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The aim was to examine the ability of staphylococci isolated from blood cultures to produce slime and to compare the slime production of strains considered clinically significant and of strains considered mere contaminants. The ability to produce slime was examined in 359 staphylococcal isolates from blood cultures by the congo red agar method. The clinical significance of an isolate was estimated according to the frequency of its occurrence in a series of blood cultures. Only strains isolated at least twice from the series of two or more blood cultures were considered significant. The slime production was detected in 18 of 32 strains (56.2 %) of Staphylococcus aureus, in 61 of 231 strains (26.4 %) of S. epidermidis and in 14 of 101 strains (14.6 %) of the remaining seven species. Out of 80 strains considered significant, 33 strains (41.2 %) produced slime, out of 132 strains considered contaminants, 24 strains (18.2 %) were slime producers. The significance of the remaining isolates was non-evaluable. We conclude that the staphylococcal isolates from blood cultures considered clinically significant produced slime more often than the isolates considered mere contaminants.

Deep thermal well (75 °C) in Bekes county, South East Hungary has been studied. The chemical measurements showed that the thermal water coming from deep geological layers (> 800 m) contains up to 117.2, 35.2, 30.2 and 26 µg/l of benzene, toluene, ethylbenzene, and xylenes, respectively. The objectives of this study are: to measure these naturally occurring compounds; estimating to potential risk and hazard index for the population who are using this well mainly for swimming and health baths; assessing the relationship between exposure to environmental chemical and human health; and to stimulate thinking about possible broader uses of risk assessment in identifying and solving public health problems. This paper is not intended as a complete study concerning the four measured compounds. A particular emphasis on benzene which is highly toxic and carcinogenic has been paid. The exposure assessment of benzene based on Risk Assistant model was done. The results showed that the Hazard Quotient (H.Q.) for benzene is more than 1 (requiring actions) and the probability of getting cancer from this exposure is 8E-5 exhibiting high risk for exposed population.

Many studies have documented a strong association of active smoking during pregnancy with fetal growth retardation. Increasing interest has also been focused on whether there is an association between exposure of pregnant women to environmental tobacco smoke (ETS) and low birthweight of their babies. In the intervention controlled study "Healthy Pregnancy - Healthy Child", mothers after delivery were interviewed by medical students who collected data about their smoking and nutrition. Students were also trained to stimulate non-smoking behaviour and to explain the risks related to smoking and exposure to ETS. Data from 1147 mothers after delivery were collected but only single births were included in the analysis of birthweight. In our study, 63.4 % women never smoked and 32.2 % women reported they had stopped smoking either before pregnancy or during the first trimester. Only 4.4 % of mothers (n = 50) smoked during the whole pregnancy. Women with the history of smoking were exposed to ETS more often than mothers who never smoked (51.6 % vs 17.4 %; p < 0.001). The number of heavily exposed both at home and workplaces was more than twice higher among former smokers compared with never smokers (22.4 % versus 9.4 %, p < 0.01). The average birthweight of babies born to women who had stopped smoking was higher than that born to never smokers. The average birthweight of babies born to women who smoked during pregnancy was lower by 119 g and 171 g than that of the babies born to never smokers and former smokers, respectively. When pre-term neonates were excluded, differences in birthweight between babies born to never smokers and either formerly smoking or still smoking mothers were slightly lower. The greatest effect of ETS exposure on birthweight was recorded in never smoking mothers; an average reduction in birthweight was 88 g. A strong dose-effect was observed; in mothers heavily exposed to ETS both at home and at work, the babies' birthweight was lower by 189 g in comparison with the group of non-exposed, never smoking mothers and even by 70 g compared with mothers smoking during pregnancy.

Most of the 26 new O (O77-O102) and 10 new H (H42-H50) and H1a1d antigens were found in various P. shigelloides strains isolated from man and other mammals, birds, fish, and water and water insects, not only in the Czech Republic but also in 12 foreign countries.

