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Objectives: The eating habits of most Lithuanian people do not adhere to the recommendations for a healthy diet. If children and adolescents were provided with the relevant information, it would not only improve their nutritional knowledge, but also their eating habits in adulthood and the subsequent health of their children. The objective of this study was to determine the need for information on nutrition among Lithuanian adolescents, the current knowledge of adults regarding recommendations for the consumption of various food groups, and the factors that influence both the need for information and the current knowledge. Methods: Two cross-sectional studies were conducted, consisting of 3,574 adolescents aged 14-18 years and 1,007 adults aged 18-75 years. Logistic regression models with confidence intervals of 95% were used to determine the influence of various socio-demographic factors on the adolescent need for information on nutrition and the adult knowledge of nutrition. Results: A total of 66.7% of adolescents stated that they need information regarding nutrition, whereas 29.8% indicated that they lack such information. Significantly more girls than boys, and more students from schools in urban areas than students from schools in rural areas, expressed their need for information on nutrition. Lithuanian adults lacked knowledge of recommendations for the consumption of various food groups. Women and respondents with higher education degrees were found to have more knowledge on recommendations of the consumption of various food groups compared to men and respondents of other levels of education respectively. Conclusions: The results of this study demonstrate that the required information on nutrition must be continuously provided via various channels to both adolescents and adults, and socio-demographic factors must be taken into account when planning public health intervention measures.

Objectives: Medical students represent a group of undergraduate students who are exposed to specific risk factors that may lead to the onset of depression and the occurrence of suicidal ideation. The aim of the article is to present information about the prevalence of symptoms of depression in medical students of different faculties at Charles University, Prague, compared to other students of this university. Methods: We used a standardized Beck's Inventory scale II (BDI-II) with added specific questions electronically distributed to undergraduate students of the full-time forms of study of all faculties of Charles University. The data collection was anonymous and took place in December 2020. The data were statistically assessed in relation to the occurrence of moderate and severe depression using univariate and multivariable analysis. Results: Moderate and severe depression rate (MSDR) was recorded in 19.6% of medical school students, who returned the questionnaire, compared to 23.4% of students of other faculties (p = 0.001) of Charles University in Prague. Differences in MSDR among students of different faculties of medicine of Charles University were not statistically significant. The total number of previous suicide attempts among respondents was 542, of which 115 were medical students, with the lifetime prevalence of suicide attempts among all students participating in the study 6.96% and in medical students of Charles University 5.73%. Conclusions: The findings of our study highlight the need for systematic, accessible and timely assistance to university students, both in terms of prevention and early intervention, which can take place at the university level and within the mental healthcare system.

Objectives: For the last three decades, although colorectal cancer incidence has been decreasing in those over 50 years of age, it has been increasing in those under 50 included in the pre-screening group (PSG). The present study aims to explain the screening-related factors and compliance of individuals in PSG who are not included in the colorectal cancer screening programme. Methods: This cross-sectional study was conducted with a total of 323 participants, 143 of whom were from the pre-screening group (40-49 years), and 180 from the screening included group (SIG) (50-70 years). Results: Individuals included in PSG were more likely to have accepted that both faecal occult blood test (FOBT) (2.23 ± 1.22 vs. 1.89 ± 1.33, p = 0.018) and colonoscopy (2.37 ± 0.97 vs. 2.02 ± 1.14, p = 0.003) were useful and suitable screening tests in colorectal cancer. Adequate health literacy (OR = 4.3, 95% CI: 1.8-10.0, p = 0.001) and better education level (OR = 3.3, 95% CI: 1.3-8.4, p = 0.010) were factors of increased knowledge of colorectal cancer screening. Conclusions: The findings show that PSG has different characteristics than SIG and may be more fitting in the colorectal cancer screening programme if included.

