Prague, Czech Republic
Prague, Czech Republic

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Bencko V.,Ustav hygieny a epidemiologie | Prikazska M.,Statni zdravotni ustav
Prakticky Lekar | Year: 2010

The most common food-borne infections in the Czech Republic are salmonellosis and campylobacteriosis. The number of reported salmonellosis cases has declined in recent years, while campylobacteriosis has been reported with increasing frequency since 1985 and has become the leading intestinal disease in many European countries. The highest age-specific incidence rates of salmonellosis have been observed in 0 and 1-4 year-old outpatients and in older hospitalised patients with other underlying diseases. The most frequent causative agent is Salmonella Enteritidis. The suspected vehicle can be best traced in outbreaks. Most Salmonella outbreaks are associated with collective catering (school and business canteens, etc.) and family celebrations where home-made pastries and specialities and products containing eggs and mayonnaise are commonly served. Campylobacteriosis, which is most frequently caused by Campylobacter jejuni, has shown the greatest increase in the youngest age groups (0 and 1-4-year-olds), which suggests poorer hygiene in food processing and handling (particularly in households). The most commonly suspected vehicles of infection are chicken and minced meat. Recently, attention has been paid to listeriosis cases and outbreaks. A relatively high fatality rate of 20-30 % has been reported in immune-compromised individuals (patients with other underlying diseases such as malignancies and immunosuppressed patients), particularly in higher age groups. In the Czech Republic, an increase in hepatitis E following a primary food-borne infection has been observed, independently of imported sources. Food-borne viral infections have also shown an upward trend. Bacterial food intoxications included in food-borne infections are caused by toxin producers, with botulinum toxin and toxins produced by some strains of golden Staphylococcus being clinically most important.


Kralikova E.,Ustav Hygieny A Epidemiologie | Kmetova A.,Ustav Hygieny A Epidemiologie
Casopis Lekaru Ceskych | Year: 2013

Current research concerning tobacco health impact revealed clear conclusions: both active and passive smoking cause diseases and premature death. No more research in this field is needed: we just need to eliminate tobacco from the society. Research outputs which have not been used represent wasting of resources. The evidence we have should be used to add more countries on the list of those with detailed End Game plans, like Finland, New Zealand or Australia. It means to decrease tobacco availability, protect population from tobacco smoke exposition, and support broadly available treatment of tobacco dependence.


The key obstacle in contemporary medicine consists in rapidly growing financial demands of diagnostic techniques and frequently expensive modern drugs. Their undoubted effectiveness presents itself through an increase in life expectancy, especially of men in the past two decades in the Czech Republic. Due to the rapid growth in financial demands of the therapy, primary prevention, thus preventing disease, found itself in the role of a Cinderella. Why? Without a doubt will useful investments pay off, yet unfortunately in such a long time in which several political leaderships may rotate. This is one of the main reasons, why attempts for a primary prevention are often left aside. When realized, they are frequently just in a form of a limited campaign. The paradox of today's era is, and one can't exclude that in the near future, a situation may appear, in which the costs of patient therapy will set such high demands on society, that politicians will finally critically understand the importance of investing into primary prevention. This concerns cardiovascular diseases including hypertension and diabetes type II, which go hand in hand with today's plague -obesity, just like as the primary prevention of malignant neoplasms and other growing problems of general public's health. This also includes e.g. osteoporosis and neuro-degenerative diseases linked to the increasing age of our population. Last but not least there is the field of highly desired preventive activities in stomatology branch. The neglected dental caries and paradontosis related problems directly and quite negatively affect the quality of our life. The challenge of 21st century medicine is the anticipation of diseases and their primary prevention as an substantial, elementary contribution towards increasing the quality of life of not only our, but for coming generations as well.


Zeleny T.,Institute Ekonomickych Studii | Bencko V.,Ustav Hygieny A Epidemiologie
Prakticky Lekar | Year: 2011

This article analyses two attributes of health care systems. The first is the continual growth of health expenditure seen right across the western world; and the second is the efficiency of mixed health care systems in select countries, of which combined healthcare financing is one, with significant private and public sector involvement. The countries that have been selected are the - USA (as the country with the highest influence of the private sector in health care), - France (with its middling influence), and - Japan, where the private sector is allowed input into health care but is very strictly regulated by a zero profit rule. The result is that the systems with greater private sector influence tend to have lesser occupancy, worse quality factors and significantly higher expenditure. This suggests the hypothesis that the influence of the private sector on health care is negatively correlated to its efficiency. The confirmation or refutal of this hypothesis is left for further more detailed analysis.


Zvolsky M.,Ustav zdravotnickych informaci a statistiky Ceske republiky | Nechanska B.,Ustav zdravotnickych informaci a statistiky Ceske republiky | Kralikova E.,Ustav hygieny a epidemiologie
Casopis Lekaru Ceskych | Year: 2012

Background. According to the International Statistical Classification of Diseases and Related Health Problems 10th Revision, tobacco dependence is coded by group F17 - Mental and behavioral disorders due to use of tobacco. There are other codes for diagnoses and conditions associated with tobacco use. The aim of our analysis was to determine how often these codes are reported in clinical practice. Methods and results. We observed the incidence of diagnoses F17, P04.2, Z72.0 or T65.2 in years 2002-2011 in hospitalized patients and the F17 diagnosis in patients of psychiatric health facilities. According to data from the Institute of Health Information and Statistics of the Czech Republic diagnoses indicating smoking patients were reported in 1.5% of hospitalized patients in 2011, although the prevalence of smoking in the population is around 30% in last 15 years. Smoking-related diagnoses were reported in 2.1% of cases in Internal medicine departments. Codes F17, T65.2 and Z72.0 occurred as an accessory diagnose in vascular brain disease in 1.8% of hospitalizations and for respiratory tract neoplasms (dg. C32-C34) it was 7.1% of hospitalizations. Conclusions. These results demonstrate the underestimation of the importance of smoking and its relationship to clinical disciplines. Although it is one of the most common diseases in the population with a direct relation to fatal diseases of civilization, the information on its incidence is not used in clinical practice. © 2008-2013 MeDitorial. © 2008-2013 MeDitorial.