The aim of the investigation was to study the effect of long term repeated heat exposure on the excretion rates of stress hormones of workers in glass manufacturing unit. Sixteen operators, exposed to heat, were studied during the hot period and compared to a control group of 16 subjects, working in the same manufacturing unit. Both groups had moderate work load. The microclimate components and the Wet Bulb Globe Temperature were used for defining the heat exposure. The excretion rates of cortisol, adrenaline and noradrenaline were followed during the early morning shifts on three hour intervals using RIA and fluoriphotometric methods. Heart rate was followed, too. The psychosocial factors were measured by the "My job" questionnaire. Highly significantly higher cortisol, noradrenaline and adrenaline values were measured in the heat exposed operators compared to the control group, while significant differences of the psychosocial factors between the two groups lacked. Even if the heart rate was in the safe limits, the found alterations in the stress system are considerable and indicate heat stress. The work in conditions of overheat is associated with considerable heat stress and the possible health implications need to be clarified.

Cloacal examination of 41 juvenile black-headed gulls (Larus ridibundus) by cultivation demonstrated Campylobacter jejuni in 26 (63 %) and Salmonella typhimurium in 21 (51 %) of them. All the bird samples were collected in a breeding colony near the town Hodonín, South Moravia, Czech Republic in 1996. Twenty six Campylobacter isolates were tested for antibiotic and drug sensitivity: all were resistant to at least three agents (Penicillin, Tetracyclin and Sulfomethoxazol-trimethoprim) while all were sensitive to Augmentan, Cefotaxim, Ciprofloxacin, Erythromycin, Nitrofurantoin and Cephazidine. Four percent of isolates were resistant to Ampicillin and Nalidixic acid. Of the 21 S. typhimurium isolates tested, 33 % were sensitive to all drugs assayed, proportions of the strains resistant to Sulfomethoxazol-trimethoprim, Tetracyclin and Streptomycin were 58 %, 16 % and 8 %, respectively.

The basic objective of the programme of monitoring the dietary exposure in the Czech Republic is to describe the character of the health risk based on the exposure of the Czech population to chemical substances in food. The conception of the monitoring programme is based on the methods of the Total Diet Study, established on the principle of defining the consumption of the most important foodstuffs, their purchase in the network of stores in selected shops on fixed dates, their transport to the central laboratory, cooking and consequent chemical analyses in the central laboratories. In the Czech Republic monitoring has been conducted since 1991/1992 and routine activities have been ongoing since 1994. The programme is fully sponsored by the government. Monitoring carried out in 1994-2001 provided a considerable amount of information, which was applied when drawing programmes of health protection and promotion, in regulatory work and when solving problems of the international food trade.

In the period of 1994-1997, 4,552 samples of sectional, clinical material and environment were examined for the presence of Plesiomonas shigelloides. In 55 cases (1,21 %) Plesiomonas shigelloides was isolated. Within 55 isolated strains, 26 serovars have been successfully identified. Among other secured cases was Plesiomonas shigelloides isolated in pig (Sus scrofa domestica), mouse Mus musculus), binturong (Arctictis binturong) and raccoon (Pocyon lotor). In mandarin duck (Aix galericulata) the strain of Plesiomonas shigelloides with a new 0 antigen-097 was isolated. In regard of the particular biological classes, the isolation of Plesiomonas shigelloides in fish (2.63 %) predominate, followed by reptiles (1.66 %), mammals (0.94 %) and birds (0.79 %). Plesiomonas shigelloides in amphibians was not demonstrated. This work surveys the incidence of Plesiomonas shigelloides and its serovars in animals in the region Moravia in the Czech Republic.

Carpal tunnel syndrome (CTS) is a painful disease of the wrist which is usually treated with corticoids locally or surgically. In this study combined infusion therapy with procain, pentoxyphyllin and magnesium sulphuricum in patients with CTS was evaluated retrospectively. 101 manually working patients (65 male, 36 female) aged 42.8 ± 8.6 years, initially examined at our department to assess professional origin of the disease and who had abnormal conduction to the distal section of median nerve on electromyography (EMG), were entrolled. The group of patients was heterogenous etiologically. 41 % of patients were found to be exposed to overlimit vibrations, while 21 % of patients were exposed to overload of upper extremities and 16 % patients to both the risks. The professional hazard was not proved in 23 % of patients. In these patients 166 CTS were diagnosed of which 144 improved after the treatment, while the condition remained unchanged in 11 and even worsened in another 11 cases. Using the clinical and EMG criteria the findings were divided to mild, moderate and severe CTS. 77 mild CTS improved by 61 % in average, 63 moderate CTS were improved by 47 % and 26 of severe CTS improved by 50 %. There was no association between the treatment outcome and sex, age or severity of symptoms. Patients with unfavourite outcome and the possible causes of treatment failure are discussed in detail.