Objectives: Previous studies have observed notable unexplained geographic differences in incidence of kidney cancer in Europe. Lithuania is among the countries with the highest incidence and mortality. Our objective was to investigate the effect of different lifestyle, anthropometric and biological factors on the risk of kidney cancer in Lithuanian men. Methods: This population-based cohort study included 6,849 men initially free from cancer. During the follow-up (1978-2008), 79 incident cases of kidney cancer were identified. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). Results: Risk of kidney cancer was significantly associated with increasing body mass index (BMI), the adjusted HR for ≥ 35 vs. < 25 kg/m² was 3.00, 95% CI 1.10-8.19 and the HR per 1 unit increment of BMI was 1.07, 95% CI 1.01-1.14. In overweight men (BMI ≥ 25 kg/m²), the HRs for kidney cancer per 10 mmHg increment of systolic or diastolic blood pressure were 1.10, 95% CI 0.96-1.25 and 1.26, 95% CI 1.01-1.56, respectively. We found no significant association between smoking, alcohol consumption or total serum cholesterol level and kidney cancer risk. Conclusions: This study supports a link between increased BMI and the development of kidney cancer among men in Lithuania. Hypertension appears to be associated with risk of kidney cancer in overweight men, although the assessment was limited by the lack of statistical power.

Objective: Epidemiological research has shown that air pollution is associated with cardiovascular events, but little is known about short-term effects on blood pressure (BP) and heart rate (HR) in Serbian population. The present study assessed the short-term association between black smoke (BS) and sulphur dioxide (SO₂) levels in urban air and the daily values of blood pressure and heart rate in 98 healthy nonsmoking female volunteers. Methods: Generalized regression model was fitted controlling for temperature, relative humidity, air pressure, season, and the day of the week. Results: There was no association between short-term air pollution exposure and BP and HR, the exposure showed a tendency toward a decrease of diastolic BP and HR, but with no statistical significance. Conclusion: The present findings did not support the conclusion that current levels of ambient BS and SO₂ may have an effect on blood pressure and heart rate in women.

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

Objectives: Smoking of water pipe (WP) and cigarettes has recently turned into a major global health burden. The present study aimed at assessing WP and cigarette smoking among Zahedan University of Medical Sciences (ZUMS) students in Iran. Methods: A cross-sectional survey was conducted on 500 students in ZUMS (182 males, 318 females). The subjects were selected through randomized cluster sampling. Morgan's chart was applied to calculate the sample size; 96.6% of the attendees completed a questionnaire designed to address the aims of the study. Results: The mean age of the subjects was 21.2 ± 2.4 years. WP and cigarette smoker rates were at 31.2% and 15.2%, respectively. The age of smoking initiation ranged between 15 and 20 years. Friends played crucial roles in triggering the smoking in both groups of WP and cigarette smokers (78% and 54%, respectively). The main reasons for WP and cigarette smoking were entertainment followed by curiosity. Furthermore, males used more cigarette (26.5 vs. 8.7%) and WP (50.6 vs. 20.4%) than females. Among father and mother smokers, respectively, 54.2% and 60% of children were also WP smokers (p = 0.001). Also, 21.9% and 60% of children smoking cigarettes had father and mother smokers, respectively (p = 0.05). Conclusion: Tobacco use, especially for WP seems to be at alarming rates among medical students in Iran. It is highly recommended to control the progressive prevalence of WP smoking by governmental/academic preventive measures as educational and smoking cessation activities.

Objective: Diabetic retinopathy is one of the leading causes of blindness. We estimated the prevalence of diabetic retinopathy among a diabetic population in the Dubrovnik-Neretva County in the Republic of Croatia and searched for potential risk factors. Methods: A prospective study was performed with 600 diabetic patients from different parts of the Dubrovnik-Neretva County who attended regular medical and ophthalmological check-ups at the General Hospital Dubrovnik from September 2014 to September 2015. Patients underwent a complete medical assessment by two ophthalmologists. Retinal examination included evaluation of the presence of diabetic retinopathy. Any retinopathy present was graded as mild non-proliferative retinopathy, moderate-severe non proliferative retinopathy or proliferative retinopathy. Results: Retinopathy was present in 44.5% of the study sample. 20.7% had the mild form of diabetic retinopathy, 18.8% had the moderate-severe form, and 5.0% had proliferative diabetic retinopathy. The mean duration of diabetes was 12.94 years ± 6.85; 12.89 years ± 9.18 in men, 12.94 ± 6.54 in women. The mean BMI was 27.14 ± 2.98; for diabetics without diabetic retinopathy 26.19 ± 2.75; for those with the mild form 28.06 ± 3.01; for those with the moderate-severe form 28.49 ± 2.54; for those with proliferative diabetic retinopathy 28.79 ± 3.16. 168 (28%) patients were treated by laser and 22 (3.7%) by vitrectomy. Conclusion: The prevalence of diabetic retinopathy in the Dubrovnik-Neretva County is 44.5%. Regular screening to detect diabetic retinopathy is highly recommended as timely intervention can prevent most diabetic causes of blindness.

