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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: Pediculosis humanus capitis is a worldwide public health concern that affects mostly school-aged children. The aim of this study is to determine the rate of pediculosis and to determine possible risk factors in a group of primary school children in Valencia, Spain; 227 children, 6-7 years old, were selected from 7 schools. Methods: A self-reported questionnaire completed by the parents/guardians about the presence of pediculosis in their children and their knowledge about pediculosis. The results recorded in the questionnaire were analysed by SPSS® software. Results: 30.4% of the children had pediculosis. The results showed significant variation (p < 0.05) in prevalence depending on the following factors: sex, hair length, level of parental education, family size, presence of affected family member in the home, and frequency of hair washing. Less than half of parents/guardians showed an appropriate level of knowledge on pediculosis. Pediculosis remains a health problem in Valencian schoolchildren. The family size and existence of another member with pediculosis were shown to be the main potentiating factors. Conclusions: Parents are not sufficiently informed about pediculosis and adopt inappropriate practices. There is a need to promote studies with the objective of determining risk factors for pediculosis as well as the need for actions to increase the knowledge of parents and healthcare professionals on this parasitosis to prevent outbreaks in the community, assure correct treatment and maintain effective epidemiological surveillance.

Objectives: The current study examined the links and interactions among headaches, screen-based media use, physical activity, sleep, and the family environment in Lithuanian school-aged children during the second COVID-19 lockdown. Methods: The study comprised data of 541 children aged 7-14 years from different Lithuania regions, and without chronic health conditions or developmental disorders. Information about the child was provided by their parents or caregivers who filled questionnaire on child's screen time, sleep duration and quality, physical activity, parental distress, parent-child relationship, history of child's headaches and infectious diseases. Results: During the study period, 54% of the children had headaches, and the frequency was positively associated with child's age, screen time and parental distress, as well as negatively related to physical activity (PA), sleep quality, and the parent-child relationship. Parental education was related to child's PA, screen time and sleep quality. The results of binary logistic regression analysis and path analysis revealed that sleep quality and parental distress were significant predictors of headaches in children. Conclusions: Family and child or adolescent education and lifestyle modification aiming to improve sleep hygiene and PA, and to reduce screen-based sedentary behaviour should be provided. Family centred approach for more effective coping with distress and improvement of parent-child relationship is also important in treating child and adolescent headache.

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: HIV positivity diagnosis is often accompanied by stigmatization and discrimination, even in developed societies. The aim of the study was to obtain current information on the quality of life of people living with HIV in the Czech Republic, to assess the level and perception of stigmatization and discrimination, and to identify existing problems of people living with HIV concerning health services, family and the public. Methods: Data for the pilot study were collected by convenience sampling between 2021 and 2022. Respondents were recruited from residents of Czech nationality and foreigners living with HIV in the Czech Republic who participated in an ECDC online questionnaire study or attended a convalescent stay for people living with HIV. Likert scales were used to capture key opinions, attitudes and beliefs of respondents. Data were processed using descriptive analysis. Results: The study involved 42 people living with HIV. A total of 77% of the respondents reported that they had learned to live with their HIV-positive status, but 21% admitted to having low self-esteem due to their status. A total of 81% of the respondents had disclosed their HIV-positive status to someone outside of the healthcare setting, however, 40% of the respondents found it difficult to do so. Assault or threats from a sexual partner were reported by 17% of the respondents. A total of 27% of the respondents admitted having been denied or suspended health care, 44% reported inappropriate comments from healthcare workers, and 32% of the respondents avoided visiting the healthcare facility. Alarmingly, 41% of the respondents had been refused dental care at some point in the past because of their HIV-positive status. Conclusions: Although the study presents only limited findings due to the small number of respondents, it is clear that stigmatization and discrimination of people living with HIV exists in the Czech society. It brings the risk of loss of motivation and involvement of people living with HIV in working together with healthcare providers on their treatment. There is a clear need for a larger study to identify the causes of stigmatization and to find ways to prevent it.

