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Objectives: Measles cases are increasing remarkably in our country as well as all over the world. In this study, it was aimed to examine the epidemiological and clinical characteristics of measles cases detected in our hospital, as well as the measles seroprevalence in our region. Methods: A total of 7,452 individuals whose measles IgG and/or IgM antibodies were studied between December 2021 and March 2023 in the Medical Virology Laboratory in Başakşehir Çam and Sakura City Hospital were included in this retrospective study. Measles IgG and IgM antibodies were analysed by enzyme-linked immunosorbent assay. Demographic information, clinical symptoms and laboratory data of the participants were obtained from the hospital's electronic medical records. Results: A total of 102 measles cases were identified between December 2021 and March 2023. Of these cases, 77 (75.5%) patients were ≤ 18 years old. Of the 73 measles cases with vaccination information, 90% were unvaccinated. The measles seroprevalence rate was 72.8%. The lowest seroprevalence rate (4.8%) among the age groups was found in 8-11-month-old babies, the highest cases rate (35.7%) was detected in this age group. It was determined that measles immunity increased with age (r = 0.276, p < 0.001) and was over 89.3% over the age of 30. Conclusions: Measles immunity is insufficient in our region and measles remains an important public health problem until the age of 18. The recent increase in measles cases in our country and around the world shows that current vaccination programmes need to be implemented more decisively and strictly.

Objectives: Temperature is the most important environmental variable associated with the varicella frequency across the world. The present study compares the incidence of varicella in the districts of Bulgaria against some climatic factors and tries to find environmental variables which account for the differences in the varicella distribution observed among the Bulgarian districts. Methods: The 28 Bulgarian districts were used as units of observation and their average 10-year varicella incidence (2009-2018) was tested for correlation with the standard bioclimatic variables of WorldClim, version 2. Results: The WorldClim estimates for the annual mean temperature, the maximal temperature of the warmest month, the minimal temperature of the coldest month, the mean temperature of the coldest quarter, and the solar radiation inversely and not significantly correlated with the average 10-year varicella frequency. The precipitation of the warmest quarter and the wind speed correlated positively and also not significantly. Only the mean temperature of the driest quarter correlates significantly with the incidence at district level (Spearman's rank correlation coefficient of -0.45, p = 0.02). The mean of average 10-year varicella incidence rates among districts with driest quarter during the winter (January, February, March) was 387.6 ± 114.1, while among districts with driest quarter during the summer/autumn (July, August, September or August, September, October) 283.3 ± 102.1 (p = 0.02, ANOVA test). Conclusions: Dry winter and/or wet summer appear as significant determinants for the fluctuant spread of varicella infection in Bulgaria.

Objectives: Childhood obesity is a growing global problem that can be prevented by improving diet quality. Mediterranean diet (MedDiet), historically present in Mediterranean countries, is considered one of the healthiest dietary patterns. This cross-sectional study aimed to determine the MedDiet adherence and anthropometric parameters in 9-year-old children from the central geographic locations of Split-Dalmatia County, Croatia. Methods: The study analysed data obtained from 158 children aged nine years from central parts of Dalmatia: Split and Hvar. To assess the MedDiet adherence, the parents of the children filled out the Mediterranean Diet Index (KIDMED) questionnaire. Appointed school medicine specialists collected anthropometric data of the children and categorized them into body mass index (BMI) categories according to the Center for Disease Control and Prevention (CDC) criteria. Additionally, we assessed the influence of parents' education degree on children's MedDiet adherence and anthropometric measures. Results: Results showed that more than a quarter of nine-year-olds included in this study were overweight or obese (BMI ≥ 85th percentile for age and sex). One of the main findings was that 72% of children had suboptimal (poor or average) MedDiet adherence. Moreover, children with suboptimal KIDMED results (KI < 8) had significantly higher body weight, waist circumference, hip circumference, and waist-to-height ratio. Also, results showed that mothers' education notably influences children's anthropometry. Conclusion: Our study found that childhood obesity is a significant concern among 9-year-olds, with a high prevalence of overweight and obesity. Additionally, our results showed that MedDiet adherence is suboptimal among this age group. These results indicate that children of the Mediterranean are not spared of modern life challenges. This problem should be prioritized in the future to prevent the development of a metabolically compromised adult population.

Objectives: The dietary composition is able to rapidly and significantly influence the diversity of the gut microbiome. This article focuses on how various types of diet affect the composition of the gut microbiome and how dietary changes are able to prevent or slow down the development of non-communicable diseases including obesity, type 2 diabetes mellitus, cardiovascular diseases, and low-grade inflammation. Methods: A review in PubMed and a hand search using references in identified articles were performed. Studies published in English from 2000 to 2024 were included. Results: The studies showed the significant effect of diet on the development of non-communicable diseases dependent on the state of the gut microbiota and molecules it produces. The Western diet that continues to gain in popularity for Czech people, leads to dysbiosis and production of bacterial lipopolysaccharide or trimethylamine N-oxide causing systemic chronic inflammation in the body and thus promoting the development of non-communicable diseases. Conclusions: Findings from this review emphasize the importance of healthy eating habits in the prevention of intestinal dysbiosis and still increasing prevalence and incidence of obesity and other non-communicable diseases.