Objectives: In some countries of the world it is legal to use plant-based marijuana for therapeutic purposes. When we had learned that 7,000 petitioners (including doctors) signed the petition to enable access to marijuana for patients in the Czech Republic, we decided to examine the knowledge about marijuana's medical properties among Polish medical students. Methods: Anonymous questionnaire study was conducted on a group of 181 of students of the last (sixth) year of medical school. Results: It was demonstrated that students are not provided with sufficient information about therapeutic administration of plant-based marijuana during medical studies. The majority of interviewees mentioned only one indication for medical marijuana use. All students did not interchange medical conditions for which marijuana is used in 30 USA states or Canada. Discussion: Marijuana smoking for medical purposes differs from recreational smoking, and its effect does not depend on occurrence of symptoms from the central nervous system. Few studies, that were carried out along with numerous previously unreported cases of patients, demonstrated that plant-derived marijuana had therapeutic effect on many diseases where conventional medicine was of no help. Conclusion: All doctors, including medical students, should receive more information about the therapeutic properties of marijuana.

Objective: Alcohol use is one of the ten most common risk factors threatening global health that is avoidable (ranked fifth after smoking). It is involved in high rates of liver cirrhosis, epilepsy, hypertension, cerebrovascular and mental illness. Negative consequences of family and social drinking are also very significant. The aim of the study is to quantify the gender and age-differentiated disparities in alcohol-related mortality in the population over 16 years between the years 1996-2017 in Slovakia. Methods: We used data from mortality reports within 1996-2017 provided by the National Health Information Centre in the Slovak Republic. We applied two-dimensional correspondence analysis where dimensions are age and chosen causes of deaths induced by use of alcohol and classified by the International Classification of Diseases. Results: In case of males, we found that K74 - Fibrosis and cirrhosis of liver diagnosis almost perfectly corresponds to age 66-75 years, and we documented strong correspondence between K70 - Alcoholic liver disease and age 46-55 years. For females, the most robust finding is that K70 - Alcoholic liver disease corresponds relatively similarly with age groups 26-35, 36-45, 46-55. The results of the analysis allow us to obtain a detailed overview of the development of mortality in individual alcohol diagnoses and their intervention in individual age groups by gender. Mortality for some diagnoses affects the young female as well as male population. We observed that there are systematic differences in alcohol-induced mortality between males and females. Conclusions: In such development of the alcohol-related mortality structure, the priority remains the permanent provision of primary, secondary and tertiary prevention at the individual and population level. The results of our analysis represent a valuable platform for health and social policymakers to develop quality national and regional health strategies aimed at eliminating the consequences of alcohol use. Lessons learned from our analysis will be supported by our other geographically oriented analytical lines to link identified and quantified regional disparities in the mortality of alcohol diagnoses to the availability of health care to treat these diseases.

In Europe, a steady mortality decline has been observed from the 1950s, however, Central and Eastern Europe underwent a period of stagnation or even worsening from the 1960s to 1980s. Since that time an evident mortality decline could be observed in that part of Europe too. Within the post-communist countries, mortality development has been most favourable in Slovenia, the Czech Republic and Slovakia. The aim of this study is to describe the latest development of cancer mortality in two selected countries - the Czech Republic and Slovakia. These two countries have much in common, including many similar long term trends in demographic or social indicators' development. The study evaluates whether cancer mortality development differs in the two countries or rather follows a similar trend. From the presented results it is clear that the development apparently differs namely according to sex. The results according to selected particular causes of death (from the group of malignant neoplasms) are presented as well. It could be assumed that many aspects could be improved by prevention programmes or screening.