Objectives: Per- and polyfluoroalkyl substances (PFASs) are a large group of persistent synthetic chemicals widely used commercially. They accumulate increasingly in all environmental components and enter the organisms, including humans. Some of them are associated with the risk of harm to health, among others with metabolic disorders. To test the associations between blood serum levels of PFASs and blood lipid profile as well as metabolic syndrome, we linked human biomonitoring with the Czech Health Examination Survey (CZ-EHES) conducted in 2019. Methods: A total of 168 participants of the CZ-EHES survey aged 25-64 years were examined including anthropometrical data and analyses for serum PFAS and blood lipid levels. Extended model approach in multiple linear regression models was used for identification of the associations between serum levels of 11 PFASs and lipid profile components. The relation between PFAS serum levels and metabolic syndrome prevalence was tested using a logistic regression model. Results: Six PFASs were detected over the limit of quantification in at least 40% cases and were examined in subsequent analyses: perfluorodecanoic acid (PFDA), perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUdA). The most dominant was PFOS with the mean value amounting to 4.81 ng/ml. After adjusting for potential confounders, we found a significant positive association between serum PFHxS and blood total cholesterol (p = 0.005) as well as LDL-cholesterol (p = 0.008). Significant positive association was also found between PFDA and HDL-cholesterol levels (p = 0.010). No significant associations were detected between PFASs and triglycerides, and between PFASs and metabolic syndrome. Conclusions: We found some evidence of a significant association between blood serum PFAS levels and blood cholesterol levels. Our results did not confirm an association between serum PFASs and the metabolic syndrome prevalence.

Objective: Acute flaccid paralysis (AFP) is a major neurological problem. Turkey has accepted over 4 million refugees since 2011 due to the wars in neighbouring countries. In the long term, refugees can have adverse effects on the limited resources of health, sanitation, water supply, foodstuff, and shelter services of host countries, precipitating the transmission and spread of enteroviruses causing AFP. This study examines the 13-year surveillance and incidence of AFP cases in southeast Turkey, and questions possible impact of refugee movements on these parameters, comparing the periods before (2007-2010) and after (2011-2019) 2011, when the refugee movements emerged. Methods: The records of cases reported from southeast part of Turkey with suspected AFP between January 2007 and December 2019 were reviewed retrospectively. Results: Of the patients, 121 (58.5%) were male. Mean age was 80.36 ± 46.67 months. Eighty-five (41.1%) were aged 60 months or younger. The number of patients under 60 months increased significantly after 2011. Mean incidence was calculated as 0.88 cases/100,000 person years versus 1.58 cases/100,000 person years in the period before and after 2011, respectively. Guillain-Barré syndrome (GBS) was the most common cause of AFP in both periods. As of 2011, however, the incidence of acute transverse myelitis increased approximately 4 times and GBS decreased proportionally. Non-polio enteroviruses were the most frequent isolates, detected from 9.1% of stool samples. Conclusion: Although refugee movements appear to may have adverse effects on AFP incidence and surveillance outcomes, larger studies involving the whole country, particularly at places where no refugees settled, are needed to achieve more conclusive evidence.

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.

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: Breast cancer is the leading cause of cancer mortality among women in Serbia and accounts for 22.8% of total cancer mortality in 2018. This study assessed the knowledge and barriers to early detection of breast cancer in women. Methods: In March 2019, at the Primary Healthcare Centre Kikinda, Serbia, a 22-item questionnaire was distributed to a series of patients (N = 403, response rate 91.8%) to assess the odds ratio (OR) and 95% confidence interval (CI) between variables explaining knowledge of breast cancer symptoms and risk factors and barriers to screening, and four types of early detection of breast cancer. Results: The majority of patients (85.4%) know that a lump in a breast is a common symptom of breast cancer and that a family history of breast cancer is a risk factor (80.1%); 63.8% of respondents aged ≥ 30 years self-examined their breasts in the past month, 39.1% of patients aged ≥ 40 years had clinical, while 34.4% had ultrasound breast examination in the past year, and 51.1% of patients aged ≥ 50 years had mammography once in the past two years. Patients aged ≥ 40 years retired and those with a positive family history were 84% and 63% less likely not to undergo a clinical breast examination in the past year. Participants over 40 years of age who reported a lack of funds were 2.46 times more likely to miss a clinical breast examination than those who did not have that barrier. Among participants aged 50-69 years, the likelihood of not receiving the mammography increases by 2.82 with an increase in wealth status and it was 65% lower for those who lack information about the available treatment. Conclusion: Women under the age of 50 rarely practice breast cancer screening. Study findings can be used to improve breast cancer screening at the primary level.

