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Objectives: Vaccination is the primary intervention to prevent influenza infection, yet vaccine uptake remains low among children and other at-risk patients. The aim of the study is to investigate the impact of a paediatric hospital visit with laboratory-confirmed influenza on the influenza vaccination behaviour of participants and their family members in the subsequent influenza season. Methods: This study compared the influenza vaccination coverage for participants < 18 years of age with a clinical suspicion of influenza in 2017-2018 during a hospital visit, in two subsequent influenza seasons. Data was retrieved from the hospital electronic medical record and a follow-up questionnaire (2018-2019) to ascertain the common reason(s) that families did not vaccinate their children the following year (2018-2019). The children were distributed into positive- (antigen and/or PCR) and negative-influenza groups. Results: A total of 133 children were enrolled in our study. Participants' mean age was 4.6 years and 74 (55.6%) were males. Overall, 47 (35.3%) had confirmed influenza virus. A significant increase in influenza immunization was found among both positive- and negative-influenza participants between 2017-2018 and 2018-2019 (6.4% vs. 27.7%, p < 0.001; 8.1% vs. 29.1%, p < 0.001, respectively), as well as among family members of positive-influenza participants - siblings and parents (6.4% vs. 19.6%, p = 0.003; 0% vs. 17%, p < 0.001, respectively). Common reasons for failure to vaccinate included doubt in vaccine effectiveness, unlikely to get "flu", busy, and side effects. Conclusions: Our findings suggest that a paediatric hospital visit with laboratory-confirmed influenza increases vaccine uptake among families. Future studies should aim to evaluate evidence-based interventions to improve influenza vaccine uptake among children.

Objectives: Allergic patients may be concerned about more frequent and/or more severe adverse events following vaccination, which may lead to the refusal of vaccines among these patients. The aim of this study is to assess whether allergic patients have more frequent adverse events (AEs) after vaccination than healthy individuals. Methods: Study participants (N = 591) underwent vaccination of their choice at a selected Vaccination and Travel Medicine Centre. At a 10 to 14-day interval, they were contacted for a telephone questionnaire survey on the occurrence of AEs after vaccination. A group of allergic patients (n = 188) and healthy controls (n = 403) were followed in the study. Results: No significant difference was found in the occurrence of AEs between study and control group. Only in redness and swelling, which was more common in allergic patients, but only in a few individuals. All side effects were minor, such as pain at the injection site or fatigue. No participant experienced a serious or life-threatening adverse event. In the studied group, no statistically significant differences were found even in the occurrence of AEs after singular vs. simultaneous administration of vaccines (p = 0.094), nor after vaccination with inactivated vs. attenuated vaccines (p = 0.655), or after vaccination against bacterial vs. viral infections (p = 0.140). Conclusions: Vaccination of allergic patients did not cause more frequent and/or more serious adverse events in our study compared to healthy people. If general contraindications are observed, then vaccination of allergic patients is considered safe.

Objectives: The aim of the study was to assess potential health risks associated with a large-scale environmental release of benzene following a railway accident in Moravia, Czech Republic, in 2025, with emphasis on differences between population and occupational exposure. Methods: An assessment of potential health risks associated with exposure was performed using available environmental monitoring data. Conservative exposure scenarios were defined for the general population and for remediation workers. Non-carcinogenic risk was expressed as the hazard quotient (HQ), and carcinogenic risk as excess lifetime cancer risk (ELCR). Results: Short-term peaks in ambient air benzene concentrations were observed in the period immediately following the accident and during remediation activities, with occasional hourly values reaching the order of tens of µg.m^-3. During the accident and its immediate aftermath, benzene concentrations at the accident site ranged from < LOQ-32.3 mg.m^-3 (LOQ – limit of quantification) in soil gas (March–April 2025), 0.0004-2.43 g.l^-1 in groundwater (March–May 2025), < LOQ-19.9 µg.l^-1 in surface water (March–June 2025), and < LOQ-849.7 mg.kg^-1 in soils (March–April 2025). Extreme values were confined to the immediate accident zone and represented the dominant exposure for workers rather than residents. For the general population, HQ values remained below 1 and ELCR ranged from 10^-6 to 10^-5. In contrast, remediation workers exhibited substantially higher risks, with HQ values reaching 10⁴-10⁵ and ELCR up to 10^-3, particularly for inhalation exposure. Conclusion: While population exposure remained within acceptable limits, occupational exposure during remediation represented the dominant health risk. Two workers involved in remediation activities were excluded from further work based on the results of biological monitoring of benzene exposure. The results highlight the need for strict exposure control and health surveillance of exposed workers.