Objectives: Hypertension is a health issue affecting adolescents. Accumulating evidence affirms that elevated blood pressure begins in childhood and tracks into adulthood. This cross-sectional study was conducted to determine the prevalence of elevated blood pressure and its predictors among secondary school students in Sarawak, Malaysia. Methods: A total of 2,461 secondary school students aged 12-17 years from 19 schools in Sarawak participated in the study. Questionnaire was used to obtain socio-demographic data, parental history of hypertension, and self-reported physical activity. Anthropometric and blood pressure measurements were taken. Data was entered and analysed using SPSS version 23.0. Results: The prevalence of adolescents with elevated blood pressure, overweight, central obesity, and overfat were 30.1%, 24.3%, 13.5%, and 6.7%, respectively. Multivariate logistic regression demonstrated the predictors significantly associated with elevated blood pressure among respondents: overweight (adjusted odds ratio = 3.144), being male (adjusted odds ratio = 3.073), being Chinese (adjusted odds ratio = 2.321) or Iban (adjusted odds ratio = 1.578), central obesity (adjusted odds ratio = 2.145), being overfat (adjusted odds ratio = 1.885), and being an older adolescent (adjusted odds ratio = 1.109). Parental history of hypertension, locality, and physical activity showed no significant associations. Conclusion: The obesity epidemic must be tackled at community and school levels by health education and regulation of school canteen foods.

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

Objectives: The aim of this study was to analyze adolescents' physical activity (PA) in two different educational settings, and to estimate the association between meeting PA recommendations and specific characteristics of adolescents' lifestyle. Methods: The study was carried out in the Moravia region of the Czech Republic and in the Silesia-Opole region of Poland. In total, 1,846 participants completed the long International Physical Activity Questionnaire (IPAQ-long) using the online Indares system. Results: Results showed that the Polish sample was significantly more physically active than the Czech one concerning school PA (p < 0.001; η² = 0.07). Comparing by gender, significant differences were found in vigorous PA (p < 0.001; η² = 0.05) and moderate PA (p < 0.001; η² = 0.08) in both samples. The recommendations for vigorous PA are met by 45.9% of Czech boys and 33.4% of girls; and by 64.5% of Polish boys and 51.3% of girls. Participation in organized PA was the main correlate to achieve the recommendations of vigorous PA in both Czech (p < 0.001; CI = 4.47-9.25) and Polish adolescents (p < 0.001; CI = 1.99-5.37). Conclusions: The Polish educational model seems to be more effective for enhancing higher levels of PA among youth, as it provides pupils with a wider offer of organized PA. Girls were found to be less active than boys at high PA intensities in both countries, therefore, more effort must be put on involving them in organized PA.

Objective: There is recent evidence that poor health literacy (HL) could be implicated in the aetiology of obesity and could be an important reason behind obese people's inability to encounter difficulties in overcoming obesity issues. The current study reviews the recent scientific evidence investigating the possible link between poor HL levels and excess body weight in adults and children. Methods: The authors performed a thorough systematic computer-assisted literature search from 1 January 2005 up to 31 May 2017. Only English original studies in healthy people, investigating the relationship between HL and excess body weight, were included. Results: Twenty-two studies in total were included in this literature review, 17 studies were conducted in adults and 5 in children. In 17 out of 22 studies reviewed, low HL was significantly associated with increased body mass index, overweight and obesity. In case of children and adolescents, the above association seems to be more consistent compared to adults. Conclusion: There is good evidence that low levels of HL are associated with excess body weight, particularly in children. Initiatives to improve health literacy levels could be a useful tool in the management of the obesity epidemic.