Objectives: Roma population is one of the major ethnic groups in the Central and Eastern Europe, having high rates of chronic diseases and associated risk factors related to their poor social conditions, unhealthy lifestyle and low educational level. The purpose of our study was to assess the health status of Roma from South Bulgaria by means of blood indicators and determine the prevalence of some cardiovascular (CV) risk factors in the Roma population sample. Methods: The study group consisted of 60 Roma (23 men and 37 women), mean age 53.7 ± 15.9 years, and the control group consisted of 68 non-Roma from the majority population (29 men and 38 women), mean age 45.8 ± 12.2 years. The data were collected via questionnaire, anthropometric measures, and venous blood samples analyses after an overnight fasting. Results: The Roma population subjects were slightly but significantly older compared to the non-Roma group and both study groups included more women. The fasting glucose, body mass index (BMI), triglycerides (TG), total cholesterol (TC), and LDL-cholesterol (LDL-C) levels were significantly higher, and HDL-cholesterol (HDL-C) levels were significantly lower in Roma compared to the control non-Roma group. The values of cardiovascular risk markers such as TC/HDL-C and TG/HDL-C ratios, atherogenic index of plasma (AIP) and lipoprotein combine index (LCI) were significantly higher in Roma compared to non-Roma subjects. The prevalence of obesity in Roma was 35%, diabetes mellitus was recorded in 16.7% of the entire Roma sample, and hyperglycaemia in non-diabetics was recorded in 32%. Hypercholesterolaemia was found in 90% and hypertriglyceridaemia was found in 88.3%. The prevalence of cardiovascular diseases (CVD) was high and was encountered in 71.7% of the Roma participants and most of the subjects (96.7%) reported family history of CVD. The studied population showed high smoking rates with 33.3% active smokers. Conclusions: Our study confirmed high prevalence of CV risk factors among Roma population, such as abnormal lipid profile parameters, obesity and heavy smoking and very high cardiovascular morbidity rate. Therefore, adequate measures and healthcare programmes aiming at the early identification, treatment and prevention of CVD risks among Roma are necessary.

Objective: The study aims to present a historical review and analysis of the establishment and development of undergraduate public health (PH) education in Bulgaria from 1878 until 2019. Methods: А search and selection of historical documents was performed, including laws, rules, regulations, government plans, programmes, scientific publications from periodical medical press, journals, specialized monographs, and books. A retrospective analysis of the normative documents related to the organization of the sanitation and public health activities, and to the provision of professional undergraduate education of the public health workforce in Bulgaria has been carried out. The required competences and tasks of the specialists exercising public health control services were extracted. Results: The development in the public health educational activities were followed in three consecutive periods: the newly independent state (1878-1944); the socialist state (1945-1990); the democratizing state (1990-2019). The development of organized PH activities began after the liberation of Bulgaria in 1878. The historical analysis reveals a direct link between the major socioeconomic changes in the country and the organization of PH undergraduate education which passed through dynamic transformations. The professional education in the sphere of PH started with the training of feldshers, followed by sanitary feldsher and sanitary health inspectors performed in secondary vocational medical schools during the socialist period, reaching the stage of undergraduate university PH education provided by medical colleges associated with universities in the third period. Conclusion: Despite the continuous development in the organization of undergraduate PH education in Bulgaria, its content is still not fully compatible with the basic European PH services and actions. There is a growing need for wider standardization and integration of undergraduate PH education in the EU so that the specialty can reach the status of a regulated health profession similar to medicine, nursing, and others.

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.