Objective: Our research was focused to find a relation between the occurrence of spondylodiscitis and occurrence of chronic diseases. We were trying to discover some new risk factors and relations between chronic disorders in our research group. This analysis was also focused to detect factors that prolong the hospitalization of patients and worsen their prognosis. Methods: A study was carried out involving patients with spondylodiscitis treated between 2013 and 2022. A statistical analysis expressed by several coefficients was calculated in software IBM SPSS 21. Results: The study group comprised 32 (53.3%) females and 28 (46.7%) males. During the period the overall incidence of spondylodiscitis was increasing (except the year 2020 where only 2 patients were treated) with a peak in 2019. The average age of patients was 69.3 (±12.3) years, and the highest incidence was in the age group 60-69 years (n = 19, 31.7%). The most impacted vertebral region was lumbar (n = 29, 48.3%). The most prevalent associated comorbidity was some cardiovascular disorder (n = 39, 65%) followed by diabetes mellitus (DM) (n = 23, 38.3%). Genitourinary system was the most common source of primary infection (n = 22, 36.7%). Average length of stay was 34.3 (±14.5) days and surgery prolonged hospitalization period. Mortality rate was 1.7%. Conclusion: The results of our study are confirmed by the data of other European and non-European studies. We confirmed diabetes mellitus and hypertension as the most common non-infectious risk factors of spondylodiscitis and the presence of pathogens in genitourinary system as the most frequent source of primary infection.

Objective: Pregnancy at advanced maternal age has become more common over the last decades. Therefore, the study aimed to describe the characteristics and maternal and perinatal outcomes of women giving birth at advanced maternal age and very advanced age. Methods: We conducted a retrospective cohort study of 2,300 singleton births that occurred in 2020-2021 at the Department of Gynaecology and Obstetrics of the Louis Pasteur University Hospital in Košice. The control (age 20-34 years), advanced maternal age (35-39 years), and very advanced maternal age (≥ 40 years) groups included 1,851, 382, and 67 women, respectively. Exclusion criteria were multiple pregnancies, maternal age less than 20 years, smoking and alcohol use, foetal malformation and intrauterine foetal death, and birth weight of 500 grams or less. Data on mothers and newborn infants have been reported from the birth book and the reports on mothers at childbirth. The data were analysed using IBM SPSS Statistics 23.0. Results: Our results confirmed statistically significant differences regarding the rate of preterm birth (p = 0.004), very preterm birth (p = 0.010), caesarean delivery rate (p < 0.001), very low birth weight (p = 0.027), extremely low birth weight (p = 0.001), and Apgar score at 5 minutes < 7 (p = 0.020) between newborns in the compared maternal age groups. Conclusion: Advanced maternal age is a prognostic factor for poor pregnancy outcomes. Women of advanced maternal age are at higher risk of adverse obstetric and perinatal outcomes.

Objectives: An occupational disease (OD) is a disorder or health condition which arises due to work related activities and tasks or is caused by work environment. The impact of ODs on medical and social system may be considered as a very important in relation to mortality, morbidity, and invalidity. The most common ODs in the European Union are musculoskeletal disorders (58% of all ODs in 2015). The aim of the study was to determine the differences in the incidence of occupational diseases between the Slovak Republic (SK) and the Czech Republic (CZ). Methods: Data were obtained from the Health Statistics Yearbooks of the National Health Information Centre of the Slovak Republic and in CZ from the Institute of Health Information and Statistics of the Czech Republic. We worked with records from 2009 to 2019. The average incidence rates (aIR) per 100,000 labourers were calculated based on the number of workers in a given year. All data were calculated separately for SK and CZ, and for males and females. P < 0.05 was considered a significant value. Results: In SK, the number of ODs diagnosed from 2009 to 2019 amounted to 2,351 cases in males and 1,605 cases in females. In CZ, the amount of ODs diagnosed from 2009 to 2019 reached 6,616 cases in males and 5,513 cases in females. In SK, from 2009 to 2019, the incidence of ODs decreased significantly from 7.3 to 4.8 cases per 100,000 labourers (rs = -0.76; p = 0.006). Diseases from one-sided excessive load were the most common ODs in SK (aIR = 7.6 ± 2.2) and in CZ (aIR = 8.2 ± 3.5), followed by ODs caused by vibration. Occupational diseases due to noise, vibrations and SiO₂ inhalation were considerably more common among males. Diseases due to long-term excessive one-sided load, skin and infectious diseases were more prevalent in females. Occupational hearing damage due to noise was more frequent in SK and silicosis, asthma bronchiale, respiratory allergies, dermatoses, and infectious diseases were remarkably more frequent in CZ. Conclusion: Regarding the main goal, we found a significantly higher aIR of ODs caused by noise in SK than in CZ. In CZ, there was a markedly higher presence of ODs caused by SiO₂ inhalation, asthma and respiratory allergy, ODs of skin and infectious and parasitic ODs when compared to SK. In both countries different principles for discontinuance in work are applied when a risk factor occurs. It is necessary to enhance surveillance data and reporting of ODs and increase investments in occupational safety, health education and research for the future.

