Jarmila Pekarcikova | University of Trnava (original) (raw)

Papers by Jarmila Pekarcikova

European Journal of Public Health, Oct 20, 2017

Journal of Epidemiology and Community Health, Sep 1, 2014

Results 3841 unique studies were identified. After screening by title and abstract, 109 full-text... more Results 3841 unique studies were identified. After screening by title and abstract, 109 full-text articles were assessed for eligibility. Eight were included in the final qualitative synthesis. Two RCTs investigated epicondylitis. Six observational studies reported on elbow, forearm, wrist and hand complaints, including specific and non-specific conditions. Study duration ranged from one to seven years and employed diverse outcome measures. Five studies reported on recovery, with results ranging from 34% to 90% case resolution. Three reported on persistent pain, ranging from 10% to 74%. Five studies identified variables associated with poor outcome, including female sex, greater age, longer history of the presenting condition, other regional pain, retreating as a coping strategy and lack of social support. A key limitation arose from the inability to pool data, preventing differentiation of categorical and clinically meaningful prognostic outcomes. Conclusion While results suggest variable prognosis of distal upper limb pain, improvement was frequently reported, regardless of pathological nomenclature. Persistent pain was related to similar prognostic factors across studies. Further investigation is required to consolidate the findings of the current review. However, the results provide a comparative basis for future research investigating prognosis and factors in relation to management strategies. Through characterisation of subgroups experiencing persistent pain, appropriate, targeted treatment pathways may be developed to reduce symptoms and associated healthcare costs.

PLOS ONE, Jan 10, 2018

Between the years 1993 and 2008, mortality rates from coronary heart disease (CHD) in the Slovak ... more Between the years 1993 and 2008, mortality rates from coronary heart disease (CHD) in the Slovak Republic have decreased by almost one quarter. However, this was a smaller decline than in neighbouring countries. The aim of this modelling study was therefore to quantify the contributions of risk factor changes and the use of evidence-based medical therapies to the CHD mortality decline between 1993 and 2008. Methods We identified, obtained and scrutinised the data required for the model. These data detailed trends in the major population cardiovascular risk factors (smoking, blood pressure, total cholesterol, diabetes prevalence, body mass index (BMI) and physical activity levels), and also the uptake of all standard CHD treatments. The main data sources were official statistics (National Health Information Centre and Statistical Office of the Slovak Republic) and national representative studies (AUDIT, SLOVAKS, SLOVASeZ, CINDI, EHES, EHIS). The previously validated IMPACT policy model was then used to combine and integrate these data with effect sizes from published meta-analyses quantifying the effectiveness of specific evidence-based treatments, and population-wide changes in cardiovascular risk factors. Results were expressed as deaths prevented or postponed (DPPs) attributable to risk factor changes or treatments. Uncertainties were explored using sensitivity analyses. Results Between 1993 and 2008 age-adjusted CHD mortality rates in the Slovak Republic (SR) decreased by 23% in men and 26% in women aged 25-74 years. This represented some 1820 fewer CHD deaths in 2008 than expected if mortality rates had not fallen. The IMPACT

Scandinavian Journal of Infectious Diseases, 2005

The aim of this study was to prospectively investigate 120 cases of viridans streptococcal bacter... more The aim of this study was to prospectively investigate 120 cases of viridans streptococcal bacteraemia (VSB) in 117 patients in major university hospitals in Slovakia in 2000-2002 (3 y) for antibacterial susceptibility, risk factors and outcome. From 127 episodes, 16 (13%) of VSB were caused by PEN-R strains and 13 (10%) by ERY-R strains. 32 cases had cancer as underlying disease (20 haematological), 41 had endocarditis and 35 were elderly (>65 y of age) patients. Concerning mortality, 29 of 127 patients died (24%). There were several risk factors associated with mortality. Solid tumour as underlying disease (p<0.02), stroke (p<0.002), concomitant lung infection (p<0.01), endoscopic procedure (p<0.036), intubation (p<0.0008), ventilatory support (p<0.002), and coma (p<0.009) were associated with more deaths. A comparison of 115 bacteraemias to 13 bacteraemias caused by erythromycin-resistant strains of Streptococcus viridans was performed. There were no significant differences in underlying disease, risk factors and mortality. Erythromycin resistance in bacteraemias caused by S. viridans did not have significant impact on outcome of the patients, nor did it show specific relation to analysed risk factors in our study. 14.5% of VSB were cause by PEN-resistant viridans streptococci. Risk factors for penicillin resistance were ventilatory support (p<0.01), intubation (p<0.001) and resistance to other antibiotics: 8 of 16 (50%) of PEN-R VSB were resistant also to erythromycin or cotrimoxazole or tetracycline compared with 9% of PEN-R VSB (p<0.005). Endoscopic procedures in the upper respiratory system were at risk for development of PEN-R VSB. There was also difference in outcome; 71% vs 22.5% (p<0.0002) of cases infected with PEN-R VSB died compared to PEN-S VSB. PEN-R is therefore clinically significant in VSB.