Objective: The COVID-19 disease caused by the SARS-CoV-2 virus belongs to the group of highly infectious diseases with increased mortality and morbidity in the population. Finding the presence of antibodies plays an important role while finding the number of individuals who overcame the disease or were vaccinated. Methods: A total of 250 employees of St. Jacob Hospital with Polyclinic, Bardejov, participated in our study, the blood samples were drawn from the index finger and processed with the help of the rapid Ag test for the detection of antibodies and venous blood using the ELISA method. The health workers (doctors, nurses, medical laboratory technicians, laboratory diagnosticians) tested during September and October 2022 participated in our study. Results: Our experimental study shows the presence of IgG antibodies in 215 (86%) of employees, who get them from overcoming the COVID-19 disease or getting vaccinated. In 17 (6.8%) of employees were detected IgG and IgM antibodies. The biggest number of IgG antibodies was found in 36 (78%) employees of the Surgical Department, 28 (84%) employees of Rehabilitation Department and 25 (89%) employees of the Internal Department, when compared with the Department of Laboratory Medicine 9 (30%) employees and Radiology Department 4 (44%) employees. Conclusion: Multiple prevalence of COVID-19 disease were found in employees of the internal, surgical and rehabilitation departments in whom we detected a higher presence of IgG antibodies. In department of laboratory medicine workers were proven lower levels of IgG antibodies, mainly for the limited contact with the positive covid patients and working with only their biological material, compared to the first-line employees exposed to direct contact with the patients.

Objective: The aim of the study was to evaluate the variant (rs2910829) of the PDE4D gene in relation to its influence on biochemical, anthropometric and physiological parameters in patients with coronary artery disease and healthy subjects of the Eastern Slovak population. Methods: The male group consisted of 72 individuals and the female group consisted of 132 individuals. On the basis of clinical screening the subjects were divided into two groups - with ischaemic heart disease and control group. Genomic DNA was isolated from peripheral blood using a commercial NucleoSpin^® Blood Machenery-Nagel kit. Molecular genetic analysis of the polymorphism under study was performed using the StepOne™ Real-Time PCR System instrument. The lipid profile markers TC, HDL, LDL, TG were measured by Cobas Integra 400 plus biochemical analyser, and systolic and diastolic blood pressure using a digital blood pressure monitor. Among anthropometric parameters, body height and weight, waist and hip circumference were measured and BMI and WHR indices were calculated. Results: A statistically significant (p = 0.018) possible association between the mutant T allele and ischaemic heart disease was found in men. In women, we found a statistically significant difference in the systolic (p = 0.013) and diastolic blood parameters (p = 0.005) in the CC genotype. In the group of women, we found statistically significant differences in all observed anthropometric parameters and in LDL and TC markers. In the group of men divided on the basis of BMI, statistical significance was found in systolic blood pressure (p = 0.028). In the group of women with ischaemic heart disease, we found a negative correlation between BMI and HDL. Conclusion: The study contributes to new findings of the representation of genotypes and alleles of the rs2910829 PDE4D gene polymorphism in the Slovak population. This is a pilot study. Interactions between genotype and observed anthropometric, physiological and biochemical markers were confirmed.

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: 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.

Objective: The study aimed at assessing the potential benefit of prostate health index (PHI) for early detection of prostate cancer (PCa) and the use of PHI as a marker predicting the presence of PCa before performing prostate biopsy. Methods: The study comprised 55 males who underwent prostate biopsy. Before the procedure, blood samples were collected to test prostate specific antigen (PSA) and free/total PSA ratio (%fPSA) and PHI was calculated. Receiver operating characteristic (ROC) analysis was used to assess the benefit of these values for predicting the presence of PCa. Results: Based on histological examination 31 males were diagnosed with PCa, the remaining 24 were negative. Among the PCa patients, 39% had a Gleason score of 6, 26% had a score of 7 and 35% had a score of 8-10. There were statistically significant differences in PHI and PSA between males with and without PCa. The areas under the ROC curve for %fPSA, total PSA and PHI were 0.712, 0.746 and 0.789, respectively. PHI showed the best predictive ability to estimate biopsy results. If the cut-off criterion PHI > 36.4 (77.42% sensitivity, 66.67% specificity) had been used, 41.7% of males would have avoided unnecessary biopsy. Conclusion: The use of PHI may considerably improve the accuracy of PCa detection in patients with elevated PSA and thus reduce the number of unnecessary biopsies.