Pregnant women living in Brno who were contacted for the first time at 18th week of their pregnancies during the period from February 1990 to January 1992 were involved into the ELSPAC group. Among others, the exposure to different occupational factors in the three periods was obtained by the self-reported questionnaire: 1. the last 9 months before pregnancy, 2. the first, and 3. second trimester periods. The women's health status during pregnancy, the history of delivery and the developmental and health status of newborns were described in details by obstetrics and pediatrics according to another internationally unified questionnaire. All data obtained from 3,897 pregnant women living in Brno were computered. Smoking women were significantly more often than non-smokers occupationally exposed to ergonomic stressors associated with the monotony work, and to chemical substances. In the whole group, the intrauterine growth retardation has been positively associated with shifting (OR 1.59, p < 0.05) and occupational exposure to permanent noise (OR 1.92, < 0.05). Newborns of such exposed women had in average lower parameters of head cimcumstances (p < 0.01). Non-physiologic, non-spontaneous deliveries have been more often observed among VDTs users (OR 1.20-1.28, p < 0.05). Women exposed to organic solvents during 2nd trimester of pregnancy delivered more often babies with some congenital malformations (OR 2.31, p < 0.05). On the other hand, the different occupational factors seemed to be protective for several markers of the women health status, as the prevalence of reproductive damages was significantly lower among exposed women than in the non-exposed group. After the standardization of the smoking habit, more significant associations have occurred in the group of smokers occupationally exposed to: shift work (low-birth-weight babies: OR 1.98, p < 0.05), chemicals (bleeding during pregnancy: OR 2.00, p < 0.05), sedentary work (placental abnormalities and congenital malformations: OR 1.59, p < 0.05). Non-smoking women using VDTs had more often babies with intrauterine growth retardation (OR 2.29, p < 0.05). Newborns with different malformations were more often born to non-smoking women occupationally exposed to chemicals (OR 2.33, p > 0.05).

In 28 neonates born by spontaneous delivery to healthy mothers with a normal course of gestation venous umbilical blood was examined to assess the immunoreactive insulin concentration. Moreover, the birth weight of the neonates was recorded, the weight increment of the mother during pregnancy and the body mass index at the end of gestation. By means of a questionnaire and the computer programme Progana the dietary intake of the mothers at the end of pregnancy was assessed and compared with recommended allowances. The assembled data were evaluated statistically by assessment of the correlation coefficient. The investigation revealed that the birth weight of the neonates in the group does not correlate with the immunoreactive insulin concentration in umbilical venous blood. Although the dietary intake of the mothers at the end of pregnancy is not ideal (fat and cholesterol intake predominates over carbohydrate and protein intake), it does not correlate with the birth weight of the neonates nor with the immunoreactive insulin concentration in umbilical venous blood. From these results the conclusion is drawn that neonates with a low birth weight do not have a higher plasma insulin concentration after delivery and that the mother's diet at the end of pregnancy does not influence the birth weight and insulin level in neonates.

The fumonisins, mycotoxins produced by Fusarium moniliforme, are known to occur worldwide as natural contaminants of corn. They are associated with several animal diseases and are a potential threat to human health. A total of 127 samples of corn-based foods (gluten-free diet) in the Czech Republic were analysed by Ridascreen Fumonisin Fast ELISA methods in years 1995-1996. Eighty eight % of the corn-based foods were found to be positive for fumonisins (FB1, FB2, FB3) and 12 % of the examined corn-based foods laid below of a determination limit which was about 9 ng fumonisins/g corn-based foods. The highest fumonisin contamination levels were recorded in extruded corn products containing up to 1,808 micrograms/kg of fumonisins. Levels ranging from < 9 to 1,243 ng/g fumonisins were detected in polenta. Lower levels of fumonisins were found in other commodities, such as corn flour (up to 487 ng/g), corn instant porridge (up to 788 ng/g), and corn pastes (511 ng/g). Intake of fumonisins from several corn-based foods (gluten-free diet) for the population with coeliac disease was estimated. The highest estimate of exposure dose of fumonisins was determined from corn-extruded bread: 3.2 micrograms/person/day (mean of measured values). Daily intake of fumonisins from polenta is expected 2.8 micrograms/person/day (mean). The lower exposure dose of fumonisins we can expect from corn instant porridge, corn postes and other corn products - corn and amaranth biscuit, corn beverage: 0.9, 1.1 and 0.3 micrograms/person/day (mean) respectively.