Objective: The objective of this study was to evaluate the effectiveness of human papillomavirus HPV test with HPV16/18 genotyping and liquid-based cytology (LBC) triage as a primary screening method for cervical cancer compared to conventional Pap test in women undergoing routine cervical cancer screening in Tbilisi. Methods: Cross-sectional, prospective study was conducted, where 1,000 enrolled women aged 30-60 years during one visit underwent conventional Pap smear and Hr-HPV testing (Roche Cobas system). Women with any positive screening results were referred for further evaluation and remaining cells from the Cell Collection Medium vial were used for LBC. The study calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each screening method and receiver-operating characteristic (ROC) curve to evaluate the accuracy of each diagnostic method in identifying people with CIN2+ diseases. Results: The HPV test with HPV16/18 genotyping and LBC triage demonstrated higher sensitivity (76.9%), specificity (71.6%), and PPV (34.5%) compared to conventional Pap tests (p < 0.05). NPV was also high with the HPV test (94.1%). The HPV test alone had the highest sensitivity (92.3%) and NPV (96.7%), but lower specificity (41.4%) and PPV (22.6%) than the HPV test with HPV16/18 genotyping and LBC triage (p < 0.05). Comparing the areas under the curve (AUCs), only the HPV with HPV16/18 genotyping and LBC triage showed a statistically significant difference when compared to conventional Pap (0.71 vs. 0.55, p = 0.03) and high figures of AUC 0.71 (95% CI: 0.58-0.85) suggesting that HPV test with HPV16/18 genotyping and LBC triage is a more reliable screening method for detecting CIN2+ disease and preventing cervical cancer, than other screening modality. Conclusion: The results suggest that the HPV test with HPV16/18 genotyping and LBC triage is a more effective primary screening method compared to conventional Pap tests. This information should be the basis for transition from cytological screening to HPV testing in Georgia.

Objective: Men who have sex with men (MSM) are disproportionately affected by HIV in Greece. However, research on HIV incidence in this group is lacking. This study aimed at estimating HIV incidence among MSM in Athens, Greece. Methods: The analysis included routinely collected data between January 2013-June 2015 from adult MSM who visited a community-based facility (Ath Checkpoint) at least twice and were non-reactive to the rapid INSTI^TM HIV-1/HIV-2 assay at baseline. HIV conversion rates were calculated by dividing the number of clients who became reactive by the person-years of observation. All statistical analyses including Poisson regression models were conducted in STATA 14. Results: A total of 1,243 MSM contributed 1,102.50 person-years (py). The overall (per 100 py) conversion rate was 3.99 (95% CI: 2.97-5.36). In multivariable analyses, age less than 30 years was associated with an increased risk of HIV conversion (rate ratio: 2.01; 95% CI: 1.08-3.76). Conclusions: This analysis shows high rates of HIV conversion among MSM who repeatedly visit a community-based testing site. Ath Checkpoint could contribute to HIV surveillance and identify a high-risk group that could benefit from essential health interventions.

Objectives: Surgical site infections (SSIs) are a frequent complication of surgical procedures and one of the most common forms of hospital acquired infection (HAI). National/international guidelines and recommendations have been issued for prevention. The objective of this study was to observe the behaviour of healthcare workers engaged in surgical procedures and hence assess compliance with SSI guidelines. Methods: An observational descriptive study was conducted at a University hospital in southern Italy. A specifically designed form was used to record the actions of the surgical team during randomly selected surgical operations. Observations comprised the use of surgical attire, the frequency of doors opening and the number of staff in the operating room. Results: A total of 308 operating room personnel was observed during 402 surgical procedures: 127 surgeons (41%), 39 anaesthesiologists (13%), 62 nurses (20%) and 80 students in training (26%). 96% of the surgical team wore scrubs, 93% of health workers wore a mask and of these 78% wore it correctly in order to completely cover the nose, mouth and beard (when present), 99% wore a cap (only in 48% was the hair completely covered), 50% of the operators wore gloves, 95% wore shoes dedicated to the operating theater and 23% also wore shoe covers, 56% wore gowns, and 22% had eye protection. Furthermore, the average number of health personnel in the operating theater was 8, the doors remained closed in 261 (65%) surgical operations. Conclusion: As the results indicated a low adherence to international guidelines among the personnel, it is suggested that training courses should be provided to increase staff awareness on prevention and management of HAI.

Objectives: The aim of the study was to analyse the attitudes and decisions regarding vaccination in general and against COVID-19 among general practitioner (GP) patients in Croatia, and to identify influencing factors, with particular attention to chronic conditions and anxiety. Methods: A total of 184 patients (stratified by sex and presence of chronic disease) from a GP's offices, aged 18-87 years (average 50.3 ± 1.3 years, 49.5% women) were included. Data were collected using a questionnaire. Results: Attitudes toward vaccination in general did not differ between patients with and without chronic diseases and were not influenced by anxiety. Chronically ill patients were more likely than those without chronic disease to believe in the efficacy of the COVID-19 vaccine and to express fear of contracting SARS-CoV-2 (p ≤ 0.003). Anxiety was associated with fear of infection (p < 0.001), but not with confidence in vaccine safety or efficacy. After controlling for sex, age, education, chronic illness, anxiety, and knowing someone infected and hospitalized with SARS-CoV-2, factors associated with the decision to be vaccinated against COVID-19 were absence of prior infection (OR = 3.9, 95% CI: 1.6-9.5, p = 0.003), history of influenza vaccination (OR = 3.8, 95% CI: 1.4-10.4, p = 0.009), and knowing someone who had died from COVID-19 (OR = 3.2, 95% CI: 1.1-9.7, p = 0.037). Conclusion: The decision to vaccinate against COVID-19 was associated with absence of prior infection, knowing someone who died from the disease, and prior influenza vaccination, but not with chronic illness, anxiety, or socio-demographic factors.