American Journal of Epidemiology, 2005

In Finland since the 1980s, coronary heart disease mortality has declined more than might be pred... more In Finland since the 1980s, coronary heart disease mortality has declined more than might be predicted by risk factor reductions alone. The aim of this study was to assess how much of the decline could be attributed to improved treatments and risk factor reductions. The authors used the cell-based IMPACT mortality model to synthesize effectiveness of treatments and risk factor reductions with data on treatments administered to patients and trends in cardiovascular risk factors in the population. Cardiovascular risk factors were measured in random samples of patients in 1982 (n ¼ 8,501) and 1997 (n ¼ 4,500). Mortality and treatment data were obtained from the National Causes of Death Register, Hospital Discharge Register, social insurance data, and medical records. Estimated and observed changes in coronary heart disease mortality were used as main outcome measures. Between 1982 and 1997, coronary heart disease mortality rates declined by 63%, with 373 fewer deaths in 1997 than expected from baseline mortality rates in 1982. Improved treatments explained approximately 23% of the mortality reduction, and risk factors explained some 53-72% of the reduction. These findings highlight the value of a comprehensive strategy that promotes primary prevention programs and actively supports secondary prevention. It also emphasizes the importance of maximizing population coverage of effective treatments. cardiac surgical procedures; coronary disease; drug therapy; mortality; primary prevention; risk factors Abbreviations: CABG, coronary artery bypass grafting; CHD, coronary heart disease. Coronary heart disease (CHD) mortality has been declining in most developed countries since the 1960s (1). Only a few studies have estimated the extent to which changes in the major cardiovascular risk factors (blood pressure, serum cholesterol, and smoking) can explain the observed changes in mortality (2-4). In Finland, risk factor changes explained almost all of the decline in CHD mortality during the 1970s. However, in the late 1980s and 1990s, mortality declined much faster than might be expected simply from risk factor reductions. Between 1972 and 1992, altogether 80 percent of the reduction in CHD mortality was explained by a decline in the major risk factors: smoking, cholesterol, and blood pressure. The biggest contribution was attributable to a large drop in cholesterol levels (3). New cardiological treatments were increasingly used in the 1980s and 1990s both to treat CHD and to prevent complications. These therapies included coronary artery surgery, angioplasty, thrombolysis, statins, angiotensin-converting enzyme inhibitors, and other medications for secondary prevention and heart failure (5-10). In controlled clinical trials,

Central European Journal of Public Health, 2010

Background: The question of the health status of the unemployed in the Slovak Republic is a relat... more Background: The question of the health status of the unemployed in the Slovak Republic is a relatively unexplored area of study, in spite of the fact that the country has experienced one of the most consistently high unemployment rates among the 27 states of the EU. The aim of the pilot study was to identify the health and the other impacts of unemployment on the population in the region of Zvolen. Methods: two groups of respondents were studied: the long-term unemployed and a control group of the employed. The data was collected using the guided-interview questionnaire procedure. A total of 214 respondents were observed out of which 107 were from the long-term unemployed group and 107 from the control group. There were 83 male (38.8%) and 131 female respondents (61.2%). The average age of the group was 36.0 (CI95% = 33.8-38.3). Results: Using logistic regression, it was established that the chances of finding a job were 1.08 times greater in cases of a higher level of education (OR = 1.08, CI95% = 1.04-1.12, P ≤ 0,001). It was also established that smoking decreases the chances of finding employment by OR = 0.91 (CI95% = 0.83-0.98) times (P ≤ 0.01). People who are employed consume more alcohol attaining OR = 1.28 (CI95% = 1.21-1.35) compared to the unemployed (P ≤ 0.0001). Conclusion: The study proved that even with restricted resources it is possible to obtain credible results comparable with those achieved by more complex studies.