Repeated serological investigations (CFT, IFT, ELISA) of 50,000 pregnant women revealed that 5.1 ‰ pregnancies in the Karvina district, Czech Republic are threatened by toxoplasmosis. In 2.8 ‰ pregnancies the infection was contracted shortly before pregnancy, one third of them ended by spontaneous abortion. In this group the birth of a congenitally infected infant is rare. Primary infections of women who are already pregnant (2.3 ‰ of pregnancies) are much more serious. This number comprises 1.2 ‰ pregnancies with a spontaneous abortion and 1.2 ‰ pregnancies leading to the delivery of a congenitally infected infant. By early detection, i.e. repeated serological examinations in all pregnancies, and by treatment of patients with Toxoplasma infections this hazard can be reduced substantially, i.e. to one eighth.

The aim of this study was to objectify and to clarity some mechanisms of the immune response of the professional sensitization with MDI. 26 workers were tested for sensitization of immediate type (ST with a broad set of indoor allergens and serum MDI-IgE) and of delayed type (ST with a standard battery of antigens for cellular immunity and with MDI), also the lymphocyte sub-populations and their functional state by flow cytometric analysis. The most frequent allergic complaints were: rhinits (70 %), skin manifestations (53 %), conjunctivitis (35 %) and initial bronchial asthma in two cases (12 %). We found indoor sensitization in 41 % and normal cellular immune reactivity in all the workers tested. Specific MDI sensitization of immediate type was found in 28.5 % of the workers and of delayed type - in 70 % of the workers with allergic complaints. The laboratory immune indices suggest prevalence of cell - mediated mechanisms for the workers with allergic symptoms - production of INF gamma, responding to stimulation and deficient or insignificant production of IL-4, as well as linear correlation between the data for CMI, INF gamma, and IL-4. Our results suggest the participation of more than one mechanism of immune injury in the clinically manifested allergic reactions.

In recent years the reassessment of goitre prevalence in Romania (thyroid palpation and urinary iodine levels) revealed two aspects: excessive goitre distribution in mountainous regions and hilly areas with geochemical iodine deficiency but also in plains and high goitre prevalence even if the concentration of urinary iodine is normal. These facts made us seek a possible interaction of some pollutants (nitrites, organochlorine pesticides) and iodine metabolism. We examined a group of 408 subjects: 100 children aged 6-16 years and 308 women 18-35 years of age; all living in Bucharest city. The examination revealed 94 goitre cases (23.0 %); only 10.0 % of whole group had urinary iodine less than 5.5 µg/dl. In 108 cases (26.46 %) the value of urinary nitrites was between 0.04-5.85 mg/l, from these subjects 62 had goitre and urinary nitrites and 46 subjects (11.2 %) had urinary nitrites without goitre. Urinary level of organochlorine pesticides (OCP) in goitre cases was in all sample between 7.6-35.2 µg/l. The presence of the nitrites especially in large concentrations and OCP, together with known factors, probably influences the process of goitre genesis.

The paper studies impacts of particular toxoplasmosis risk factors (consumption of raw meat and contact with cats), their interactions, and their relationship with the personality of the subjects. Among 243 men and 343 women the frequency of subjects with antitoxoplasma immunity was 26.6 % and 21.6 %, respectively. The association of antitoxoplasma immunity (assessed by the toxoplasmin skin test) with the two risk factors was estimated by log-linear analysis. Reported contact with cats has no influence on the probability of having antitoxoplasma immunity (P = 0.23) while the consumption of raw meat increased this probability (P = 0.0008). Very strong positive association between the contact with cats and the raw meat consumption was found among subjects without toxoplasmosis (P = 0.0028), suggesting that among these persons some subjects either incorrectly assessed their exposition to the risk factors or provided false data during the interview. The results of logistic regression suggest that the contact with cat and the consumption of raw meat are associated with particular personality traits. However, these traits differ from those associated with antitoxoplasma immunity suggesting that the correlation between antitoxoplasma immunity and consumption of raw meat reflects epidemiological importance of the raw meat rather than a correlation of both factors (raw meat consumption and probability of acquiring toxoplasmosis) with the subjects personality.