Objective: Anxiety and depression in patients following cerebrovascular accidents are among frequently occurring complications of the medical condition. The consequences affect personal, family, professional, and social life. They cause severe functional and cognitive impairments, limit the ability to perform normal daily activities, which can result in complete disability. The aim of the study was to monitor the occurrence of anxiety and depression in patients following cerebrovascular accidents hospitalized in neurological departments in the region of eastern Slovakia. Methods: A total of 101 patients following cerebrovascular accidents, aged from 48-86 years, were included in the descriptive study. Demographic and clinical data were obtained from patients and from medical records. We determined the occurrence of anxiety disorders, depression and emotional distress in patients following cerebrovascular accidents using a standardized Hospital Anxiety and Depression Scale (HADS) questionnaire. Results: Data analysis confirms a high incidence of anxiety in the HADS-A subscale (9.23 ± 4.13) and depression in the HADS-D subscale (9.09 ± 4.43) during the hospitalization phase of the disease. It demonstrates the pathological occurrence of anxiety states in 37%, depression in 36%, emotional distress in 36%, and a serious degree of combination of pathological values of the anxiety subscale and the depression subscale in 27% of patients. The existence of a strong positive correlation between anxiety and depression indicators was confirmed. Conclusion: The results confirm a high prevalence of anxiety and depression in the acute phase of the disease. The findings indicate that patients recovering from cerebrovascular accidents not only face physical difficulties and loss of independence but also struggle with anxiety and depression, which can negatively impact and slow their recovery. Given the high frequency of these psychological conditions, further research is needed to enhance the quality and effectiveness of care provided to patients with cerebrovascular accidents.

Objectives: This study aimed to determine the metabolic syndrome (MS) prevalence in a sample of adolescents, to calculate their continuous metabolic syndrome scores, and to determine the associations of continuous metabolic syndrome score with overweight/obesity and selected cardiometabolic and lifestyle factors. Methods: We enrolled a sample of 2,590 adolescents (1,180 males, mean age 17.1 ± 1.04 years) from 14 grammar schools and 48 secondary schools in the Bratislava Self-Governing Region, Slovakia. Data were collected from a standard anthropometric examination, biochemical analysis of fasting venous blood, blood pressure measurement, physical fitness assessment, and a comprehensive questionnaire focused on selected lifestyle characteristics. Continuous metabolic syndrome score and paediatric simple metabolic syndrome scores were calculated. Results: The criteria for the MS diagnosis according to the International Diabetes Federation (IDF) guidelines for children and adolescents were fulfilled in the whole sample by 38 (1.4%) adolescents; all were classified as overweight/obese. In the obese subgroup (n = 270), the MS prevalence rose to 13.3%. The largest number of adolescents was in the group without any of the MS components (67.5%). In the groups with 1, 2 or 3 MS components, males predominated; 0.6% of males and no females had 4 components of MS. The increasing number of individual components of MS is accompanied by a continuous increase (in the case of HDL-cholesterol - a decrease) of mean values mostly of blood lipid levels. Mean values of blood pressure (BP) and anthropometric parameters were highest in the group with three MS components. Significant correlations with body fat content or with selected lifestyle factors were not found. Using the continuous MS score calculation we found 31 adolescents, of whom 14 (45.2%) had only 1 or at most 2 MS components, i.e., they did not meet the criteria for the MS diagnosis. Conclusion: From the point of view of atherosclerosis prevention and early intervention, it is extremely important to monitor the MS prevalence in children and adolescents, especially in the current obesity pandemic. The paediatric MS score calculation is simple and accurate, allowing assessment of the severity of cardiometabolic risk in individuals even before the diagnosis of MS. The continuous MS score is useful in identifying individuals at increased risk and in the management of preventive health care for children and youth.

Objectives: This study investigates the impact of COVID-19 on various long-term psychological and physical symptoms in young adults from Slovakia. Methods: We assessed 229 Slovak young adults aged 18 to 30 years. Probands were interviewed using standardised questionnaires. The relationship between COVID-19 and long-term health symptoms was determined using Pearson's chi-square test. The McNemar test was used to determine the differences in health symptoms before and after COVID-19 recovery. Results: The statistically significant effect of COVID-19 after recovery on adverse cognitive health was only documented in women in the following symptoms: memory deterioration (p < 0.001), problems with concentration (p < 0.001), difficulty in handling tasks requiring thinking, planning and problem-solving (p < 0.001), and problems with finding the correct words in their expressions (p = 0.001). The prevalence of these symptoms was higher in women after the COVID-19 recovery than before. Participants also reported the most pronounced long-term changes in the following physiological symptoms: decreased physical fitness (p < 0.001 for women and men) and headaches (p < 0.001 for women). In addition, women menstrual cycle changes were reported significantly more frequently in women after COVID-19 recovery than before (p < 0.001). Furthermore, it was found that in addition to overcoming COVID-19, physical inactivity was also significantly associated with a deterioration in memory (p = 0.042), concentration problems (p = 0.041), and decreased physical fitness in women (p = 0.014). Smoking was associated with changes in the menstrual cycle (p = 0.002). Conclusions: Significant effects of COVID-19 on mental and physical health were found. These effects demonstrate that COVID-19 has had a negative impact on the long-term health and quality of life of young adults.

Objectives: The aim of this study was the evaluation of a group of patients treated at the Department of Orthopaedics and Traumatology of Locomotory Apparatus at Luis Pasteur University Hospital in Košice for septic arthritis in relation to risk factors and chronic diseases and its microbial aetiologic profile. Methods: We conducted a retrospective study of patients including all episodes of septic arthritis from March 2013 to August 2022. The occurrence of chronic diseases, risk factors and its microbiological profile were investigated. Results: A total of 141 patients were included: 92 (65%) males and 49 (35%) females, the mean age of patients was 58.1 years. A continued decrease in cases was recorded during the period of COVID-19 pandemic and the post-pandemic years. The largest group of our cohort represented septic arthritis of the knee (87 cases, 61.7%), followed by hip and shoulder arthritis - 17 (12.1%) and 14 (9.9%) cases, respectively. Gram positive aetiologic flora represented 87.5% of all pathogens isolated and antibiotics were administered to 46 (32.6%) patients before microbiological culture samples were obtained. The dominant chronic disease was diabetes mellitus with 42 (29.8%) cases and degenerative joint disease affecting the joint was verified in 86 (61%) patients. Dental foci in 28 (19.9%) cases and skin infections in 17 (12.1%) cases were the most numerous groups of risk factors with predominant distribution for cases without previous intervention in the affected joint leading to infection. Conclusion: The distribution of joint involvement and microbial agents was similar to other literature without affecting negative culture results by prior administration of antibiotics. Representation of chronic diseases and risk factors was comparable to the work of other authors. Notable was the continued decline in total number of cases in post-pandemic years of COVID-19 pandemic. What was interesting was the number of confirmed cases of distant focal infection distributed mainly in the group of patients without a history of any previous intervention on the joint before the infection. There is a lack of literature on distant silent infection as a risk factor.