Objectives: The impact of air pollution on gastrointestinal diseases remains unclear. This study examines the association between air pollutants and paediatric intussusception incidence. Methods: Using data from the Health Insurance Review and Assessment Service (HIRA), we analysed daily intussusception cases in Seoul (2009-2019). Air pollutants, including particulate matter (PM₁₀), ozone (O₃), nitrogen dioxide (NO₂), carbon monoxide (CO), and sulphur dioxide (SO₂), were assessed alongside temperature. A generalized linear model with a negative binomial link function evaluated the relationship between each pollutant and intussusception incidence, adjusting for long-term trends and seasonality. A distributed lag non-linear model (DLNM) examined non-linear cumulative lag effects. Results: In the model without lag and non-linear effects, NO₂ was significantly associated with intussusception incidence, while other pollutants and temperature showed no significant associations. DLNM analysis with a 3-day cumulative lag demonstrated a gradual increase in intussusception incidence with rising NO₂ levels, with significant rate ratio changes at lag 0 and lag 1 but not at lag 2 or lag 3. Extending the cumulative lag to 2, 4 and 5 days showed progressively decreasing significant intervals. Conclusion: These findings suggest a potential link between NO₂ exposure and paediatric intussusception. Further studies are needed to clarify underlying mechanisms.

Objectives: This study aimed to systematically analyse original research publications to provide a comprehensive assessment of the transmission chain of healthcare-associated infections (HAIs). The review focused on identifying transmission routes, sources of pathogen detection, and the predominant microorganisms detected in healthcare environments. Methods: A systematic review was performed following PRISMA methodology. Relevant studies were searched in PubMed and Scopus databases using predefined keywords. Results: Forty-four original studies published in English between January 2015 and July 2025 were included. Indirect transmission was reported in 37 (84.1%) studies, while 27 (61.4%) studies identified it as the sole transmission route. Fomites were reported as the sole source of pathogen detection in 30 (68.2%) studies. Among studies investigating fomites or environmental contamination, stethoscopes were the leading contaminated item (n = 5, 13.5%). Among detected microorganisms, Gram-negative bacilli (n = 94, 51.1%) and Gram-positive cocci (n = 76, 41.3%) prevailed. The dominant bacterial genus was Staphylococcus spp. (n = 55, 29.9%), whereas Staphylococcus aureus represented the leading species (n = 25, 13.6%), followed by Klebsiella pneumoniae (n = 12, 6.5%) and Escherichia coli (n = 11, 6.0%). Multidrug-resistant strains, including methicillin-resistant Staphylococcus aureus (n = 11, 6.0%) were also observed. Conclusion: Indirect transmission through contaminated fomites represented the predominant transmission pathway, including medical devices such as stethoscopes. Staphylococcus aureus was among the most frequently detected microorganisms, while multidrug-resistant organisms were also reported. These findings emphasize the importance of infection prevention and control measures in healthcare settings.

Objectives: Smoking remains a major global public health problem, and pharmacological therapies are central to cessation strategies. Cytisine, a plant-derived alkaloid, has recently been introduced in Türkiye as a smoking cessation aid. This study aimed to evaluate the early effectiveness and cessation outcomes of cytisine in a Turkish population. Methods: This retrospective observational study included 289 patients who were prescribed cytisine at a smoking cessation clinic between March and May 2024. Socio-demographic characteristics, smoking history, nicotine dependence, treatment duration, and smoking cessation outcomes at 1 month and 6 months were analysed. Smoking cessation status was self-reported. Analyses were conducted using the intention-to-treat principle, with participants lost to follow-up classified as non-quitters. Results: Cytisine was prescribed according to the national 25-day tapering regimen, and the actual duration of use was recorded. In the intention-to-treat population, smoking cessation was achieved by 42.6% of participants at 1 month and by 39.8% at 6 months. At both follow-up points, participants who quit smoking were younger and had shorter smoking duration and lower cumulative smoking exposure. Higher educational attainment was associated with greater cessation success, whereas sex, marital status, chronic disease, daily cigarette consumption, smoking exposure, previous quit attempts, and baseline nicotine dependence were not. In multivariable analyses, higher educational level independently reduced the likelihood of cessation failure at 1 month (adjusted odds ratio = 0.52, 95% CI: 0.29-0.96), while longer duration of cytisine use was independently associated with greater smoking cessation success at 6 months, with each additional treatment day increasing the odds of cessation by approximately 15.0% (aOR = 1.15, 95% CI: 1.10-1.19, p < 0.001). Conclusions: Cytisine showed promising early effectiveness as a smoking cessation aid in Türkiye. Treatment adherence appears to be a key determinant of cessation success, supporting its potential role in national smoking cessation programmes.

