[Twelve years of continuing medical education in Slovakia]. / 12 rokov kontinuálneho medicínskeho vzdelávania na Slovensku.

Continuing medical education (CME) is an important part of the medical practice today. After the pregraduate and postgraduate education each general practitioner and specialist should follow the CME to maintain, develop or increase the knowledge and professional skills. In May of 2004 a Slovak accreditation council for continuing medical education (SACCME) was established on the base of mutual agreement among statutory representatives of Slovak Medical University, Association of Medical Schools, Slovak Medical Association, Slovak Medical Chamber, and Association of Private Physicians as non governmental non for profit organisations. During the period of 2004-2009, the number of accredited events (educational meetings, conferences and congresses) increased from 133 to 938 including the autodidactic tests in medical journals. From the beginning of 2009, SACCME credits obtained by physicians yearly are being transferred to the database of Slovak medical chamber which is responsible by law for control of CME process.

[Epidemiologic and microbiological aspects of mycobacteriosis in Slovakia--Mycobacterium szulgai]. / Epidemiologické a mikrobiologické aspekty mykobakterióz na Slovensku--M. 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.)

Pulmonary complications in patients with inflammatory bowel disease.

BACKGROUND/AIMS: Between 1996 and 1998 we investigated the occurrence of lung disorders in 82 patients with inflammatory bowel disease (30 patients with ulcerative colitis and 52 patients with Crohn's disease) and a control group of 60 subjects. The aim of our study was to determine the occurrence of pulmonary complications in patients with inflammatory bowel disease, to investigate whether ulcerative colitis or Crohn's disease are connected with a typical lung function disorder, with the inflammatory activity of the disease or if they depend on the presence of other extraintestinal manifestations. METHODOLOGY: We investigated the occurrence of lung disorders in terms of the following parameters: clinical pulmonary symptoms, chest radiography and pulmonary function tests (body plethysmography, pneumotachography, lung transfer capacity for carbon monoxide, and blood gas analysis). RESULTS: Lung function abnormalities were significantly more frequent in patients with inflammatory bowel disease as compared to controls (p<0.001). There was no apparent correlation between these abnormalities and either bowel disease activity or drug administration (sulphasalazine, mesalazine). CONCLUSIONS: Despite the lack of radiological abnormalities, we identified a high incidence of pulmonary function abnormalities (suspicious of interstitial lung disorder) in patients with inflammatory bowel disease; 56.7% of patients with ulcerative colitis and 57.7% of patients with Crohn's disease had reduced lung transfer factor.

[Changes in respiratory mechanics after cardiac surgery]. / Zmeny mechaniky dýchania po operáchii srdca.

Cardiac surgery involves a complex of factors adversely affecting the pulmonary function (PF). Among them mainly pleurotomy and hypothermic phrenic nerve injury may potentially deteriorate postoperative PF. In a prospective study of 236 patients undergoing cardiac surgery, pre-, early and late postoperative PFs were evaluated. The impact of different techniques of coronary artery bypass grafting, of pleurotomy and diaphragmatic dysfunction and the effect of COPD on the postoperative modification of PF was investigated. The analysis revealed a substantial impairment of postoperative PF especially when pleural cavity was entered, the patients had COPD history, diaphragmatic dysfunction, or multiple pulmonary complications were present. These aspects should be considered in optimizing the pre-, per- and postoperative management of cardiac patients. (Tab. 5, Fig. 6, Ref. 34.)

[Epidemiologic and microbiologic aspects of mycobacteriosis in Slovakia--M. xenopi]. / Epidemiologické a mikrobiologické aspekty mykobakterióz na Slovensku--M. xenopi.

The first mycobacterioses caused by M. xenopi in Slovakia were discovered in the year 1979. Gradually they became the most often occurring mycobacterioses caused by facultative pathogenic mycobacteria. The purpose of investigation is to describe epidemiological situation of diseases caused by M. xenopi in Slovakia and to confront it with the situation in chosen developed countries. The methodology of this paper is based upon surveillance of tuberculosis as applied on mycobacterioses. During the period of last 10 years 960 isolations of M. xenopi from 622 persons were registered in Slovakia. Pulmonary mycobacterioses caused by M. xenopi was discovered in 58 persons until the end of the year 1966, 48 of them are men and 10 are women. The most often transmission factor is water in water supply mainly in city-habitation and hospital environment. The occurrence has endemic character. (Ref. 31.)

[Epidemiologic and microbiologic aspects of mycobacteriosis in Slovakia. M. fortuitum]. / Epidemiologické a mikrobiologické aspekty mykobakterióz na Slovensku. 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.)

Contribution to the problem of occurrence of tuberculosis in patients with systemic lupus erythematosus.