Objective: This study analyses the differences in birth outcomes between Roma and non-Roma mothers and investigates the potential causes of such differences. Methods: We conducted a retrospective cohort study of 1,989 non-Roma and 799 Roma mothers who gave birth in 2014 and 2015 at the Gynaecology and Obstetrics Clinic of Louis Pasteur University Hospital in Košice. Data on mothers and new-born infants have been obtained from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a new-born weighing less than 2,500 grams and as for premature birth we referred to childbirth before pregnancy week 37. The file was split by ethnicity and statistically processed in IBM SPSS Statistics 21.0. Results: Our results confirmed a lower birth weight among Roma children (-365.4 grams, p < 0.001). The shorter gestation age and higher risk of premature birth were not statistically significant regarding Roma children. Based on the characteristics of Roma mothers, they are at higher risk of giving birth as minor (OR = 23.64; 95% CI = 15.29-36.54; p < 0.001), as single mothers (OR = 7.13; 95% CI = 5.80-8.76; p < 0.001), with basic education or lack of education (OR = 141.31; 95% CI = 100.47-198.76; p < 0.001). They also have a higher risk of smoking during pregnancy (OR = 23.84; 95% CI = 18.06-31.49; p < 0.001); drinking alcohol (OR = 11.71; 95% CI = 3.36-40.90; p < 0.001) and taking drugs (OR = 8.70; 95% CI = 1.81-42.02; p < 0.001). Roma women attended gynaecologists more rarely. Conclusion: It is therefore important to support the work of community health workers and stimulate collaboration between community health professionals, paediatricians and gynaecologists to overcome institutional barriers in maternity and child care for mothers living in Roma settlement.

Objective: The aim of this study was to assess the incidence of thoracic tuberculosis (TB) in patients who underwent surgery for indeterminate lung nodules, mass and pleural effusions. Methods: A monocentric retrospective study was carried out from 2012 to 2018 in a high-volume thoracic surgery centre. All patients with finding of thoracic TB within surgery and/or confirmed post-surgery were studied. Demography, origin, TB related symptoms, immunosuppression, type of surgery, and complication of surgery were analyzed. Results: During the seven-year period TB was diagnosed in 71 cases, 58% were men. The mean age was 50 years. 21% of the cases had family history of TB or were successfully treated for TB in the past. 14% of patients had prior history of treatment for malignancy. Five patients (7%) received immunosuppressive therapy. The indication for surgery was indeterminate lung nodules and mass in 55 patients (77.5%) and indeterminate recurrent or persistent pleural effusions in 21 patients (22.5%). In five patients (7%) a lung carcinoma and a concomitant TB infection was detected. 63 of the cases (88.7%) had positive real-time PCR TBC test. Direct microscopic detection of Mycobacterium tuberculosis detected TB in five cases (7%). The microbiological diagnosis by culture was achieved in 19 patients (26.8%). Two patients (2.8%) were diagnosed with multidrug-resistant TB. Surgical procedure complications occurred in nine cases (12.7%). Conclusions: Although the overall incidence of TB in the Czech Republic is low and constantly continues to decrease, the number of TB detected by surgical procedures is increasing. Surgery still remains an important tool in diagnostics of nonobvious cases of TB, especially in patients with a potential risk of malignancy.

Objective: The objective of this research was to determine the prevalence of problematic and risky sexual behaviour after alcohol consumption and the correlation between this prevalence and sex, behavioural factors, problematic drinking, and alcohol consumption characteristics. Methods: A survey of students was carried out at four faculties. Data were gathered via internet and self-administered paper-pencil questionnaires. The analysis employed Pearson's chi-squared test, gross odds ratios and logistic regression to calculate the adjusted odds ratios (OR) and their confidence interval (CI). Results: Problematic drinking was detected by the CAGE test. Sixteen percent of students reached the CAGE score of 2, which indicates a potential threat of addiction, while 6% of students reached even higher problematic scores (3 or 4). Among those respondents who did drink alcohol, 23% had unprotected sex and 21% had sex which they later regretted. There were some differences between male and female respondents with men reporting more instances of risky behaviour. Among university students, problematic and risky sexual behaviour after alcohol use is associated with sex, the intensity of problematic drinking, first drunkenness, the place of alcohol use, and attitude to alcohol use. Conclusions: Problematic drinking and risky sexual behaviour after alcohol consumption exist among students and deserve special attention and response in the form of suitable measures. Problematic and risky sexual behaviour after alcohol consumption among university students is associated with behavioural factors and characteristics of alcohol use that allow a targeted approach to preventive efforts.