Objectives: Urinary incontinence is an extremely stressful and often debilitating disease, increasing morbidity in society. The aim of the work is to point out the problems of the management of incontinent patients - seniors in the context of their quality of life as well as treatment costs to find ways to make the widest possible public awareness of the fact that in most cases incontinence is solvable in terms of improving the quality of life. Methods: The group consisted of 100 patients with urinary incontinence who were treated with conservative medical procedures at the urological outpatient clinic of the Railway Hospital in Košice. The research was conducted in the period from September 2018 to February 2019. The extended standardized Urinary Incontinence Quality of Life Measure (I-QOL) questionnaire was used to evaluate the quality of life. The SPSS program - version 16.0 was used for statistical analysis of the file and hypotheses, and the chi-square test and the McNemar test for analysis of non-parametric data distribution. Results: The average value of the total social I-QOL score was 14.15 ± 5.03, which means that this area contributes significantly to the reduction of the quality of life. The average value of the total I-QOL score of the group studied was 63.86 ± 19.29, which indicates that urinary incontinence has a significant impact on the quality of life of seniors. Respondents considered the frequent urge to urinate and the absence of a toilet in a reachable place to be a negative factor. Feeling of the state of a certain form of inferiority and obsession was the most serious. Patients expressed approximately equal concerns about feeling out of control of their bladder and concerns about urinating as well as concerns about worsening incontinence due to aging. Conclusion: Based on the presented results, participants achieved the highest average score in the psychological domain of quality of life (27.81 ± 7.54) and the lowest in the social domain (14.15 ± 5.03). Social support programmes aimed at reducing stigma and enhancing social engagement for individuals dealing with incontinence could help improve the social quality of life. Physical health interventions, such as pelvic floor exercises could support physical well-being.

Objectives: Smoking is a strong addiction, that affects a huge number of people worldwide, including the young ones. Due to composition of cigarette smoke, which contains nicotine and other chemical substances, lots of harmful effects on human health were described. Apart from the influence on other organs smoking is associated with hearing loss. Methods: The literature review was conducted using PubMed and the combination of the following words: smoking, hearing impairment and hearing loss. Results: The total number of 585 articles published in the recent 10 years were analysed. The review results show a strong association of hearing loss with smoking, both active and passive. As the main reason for hearing loss, a damage to outer hair cells was identified. Hearing loss in such cases is basically sensorineural and usually affects high frequencies. It was also observed that the risk of hearing loss increases with time of smoking. Smoking cessation reduces the risk of hearing loss associated with smoking. This article is a review of the literature that summarizes the results of studies aiming to analyse the influence of smoking on human hearing. Conclusions: As smoking causes serious health problems, public health policies in societies should promote primary prevention as well as smoking cessation (secondary prevention) to diminish the total burden of healthcare systems.

Objectives: The main aim of the article is to indicate how selected socioeconomic factors contribute to the selected characteristics of the subjectively perceived health of seniors 65+ living in the Czech Republic. Methods: Data collection took place in the Czech Republic from 27 January 2020 to 14 February 2020. The total number of interviews carried out in the research was 1,172, from a representative quota sample of seniors from the senior population living in the Czech Republic. Questionnaires were distributed in the form of PAPI interviews. Results: The assessment of subjective social status increases with education and employment (these three aspects are closely linked), and the assessment transferred to the senior years. Conclusion: The accumulation of advantages and disadvantages should encourage the Government of the Czech Republic, as well as other European states, to focus on those who, based on their low levels of education and social status, have very low assessments of their subjective health. Prevention (in both health and social fields), which includes access to information and the subsequent better life decisions, must be implemented throughout a person's lifetime (so as to reduce the disadvantages that accumulate from the cradle to the grave).

Objectives: The study aimed to assess the attitudes of pregnant women toward vaccination against COVID-19. Methods: The research was conducted using a diagnostic survey with our original questionnaire among 283 pregnant women. The survey was carried out in Poland in the first quarter of 2022. Statistical analyses were performed using IBM SPSS 26.0 (p < 0.05). Results: It was shown that 140 (49.5%) pregnant women were vaccinated against COVID-19, of which 90 (64.3%) received vaccination during pregnancy. In the group of 143 (50%) unvaccinated people, only 11.9% of respondents expressed willingness to be vaccinated against COVID-19. The most frequently cited arguments for receiving the vaccine were fear of a severe course of the disease (37.5%) and the possibility of passing antibodies to a child (37.1%). Women who did not undergo vaccination believed that they did not want to put themselves and their babies at risk (39.9%) and were concerned about adverse post-vaccination reactions (35.2%) and the safety of the vaccine (32.5%). Women with higher education and professionally active (p = 0.004) were vaccinated more often than respondents with a lower level of education (p < 0.001). Age (p = 0.101) and place of residence (p = 0.179) did not indicate statistically significant differences in decision-making regarding vaccination against COVID-19. Conclusion: Pregnant women presented both pro- and anti-vaccination attitudes. Less than half of the respondents were vaccinated against COVID-19, and most of the women took the preparation during pregnancy. Selected socio-demographic factors determined women's attitudes toward vaccinations against COVID-19. Medical personnel should play a role in deciding whether a pregnant woman is vaccinated.