Italian Journal of Public Health, May 16, 2012

Background : To integrate health impact assessment (HIA) into existing decision-making processes ... more Background : To integrate health impact assessment (HIA) into existing decision-making processes requires not only methods and procedures but also well-trained experts, aware policy makers and appropriate institutions. Capacity building is the assistance which is provided to entities, which have a need to develop a certain skill or competence, or for general upgrading of performance ability. If a new technique is planned to be introduced there is a need for capacity building with no respect to levels (local, regional, national, international) or sectors (health, environment, finance, social care, education, etc.). As such, HIA is a new technique for most of the new Member States and accession countries of the European Union. Methods : To equip individuals with the understanding and skills needed to launch a HIA or be aware of the availability of this methodology and to access information, knowledge and training, we focused on the organization of workshops in participating countries. The workshops served also as pilot events to test a “curriculum” for HIA; a set of basic topics and presentations had been developed to be tested during workshops. In spite of classical in-class workshops we aimed to organize e-learning events as a way to over come the “busyness” problem of decision makers. Results : Throughout March – October 2006 we organized and ran 7 workshops in Denmark, Turkey, Lithuania, Poland, Bulgaria, Slovak Republic and Hungary. Participants came from the public health sector (141), non-public health decision makers (113) and public health students (100). A concise curriculum was developed and tested during these workshops. Participants developed a basic understanding of HIA, skills to develop and use their own screening tools as well as scoping.Within the workshop in Denmark we tested an online, real-time Internet based training method; participants highly welcomed this method as it allowed them to take part in training from their workplace, and it did not disturb their daily work. Conclusions : The workshops set a very good baseline for the introduction of HIA in participating countries. The training documents are being translated into their national languages and will be posted on the national HIA web pages of the participating countries. Participating countries have expressed an interest in continuing on with similar workshops on specific issues related to HIA, providing more in-depth training.

The International Journal of Psychiatry in Medicine, 2012

Objective: The patterns of relationships between diabetes and depression in countries of central ... more Objective: The patterns of relationships between diabetes and depression in countries of central and eastern Europe (CEE) might differ from those in countries of western Europe and the United States. Among the reasons are specifics of transitioning healthcare systems (including mental health) and the general social, cultural, and economic background of these countries. The aim of this article is to analyze the prevalence of depression symptoms in patients with diabetes in Slovakia and to identify its predictors. Method: Diabetes patients ( N = 1043) from two diabetes outpatient-care offices were recruited for the study. The Patient Health Questionnaire 9 (PHQ-9) was applied to screen for depression symptoms. Patients were categorized into four categories based on depression symptom severity. Demographic and disease-related factors were analyzed as predictors of depression symptoms. Results: In the univariate analysis, a number of factors were associated with increasing severity of d...

Chemotherapy, 2007

We compared 115 cases of bacteremia caused by erythromycin-sensitive VS with 13 cases of bacterem... more We compared 115 cases of bacteremia caused by erythromycin-sensitive VS with 13 cases of bacteremia caused by erythro-mycin-resistant VS. There were no signifi-cant differences in the underlying disease and source/site of infection in both groups. The only risk factor for ...

Journal of Infection, 2006

Environmental Impact Assessment Review, 2012

Marginalized Roma communities in European countries live in substandard housing conditions the im... more Marginalized Roma communities in European countries live in substandard housing conditions the improvement of which has been one of the major issues of the Decade of Roma Inclusion, the ongoing intergovernmental European Roma program. The paper presents EU-funded health impact assessments of national Roma housing policies and programmes in 3 Central and Eastern European countries in light of the evaluation of a completed local project in a fourth CEE country so as to compare predicted effects to observed ones. Housing was predicted to have beneficial health effects by improving indoor and outdoor conditions, access to services, and socioeconomic conditions. Negative impacts were predicted only in terms of maintenance expenses and housing tenure. However, observed impacts of the completed local project did not fully support predictions especially in terms of social networks, satisfaction with housing and neighbourhood, and inhabitant safety. In order to improve the predictive value of HIA, more evidence should be produced by the careful evaluation of locally implemented housing projects. In addition, current evidence is in favour of planning Roma housing projects at the local rather than at the national level in alignment with the principle of subsidiarity.

