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Biomedical subjects

M Bobák

Publications and source records attributed to M Bobák.

At least 19 recordsLinked to original sources
PubMed1998

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

OBJECTIVES: To compare plasma levels of antioxidant vitamins in the Czech population with those in a western European population, and to investigate whether plasma levels of antioxidant vitamins in Czech population are related to risk of MI. DESIGN: The study has two parts: a cross-sectional survey and a population based case-control study. SETTING: Adult population in two districts of the Czech Republic, and London based civil servants group as the comparison. SUBJECTS: A random sample of men and women aged 25-64y resident in two districts were selected for the cross- sectional survey. Subjects in the age group 40-49 y were compared to a sample of British civil servants of the same age enrolled in the Whitehall II Study. Men in the Czech sample served as controls to 52 male cases of first non-fatal myocardial infarction (MI) which occurred in the same population. Plasma samples were obtained from venepuncture during an interview in hospital in the population sample and immediately after hospitalization in the MI cases. MAIN OUTCOME MEASURES: Plasma levels of beta-carotene and alpha-tocopherol, and the event of MI. Identical protocol and one laboratory was used for all analyses. RESULTS: The mean plasma levels of beta-carotene and alpha-tocopherol in healthy Czech men and women were substantially lower than in a subsample of British civil servants examined in the same laboratory. Smoking was strongly related to beta-carotene in both populations but differences between Czechs and Brits were present in both smokers and non-smokers. In the case-control study among Czech men, low levels of the vitamins were strongly related to an increases risk of MI. Age-adjusted odds ratios for concentrations below the median were 3.33 (95% confidence interval 1.43-8.33) for beta-carotene and 1.89 (0.94-3.45) for alpha-tocopherol; further adjustment for a range of variables reduced these estimates only slightly. CONCLUSIONS: Plasma concentrations of antioxidants in the Czech population appeared to be very low, and men with low levels of these substances are at increased risk of MI. This indicates that sub-optimal intake of antioxidants or related dietary factors may have played a role in the high rates of coronary heart disease in this population.

Adult↗
PubMed1998

Social variation in size at birth and preterm delivery in the Czech Republic and Sweden, 1989-91.

All livebirths resulting from singleton pregnancies reported to the Czech (n = 380,633) and Swedish (n = 351,775) birth registries in 1989-91 were studied with respect to social variation in birthweight, ponderal index (weight/length at birth3) and preterm delivery. The mean birthweight was significantly lower in the Czech population (3310 g vs. 3522 g, P < 0.001). The mean difference in birthweight between children of mothers with primary and university education was 197 g [95% CI 190, 205] in the Czech and 136 g [95% CI 128, 144] in the Swedish population, adjusted for maternal age, parity and sex of the infant. Mean birthweight was significantly higher in mothers who were married or lived with partners in both countries; the difference was 167 g [95% CI 161, 173] in the Czech Republic (CR) and 86 g [95% CI 78, 94] in Sweden, adjusted for age, parity and sex. The extent of social variation in ponderal index and frequency of preterm birth was also greater in the CR. Between 1989 and 1991, mean birthweight in the CR fell from 3323 g to 3292 g (P < 0.001) and the social differences increased, largely as a result of more rapid worsening in the lower socio-economic groups. There did not appear to be such a decline in birthweight in Sweden. We suggest that the fall in mean birthweight and the increasing social variation in birth outcome in the CR is related to decline and divergence in living standards in 1989-91.

Adolescent↗
PubMed1998

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.

Adult↗
PubMed1998

Association between psychosocial factors at work and nonfatal myocardial infarction in a population-based case-control study in Czech men.