The effect of temperature throughout 18 day-storage and the efficacy of different free chlorine concentrations in washing solutions upon the survival of Yersinia enterocolitica on surface of inoculated fresh tomatoes were studied. Two virulence plasmid-bearing strains. A. Y. enterocolitica W1024 0:9 - a reference strain - and B. Y. enterocolitica B1 0:5 Lis Xz - a strain isolated from food in San Luis, Argentina, were assayed. Counts of both strains at 6 °C did not present significant changes during the first 4 days, but increased until day 15. Both strains were able to grow on tomatoes stored at 22 °C and 35 °C. At 22 °C maximum values were obtained on days 3 and 4, with a subsequent significant decrease. Highest counts were obtained at 37 °C. No detectable levels of viable cells were observed by using 500 ppm free chlorine washing solution. Non-inoculated tomatoes were analyzed for Y. enterocolitica with negative results. Zero tolerance for pathogenic Y. enterocolitica strains has been recommended for ready-to-use vegetables. Therefore, sanitary measures should be taken in the manipulation and storage of fresh tomatoes.

The Karviná district (northwestern part of North Moravia and Silesia) is typical by its industrial character, above all mining of black coal which is coked and which led to the devastation of the countryside. The ratio of light industry is low. In a small area (347 km²) there is a population of 824 inhabitants per km². The population is concentrated in particular in urban agglomerations of the flat block type. Up to 1990 almost 55 % of the population was employed in heavy industry. Due to its industrial activities, incl. metallurgical plants and ironworks in nearby Ostrava and Trinec, the district is one of the areas with a heavily contaminated atmosphere in particular with solid aerosol containing toxic metals (the values of solid aerosol varied on average between 100 and 150 µg/ml), the elevated values of Nox due to contamination from traffic and polyaromatic hydrocarbons were not negligible either during the investigation period. Since 1968 an endemic incidence of mycobacteria has been recorded which is due to Mycobacterium kansasii. At first only an occasional incidence was involved, since 1973 there has been a more substantial increase with a maximum in 1983 (64 cases) and thus up to 1995 there are 961 cases on records, incl. 787 (81.8 %) in men and 174 (18.2 %) in women. From the total number of recorded M. kansasii in 937 instances (97.3 %) the lungs were affected (777 men, 160 women). The mean annual incidence was 34.3 cases, i.e. 12.03 per 100,000 population (28.1, i.e. 20/100,000 in men, 6.2, i.e. 4.28/100,000 in women). As to age, 78.8 % of cases are recorded in the age bracket from 25 to 64 years (in men 81 %, in women 68.9 %). The highest specific morbidity in men is in the age group from 45-54 years (on average 73.13 per 100,000 per year), in women in the age group from 75 to 84 years (on average 9.75 per 100,000 per year). As to occupation, the ratio of mine employees at the time of contraction of the disease (incl. retired miners) was 52.2 %), other workers 14.6 % - all stigmatized by an increased dust concentration in other workplaces in heavy industry. As far as the domicile is concerned, the incidence was by far highest in Havířov (more than 56 %), followed by Karviná (26.7 %). These towns are inhabited mostly by miners. As to the mode of assessment 68.8 % cases were diagnosed on account of pulmonary complaints and during dispensarization (stigmatization by dust) and 24.6 % cases during preventive radiodiagnostic examinations of miners lungs. It did not prove possible to reveal the source. Interhuman transmission was not proved in any of the patients. The causal agent of the infection is most probably transmitted through water (by the aerogenic route). M. kansasii was isolated from drinking water (560 samples, in 7 % M. kansasii was found), as well as in industrial water. In 1971-1995 a total of 1231 samples of industrial water were examined (scrapings and untreated water). From these M. kansasii was isolated in 43.7 % (538 specimens). In soil samples (93) and small mouse-like rodents (187) M. kansasii was not detected. The authors confirm that the development of disease depends in a decisive way on the susceptibility of the individual which in turn depends in particular on exposure to dust w