Objectives: Since 2009 the number of unvaccinated children in Poland has been regularly increasing. The purpose of the study was to learn what parents who decide to vaccinate their children feel and believe about their children's vaccines and in particular to find out how these sentiments and beliefs affect their attitude and decision-making with reference to vaccinations. Methods: The interviews were conducted during an immunization visit of parents whose children are covered by immunization schedule; 53 parents aged 23 to 48 years took part in the study. Most study participants were high school or university graduates living in rural areas. Children were 1 week to 5 years old. Thematic analysis was used to analyse interview data. Results: Identified factors shaping the parents' positive attitude to vaccination included conviction of necessity of vaccines (effective disease prevention, safety, favourable benefit-to-risk ratio, and concerns about the child). The general anti-vaccination belief was that vaccines are unnecessary. External factors, mainly authority figures and media broadcasts, affect parents' beliefs and decisions. Conclusions: Various factors affect parents' decision concerning immunization of their children. Both compulsory and recommended vaccines should be provided free-of-charge. Choice overload should be reduced. Paediatricians should address parental vaccine hesitancy.

Objectives: The purpose of the current study was to analyse the risks of Lyme borreliosis (LB) among 1,070 forestry workers, the influence of responsible behaviour (use of repellents, skin self-inspection) on Borrelia screening result status, and the occurrence of immediate and mid-term symptoms after tick bites and LB positive serological screening test. Methods: The questionnaire was conducted as well as blood tests for LB disease by one-stage serological screening procedure using ELISA for specific B. burgdorferi IgM and IgG antibodies (EuroImmun AG company, Germany). Results: While 39.6% of foresters were LB positive among bitten foresters, as many as 27.0% were LB positive among those, who did not recall any tick attacks at all. Individuals with known history of tick bites had significantly higher odds (1.770×) of being LB positive (p < 0.05), while the use of repellents or skin self-inspection after visiting woods had no influence on LB results. The odds of skin discolouration after tick bites was significantly lower (0.682×) in case of LB positive test compared to LB negative test (p < 0.05), which can be explained by the fact that foresters could be unaware about erythema migrans appearance and timing, considering tick bite and developed later rash as completely separate events. Moreover, 69.1% of the bitten foresters with LB positive result developed no secondary symptoms (excluding those related to the skin), and the most frequent clinical symptoms were arthralgia (24.9%), followed by myalgia (7.6%), headache (5.7%), and damage to facial nerve (2.7%), which are non-specific and can be present in other illnesses. Conclusion: Therefore, the recommendations proposed would be the regular laboratory testing for LB of sensitive and at-risk population, who visits endemic woody areas, irrespective of all other factors involved.

Objective: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure. Methods: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax. Results: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH. Conclusions: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.

Objectives: The aim of the study was to identify potential areas for improvement in the prevention of oral diseases in pregnant women by assessing their oral care habits and awareness regarding oral health. Methods: An original, anonymous, web-based survey was conducted among women at any stage of pregnancy. The survey consisted of 23 questions regarding oral care habits, knowledge about oral health of mother and child, general and oral health changes, and attendance of oral healthcare services during pregnancy. The data analysis was performed using IBM SPSS 27.0 version software. Descriptive statistics, Chi-square and Wilcoxon signed-rank tests were used to analyse the data. The level of statistical significance was set at p < 0.05. Results: A total of 714 pregnant women participated in the study, with a mean (SD) age of 30.2 (4.4) years. Majority of the respondents demonstrated acceptable oral health-related knowledge and habits. A lack of interdental care among pregnant women was discovered. Nearly a third (27.6%) of the respondents reported a decline in their oral health during pregnancy. The most commonly reported general and oral health issues during pregnancy were increased stomach acid levels (71.3%) and gum bleeding (43.3%). Pregnant women were most frequently informed about the importance of oral care by an obstetrician-gynaecologist (25.4%). Conclusions: The study revealed the need for targeted interventions to enhance oral health awareness and practices among pregnant women in Lithuania. While overall oral hygiene habits were acceptable, deficiencies in interdental care and knowledge regarding oral health during pregnancy were evident. Higher level of education and urban residency were associated with superior oral care practices of pregnant women. In order to improve oral health of mother and child, interdisciplinary collaboration and dissemination of accessible, evidence-based information are essential.

Objectives: This study aimed to evaluate the beliefs about third-hand tobacco smoke (THS) among administrative and academic staff at a university. THS is a residual pollutant from tobacco smoke that lingers on surfaces and poses health risks, particularly to children. The study also aimed to understand these beliefs in relation to socio-demographic factors. Methods: A cross-sectional survey was conducted with 332 university employees aged 18 and over. Data were collected between September and December 2023 through face-to-face and online questionnaires. The survey included the Beliefs About Third-hand Smoke (BATHS-T) Scale and questions on socio-demographic characteristics, second-hand smoke exposure, and attitudes towards a smoke-free campus. Beliefs About Third-hand Smoke Scale total and sub-dimension scores increase, it is understood that the participantʼs belief in the negative effects of third-hand tobacco exposure on persistence and health increases. Results: The average age of participants was 36.1 years, with 38.3% being administrative personnel and 61.7% academic personnel. About 40.5% of the participants used tobacco products. The mean total BATHS-T score was 35.6, with health and persistence subscale scores averaging 19.9 and 15.7, respectively. Non-smokers had significantly higher BATHS-T scores than smokers. The participants with children scored higher on the health sub-dimension. Additionally, 78.9% supported a smoke-free campus, and those supporting it had higher BATHS-T scores. Awareness of the harms of second-hand smoke correlated with higher BATHS-T scores. Conclusion: The study highlights that non-smokers and those with children are more aware of THS risks. There is strong support for a smoke-free campus among university staff. The findings suggest a need for increased education on THS, especially targeted at smokers and those without children. Universities can play a crucial role in promoting smoke-free environments and raising awareness about the health risks associated with THS.