We examined the effect of decision latitude and work demand on risk of myocardial infarction in a former Soviet Bloc country and analyzed whether these factors contributed to the educational gradient in myocardial infarction in this population. We conducted a case-control study among full-time working men in the general population of five districts of the Czech Republic. Cases were 179 men 25-64 years of age with a first nonfatal myocardial infarction diagnosed in selected districts over a 1-year period, and controls were 784 men in the same age group randomly selected from the population register. We used logistic regression to estimate the odds of developing myocardial infarction in relation to self-reported work demand and decision latitude at work and the contribution of these factors as well as standard risk factors to socioeconomic differences in the risk of myocardial infarction. Cases reported lower decision latitude and lower work demand than controls. Age-adjusted odds ratios for the highest vs lowest quartiles of decision latitude and work demand were 0.43 (95% confidence interval = 0.25-0.75) and 0.54 (95% confidence interval = 0.31-0.93), respectively. Further adjustment for coronary risk factors and education did not change these estimates. Decision latitude accounted for part of the association between education and myocardial infarction, and decision latitude and risk factors jointly explained virtually all of it. The association between decision latitude at work and myocardial infarction found in our study is consistent with research in western populations and may partly explain the socioeconomic gradient in myocardial infarction.

Adult↗
PubMed1997

[Decrease in cardiovascular disease mortality in the Czech Republic from 1984 to 1993 and its possible causes].

BACKGROUND: The objective of the investigation was to evaluate the ten-year development of the cardiovascular mortality rate in two population groups in the age bracket from 25 to 64 years, i.e. in subjects living in six districts which participated in the international WHO project MONICA and in the population of the whole Czech Republic. METHODS AND RESULTS: Data on the mortality rate in 1984-1993 for the age group from 25-64 years were provided by the Institute of Health Information and Statistics, information on the prevalence of risk factors was obtained in three cross-sectional studies implemented in six districts as part of the MONICA project in 1985, 1988 and 1992. In the mortality rate per 100,000 population in the six districts the following changes were revealed (in parentheses the values for 1984 and 1993 are given): men - a statistically significant declining trend in the from all caused mortality (849.3-742.5; p < 0.001) and cardiovascular mortality (367.2-280.4; p < 0.001) and cerebrovascular mortality (69.7-44.8; p < 0.001). In the mortality from ischaemic heart disease (215.7-170.6; ns) a declining trend was not recorded. In women aged 25-64 years in the six districts there was a statistically significant decline of the mortality from all caused (359.5-322.1; p < 0.001), the cardiovascular mortality (115.6-100.6; p < 0.001) and cerebrovascular mortality (31.1-23.6; p < 0.001). The mortality from ischaemic heart disease did not change (49.2-48.8; ns). In the population of the Czech Republic in men the following were detected: a drop of the from all caused mortality (907.1-784.8; P < 0.001), the cardiovascular mortality (383.5-308.4; p < 0.001) and cerebrovascular mortality (76.5-55.3; p < 0.001). Also in women of the Czech Republic a decline of the mortality from all caused was recorded (390.1-328.5; p < 0.001), the cardiovascular mortality (135.3-103.8; p < 0.001), ischaemic heart disease (58.0-48.6; p < 0.001) and cerebrovascular mortality (43.5-27.4; p < 0.001). In 1990 an increased cardiovascular mortality was recorded in men different from the trend during 1984-1993, statistically significant in the Czech Republic (p < 0.05) and in the six districts (p < 0.05). The reasons of this trend are not clear. The role of health services in the mortality drop is not clear, although available data indicate their improvement. Favourable changes were found in risk factors: during the period from 1985-1992 the prevalence of hypercholesterolaemia declined significantly in men and women, the prevalence of hypertension in women and the prevalence of smoking in men declined in the six districts. From nationwide data ensues that after 1989 significant changes occurred in the diet of the Czech population. The meat consumption declined by 1993 by 13%, the milk and dairy product consumption by 26.8% the butter consumption by 43.6% the consumption of vegetable fats increased by 16%, of vegetables by 8%, tropical fruit by 43.2%. These changes probably had an impact on the cholesterol level and BMI of the Czech population. CONCLUSIONS: In the declining cardiovascular mortality trend during 1984-1993 the following may have participated: improved medical care, dietary changes, improvement of the risk profile and other, in particular socioeconomic factors. With regard to the close temporal association of the investigated changes it may be assumed that this development is at least partly associated with changes of the political and economic position in the Czech Republic after 1989.