Objectives: The global situation concerning the incidence of infectious diseases emphasises the need for increased health literacy, particularly after the COVID-19 pandemic. A large part of this need relates to the area of education. The aim of this study was to analyse health literacy in relation to the cognitive dimension in the field of knowledge about the COVID-19 disease in the post-pandemic period among future teachers. Methods: The research sample comprised 286 female students in the first year of Bachelor's teacher training courses at the Faculty of Education in the Czech Republic. The research study was conducted during the academic year 2022/2023. To explore the level of health literacy, the present research used the standardized HLS-EU-Q86 questionnaire designed by the World Health Organization. For the purposes of this study, the original 'structured interview' method was changed to an online questionnaire. An additional online questionnaire was attached to explore participants' knowledge related to the COVID-19 disease. Results: The average score for general health literacy was 34.1, placing it within the 'sufficient' category. A total of 14.0% of the students showed an excellent level and 38.1% a sufficient level of general health literacy. Relatively the most favourable results were observed in the dimension of health promotion literacy. The threshold for successful completion of each knowledge test related to the COVID-19 was set at 80% of correct answers. Only 14.0% of the future teachers met the criteria for inclusion in the overall excellent level of the knowledge test. Conclusions: The level of knowledge of future teachers associated with COVID-19 is inadequate. Therefore, it is desirable to strengthen education in the field of prevention of infectious diseases. The results indicate the need for some action, e.g., expanding the portfolio of compulsory courses in all branches of teacher training in order to increase the level of health literacy among future teachers.

Objectives: The Russian military aggression against Ukraine in February 2022 became the cause of the biggest humanitarian crisis. Postpartum depression (PPD) is a type of mood disorder of pregnant and postpartum women. It was earlier reported that depression of pregnant women is increased in a combat zone, while effects of war on pregnant refugee and displaced women are less studied. The aim of the study was to determine the features of emotional state of temporarily displaced Ukrainian women who gave birth in Lithuania in spring-autumn 2022, and compare it with the state of Lithuanian women who were not directly affected by war. Methods: The study was conducted by surveying a group of Ukrainian refugee women (UG) and a group of Lithuanian women (LG) who gave birth in maternity units of Lithuania, using Edinburgh Postpartum Depression Scale (EPDS), the questionnaire elaborated for evaluation of social and medical peculiarities of mother-child pair in early postpartum period as well as medical records of maternity unit. Results: The average mean scores of EPDS in UG were significantly higher compared to LG; 42% of UG exceeded the threshold for the high risk of PPD (> 13). UG, who arrived in Lithuania during the war because of close relatives legally working in Lithuania, had lower EPDS scores to compare to UG who came from combat zones and who did not have close relatives. Conclusions: Support of closest relatives and convenient surrounding is important for women's emotional state during the vulnerable period of maternity and especially during the crisis time.

Objectives: This study aimed to investigate the acrylamide exposure of different children and adult population groups (10-14 years, 15-17 years, 18-24 years, 25-44 years, 45-64 years, and 65-74 years) resulting from the consumption of potato chips and wheat-based bread from Montenegrin market and to evaluate it in terms of health risk. Methods: The acrylamide content was monitored in 51 samples of bread and 20 samples of chips. The carcinogenic health risk in different population groups was assessed through the incremental lifetime cancer risk (CR) and total cancer risk (TCR). Results: The average acrylamide content in potato chips and bread was calculated to be 238 μg/kg and 30 μg/kg, respectively. Acrylamide content in a tested sample met the criteria prescribed by Commission Regulation (EU) 2017/2158 in 98% of the tested samples of chips and 85% of bread samples. The carcinogenic health risk of acrylamide exposure for the investigated population groups is of concern. The values of CR for all the investigated groups were in the range of 10^-6 < CR < 10^-4 and the values of TCR were 10^-5 order of magnitude, indicating a potential cancer risk. Conclusion: The youngest population (10-14 years) was exposed to the highest cancer risk through the consumption of both, chips and bread. For the population of 10-14 years, 15-17 years, 25-44 years, 45-64 years, and 65-74 years, a higher risk of cancer was found due to the consumption of bread compared to the consumption of chips. Only the population aged 18-24 years was faced with a higher risk of cancer due to the consumption of chips compared to the consumption of bread.