Objectives: In Hungary, 37% of women living in poverty were smokers in 2012. There are no valid data of pregnant women's spontaneous smoking cessation. Methods: Our retrospective cohort study (2009-2012) targeted the most underdeveloped regions with an estimated 6-8.5% of Roma population. The sample (N = 12,552) represented 76% of the target population i.e. women in four counties in a year delivering live born babies. Chi-square probe and multivariable logistic regression model (p < 0.05) were used to assess relationship between socio-demographic characteristics and spontaneous cessation. Results: Prior to pregnancy, the overall smoking rate was 36.8%. That of women in deep poverty and Roma was 49.7% and 51.1%, respectively. 70.3% of smokers continued smoking during the pregnancy. Among them 80.6% lived in deep poverty. Spontaneous quitting rate was 23.0%. Factors correlated with continued smoking included being Roma (OR = 1.95), undereducated (OR = 2.66), living in homes lacking amenities (OR = 1.48), and having regularly smoking partner (OR = 2.07). Cessation was promoted by younger age (≤ 18 years) (OR = 0.18), being married (OR = 0.50), and the first pregnancy. Conclusions: Tailored cessation programmes are needed for Roma, older, low-income, and multiparous women who are less likely to quit on their own. Engaging husbands/partners is essential to reduce smoking among pregnant women and second-hand smoke exposure.

Objectives: Asians (including Chinese, Japanese and Koreans), who generally have a relatively smaller body size and a lower mean body mass index (BMI), have a relatively higher risk of developing android-type obesity than westerners. Substitution of alanine for threonine (Ala54Thr) on the FABP2 gene (rs 1799883) is related to insulin resistance and obesity. However, few studies have examined this substitution in Koreans, and the number of Korean subjects in those studies is limited. For this reason, we investigated the differences between the FABP2 Ala54Thr polymorphism and obesity, hemodynamic variables, blood lipid profile results, and insulin resistance among middle-aged Korean women with abdominal obesity. Methods: We studied 243 middle-aged community-dwelling Korean women with abdominal obesity from Gyeonggi Province, Republic of Korea, who had no history of taking chronic medications. We examined each subject (n = 243) for the presence of FABP2 Ala54Thr polymorphism using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Subjects were also examined for obesity hemodynamic variables (n = 243), lipid profiles (n = 142), and insulin resistance (n = 142). Results: Of the 243 subjects, 117 had AA ("normal") homozygotic genotype, 100 had AT heterozygotic genotype, and 26 had TT homozygotic genotype for the FABP2 Ala54Thr polymorphism. The AT heterozygotic individuals had a significantly higher mean waist-to-hip ratio, abdominal fat area, and visceral fat area than individuals with other genotypes. TT homozygotic individuals had higher mean triglyceride and fasting glucose levels than individuals with other genotypes. Conclusions: The results of this study show that the FABP2 Ala54Thr polymorphism was associated with central obesity and obesity-related metabolic syndrome among middle-aged Korean women.

The dramatic progress in tumour biology and immunology in the past several years has opened new avenues for the treatment and prevention of cancer. One of the great contributions of the immunotherapeutic approaches is an increasing understanding of the immunology of cancer, which is, gradually creating conditions for the development of prophylactic anti-cancer vaccines. Efficient vaccines have been developed and employed for the prophylaxis of two frequent cancers of viral origin, namely cervical cancer and liver cancer. The new knowledge on the interactions between the immune system and the malignant tumors seems to provide means for the development of prophylactic vaccines against cancers developing due to the mutations in the proto-oncogenes converting their products into oncoproteins. According to the present estimates, these cancers form a great majority of human malignancies. Recent evidence has indicated that the immune system recognizes such mutated proteins, and that the development of cancer is due to the failure of the immune system to eliminate neoplastic cells. Followingly, it can be expected that inducing immunity against the mutated epitopes will increase the capacity of the body to deal with the initiated precancerous cells. In the present paper this hypothesis is primarily discussed in the relationship with colorectal cancer (CRC), which seems to be a well-fitting candidate for prophylactic vaccination. CRC is the third most frequent malignancy and the fourth most common cause of cancer mortality. Mutations of two proto-oncogenes, namely RAS and RAF, are involved in the majority of CRC cases and, in addition, they are shared with other human malignancies. Therefore, the strategy to be used for prophylaxis of CRC is discussed together with several other frequent human cancers, namely lung cancer, pancreatic duct cancer and melanoma. The prophylactic vaccines proposed are aimed at the reduction of the incidence of these and, to a lesser extent, some other cancers.