Objectives: The aim of this study was to examine the frequency of fatalities in injuries in traffic accidents in Montenegro, identify contributing risk factors, and determine the most vulnerable participants in these accidents. Methods: The research was designed as a retrospective descriptive study. Participants were people admitted to the Urgent Centre of Clinical Centre of Montenegro due to injuries in traffic accidents that resulted in serious bodily injury or death in the period from 2011-2020. We presented data using descriptive statistics. The square test was used to examine the association between the outcome of traffic injury with sex, age, category of injury, type of traffic participant, and injury localisation. Additionally, we used logistic regression to estimate the best predictor value of these variables for outcome. Results: It was found that 44.7% of injured people died, the most frequent fatal outcome was registered in patients with central nervous system injuries (73.2%), then in patients with asphyxia (47.0%), and patients with bleeding (40.5%), χ² = 27.530, p < 0.001. The most frequently injured traffic participants were drivers, but the highest number of deceased were among cyclists. Also, logistic regression showed that the category of injury was the most predictive impact on outcome in traffic-injured correspondents (p < 0.001). Conclusion: Among the injured, the highest number are drivers, and the fatal outcome mostly depends on the injury category. Nearly half of those injured in traffic accidents die, especially those with central nervous system injuries and cyclists. Therefore, special attention should be given during public health campaigns related to traffic accident prevention, focusing on this injury and this category of traffic participants.

Objectives: Chronic back pain is the most common cause of incapacity for work. The purpose of the study was to determine the effectiveness for activating the function of the deep stabilization system (DSS) in patients with chronic low back pain. Methods: The effectiveness of three different methods was compared: Pilates method (PM), dynamic neuromuscular stabilization and balance aids on deep stabilization system function and pain perception in the lumbar spine. The group consisted of 75 patients. Results: The results show differences in the effectiveness of the methods depending on the observed characteristics. The least significant differences were observed when comparing the Pilates method to balance aids. No statistically significant difference was observed in four out of five areas. The only area where a statistically significant effect of the exercise method got recorded was the intra-abdominal pressure test (p < 0.05). The lowest change was recorded in the measured values using the intra-abdominal pressure test at PM, and the highest change was recorded in Thomayer's values at dynamic neuromuscular stabilization. Conclusion: By comparing the three methods it was noted that each of them has its own positive reaction to the pain and the muscular apparatus. The most appropriate method to affect DSS function appears the dynamic neuromuscular stabilization (DNS) concept, where was the most significant improvement in DSS activation and the most significant reduction in chronic low back pain.

Objectives: In 2022, about 17% of Andalusian population lived in disadvantaged areas, which accounted for 21% of tuberculosis (TB) cases. This concentration of cases resulted in TB rates in these areas being higher than both the regional and national averages. The aim of the present study was to understand the behaviour of TB in terms of person, time, and place in the city of Cordoba during the period 2015-2021 and its association with areas in need of social transformation (ANST). Methods: A retrospective observational analytical study was conducted on cases reported to the Andalusian Epidemiological Surveillance System (Spanish acronym SVEA). Membership in ANST was determined by the SVEA. Results: A total of 136 cases were reported, with 26.5% in ANST. The incidence rate (IR) in the city was 5.97 cases per 100,000 population per year, higher in ANST (11.82) compared to non-ANST (5.06), RR = 2.34 (95% CI: 1.60-3.42). In 2020, fewer cases were reported (IR: 3.99). The mean age was 44.82 years, lower in ANST (38.08) than in non-ANST (47.25), with a p-value < 0.05. Hospitalizations were more frequent in ANST (78% vs. 68%, p = 0.3). In ANST, the IR was highest in men over 60 years old and lowest in women of the same age. No significant difference was found between the groups regarding risk factors, except for HIV status (p = 0.02). Conclusions: TB incidence rates in Andalusia vary by area of residence. To make better public health decisions, it is crucial to enhance the collection of socio-demographic and clinical data related to these cases.

Objectives: The first aim of this cross-sectional study was to reveal the prevalence of overweight and obesity among Czech military personnel (CMP). The second aim was to compare accuracy of the body mass index (BMI) classification with the body fat percentage (BF%), waist circumference (WC), and visceral fat area (VFA). BMI is a commonly used method to assess obesity, but its accuracy in reflecting body composition, especially in physically fit individuals, has been questioned. Methods: Data were collected from six military units in the Czech Republic. Soldiers underwent anthropometric assessments including height, weight, WC, BF%, and VFA using the bioelectrical impedance method (BIA). Results: The study group consisted of 446 soldiers (337 males, 109 females). The prevalence of obesity in Czech soldiers regardless of gender was 18%-20% according to BF% and 13%-16% according to WC. There were almost one fifth of obese males and more than 5% of females with BMI ≥ 30. The risk level of VFA was observed in 24% of male a 34% of female soldiers. In male soldiers there was a high rate (43%) of false positives according to BMI (BMI ≥ 25, BF% < 20), on the other hand, a certain part (18%) of female soldiers was classified as false negative according to BMI (BMI < 25, BF% ≥ 28). When overweight and obesity were assessed by WC and BMI, significant false positives (56%) were found in male soldiers (BMI ≥ 25, WC < 94). When obesity was evaluated using VFA and BMI, a certain rate of false negatives (30%) was found in female soldiers (BMI < 25, VFA ≥ 100). Conclusion: Through an analysis we explored the limitations of BMI, and we propose an alternative method (measurement of BF%, VFA using BIA) for a more accurate assessment of body composition in this specific population.