Objectives: The Cervical Cancer (CC) Screening Programme in Georgia provides insufficient coverage of the target population. The aim of the study is to identify the barriers to cervical cancer screening for women in Georgia in order to plan and implement adequate measures to increase the screening effectiveness. Methods: The study is based on the results of a survey of 582 women aged 25-60 years (mean age 42.11 + 12.17). Respondents were selected in out-patient clinics. The questionnaire included questions related to the place of residence, ethnicity, religion, marital status, education, employment, cervical cancer awareness and screening, screening participation practices, and barriers to participation. Results: The following factors reliably increase the chance of participating in the screening: residing in Tbilisi, OR = 1.84 (95% CI: 1.10-3.07); higher education, OR = 1.87 (95% CI: 1.09-3.19); being employed as a nurse, OR = 3.42 (95% CI: 1.49-7.85); receiving screening-related information from medical staff, OR = 2.43 (95% CI: 1.42-4.15); and from television, OR = 2.57 (95% CI: 1.47-4.50). The chance of participating in the screening is reduced due to incomplete secondary education, OR = 0.10 (95% CI: 0.01-0.77); single marital status, OR = 0.49 (95% CI: 0.28-0.87); employment in public service, OR = 0.39 (95% CI: 0.17-0.89); and receiving screening-related information from friends, OR = 0.26 (95% CI: 0.09-0.77). Women with higher education are undoubtedly more informed about screening, screening procedures and free programmes than those without higher education. The common barrier to participation in the screening was "fear of the manipulation-related pain" but the most frequent answer was "I'm afraid that the test will detect cancer (36.3%)." Women with a lower level of education are more likely to believe that "Pap testing is appropriate for the women who have active sexual life", and/or "have multiple sexual partners", and/or "have children," and "it is not necessary if a woman has no complaints". Conclusion: Screening participation among women in Georgia depends on screening availability, formal education and awareness of CC, sources of information, and employment type.

Objective: The poor health of Roma is well documented, but there is only limited data regarding the health of Roma children. The aim of this study was to describe the socioeconomic status, health related behaviour, and health of children living in segregated Roma settlements, and to compare the data with that of non-Roma children. Methods: In March-April of 2011, a cross-sectional questionnaire-based survey among 11-year-old (211 boys and 252 girls) and 13-year-old (205 boys and 247 girls) children living in Roma settlements was performed (response rate: 91.5%). These data were compared with data from the Health Behaviour in School-Aged Children (HBSC) survey carried out in 2009/2010. Results: The parents of Roma children were substantially less educated and less likely to be actively employed, and Roma children reported lower material welfare than non-Roma ones. The prevalence of consuming sweets and soft drinks at least 5 times per week was 1.5-2 times higher among Roma children. The prevalence of regular intense physical activity was higher at the age of 13 years among Roma boys, while physical inactivity was substantially higher in both age groups among Roma girls. Almost one quarter of Roma children and approximately 14% of non-Roma children had tried smoking at the age of 11. More Roma boys tried alcohol at the age of 11 than non-Roma ones. One in ten Roma children was obese in both age groups. The self-rated health status of Roma children was worse than that of non-Roma children. Conclusions: Children living in Roma settlements reported poorer socioeconomic conditions, higher consumption of sweets and soft drinks, earlier smoking and alcohol initiation, and worse self-rated health, but with some exceptions do not differ in fruit or vegetable consumption and BMI from general child population. To promote health of children living in Roma settlements, a multi-sector approach, special health education, plus social and health promotion programmes are needed.

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.

The COVID-19 pandemic has revealed a significant number of cracks in the current vigilance techniques that stand to minimise outbreaks of SARS-CoV-2. There is a serious inadequacy of the testing capacity of healthcare systems worldwide, which can be attributed to the lack of appropriate testing and monitoring methods for a disease such as COVID-19. The current tools in use for COVID-19 surveillance are either expensive, not applicable to large populations or yield results after the outbreak has already occurred. The immense contagiousness in combination with a wealth of asymptomatic carriers means that RT-PCR testing is not feasible on a mass scale. It is evident that new methods are required for the monitoring of COVID-19 and a range of new epidemiological tools must be implemented if public health systems worldwide want to make relevant predictions on the patterns of disease spread and increase the efficacy of their decisions. In addition to this, the pandemic has highlighted the necessity for redirecting biomedical research towards early diagnosis and rational therapy of respiratory viruses in particular, as well as prevention of their spread by conventional means. An efficient early detection system would save lives and allow countries to return to pre-pandemic standards of living. At the forefront of this lies wastewater-based epidemiology, which carries immense potential as a means of pre-symptomatic diagnosis and population-based surveillance.

Objectives: The aim of the study was to assess the effectiveness and safety of dupilumab therapy in patients with moderate-to-severe atopic dermatitis (AD) in a real-life Czech bicentric cohort. Methods: We retrospectively analysed 50 patients with moderate-to-severe AD treated with dupilumab in two centres in the Czech Republic. Baseline characteristics, the Eczema Area and Severity Index (EASI) score and Dermatology Life Quality Index (DLQI) were collected at baseline and each 3 following months. The proportion of patients achieving EASI50, EASI75, EASI90 and EASI100 were analysed. Levels of immunoglobulin E (IgE) were collected before and after 6 and 12 months of therapy. Adverse events were recorded as well. Results: Thirty-two men and 18 women with mean body mass index (BMI) of 25.7 were enrolled in our analysis. The mean age of the patients was 37.6 years and the mean time from diagnosis until the initiation of dupilumab therapy was 35.0 years. After 4 months, EASI75 was achieved by 75.7%, out of which 40.5% achieved EASI90 and 10.8% achieved complete clearance. Improvement continued with time, and the proportion of patients with EASI90 increased to 71.4% at the 6th month and at the 12th month of therapy the EASI90 was 65.2%. EASI100 was achieved by 14.3% and 13.0% at the 6th and 12th month, respectively. A marked reduction was observed in the DLQI and also in IgE levels. EASI responses were independent of BMI. No new safety issues were identified. Adverse events were experienced by 44% (22/50) of the patients and they were all mild in intensity. Conjunctivitis and herpes simplex virus infection were the most common adverse events. Conclusion: Our results confirmed the effectiveness and safety of dupilumab in a real-life setting in adult patients with moderate-to-severe AD in the Czech Republic. Dupilumab was well-tolerated and resulted in a significant clinical improvement in combination with improvement of quality of life.