Cardiovascular mortality and morbidity in the Czech Republic are among the highest in the world. The morbidity data, however, are not routinely registered and thus a basis for preventive program evaluation is not available. Aim of the study is to establish the incidence of acute myocardial infarction in the Olomouc district in 1994 and to compare it with the incidence of this disease in the Czech Republic. Cases of acute myocardial infarction (diagnosis 121 according to the 10^th revision of ICD established by a physician) were included. Sources of data concerning the diagnosis included the registries of internal clinics, departments of internal medicine, department of forensic medicine of the Faculty of Medicine in Olomouc, and general practitioners practising in the Olomouc district. Data concerning myocardial infarction mortality were obtained from the Olomouc Regional Statistical Office. The 6^th version of EPI-Info Programme was used to process the data. In 1994, 523 cases of acute myocardial infarction were diagnosed in the Olomouc district, 313 in men and 210 in women. The respective incidence per 100,000 inhabitants was 227: 286 in men and 178 in women. Acute myocardial infarction mortality per 100,000 in Olomouc district was 98.05, it is 109.57 in men and 87.26 in women. For comparison, acute myocardial infarction mortality per 100,000 in the Czech Republic at the same period was 171.4 and 117.2 for men and women, respectively. Highest incidence was observed in March and October/November, lowest occurrence was observed in July and August. The incidence decreased with increasing size of the place of residence. As to the latter, further analysis is required to formulate conclusions concerning the morbidity trends.

Active exercise therapy plays a decisive role in the prognosis for early forms of peripheral arterial occlusive disease (stages I and II). We present a model project for an outpatient claudication group which has proved successful in the active exercise therapy of early forms of arterial occlusive disease (PAOD). In addition to the training principles familiar from intensified, performance-keyed walking programs, a newly developed pedal ergometer was employed which makes controlled endurance training possible for this patient group. The distance patients were able to walk without pain increased significantly in 17 out of the 26 patients taking part in the program. This clinical success was confirmed by an examination of arterial hemodynamics. The transformation of a theoretical concept into a functioning training program and the positive results achieved with it should encourage others to establish similar programs close to the patients' homes.

In spite of a large collection of MAbs used for the whole-cell ELISA (WCE) in the National Reference Laboratory for Meningococcal Infections in Prague 50-80% of N.meningitidis strains isolated in the Czech Republic remained non-typable (NT) and/or non-subtypable (NST). A project focused on the problem of NT/NST N.meningitidis was started and the new serotype candidate designated "22" resulted from this research. This paper presents the method of preparing and testing of the monoclonal antibody (MAb) specific for this new serotype and the first experience acquired from using it. The new serotype-specific MAb is of IgG3 class, does not react with any serotype/subtype reference strains and reacts in WCE with the strain used for its production and with some other NT/NST strains in the dilution 1:1,000. A collection of 97 N.meningitidis B:NT strains isolated from cerebrospinal fluid and/or blood of patients with invasive disease in the Czech Republic since 1973 to 1995 was serotyped using the new serotype "22"-specific MAb and 37 of these strains (38.2%) gave positive WCE result. The total number of 59 N.meningitidis B:NT strains isolated in 1995 from various clinical situations were serotyped and 26 of them (44.1%) were positive with the new serotype "22"-specific MAb. Seven of these N.meningitidis B:NT strains isolated in 1995 from various clinical situations were serotyped and 26 of them (44.1%) were positive with the new serotype "22"-specific MAb. Seven of these N.meningitidis B: "22" strains were isolated from cerebrospinal fluid or blood of patients with invasive meningococcal disease and prevailed in the age group of 0-4 years (5 cases). The significance of the new serotype candidate was underlined recently, when this serotype "22" was recognized in N.meningitidis B strain isolated from a died 10 months old boy. These results indicate the epidemiological and clinical significance of the new serotype candidate "22" in the Czech Republic.

The purpose of the paper is to present the effects of active and passive tobacco smoking during pregnancy on the birth weight in the sample of 1165 schoolchildren covered by the health survey in Cracow. Data on main-stream tobacco smoke (MS) and side-stream tobacco smoke (SS) and the birth weight of children were collected by standardized interviews with mothers. As expected, exposure to MS tobacco smoke was the single strongest factor related to the reduced birth weight, however, the effect was statistically significant only in those respondents who confirmed the cigarette smoking over the whole pregnancy period. On the basis of multiple regression model considering child's gender, active and passive smoking during pregnancy, parity and gestational age, it was estimated that MS tobacco smoke is to reduce the birth weight on average by about 210 g, however, in heavy smokers up to 450 g. The effect of SS tobacco smoke was to reduce birth weight by about 60 g after accounting for confounders. Both effects of active and passive smoking in pregnancy were statistically significant. When the self-reported smoking status was compared with plasma cotinine levels in women at delivery, a substantial misclassification error has been disclosed and it resulted mainly from the low sensitivity (47%) of the self-reported data on smoking status. This exposure bias may lead to a significant underestimation of correlation between low birth weight (< 2500 g) and tobacco smoking of mothers in pregnancy. Odds ratio (OR) corrected to exposure misclassification was much higher than the crude one (corrected OR = 8.0, crude OR = 2.9).