Objectives: The aim of the study was to describe alcohol consumption and its changes in the Czech Republic during the period of governmental restrictions related to the COVID-19 pandemic. To this goal, an overview of the governmental measures that may have affected alcohol consumption was compiled from various sources (mostly media reports). Methods: The paper analyses three surveys where the group from Charles University, Prague, participated in design and execution: the European Study Group on Alcohol use and COVID-19 (ESAC) convenience online survey that (in Czechia) took place at the onset of the COVID-19 pandemic in Europe, in April through June 2020 (n = 1,434), a computer-assisted web interviews (CAWI) survey carried out in November 2021 (n = 790), and another CAWI survey carried out in November 2022 (n = 1,738). These are complemented by a brief overview of official data on alcohol sales between 2019 and 2021 in Czechia from two sources, Ministry of Finance of the Czech Republic and the Nielsen IQ market research company. Results: Changes in alcohol use appeared to be distributed among the population unequally, when the pandemic influenced different population groups in a different way. In all three surveys, the majority of respondents reported no change in their drinking frequency or quantity. Decreases in alcohol use were more prevalent than increases. Most pronounced changes were detected in at-risk drinkers, who have increased their alcohol use. Official revenue data suggest a small reduction in total alcohol sales in 2019-2021. Conclusions: Our research results do not support the hypothesis that substantial and unexpected social and economic changes caused by the COVID-19 pandemic, along with corresponding measures, acted as stressors that would have caused the majority of people in Czechia changing their behaviour related to alcohol use; however, high-risk users increased their consumption.

Objectives: The aim of the study was to evaluate the feasibility and acceptability of remote prenatal care using a smartphone application for women with low-risk pregnancies, and to compare outcomes with standard in-person care.
Methods: A prospective observational study was conducted at the Institute for Maternal and Child Care in Podolí, Prague. A total of 225 pregnant women were enrolled: 119 received combined telemedicine and standard in-person follow-ups (W-DF group), while 106 received only standard in-person care (W-PF group). Data on patient satisfaction across various domains of care were collected and analysed.
Results: Women in the W-DF group reported significantly higher satisfaction with information adequacy, confidentiality, and understanding of test results (p < 0.001). Conversely, the W-PF group showed greater satisfaction in childbirth preparedness, access to community programmes, and lifestyle guidance (p < 0.05). Overall satisfaction scores were comparable between the two groups (W-DF mean = 263.0, W-PF mean = 275.1; p = 0.263).
Conclusions: Telemedicine in prenatal care offers advantages such as reduced time and logistical burdens and improved personalization of care. However, psychosocial and lifestyle support remains stronger in traditional models. A hybrid model that integrates telemedicine with periodic in-person visits may provide more comprehensive support. Further large-scale studies are needed to optimize implementation.

Human immunodeficiency virus 2 (HIV-2) is a retrovirus related to HIV-1. It is believed to have evolved from the simian immunodeficiency virus (SIV). The disease caused by HIV-2 is manifested by a slower progression compared to HIV-1. Data from West Africa show that 37% to 50% of HIV-2 infected people have undetected or very low viremia and if left untreated, have a much more gradual decline in CD4 T lymphocytes, thus longer survival. However, treatment should not be postponed even in this case, because the course of immune reconstitution inflammatory syndrome (IRIS) in people with HIV-2 is more severe than in HIV-1, and also the year-on-year increase in the number of CD4 T lymphocytes is approximately half that of HIV-1. Approximately 6% of people living with HIV-2 (PWH2) can be defined as non-progressors and 9% as elite controllers. However, most untreated PWH2 develop AIDS.

Objectives: The aim of the article is to present the behaviour of Slovak consumers in terms of consumption in the field of functional food. Methods: The survey was initiated in all regions of Slovakia. The sample involved 1,373 families which consisted of respondents aged 18-92 years. Friedman's test and subsequent post-hoc analysis were used to determine the reasons why people buy (or do not buy) a specific type of food. The survey deals with functional foods. Additionally, another classification method, namely a decision tree, was used. Results: Decision trees help to identify factors influencing the choice of food by buyers. Based on this method, it can be stated that Slovak households still do not trust the functional foods bought in shops and are not interested in purchasing these foods. Conclusion: In short, it could be assumed that the millennium generation would dominate households, and that they will probably prefer foods, in a higher degree of choice, as being pre-prepared foods. Therefore, food sales will move in this direction, although traditional patterns of behaviour, determined by the role of the mother in the family, still dominate. This trend can be reinforced by the lack of cooking skills and confidence among the younger generation, which will lead to reduced cooking and is considered barriers to healthy eating.