Objectives: Industrially produced trans fatty acid (iTFA) have adverse health effects and thus their consumption should be limited. The aim of this study was to determine and compare the iTFA content in frequently consumed food products by young adults from the Serbian and Slovenian market with supposedly elevated iTFA content in 2015. At the time of this study, there was no recommended limit of iTFA in both countries, and reduction of iTFA in foods was on voluntary basis. Methods: We determined iTFA content in food products, 19 from the Serbian and 22 from the Slovenian market, blinded and analysed in the same analytical run. Contents of fatty acids (FA) methyl esters were analysed by capillary gas chromatography with a flame ionisation detector. Heptadecanoic acid was used as internal standard. Individual FA along with TFA were expressed as percentages of total measured FA. The amount of each FA in the sample was then calculated from the response factor and the transformation factor of the FA from the FA methyl ester content. Results: Elaidic acid (C18:1t) was found as the most abundant TFA in analysed products, ranging from 0.52 g/100 g of total FA in chocolate candy up to 60.4 g/100 g in a salami from Serbian market. In Slovenian products, the values for elaidic acid were lower, 0.04-3.95 g/100 g of total FA, except in one type of wafers (24.3 g/100 g). Conclusions: The majority of analysed products from the Serbian and three from Slovenian market exceeded the recommended WHO and EU limit of 2% iTFA of total fat in foods. Samples of frequently consumed salami, wafers, tea biscuits, and snacks were identified as products with potentially higher burden of iTFA in diets of young adults in Serbia.

Objectives: Low birth weight (LBW) is one of the major factors affecting child morbidity and mortality worldwide. Every day, approximately 800 women die from causes related to pregnancy and childbirth worldwide. Maternal ill health increases the risk of LBW. This study seeks to investigate determinants and incidence of LBW. Methods: This study was conducted based on the medical records of mothers and their 1,946 infants born in 2016-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants were obtained from the Reports on mothers at childbirth. The inclusion criteria were singleton births and birth weight > 500 g. The exclusion criteria were twins or multiple births, congenital anomalies and stillbirths, birth weight ≥ 4,000 g or ≤ 500 g, and Roma ethnicity. Roma children are more likely to be born prematurely, with low birth weight. Roma mothers have different lifestyle. Univariate analysis was employed to evaluate the association between the independent variables and LBW. Variables that were found to be statistically significant were then further analysed using multivariable logistic analysis for each dependent variable. The implementation of the research was approved by the Ethics Committee. Results: Of 1,946 newborns, 271 (13.90%) have low birth weight. The mean of birth weight at delivery was 3,068.62 (SD 671.16) grams. Factors that were associated with LBW were primary maternal education (OR = 2.98, 95% CI: 1.08-8.21, p = 0.034), marital status single (OR = 2.88, 95% CI: 1.68-4.94, p < 0.001), number of prenatal care visits less than 8 (OR = 1.62, 95% CI: 1.01-2.61, p = 0.047), and preterm birth (OR = 74.94, 95% CI: 45.44-123.61, p < 0.001). Conclusion: The reducing of LBW requires strategies to improve maternal lifestyle, maternal care before, during and after birth and to strengthen social support.

Objectives: The study aimed to investigate the use of electronic cigarettes (EC) among medical students, their knowledge and beliefs (opinion about harmfulness and addiction potential) on ECs, perceptions of the risk, as well as to assess the type of education and cessation training they received during their study at Faculty of Medicine, Comenius University in Bratislava, Slovakia. Methods: This cross-sectional, anonymous online e-mailed survey was conducted among medical students via the Study Department by sending e-mails containing the survey link. Participants completed the online questionnaire adapted from the American Survey on Tobacco and Alternative Tobacco Products. It included questions about the personal use of EC, perceptions about the harms and their role in disease causation, education and cessation training, and practices related to conventional cigarettes (CC), EC, and alternative tobacco products (ATP). The e-mailed questionnaire filled in 577 medical students (71.9% women) from Comenius University in Bratislava, the average age was 23 ± 2 years. The sample comprised 486 (84.2%) Slovak and 91 (15.8%) foreign students. The data were analysed using the Statistical Package for Social Science (SPSS) version 25. Results: There were 385 (66.7%) non-smokers, 111 (19.3%) ex-smokers and 81 (14%) current smokers in the study sample. EC currently use 13.5% of medical students, with a statistically significant intersexual difference (22.2% males vs. 10.12% females; OR = 2.53, 95% CI: 1.55-4.13), more foreign students than Slovak students (24.2% vs. 11.52%; OR = 2.44, 95% CI: 1.41-4.26), more smokers of conventional cigarettes than non-smokers (46.9% vs. 8.06%; OR = 10.07, 95% CI: 5.85-17.34). EC seems to be less harmful to 59.97% of students, mostly in the age group ≤ 24 (61.76% vs. 51.49%; OR = 1.46, 95% CI: 1.03-2.07), 41.25% of students consider EC to be less addictive, 55.6% think they do not get enough education on EC during their medical study. Conclusion: The results overall show the high consumption of tobacco products and the lack of knowledge and awareness among medical students, future health care providers. In health promotion and disease prevention, they should serve as a model for their patients and for the general public as well. Our study emphasizes the need for intervention in this field at medical faculties and for support of further monitoring in Slovakia and other countries and draws attention to the ongoing lack of EC regulation.