Viral hepatitis A is a common disease, particularly in developing countries. All staff and troops of the U.N. (United Nations) are vaccinated by the Havrix vaccine. Till 1995 we did not vaccinate Czech troops which have operated in the area of former Yugoslavia. The main goal of this study was to obtain data about the seroprevalence of hepatitis A antibody among the Czech U.N. troops before their departure to the conflict area and to optimize the vaccination approach. The serum samples were examined by the MEIA (Microparticle Enzyme Immunoassay) method in the fully automated system for immunoassays IMx in the Military Institute of Health in Ceské Budĕjovice. We used HAVAB kits of Abbott Company. 692 serum samples (military staff of the Czech U.N. troops in Yugoslavia) were examined in 1991-1995. In the laboratory 19 samples were eliminated due to small amounts (less than 50 microliters) or haemolysis. 673 (1991 - 65, 1992 - 296, 1993 - 265, 1994 - 35, 1995 - 12) were investigated. The staff was divided into four age cohorts by decades (20-29, 30-39, 40-49, 50-59); 26.0%, 47.4%, 24.9% and 1.7%, respectively. There were 253 (37.4%) positive samples and 420 (62.6%) negatives ones, ratio 1:1.7. The ratio of the positive and negative samples - immunity rate and seroprevalence - were 1:0.4 (26.2%), 1:0.6 (37.9%); 1:0.9 (46.4%) and 1:2.7 (72.7%), respectively in the age cohorts. The results show a relatively low seroprevalence of the anti-HAV antibody in all the age cohorts and necessity to vaccinate the Czech U.N. troops by the special basic schedule - Havrix 2 x 720 E.U. at the same time. This regimen will be used in the new units that will be stationed in Bosnia. So far 200 persons have been vaccinated in this way.

A commercially available set, the Gen-Probe amplified MTD test (Mycobacterium tuberculosis Direct Test; Gen-Probe Incorporated, 9080 Campus Point Drive, 92121 California, USA) has been applied for the detection of the M. tuberculosis complex in clinical material in parallel to direct microscopy and cultivation in liquid and solid growth media. The method is based on the amplification of a specific 16 S rRNA segment. Detection of the amplified segment is facilitated by single-strand probes tagged with acridinium ester. Hybridization results are interpreted in RLU (Relative Light Unit) values and readings exceeding 30,000 RLU are considered positive, lower values being negative. In all, there have examined 69 samples of clinical material (35 sputums, 29 bronchoalveolar washings or bronchial aspirations, and 5 cerebrospinal fluids). As positive amplification controls served freshly cultured strains of M. tuberculosis and M. bovis BCG; negative controls were M. gordonae, M. xenopi, M. kansasii, and M. terrae. Out of a total 69 samples examined, M. tuberculosis was detected in 28 (40.7%) cases by the Gen-Probe amplified MTD test, in 10 (14.5%) cases by direct microscopy, and in 26 (37.7%) cases by cultivation. In samples from 8 patients M. tuberculosis was detected by just Gen-Probe amplified MTD test the results of cultivation and direct microscopy being negative. Culture-positive samples yielded no Gen-Probe amplified MTD test negative results. The Gen-Probe amplified MTD test contributes significantly to the speeding up of diagnostics in tuberculosis because the results is obtainable with six hours. Under the conditions of this pilot study the results were termed as preliminary and collaborating physicians were advised to wait for cultivation results and their definite evaluation.

Concentrations of chlorinated pesticides (p,p'-DDE, lindane), hexachlorobenzene (HCB), sum of polychlorinated biphenyls (PCBs), and PCB congeners in breast milk during lactation and the distribution of the chlorinated compounds in fat tissue, blood serum and breast milk were pursued in five primi- or secundipara from the hinterland of a clinic of gynaecology and obstetrics in Brno in 1993. Capillary gas chromatography with ECD detection was used for the determination of the residues. The concentrations of HCB, lindane, p,p'-DDe, and sum of PCBs ranged from 42.5 to 238.4, from < 1.0 to 7.4 from 231.4 to 557.6, and from 661.3 to 2888.9 micrograms.kg-1 of milk fat, respectively. Seventeen PCB congeners were screened, of which 11 were identified in most of the milk samples (IUPAC numbers 28, 101, 118, 126, 128, 138, 153, 156, 170, 180, 194). Congeners 138, 153, 170, and 180 were the most abundant and their concentrations in microgram.kg-1 of milk fat ranged from 122.9 to 501.0 for 153, from 103.4 to 372.1 for 138, from 66.1 to 407.9 for 180, from 26.8 to 183.1 for 170, and from 10.0 to 41.7 for 118.