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: Ischaemic heart disease (IHD) is one of the leading causes of premature mortality. Our aim was to analyse standardised premature mortality rates from IHD by geographical groups in the age group 45-59 years. Methods: We performed a retrospective, quantitative analysis of age-standardized mortality rates from IHD between 1990-2014 per 100,000 population in Western European (WE: N = 17), Eastern European countries (EE: N = 10), and countries of the former Soviet Union (fSU: N = 15) within the European Region of the World Health Organisation (WHO) based on data retrieved from the WHO European Mortality Database. Descriptive statistics, time series analysis and statistical tests were used for the analyses (ANOVA, Kruskal-Wallis test, Mann-Whitney test, paired t-test). Results: On average, age-standardized death rates (ASDR) from IHD per 100,000 population were the lowest in WE (men 1990: 143.67, 2014: 50.29; women 1990: 29.06, 2014: 9.89), and the highest in fSU (men 1990: 358.69, 2014: 253.25; women 1990: 99.78, 2014: 57.85). Between 1990 and 2014, all three groups experienced significant decrease in ASDR both in men and women (fSU: -29.39%, -42.02%; EE: -49.41%, -50.57%; WE: -64.99%, -65.97%, respectively) (p < 0.05). Between 1990 and 2004, ASDR decreased in WE in both sexes (p < 0.001), in EE among males (p = 0.032). Between 2004 and 2014, ASDR from IHD decreased significantly in both sexes in fSU and WE, in EE only among women (p < 0.05). Conclusions: During the whole period analysed, ischaemic heart disease mortality significantly decreased in both sexes in all the groups.

Objectives: This study aims to analyse the way immigrants and their personality traits get affected by traumatic events in the post-migration process. Methods: This descriptive study was conducted through Google Forms with the involvement of 2,509 immigrants. A descriptive questionnaire, the "IFOMA Post-Migration Post-Traumatic Effect Scale" and the "GADOT Personality Types Determination Scale" were used to collect the research data. Independent samples t-test, one-way ANOVA, and related sample Friedman's two-way analysis tests were used in data analysis. Results: Immigrants were exposed to significant effects in all sub-dimensions of the Post-Migration Post-Traumatic Effect Scale. Experiencing post-traumatic stress was found to be significantly related to the research parameters, which, respectively, are gender, age, marital status, educational background, legal status, years of living in the current country, employment status, ethnicity, Turkish language proficiency, and post-migration psychological problems (p < 0.05); 42.8% of the immigrants had the Type 9 personality, and all personality types were affected by the Psychological Affection, Physical Affection, Anxiety, and Social Adaptation sub-dimensions, respectively (p < 0.05). Conclusion: By analysing the impact of migration-induced trauma on immigrants within their society, it can be recommended to implement initiatives specific to immigrants' personality traits and to carry out protective/preventive projects that will minimize immigrants' exposure to trauma and encourage their participation in social adaptation processes.

Objectives: The main aim of the study was to show the effect of diabetes in relation to the gender of the patients, duration of the disease, and on the incidence of diabetic retinopathy. In this study, we investigated the prevalence of these two diseases, pathological ocular changes and progression of disease occurrence in relation to the duration of the disease with respect to their impact on the quality of vision of the patient. Methods: The prospective observational cross-sectional study included 3,951 patients (1,838 males, 2,113 females) with diabetes mellitus from 7 districts of eastern Slovakia. Patients with diabetes mellitus and diabetic retinopathy were identified by special screening in the number of 2,093 (1,094 females and 999 males). Subjects were divided by sex and by duration of diabetes into 5 groups: patients with diabetes under 5, 10, 15, 20, and over 20 years. We differentiated between proliferative and non-proliferative forms of diabetic retinopathy and monitored changes in visual quality. Manifestations of pathological changes were recorded using special examination methods in the eye clinic. We observed a decrease in vision by two lines, pathological changes on the retina and the occurrence of practical blindness. Results: Of the total number of diabetic patients examined, diabetic retinopathy was also present in more than half of the patients. The major form represented in the patients was the non-proliferative form of retinopathy. The obtained results confirmed that the representation of patients with diabetic retinopathy increases with increasing duration of diabetes. Similarly, pathological changes characteristic of this type of late complication of diabetes were also more frequent, such as deterioration of visual acuity, the appearance of aneurysms, hard exudates macular edema, and gradual loss of vision, which can result in practical blindness. Conclusion: The percentage of people with diabetic retinopathy increases with the duration of diabetes, as well as the increased frequency of pathological late complication of diabetes, including deterioration of visual acuity, the development of aneurysms, hard exudates, macular oedema, and gradual loss of vision, which can result in practical blindness. Early diagnosis of the disease and introduction of appropriate treatment would alleviate the symptoms of the disease in more than half of the patients, so more frequent preventive check-ups with an ophthalmologist should be performed in diabetic patients to avoid detection of the disease in its late stages.