Vocka M.,Ustav Hygieny A Epidemiologie | Bencko V.,Ustav Hygieny A Epidemiologie
Prakticky Lekar | Year: 2010

Colorectal cancer is one of the most common malignant neoplasms in the Czech Republic. 7,801 new cases of colorectal cancer were diagnosed in the country in 2006. This means that Czech males are ranked 2nd, and Czech females ranked 5th in Europe for the incidence of this type of cancer. Moreover, colorectal cancer is one of the most common causes of death by cancer patients in the Czech Republic. Nutrition plays a key role in the aetiopathogenesis of sporadic colorectal cancer, mainly the excessive consumption of red and processed meat. Fish has a protective effect on the colon and the consumption of poultry is not associated with any change of risk assessment. Proteins in meat influence the level of endogenous nitrosocompounds which originate from the digestion of HEM iron or proteins, heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAUs) formed in meat during food processing at high temperatures, or increase of polyamine levels (putrescine, spermidine, spermine). Gene polymorphism of enzymes is also involved in the metabolism of HCAs and PAUs. Meat is also the main source of one important amino acid in carcinogenesis, arginine. Arginine is a key amino acid in two pathways: - one mediated by inducible NO-synthase II, and - the second pathway leads to the formation of ornithine, a precursor for putrescine formation (first step in polyamine synthesis). Polyamines regulate gene expression and modulate signal transduction. They can alter the regulation of cell proliferation resulting in development of colorectal cancer. In terms of primary prevention is very desirable to restrict consumption of red and processed meat, especially smoked or otherwise modified and increase the intake of fish, which is thought to have a protective effect.


Vaccination is one of the most important achievements in the field of prevention of infectious diseases, which in the 19th century were one of the most common causes of death in Europe, and still in the developing world are the major cause of mortality especially in child population. Vaccination is one of the few activities in the area of disease prevention fulfilling all the conditions required by contemporary medicine "based on evidence" and his questioning is to some extent a fashion, but utterly undesirable phenomena of the postmodern society, emphasizing individual freedom in decision making without the necessary balance its duties and responsibilities, in terms of the principle of solidarity to the society in which he lives.


The traditional approaches and study designs in cancer epidemiology have not been very successful in identifying and evaluating adequately the potential risk and/or protective factors associated with the disease. The main reasons for the failure were often due to not relevant care to principles of validity of study pattern, small study sample size, and inadequate exposure data. In this paper, issues and approaches relevant to these two challenges are discussed. Multicentre study were proposed as a way to increase study size and to mitigate criticism about meta-analysis of independent studies. A multicentre study of large cohort or case-control studies also offers an exciting opportunity to study the contribution of genomics, epigenomics and metabolomics events that may be causally associated with life-style and environmental risk factors for human health. Optimizing methods for exposure assessment and how to reduce exposure misclassification represent a difficult component in epidemiology studies. A potentially useful approach for improving exposure estimate is to rely on biomarkers of exposures. Finally, it is argued that risk assessment and the precautionary principle should not be viewed as conflicting paradigms but, rather, as a complementary approach for developing appropriate policies to address risks posed by human exposure to carcinogens and a wide spectrum of other health hazards.


Bencko V.,Ustav hygieny a epidemiologie | Chlibek R.,Fakulta vojenskeho zdravotnictvi
Pediatrie pro Praxi | Year: 2015

Vaccination is one of a most important achievements in the field of prevention of infectious diseases, which in the 19th century were one of the most common causes of death in Europe, and still in the developing world are a major cause of mortality especially in child population. Vaccination is one of the few activities in the area of disease prevention fulfilling all the conditions required by contemporary medicine "based on evidence" and his questioning is to some extent a fashion, but utterly undesirable phenomena of the postmodern society, emphasizing individual freedom in decision making without the necessary balance its duties and responsibilities, in terms of the principle of solidarity to the society in which he lives.


Medicine is a specific area that draws not only on empirical knowledge of sciences but also on principles from the humanities, and the fact that health and disease are not only exclusively categorised as natural science but as value based entities where it is necessary to maintain proportionality between the legitimate requirements of biomedical research and ethical requirements and the moral imperatives of medical practice. It is here that we find the niche for ethics and ethical approaches to solving unclear or disputed issues of our actions; questions that are very sensitively perceived by the public, often leading to a loss of confidence in both health care professionals and the health system but also in the whole social system as such. Ethical principles in medicine, including hygiene and epidemiology are based on two basic assumptions: the first is the professional ethic of responsibility, which ensures quality of care with a high degree of expertise from assisting physicians and prevention of possible harm (primum non nocere) and the second is the right to self-determination (individual autonomy) with the right to be informed. It likewise comprises informed consent based on clear information regarding planned diagnostic procedures, therapeutic and preventive measure and informed consent regarding epidemiological studies in which patient's cooperation is requested. The paper deals with methodological questions of ethical approaches to health related problems, stressing problems related to infections and chronic noncommunicable diseases of high incidence with a view to preventive measures.

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