Objectives: The scale of the economic problem of the occurrence of nosocomial infections and the resulting high additional costs of treatment can only be assessed using economic analyses. The aim of the study was to analyse the impact of a nosocomial infection in a patient in the treatment process and the direct costs of patient hospitalisation. The article contributes to a cost analysis, which is a relevant basis for adopting effective solutions and decisions on the introduction of new programmes and measures to reduce nosocomial infections and associated costs. Methods: In the first phase of the micro-economic analysis, we analysed the course of hospitalisation of a non-colonised patient treated in an ordinary hospital room. In the second phase, we analysed the process of hospitalisation of a patient who developed a nosocomial infection and was transferred to an isolation room. The difference in cost of both types of treatment allowed us to carry out an economic analysis to estimate the direct costs of nosocomial infection, which are not related to the initial diagnosis of the patient but only to the patient hospitalisation. To calculate the individual types of direct costs of both alternative treatments, we first used the process flow diagram method, which then enabled us to analyse the impact of the occurrence of nosocomial infection on the efficiency and costs of the hospital. Results: The results showed that the total direct cost of hospitalisation of a non-colonised patient was 1,317.58 euro per day, and the direct cost of hospitalisation of a patient with a nosocomial infection was 2,268.14 euro per day of hospitalisation. Conclusions: We found that reducing nosocomial infections would have a significant impact on the savings or reduction in healthcare costs associated with a different work process for patients in isolation. It would save 950.56 euro per patient for each day of hospitalisation for individual treatment of a patient hospitalised in an isolation room as consequence of a nosocomial infection.

Objectives: The use of alternative water sources such as rainwater or greywater (i.e., wastewater excluding water from toilets) for non-potable purposes may save water but, on the other hand, can also pose health risks to users. The main health risks come from microorganisms (such as bacteria, viruses, fungi, and protozoa). This work aims to analyse especially microbiological quality of rainwater and greywater used inside buildings in detail and to expand the existing knowledge about the potential health risks associated with these alternative water sources. It also considers methodological problems during E. coli and coliform bacteria detection. The final objective is to discuss requirements and appropriate indicators for monitoring recycled water quality. Methods: We examined 30 buildings with non-potable water systems in the Czech Republic and analysed a total of 137 samples of rainwater and 120 samples of greywater. From these 30 buildings, eleven, 5 of which used rainwater and 6 of which used greywater, were sampled regularly for 1-2 years for basic chemical parameters, various faecal indicators, C. perfringens, Legionella spp. and P. aeruginosa. Occasionally, samples were analysed also for the presence of environmental mycobacteria, amoebas, viruses, and selected pathogens. Results: Nearly three quarters of rainwater samples contained the faecal indicators E. coli or enterococci, or both, and in samples from several buildings also Clostridium perfringens was repeatedly detected. Untreated and treated rainwater were in respect to microbiological quality similar, suggesting that treatment processes were not very efficient. In greywater samples, beside faecal indicators, also P. aeruginosa and thermotolerant amoebas were repeatedly detected. Treatment technologies used for greywater were more efficient than those for rainwater systems. Conclusion: Based on the results we evaluated appropriate indicators for monitoring recycled water quality and drafted the first Czech regulation for non-potable water.

Objectives: This study aims to assess the frequency of smoking cessation and to identify the factors affecting smoking cessation success among individuals seeking assistance at a smoking cessation centre. Methods: This cross-sectional study included 1,570 individuals who applied to the smoking cessation centre in Izmir, Turkey, between 2009 and 2018, and completed three follow-ups. Data were obtained from the centre's records. Factors affecting smoking cessation success were analysed using logistic regression in multivariate analysis. Results: The median age to start smoking was 19 (17-22), and the median number of cigarettes consumed per day was 20 (20-30). Among the participants, 59.9% exhibited a high/very high level of nicotine dependence, and 79.6% had attempted to quit smoking previously. The median number of patient follow-ups was 7 (5-10). Of the patients, 34.0% successfully quit smoking for one year. According to the multivariate analysis results, smoking cessation success increased with being married by 2.26 times (95% CI: 1.51-3.38, p < 0.001), the absence of other smokers in the household by 1.38 times (95% CI: 1.01-1.88, p = 0.04), having a low level of nicotine dependence by 1.75 times (95% CI: 1.23-2.48, p = 0.002), and more patient follow-ups by 1.61 times (95% CI: 1.52-1.72, p < 0.001). Conclusions: Smoking cessation success is increased by the support and follow-up provided by healthcare professionals, the absence of other smokers in the household, and a low level of nicotine dependency.