Adult↗
PubMed1997

Association between ambient air concentrations of nitrogen dioxide and respiratory symptoms in children in Prague, Czech Republic. Preliminary results from the Czech part of the SAVIAH Study. Small Area Variation in Air Pollution and Health.

The primary objective of the SAVIAH, a multi-centre study funded by European Union, was to assess new methodology for study of small area health statistics and to implement it in epidemiological health statistics and geography. In Prague, the study has been conducted in two city districts with large variation in air pollution. Data at individual level (health symptoms and socio-economic circumstances of the family) were collected by questionnaires completed by parents of 3680 children aged 7-10 both resident and attending schools within the area (response rate 88%). Aggregated data for geographical areas were available from census and urban planning sources for 692 enumeration districts in the study area which were aggregated into 75 medium sized areas. Outdoor concentrations of nitrogen dioxide (NO2) were monitored by passive samplers. All these data were integrated into a geographic information system (GIS). Spatial distribution of air pollution was estimated by kriging and multiple regression modelling. These models explained about 80% of the variation in air pollution measured by passive samplers. GIS was then used to assign to individuals an exposure based on place of residence and school in order to conduct individual based analyses. Association between NO2 and life-time prevalence of wheezing and/or whistling, and wheezing/whistling in the last 12 months was studied by logistic regression. For both outcomes, school levels of NO2 were positively related to symptoms but home levels of NO2 showed a negative association. Logistic regression at individual level gives similar results as ecological analysis and multilevel modelling. Hierarchical model yielded somewhat wider confidence limits. Adjustment for parental behavioural and socio-economic factors did not affect these estimates substantially. This study demonstrated the power of the GIS methodology in studying the effects of complex environmental factors on respiratory health of children.

Air Pollution↗
PubMed1996

[Relation between socioeconomic factors and mortality in districts in the Czech Republic 1989-1993].

BACKGROUND: Socioeconomic factors have been identified as important determinants of morbidity and mortality in many populations but only few studies examined their importance in the Czech population. The objective of this study was to analyse the relationship between socioeconomic characteristics and mortality in districts of the Czech Republic in 1989-1993. METHODS AND RESULTS: The association between age-standardised mortality (for men and women separately) from all causes, all cancers, lung cancer, cardiovascular and ischaemic heart disease in the age group 35-64 and socioeconomic characteristics of districts reported from the 1991 Census was studied in multiple linear regression. In principle, associations between socioeconomic factors and mortality were similar for all causes of death. Mortality was inversely related to percentage of population with secondary and university education and to proportion of population with any religious denomination. After controlling for other factors, correlation coefficients (r) between all cause mortality and proportion of population with primary education were 0.69 in men and 0.64 in women; for the proportion of population with any religious denomination the r were -0.42 and -0.72, respectively. Relation of mortality to mean of persons per room was stronger in women (r = 0.29) than in men (r = 0.10). Population density was most closely correlated with ischemic heart disease (r = 0.41) in men and 0.43 in women). Available socioeconomic factors explained over 60% of geographical variation in mortality from all causes, more than 50% of variation in cancers and about 40% of variation in ischaemic heart disease. CONCLUSIONS: Although ecological studies do not allow firm identification of causal factors, our results agree well with other studies, and confirm the important effect of socioeconomic factors on health in the Czech population.

Adult↗
PubMed1996

[Is the recent decrease in cholesterolemia in the Czech Republic convincing evidence?].

