthweight between mothers with a primary education and those with a university education, adjusted for age, parity, and sex of infants, widened from 182 g (95% confidence interval [CI] = 169, 19) in 1989 to 256 g (95% CI = 240, 272) in 1996. Similar trends were found for preterm births. Postneonatal mortality declined most among the better educated and the married. The odds ratio for postneonatal death for infants of mothers with a primary (vs university) education, adjusted for birthweight, increased from 1.99 (95% CI = 1.52, 2.60) in 1989 through 1991 to 2.39 (95% CI = 1.55, 3.70) in 1994 through 1995. CONCLUSIONS: Despite general improvement in the indices of fetal growth and infant survival in the most recent years, social variation in birth outcome in the Czech Republic has increased.     

Changing patterns of extramarital conceptions in the Czech Republic, 1960-93

Patterns of reproduction associated with extramarital conception are examined using data on non-marital births, marital births occurring during less than 8 months after marriage, and spontaneous and induced abortions experienced by unmarried women. Trends in the incidence and demographic outcomes of conceptions resulting from extramarital coitus are analysed by means of age-specific probabilities of becoming pregnant outside marriage; and of terminating such a pregnancy by abortion, by legitimating it through marriage before confinement, or by having a baby while remaining unmarried. Substantial increases in the proportion of extramaritally conceived pregnancies leading to non-marital births are detected for the period since the late 1980s, and ascribed mainly to rising levels of unmarried cohabitation. The demographic effects of the post-1989 transition from state to market economy are discussed.     

Present state of research on ticks (Ixodoidea) in the Czech Republic

Tick research in the Czech Republic started developing rapidly after World War II and was directed to the faunistics and taxonomy, biology, ecology and behaviour, physiology and genetics, disease transmission, host-parasite relationships and control. Altogether 15 tick species were reported from the territory of the Czech Republic. Most studies in biology, ecology and virus transmission were dedicated to Ixodes ricinus, but biology and ecology of Dermacentor reticulatus, I. laguri and I. hexagonus were also studied. Many studies were done on argasid ticks, mostly on pheromonal communication of Argas persicus and immunology of feeding of A. polonicus. Population variability of both these species was also studied. The present research on ticks is mostly directed to study of interaction among hosts, ticks and pathogens on the humoral, cellular and molecular level.     

Trends in epidemiologic indicators of lung cancer in the Czech Republic 1970-1990

BACKGROUND: Lung cancer is the malignant tumour with the highest mortality in the Czech Republic as well as in highly developed countries of the world. The objective of the present study in an account on the incidence, diagnosis, treatment and mortality in the Czech Republic, at the Pneumological Clinic and the population in the district. METHODS AND RESULTS: The incidence and mortality rate from lung cancer increased during the past twenty years in men by 12% and declined by 2% resp. In women both indicators are steadily rising by 100 and 76% resp. The highest values of incidence and mortality in men were recorded at the end of the seventies and beginning of the eighties. During the investigation period a reduction of the age of those who died from lung cancer-men and women -was found, the increase in the group of 35-49-year-olds is 51% in men and 159% in women. As to histological types, spinocellular carcinoma is still the most frequent type, gradually the small cell type and adenocarcinoma are increasing in numbers. The authors investigated also differences in the epidemiological situation as regards lung cancer in the southern and northern Czech regions and compared the position in this country with that in other European countries. CONCLUSIONS: Despite some positive signals (decline of the lung cancer incidence in men), lung cancer still remains a serious medical and social problem. An alarming feature is in particular the linear rise of lung cancer incidence in women and the shift of deaths from this disease to younger age groups.     

Polyester arterial prostheses. Recent developments from the Czech Republic and Poland

Immune and inflammatory responses must be rightly regulated to maintain a homoeostatic balance between an effective immune response and tissue damage to the host. NO is a principal mediator of many of the cytokine-inducible macrophage activities during a normal cell-mediated immune response. STK, the murine homologue of the human RON receptor tyrosine kinase, is expressed on murine resident peritoneal macrophages. The ligand for STK, macrophage-stimulating protein (MSP), is a serum protein that is activated by members of the coagulation cascade in response to tissue damage. In addition to its potential to induce chemotaxis and phagocytosis of C3bi-coated erythrocytes, MSP has an inhibitory effect on the production of NO by activated peritoneal macrophages in vitro. Here we demonstrate that peritoneal macrophages from mice lacking STK produce elevated levels of NO in response to interferon (IFN)-gamma in a dose-dependent manner, without the need for a co-stimulus. However, production of pro-inflammatory cytokines by activated macrophages from stk -/- mice is unaltered. In vivo, stk -/- mice exhibit increased inflammation in an IFN-gamma-mediated delayed-type hypersensitivity reaction and increased susceptibility to lipopolysaccharide (LPS)-induced endotoxic shock. Furthermore, the levels of NO in the serum of mice injected with LPS are significantly higher than those in control littermates. Nevertheless, the serum levels of IFN-gamma and the intermediate cytokines generated by the inflammatory response, which have previously been shown to play a role in septicaemic shock, do not differ significantly from controls. These data suggest that the STK receptor suppresses NO production, therefore ameliorating the potentially tissue-damaging effects of a cell-mediated immune response, through negative regulation of the IFN-gamma signalling pathway.