An indirect fluorescent antibody test was performed on sera collected from dogs housed in the municipal kennel of Setúbal to assess the prevalence of antibodies to Ehrlichia canis, the causative agent of canine ehrlichiosis and to Rickettsia conorii, agent of boutonneuse fever in humans. Two other members of the family Rickettsiaceae, Coxiella burnetii and Rickettsia typhi, were included in the serosurvey. Of the 104 dogs tested, 85.6% had antibodies to R. conorii, 50% to E. canis, 26.9% to R. typhi, and 4.8% to C. burnetii. These high seroprevalence rates of dogs with antibodies all year around against Rickettsiaceae suggest that physicians, public health officers and veterinarians should more frequently consider the diagnosis of these infections in Portugal.

Two hundred and ninety-four vibration-exposed workers were examined for vibration disease (VD) for the worker's accident compensation. Most subjects were male. Their ages ranged from 24 to 68 years. Duration of vibration exposure ranged from 3 to 30 years. After acclimatization at 25 degrees C to 27 degrees C for at least an hour, the nailfold capillaries of the ring (or middle) finger were studied with a light microscope. A cold water immersion test (5 degrees C, 10 min) was then performed. The morphological findings of the nailfold capillaries were classified based on the criteria by Fagrell & Lundberg. A hundred and eighty subjects were diagnosed as VD and 75 as non VD, even without taking the capillaroscopic findings into consideration. The classification of the capillarograms retrospectively investigated were as follows, i.e. in 98 VD subjects 40 cases were stage A, 42 stage B, and 16 cases stage C. In 26 nonVD subjects 13 cases were stage A, 10 stage B, and 3 cases stage C, respectively. When the borderline of VD and nonVD existed between stage A and stages B and C, the sensitivity was 59.2%, specificity was 50.0%, and false positive and negative were 50.0% and 40.8%. Relationship between the capillary stage and recovery (%) of the skin temperature during the cold water immersion test was also studied. The recovery in stage C was not always lower than that in stage A. Among them, arteriography was performed in 57 cases. Despite the use of vasodilator, markedly delayed perfusion of the finger tips was observed in 28 cases. Their capillary stages were A in 12 cases, B in 11 and C in 3. The peripheral microcirculatory state in VD should be carefully evaluated in combination with appropriately selected examinations, including finger nailfold capillaroscopy.

The effect of vibration on thin unmyelinated sensory fibers was studied by perception threshold measurement of heat pain. The investigation was a cross-sectional study of 98 vibration-exposed and 53 non-vibration-exposed workers. Pain perception was determined by using the "Marstock" method. The perception threshold of contact heat induced pain was assessed by the method of limits. Quantified personal energy-equivalent vibration exposure was assessed for all subjects on a group basis. The cumulated lifetime equivalent frequency-weighted vibration exposure was estimated based on measurements according to ISO 5349. The mean heat perception threshold was 46.2 degrees C (SD 2.6 degrees C) for the right hand and 46.0 degrees C (SD 2.7 degrees C) for the left. The results showed no mean difference (left = 0.1 degree C, right = 0.6 degree C) in heat pain perception between vibration-exposed and non-exposed subjects. There was a high correlation between the right and left hand measurements (r = 0.81). The risk (rate ratio) for impairment was 1.02 (95% CI 0.81-1.30) for the right hand and 1.00 (95% CI 0.79-1.26) for the left. The results of the study did not indicate any impairment as assessed by an increased perception threshold for heat pain. The lack of an increased heat pain threshold among the vibration-exposed workers in our study cannot exclude a possible lesional somatosensory influence from the exposure, as the lesional effect may also be a lowering of the threshold. The multiple and unrelated percepts of thermal sensations imply that it is not legitimate to draw conclusions about the total status of the small calibre afferents when testing only the heat pain perception.