Objectives: The aim of this study is to examine the knowledge levels, beliefs, and self-efficacies of men regarding osteoporosis according to the health belief model. Methods: Men aged 55 years and older were included in the study. After the descriptive characteristics of the participants were recorded, the Male Osteoporosis Knowledge Quiz, Osteoporosis Health Belief Scale, Osteoporosis Self-Efficacy Scale, and Osteoporosis Knowledge Test were administered to the participants face-to-face. Results: A total of 435 men with an average age of 67.3 ± 0.4 years participated in the study. When the participants were categorized according to age subgroups, it was found that marital status (p = 0.002), economic status (p = 0.016), and education level (p < 0.001) differed with age. The results of the osteoporosis-specific measurement tools used in data collection also differed with age (p < 0.05). It was observed that men's levels of osteoporosis knowledge decreased with increasing age (p < 0.05). The lowest scores for the exercise benefits and health motivation subdimensions of the Osteoporosis Health Belief Scale and the Osteoporosis Self-Efficacy Scale were obtained from the subgroup that included the oldest participants (p < 0.05). The highest scores for the calcium barriers subdimension of the Osteoporosis Health Belief Scale were obtained from younger participants (p = 0.036). The level of osteoporosis knowledge showed a low-to-moderate correlation with each question of the Osteoporosis Health Belief Scale (p < 0.05). Age, education, associating the role of physiotherapy with primary-secondary treatment approaches, and health beliefs were the factors that affected the osteoporosis knowledge levels of the participating men (p < 0.05). Conclusions: The knowledge of osteoporosis and preventive beliefs and behaviours of men need to be increased. Knowledge and perceptions of susceptibility to osteoporosis should be developed in men with appropriate education from an early age. We recommend that exercise and physiotherapy approaches should be utilized to a greater extent, especially for individuals in the at-risk age range.

Last time the world faced a deadly pandemic was the H1N1 Spanish flu in 1918, which affected almost one-third of the world's population (500 million people). Since then, almost 100 years later, we are now facing another pandemic of the SARS-CoV2 virus (COVID-19), which is still endemic to this day. As the technology evolved during those 100 years, an effective vaccine for COVID-19 was produced within only a year, a huge feat. But, unfortunately, due to its fast development, another force would arise limiting the impact of the vaccine: vaccine hesitancy and anti-vaxxers, which John Hopkins and the World Health Organization call the biggest current threat to global health. From politics to social media, it is clear that there has been a rapid spread of misinformation, resulting in hesitancy, especially from sociopolitically motivated people popularly referred to as anti-vaxxers. However, a second group of vaccine-hesitant people have also emerged, who are uneducated and remain undecided about vaccination mostly due to safety concerns. They come under the massive influence of anti-vaxxers and anti-vaccine propaganda through social media and politicians, which often make bold claims and huge headlines. To combat vaccine hesitancy, it is crucial that we debunk these conspiracy theories and misinformation that so many believe in, with factual, data-based information. Actively spreading correct information about the vaccines, such as disclosing the rigorous developmental processes and validation of safety data by the Food and Drug Administration (FDA), assurance for the unlikeliness of getting a lethal side effect along with tremendous health benefits, will encourage people for safe vaccination against COVID-19 and other potential infectious diseases in the future. This article discusses the role of anti-vaxxers and vaccine-hesitant groups, electronic social media, and politics in vaccine hesitancy among people. It describes the strategies to combat the roadblocks in the vaccination programmes and health benefits, offered by recent advances in scientific and technological developments.