Objectives: The aim of the study was to synthesize the body of knowledge on the factors that are important to the process of returning to work after ischaemic stroke in young adults under 55 years of age. Methods: Guidelines regarding the scoping review methodology developed by the Joanna Briggs Institute, and the PRISMA checklist for scoping reviews were used. A total of 2,249 studies were identified through a bibliographic search in six databases. Results: A total of ten studies were finally selected to respond to the research questions. Eight studies were quantitative observational studies, and two studies had a case study design. The rate of returning to work varied between the studies. The frequency of returning to work in young stroke patients, independent of the time of assessment, ranged from 42.4% to 86%. Returning to work after ischaemic stroke in young adults is a complex process and multidimensional problem which is affected by clinical variables (level of neurological deficits, cognitive ability, independency in activities of daily living, fatigue and depression, cardiovascular factors), as well as the socioeconomic and occupational status. Conclusion: There is insufficient evidence concerning interventions promoting return to work. Future studies should focus on examining effective interventions to help young stroke survivors return to work.

Objectives: Influenza A and B viruses cause epidemics every year, with approximately 3-5 million serious cases and about 290,000 to 650,000 deaths worldwide. Most patients die from bacterial complications of influenza. The aim of our study was to describe the clinical pictures of influenza and the development of the complications in seniors over 65 years of age, who were treated in University Hospital Pilsen. The course of the disease and changes in laboratory parameters were evaluated with regard to the method of treatment performed. Methods: A descriptive retrospective study was performed. Clinical and laboratory data of seniors with the diagnosis of influenza were extracted from electronic medical records and later analysed. The data were processed with Excel 2016 and Statistica. Results: A collection of 261 seniors, of whom 218 were hospitalized and 43 treated in an outpatient setting, has been studied. Patients who later developed complications had elevated values of CRP, procalcitonin, urea, and creatinine. The antiviral drug oseltamivir was administered to 226 of 261 seniors. Forty-seven seniors (18.0%) died from influenza and its complications (severe pneumonia with acute respiratory insufficiency or heart failure). Conclusions: The course of influenza in seniors was usually more severe and required hospitalization along with antiviral treatment. The mortality rate in the monitored group exceeded 18%. Annual timely vaccination, but also other preventive measures, and maybe considering other risk groups are methods to prevent severe or even fatal cases of influenza.

Objectives: Overweight and obesity are important concerns for global health. They are characterized by excessive fat accumulation that can harm health. Childhood obesity has reached alarming levels around the world due to urbanization and changes in lifestyle. This trend highlights an urgent need for effective public health strategies to promote healthier lifestyles, prevent chronic diseases, and support the wellbeing of future generations. This study aimed to monitor the impact of the risk factors on blood pressure and lipid profile parameters. Methods: Data were collected from 267 school-age children from Slovakia. The study assessed blood pressure using the sphygmomanometer technique, where systolic (SBP) and diastolic (DBP) blood pressure were measured in a seated position and repeated three times. The pulse rate was evaluated using Ruffier's physical fitness test. Anthropometric measurements included body weight, height, waist circumference, hip, and chest circumference, body mass index (BMI), and fat skinfolds measurement. The children's parents completed a comprehensive questionnaire. The data were statistically evaluated using IBM-SPSS version 19. Results: Our analysis showed a statistically significant difference in SBP between obese and non-obese children (p < 0.001), but no significant differences for DBP and total cholesterol. Similar results were found between normal-weight and overweight children for SBP (p < 0.001), with overweight children showing higher SBP. No significant differences were noted for DBP or total cholesterol. Among children with "bad fitness", 57.9% had elevated SBP, compared to 37.86% with "good fitness" (p < 0.01). Additionally, 41.67% of children with bad fitness had elevated DBP, versus 23.05% in good fitness (p < 0.001). Significant differences in total cholesterol were also observed in these two groups (p < 0.05). Conclusions: The results of this study confirm the importance of monitoring risk factors that significantly influence cardiovascular parameters.

Objectives: Patients suffering from rheumatoid arthritis (RA) are repeatedly affected by oral diseases or problems, including dental caries and periodontal diseases (PDs). Periodontitis and rheumatoid arthritis are chronic inflammatory destructive diseases that share many similarities. The objective of this study was to assess oral health status including examination of hard dental tissues and periodontium in patients with rheumatoid arthritis and compare the results with healthy controls. We hypothesize some interlink between oral diseases and RA. Methods: The epidemiological case-control study involved a total of 64 subjects divided into an experimental group (14 rheumatoid arthritis cases) and a control group (50 healthy individuals). Disease activity in the subjects with RA was assessed by the Disease Activity Score (DAS28). The number of Decayed, Missing and Filled Teeth (DMFT) and Community Periodontal Index of Treatment Need (CPITN) as a basic epidemiological oral health indexes were recorded. Finally, the data were analysed statistically. Results: The RA patients (19.21, SD = 6.95) showed a higher caries index level measured by DMFT than the control group (17.72, SD = 6.19); the difference was not statistically significant (U = 387.5, p = 0.547). In terms of a mean number of teeth decayed (p = 0.078), teeth filled due to caries (p = 0.397), and missing teeth (p = 0.126), the two groups were not significantly different. In terms of periodontal health, a significant difference was observed between the two groups concerning the CPI maximum score (p = 0.003). The RA patients showed higher prevalence of periodontitis than the controls. Conclusions: A complete basic oral examination, along with an oral health instruction including adequate oral and dental hygiene, is crucial to prevent dental caries and periodontal diseases and associated complications in RA patients, since they appear to be more vulnerable than the non-RA population.