BACKGROUND: The objective of the study was to evaluate the 8-year trend of serum cholesterol levels in six districts of the Czech Republic, to assess whether the reduction of mean values of total cholesterol recorded during the period between 1985 and 1992 was convincing and to discuss possible causes and consequences of this development. METHODS AND RESULTS: Three cross-sectional surveys of risk factors were implemented in independent random 1% samples of the population aged 25-64 years. In 1985 1256 men (respondence rate 81.5%) and 1317 women (85%) were examined, In 1988 1357 men (85.2%) and 1412 women (88.4%), in 1992 1142 men (73.2%) and 1211 women (76.7%). A detailed check of the deviations in estimations during different time intervals from reference values provided evidence that the analytical method did not have an impact on the revealed changes. In men the mean total cholesterol level was 6.21 (95% confidence limit 6.14-6.28 mmol/l in 1985; 6.29 (6.23-6.35) mmol/l in 1988; 5.99 (5.91-6.06) mmol/l in 1992. In women the mean value of the total cholesterol level was 6.19 (6.12-6.25) mmol/l in 1985; 6.23 (6.17-6.30) mmol/l in 1988; 5.95 (5.88-6.02) mmol/l in 1992. According to variance analysis (ANOVA) the serum cholesterol in 1992 was lower by 0.22 mmol/l (p < 0.0001) than in 1985 and by 0.28 mmol/l (p < 0.0001) lower than in 1988. The drop of cholesterol between 1988-1992 may have been caused by dietary changes recorded in the population. According to nationwide data after 1990 there was a marked drop of the consumption of meat and meat products, milk and dairy products and animal fats, while the consumption of vegetable fats increased. Despite these dietary improvements, in six districts in 1992 fats accounted for 37% of the energy intake, the P/S ratio was only 0.41 in men and 0.46 in women. In these districts in 1992 and 1993 a decline of the standardized mortality rate from IHD in men was recorded. CONCLUSIONS: During an eight-year period the mean serum cholesterol level of men and women decreased significantly in six districts of the Czech Republic. This change was probably associated with a restricted intake of foods which have an impact on the serum cholesterol level.

Adult↗
PubMed1995

[Evaluation of the effectiveness of targeted vaccination with the meningococcal polysaccharide A and C vaccine in one location in the Czech Republic].

In the Czech Republic where meningococcal disease occurred only sporadically for a very long period and Neisseria meningitidis B prevailed, the use of a meningococcal polysaccharide vaccine was never indicated. This situation changed in 1993 when a new clone of Neisseria meningitidis C:2a:P1.2(P1.5) appeared in the Czech Republic, found to be responsible for a new epidemiological and clinical situation. The disease caused by this new clone is more serious, showing a high fatality rate (20%) and frequently an atypical clinical course. In May 1993, the highest age-specific incidence in the most affected locality was established in the age group of 15-19 years (52.1/100,000), while in the whole Czech Republic the respective figure was 2.4. A vaccination campaign focusing on the most affected age group started in this locality at the beginning of June 1993, using a polysaccharide meningococcal vaccine A+C (Mérieux). During two weeks 6191 students of the age group of 15-19 years were vaccinated, i.e. 96% of all students of this age group, 64.5% of the population 15-19 years old and 5.6% of the whole population of this locality. This age targeted vaccination prevented the spread of the meningococcal invasive disease caused by Neisseria meningitidis C in this locality. The decrease in morbidity in this locality is statistically highly significant (p < 0.001). In another affected locality, where vaccination was not age targeted and showed a very low coverage, the incidence of the invasive disease caused by Neisseria meningitidis C did not decrease. During the following period (1993-1994) the new meningococcal clone spread to all regions of the Czech Republic. Active surveillance of meningococcal invasive disease has been conducted with the aim to recognize as early as possible an emerging epidemiological indication for targeted vaccination.

Adolescent↗
PubMed1994

[Relation between educational level and prevalence of cardiovascular risk factors].