European Journal of Trauma and Emergency Surgery

Purpose The association of TBI with socioeconomic characteristics of patients has not been studie... more Purpose The association of TBI with socioeconomic characteristics of patients has not been studied extensively. The objective of this study was to analyse the differences in injury characteristics and outcome in TBI patients based on their occupational status. Methods Data on patients from 13 centres based in Austria, Croatia, Slovakia, Bosnia and Herzegovina, and Macedonia were included in the analysis. Demographic characteristics, injury characteristics, treatment and outcome at various post-injury stages were compared according to occupational status. Logistic regression was used to adjust for the effect of co-variates. ICU mortality, hospital mortality, 6 months mortality, and outcome at 6 months were used as dependent variables. Results Overall, 886 patients were analysed with a mean age of 45.5 years. High-level falls were most prevalent in the bluecollar group (19%), most low-level falls occurred in the retired group. Traffic accidents were most common in students. The injuries were most severe in the blue-collar group and students. Highest mortalities and unfavourable outcomes were in the retired, students and white-collar workers had the best outcomes. Compared to retired patients, all groups had higher odds of favourable outcome at 6 months after adjusting for co-variates-OR from 2.2 (95% CI 1.1-4.6) for entrepreneurs to 3.6 (95% CI 1.8-7.2) for the blue-collar group. Conclusion Our paper provides clues pertaining specifically to variations in patterns and outcomes of TBI according to occupational status which can inform prevention and planning of services and can serve to plan priorities for further research.

Wiesław Koźlak: Badania układów "szkła wodne sodowe-wybrane sole ołowiu" dla oceny możliwości zas... more Wiesław Koźlak: Badania układów "szkła wodne sodowe-wybrane sole ołowiu" dla oceny możliwości zastosowania krzemianów do usuwania 2+ jonów Pb z zanieczyszczonych ekosystemów wodnych-Studies on the systems containing sodium water glasses and selected lead salts in

European Journal of Epidemiology

Bratislavské lekárske listy, 2009

The aim of this study was to describe the relationship between smoking habits and socioeconomic d... more The aim of this study was to describe the relationship between smoking habits and socioeconomic determinants among adolescents. Tobacco use among young people is a formidable social health concern. The aim of this paper is to describe the situation in selected localities surveyed, and to elucidate the relations among experiments with tobacco in adolescent youth and behaviour of parents, friends and teachers and media influence. Thd objectives of this study are to describe patterns of self-reported smoking and to describe the association of trying smoking with other variables, such as social, or socio-demographics among a sample of young students. Global Youth Tobacco Survey to track tobacco use among youth across countries using a common methodology and core questionnaire. In Slovakia, GYTS was carried out at the turn of 2002 to 2003. A total of 4.594 students participated in the study. The results indicate that the majority of the students (74.3%) have tried smoking where both pare...

Central European journal of public health, 2013

Cardiovascular diseases (CVD) and especially coronary heart disease (CHD) are the main causes of ... more Cardiovascular diseases (CVD) and especially coronary heart disease (CHD) are the main causes of death in the Slovak Republic (SR). The aim of this study is to explore trends in age-adjusted coronary heart disease mortality rates in the whole Slovak population and in the population of working age between the years 1993 and 2009. A related indicator - potential years of life lost (PYLL) due to CHD--was calculated in the same period for males and females. Crude CHD mortality rates were age-adjusted using European standard population. The joinpoint Poisson regression was performed in order to find out the annual percentage change in trends. The age-adjusted CHD mortality rates decreased in the Slovak population and also in the population of working age. The change was significant only within the working-age sub-group. We found that partial diagnoses (myocardial infarction and chronic ischaemic heart disease) developed in the mirror-like manner. PYLL per 100,000 decreased during the obs...