Objectives: Demographic differentiation caused by the history of migration in the Czech and Slovak Republics led the authors of this article to analyse generational differences in the groups of foreigners living in the Czech Republic (CR) and the impact of generational differences on selected aspects of their social situation and perceived health. The crucial research question was whether and to what degree do different generations of foreigners vary from each other and what impact this has had on their social situation and health determinants. Methods: The main goal was to examine mutual relationships between selected characteristics of social situation and health determinants in various groups of foreigners living in the CR. A total of 1,003 questionnaires among foreigners officially living in the Czech Republic were collected and analysed. In the area of subjective perception of health, a comparison of foreigners with Czech citizens (representative sample of Czech seniors; 1,172 respondents) in the age category 65+ was made in order to find out whether this perception differs between senior foreign nationals and senior Czechs. Results: Older individuals (50-64 years and 65+ years) appeared to have the best integration into Czech society. This age generation felt positive about stay and migration status in the CR. Older foreigners differ from older Czech citizens who tend to refer to their health as very good to rather good compared to foreigners who described their health as neither good nor bad. The middle generation (30-49 years) of foreigners was characterized by hard work and the initial stages of integration into Czech society. This group also reported positive feelings about living in the CR relative to their home country. Conclusion: The oldest generation of foreigners is the best integrated in the Czech Republic (with regard to selected aspects tested in this article). This generation is able to offer new immigrant effective integration strategies. However, they assess their subjective health one degree worse in comparison with Czech seniors (representative sample), this finding should lead to the setting of preventive programmes related to a healthy lifestyle, including lifestyle for foreigners living in the Czech Republic.

Objectives: Acrylamide (AA) is considered one of the contaminants that occur in heat-processed agri-food products, which through diet can increase the risk of developing cancer for consumers of all age groups. Methods: This review analysed the level of acrylamide of the most important heat-processed agri-food products that contribute to the dietary exposure of the population of different European countries and the assessment of health risks related to the presence of AA in food. Results: The results of monitoring AA concentrations in agri-food products, reported individually by researchers or projects such as CONTAM in 2015 and the UK Food Standard Agency in 2017, show that some products exceeding the recently set European reference level are reported as such for specific values - mean UB/RLs in µg.kg^-1: French fries (550/500), coffee dry (523/400), coffee substitutes (1,499/500, 400), processed cereal-based baby foods (76/40), potato crisps and snacks (2,214/750), breakfast cereals (744/300), biscuits and crackers (637/350, 400), and coffee substitutes (1,897/500). Average values (µg/kg body weight per day) of exposure to AA from food for different age groups (EFSA) are estimated at 0.4-1.9, but in different European countries, as reported by several studies (including Romania), are between 1.4 and 3.4. Conclusion: Starting from the genotoxic and carcinogenic potential of acrylamide, it is important to regularly monitor the presence of acrylamide and its levels in food and to investigate the food pattern of the population to detect the share of foods at risk of exposure.

Objectives: Indoor air toxicity is of major public health concern due to the increase in humidity-induced indoor mould exposure and associated health changes. The objective is to present evidence for the causality of health threats and indoor mould exposure. Methods: PubMed search on the following keywords: dampness, mould, indoor air quality, public health, dampness, and mould hypersensitivity syndrome, sick building syndrome, and building-related illness as well as information from the health authorities of Bavaria and North Rhine-Westphalia, the Center of Disease Control (CDC), World Health Organisation (WHO), and guidelines of professional societies. Results: The guidelines of professional societies published in 2017 are decisive for the assessment of the impact of mould pollution caused by moisture damage on human health and for official regulations in Germany. Until 2017, a causal connection between moisture damage and mould exposure could usually only be established for pulmonary diseases. The health risk of fungal components is apparent as documented in the fungal priority pathogens list (FPPL) of the WHO. Since 2017, studies, especially in Scandinavia, have proved causality between moisture and mould exposure not only for pulmonary diseases but also for extrapulmonary diseases and symptoms. This was made possible by new test methods for determining the toxicity of fungal components in indoor air. Environmental medical syndromes, e.g., dampness and mould hypersensitivity syndrome (DMHS), sick building syndrome (SBS), building-related symptoms (BRS), and building-related illness (BRI), and fungal pathogens, e.g., Aspergillus fumigatus, pose a major threat to public health. Conclusion: There is evidence for the causality of moisture-induced indoor moulds and severe health threats in these buildings. According to these findings, it is no longer justifiable to ignore or trivialize the mould contamination induced by moisture damage and its effects on pulmonary and extrapulmonary diseases. The health and economic implications of these attitudes are clear.

Objectives: During the covid-19 pandemic, protective equipment such as respirators and masks were widely used to protect respiratory tract. This disposable protective equipment is usually made from plastic fibre-based nonwoven fabrics. If used masks and respirators are improperly discarded, they pollute the environment by becoming a source of micro and nanoplastics. The aim of the study was to find out how stable the materials of protective equipment are and how released nano and microplastics can affect aquatic and soil organisms. Materials: The input materials used to produce respirators and masks were tested for their thermal stability and resistance to the release of plastic particles into the environment. To determine the thermal stability of the materials, a simultaneous thermal analysis - thermogravimetry (TGA) and differential scanning calorimetry (DSC) were performed. Results: Materials of masks and respirators are stable at temperatures common to temperate climate zone. However, the possible effects of chemical reactions of the materials with the environment were not considered during the measurement. The materials were also subjected to ecotoxicity tests according to European standards. Conclusion: While the leachate obtained by shaking the materials in water did not show acute toxicity to the selected aquatic organisms, the material itself had a significant effect on selected soil organisms (springtails).