The association of SLE with tuberculosis (TB) was studied in a group of 388 patients with SLE monitored between 1953-1994. TB was diagnosed in 14 patients (3.6%). The occurrence of septic fevers in SLE patients that did not respond to glucocorticoid therapy indicated the possibility of complication with TB. SLE-associated TB included miliary and far-advanced pulmonary and extrapulmonary forms. Three patients from our group died due to myco-bacterial infection and one patient died of active SLE and TB. The treatment was successful in nine patients. Early diagnosis and appropriate management are mandatory in SLE associated TB, which otherwise may have a potentially fatal outcome.

[Epidemiologic and microbiologic aspects of mycobacteriosis in Slovakia]. / Epidemiologické a mikrobiologické aspekty mykobakterióz na Slovensku--M. kansasii.

Mycobacterioses are diseases caused by mycobacteria other than those that induce the classical tuberculosis: M. tbc (previously to as "human" type) and M. bovis (previously to as "bovine" type of mycobacteria). The purpose of this paper is to confront the limited knowledge about the epidemiology of this disease abroad with the information obtained in Slovakia. The methodology of this paper is based upon the surveillance of tuberculosis as applied on mycobacterioses. Pulmonary mycobacteriosis caused by M. kansasii was diagnosed in 51 subjects in Slovakia within the period 1979-1993: 47 men and 4 women. The average age of men was 47 and of women 55 years. The highest incidence of the disease was observed in Central Slovakia (25 subjects), followed by Eastern Slovakia (18 subjects) and Western Slovakia (8 subjects). Geographic distribution coincides with the profession of Slovak miners who work either in the Slovak mining area or in Ostrava-Karviná mining complex. Miners accounted for 20 out of 51 patients. Apart from preventive measures applied in tuberculosis caused by M. tbc, it is vitally important to pay great attention to the prevention and treatment of pneumoconioses and chronic obstructive bronchitis. Both miners and heavy smokers should avoid working in an environment where M. kansasii is present. Examinations within the focus of the disease should be targeted at the working environment (Ref. 13.).

[Epidemiologic and microbiologic aspects of mycobacteriosis in Slovakia. M. avium complex]. / Epidemiologické a mikrobiologické aspekty mykobakterióz na Slovensku. M. avium komplex.

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.)

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.

[Activity of the Department of Clinical Epidemiology during the 25 years of its existence in the clinical arena]. / Skúsenosti s cinnost'ou oddelenia klinickej epidemiológie po 25 rokoch jeho existencie v klinickom zariadení.

Twenty-five years ago in the Institute of Tuberculosis and Respiratory Diseases in Bratislava was created a Department of Clinical Epidemiology. It was the first department to bear this title. The authors analyze the activity of this department. They paid special attention not only to quantitative characteristics of the gained results, but also to the description of the used strategy in inserting clinical epidemiology into practice of institutions of therapy and prevention. After the lapse of 25 years the authors consider the establishment of the mentioned department as a correct decision which led to qualitative improvement and more effective activity of the Institute. (Ref. 8.)

[Incidence and characteristics of bronchial asthma in a selected region in the Slovak Republic]. / Výskyt a charakteristika bronchiálnej astmy vo vybranej územnej oblasti Slovenskej republiky.

In a selected area comprising five districts with a population of 744,762 the authors analyzed a group of 2168 cases of confirmed bronchial asthma. The number of women predominated (61.10%). The highest frequency of asthma was in the age group between 35 and 44 years. As to the type, the mixed type of asthma predominated (61%). Impaired pulmonary function was recorded in 46% of the patients. The condition was found most frequently in workers (40.5%). 62% of the investigated group of patients was treated with Intal, Zaditen, Berotec or a combination of these drugs.

[Pulmonary function in heart surgery patients]. / Funkcia pl'úc u kardiochirurgických pacientov.

In patients undergoing open-heart surgery pulmonary functions can be deranged by primary cardiac disorders, associated chronic pulmonary disease, as well as by other factors, such as obesity and smoking. Cardiac surgery involves a complex of several factors adversely affecting pulmonary functions, i.e. the cardiosurgical procedure itself, extracorporeal circulation, anesthesia, postoperative pain, delayed chest physiotherapy, immobilization of the patient. There is a direct correlation between pulmonary functions and postoperative pulmonary complications. The paper analyzes postoperative pulmonary complications and their causes, as well as possibilities of identifying of the patients at risk, and it evaluates the value of pulmonary function testing in this process. The possibilities of prophylaxis and prevention of pulmonary complications in the preoperative, peroperative, and postoperative period are surveyed.

Reference values and modelling of lung function development as a transcendent function of age, body height and mass.

We present new lung function reference values based on an investigation of 1024 healthy subjects aged 6-81 years. The dependent variables, i.e. VC, FEV1, RV, FRC, TLC, PEF, MEF50 and MEF25 are expressed as transcendent functions of age, body height and mass. A single equation covers the age range from 6 to 81 years and reflects certain phenomena such as growth, maturation, ageing, sex differences and the undermass-overmass effect. This allows a more accurate determination of individualized reference values and normal limits.