BACKGROUND: Although socioeconomic factors are significant predictors of cardiovascular disease risk, their role has not yet been fully elucidated in our country. The objective of the present work was to find out whether they participate, and to what extent, in cardiovascular diseases. METHODS AND RESULTS: We re-analyzed data assembled during the second cross-sectional survey of the MONICA project in 1988: the investigated population, comprising 1349 men and 1407 women, was divided into four age groups (25-34, 35-44, 45-54 and 55-64 years) and into three groups by the highest achieved education (elementary, secondary and university). The age specific prevalence of cigarette smoking, obesity (expressed as BMI), serum cholesterol and blood pressure reading by level of education was investigated. While in the younger age groups--consistent with observations in western countries--an inverse correlation between education and risk factors predominates, in the older age groups this relationship is reversed. The contrast between groups by attained education is manifested most markedly in smoking (men, trend p < 0.001), obesity (women, trend p < 0.001), total cholesterol (men, women, the difference is, however, not statistically significant), and systolic blood pressure in men (trend p < 0.001). In all these risk factors the profile is more favourable in subjects with a higher (university) education. An exception is the lower HDL cholesterol level (p < 0.001) in women with elementary education (in men a reversed relationship, but not statistically significant). The contrast between younger and older age groups was manifested most markedly in smoking and obesity. CONCLUSIONS: The observation supports the hypothesis that gradually a change of the socioeconomic gradient of cardiovascular diseases is taking place. The results indicate that subjects with lower education in the younger age groups and subjects with higher education in the older age groups are a population with an unfavourable risk profile on which preventive programmes should be focused in the first place.

Adult↗
PubMed1994

Socioeconomic factors and height of preschool children in the Czech Republic.

The effect of socioeconomic factors on growth was investigated among 2275 children 3 to 6 years old attending nurseries in the Czech Republic. Measured heights of children were converted into height-for-age z scores. After adjustment for birthweight, parental height, and other socioeconomic variables, only mother's education was independently and significantly associated with children's height; adjusted differences in z scores between children of secondary- and university-educated mothers and children of mothers with only primary education were 0.12 and 0.31, respectively. This is equivalent to 0.5 and 1.5 cm, respectively, for children 5 years old.

Body Height↗
PubMed1994

Socio-economic factors and growth of preschool children attending nurseries in Prague, Czech Republic.

Association between socio-economic circumstances and children's growth was investigated in a cross-sectional study in preschool children attending nurseries in one district in Prague. Data on socio-economic variables and growth were available for 352 children. In presented analysis, height-for-age percentiles are used as the outcome. Education of mothers was most strongly related to growth in unadjusted analysis. Independent contribution of individual factors was then assessed by logistic regression. After adjustment for birth length, parental height, frequency of illness, housing and car ownership, children of mothers with secondary or lower education had about twice the risk of being in lowest tertile of height-for-age (odds ratio 1.91, 95% CI 0.98-3.70) compared with children of mothers with university education. Paradoxically, children from families without a car had lower risk of delayed growth than those from families with a car (odds ratio 0.52, 95% CI 0.28-0.95). Our results suggest that social environment and behaviour rather than material conditions determine the physical growth of preschool children in Prague 10.

Body Height↗
PubMed1990

[Serotyping and subtyping strains of Neisseria meningitidis isolated from patients in Czechoslovakia 1975-1986].

The paper presents results of serotyping and subtyping of 181 strains of N. meningitidis isolated from patients in the CSR during 1975-1988. A new method of whole-cell ELISA with monoclonal antibodies was used. During the investigation period in strains of N. meningitidis serogroup A only serotype 4 was detected (68.4%) and no subtype was found. In N. meningitidis, serogroups B and C, heterogeneity of serotypes and subtypes was found and a relatively high percentage of strains where the type or subtype could not be detected. In N. meningitidis serogroup B serotype 15 (11.0%) and 4 (8.2%) and subtype P1.15 (14.9%) and P1.2 (12.9%) predominated. In N. meningitidis serogroup C serotype 4 (28.8%) and 15 (7.7%) and subtype P1.2 (21.1%) and P1.6 (11.6%) prevailed. This detected heterogeneity of serotypes and subtypes corresponds to the findings of other authors during non-epidemic conditions. The authors present the most frequent combinations of serotypes and subtypes in strains of different serological groups A : 4 : NT, B : NT : P1.2, B : 4 : P1.15, B : 15 : 1.15, B : 15 : NT, C : 4 : NT, C : NT : P1.2. The work confirms the homogeneity of antigenic properties of N. meningitidis strains isolated from one focus.

Antibodies, Monoclonal↗