Objectives: Although the association between anthropometric parameters and blood pressure has been established for adults, the relationship for children has not been thoroughly studied in Slovakia. Present study investigates the association between anthropometric parameters and systolic and diastolic blood pressure in the group of randomly selected schoolchildren. Methods: Examinations were conducted as a cross-sectional study with 760 schoolchildren from Eastern Slovakia, 381 boys and 379 girls. The blood pressure evaluation included sphygmomanometer technique (seated, 3 times repeated) measurement of systolic and diastolic blood pressure (SBP; DBP). Anthropometric measurements included: body weight, height, circumference of waist, hip and chest, BMI, WHR (waist-hip ratio), fat skinfolds measurement, triceps skinfold, and derivation of body fat percentage. The parents' questionnaires incorporated basic demographic and socioeconomic characteristics of the family, reported BMI of father and mother, and child's birth-weight and birth-length. Statistical analysis included Student's t-test gender differences in measured parameters, partial Pearson's correlations and linear regression model of the impact of body parameters Z-scores on SBP and DPB. Results: Statistical analysis confirmed gender difference in basic anthropometric parameters. Pearson's correlations revealed highly significant relationship of anthropometric indices to SBP compared to DBP. Correlations of anthropometric parameters with SBP and DPB were more significant for boys compared to girls. Linear regression analysis showed that the highest impact on SBP and DBP had Z-score of BMI, followed by weight and height. Z-score of body weight has statistical impact on SBP and DBP in all group and group of boys (p < 0.001), lower significance was in DBP of girls (p < 0.01). Similar results were obtained for Z-score of height and BMI for SBP and DBP in both total group and group of boys on level p < 0.001. Z-score for BMI and height in DBP has lower statistical significance. Conclusions: Linear regression model confirmed higher statistical relationship of SBP and DBP in the group of boys compared to the group of girls. SBP correlations and linear regression model of anthropometric parameters revealed more significant outputs compared to DPB. The results confirmed the fact that we have to consider anthropometric indices in paediatric blood pressure evaluation.

Objective: The aim of the study was to evaluate alcohol consumption in a representative sample of the population of the city of Brno, as part of research on cardiovascular risk factors. Methods: Cross-sectional survey on a sample of 2,160 randomly selected residents 35-65 years old was carried out. For the invited volunteers who became a part of the investigation, alcohol consumption was determined in a controlled, face to face interview structured in accordance with a special questionnaire form. The frequency of alcohol consumption during the previous year was determined, in more detail during the last month (including quantification using "units of alcohol", their normal and maximum level of drinking, and any association between alcohol consumption and meals), and during the last week in the form of a complete, beverage specified and quantified 7-day recall period. Typical patterns of alcohol consumption were explored by the means of cluster analysis. Results: During the past 12 months, 90.0% of the men and 79.0% of the women had consumed alcohol, the rest can be considered abstinent. The most commonly reported frequency was 2-4 times per week (35.6% of the men), or 1-3 times per month (22.8% of the women). Daily or almost daily consumption was reported by 24.8% of the men and 12.8% of the women. The number of units of alcohol consumed usually on one occasion amounts to an average of 3.88 ± 4.80 for the men and 2.25 ± 1.39 for the women, but the amount most often cited by both sexes was 2 drinks (36.4% of the men and 40.4% of the women). The largest amount consumed on any occasion during the last 30 days was 5 or more units in 69.3% of the men, and in 33.9% of the women it was 4 or more units (this amount of alcohol leads to a blood alcohol concentration (BAC) of 0.08, the border of drunkenness). In 19.9% of the men and 7.5% of the women, this border was exceeded more than 5 times in the past month. Only 14.7% of the men and 10.3% of the women reported that the majority of their alcohol consumption occurs with food; on the contrary, 64.3% of the men and 77.6% of the women drinkers drink it either always without food or only rarely with it. During the past week, 81.6% of the men and 63.4% of the women drank alcohol (p < 0.001, chi-square). The average value of consumption for one man was 11.57 ± 11.91 doses, and for one woman 4.68 ± 6.38 doses per week (p < 0.001, t-test). A total of 17.8% of the men exceeded the limit of 21 doses per week, and 7.4% of the women exceeded 14 doses/week. After converting the weekly consumption into the number of units of alcohol per week expressed in litres per year, the total average consumption was 5.01 ± 6.36 litres; for the men 7.26 ± 7.62 litres and for the women 3.02 ± 4.08 litres of pure alcohol per person annually. Consumption during the week was not uniform (p < 0.001, ANOVA), with the highest occurring on Saturday, followed by Friday. The men mostly drank beer (62.9% of the total volume of alcohol), the women wine (68.6%). The cluster analysis identified 5 clusters of respondents, based on a set of alcohol consumption variables, as follows: very heavy drinking (1.6% of the respondents who drink alcohol); heavy drinking (8.8%); binge drinking (6.3%); mod

Objective: Period of elderly age preordains the occurrence of many health issues. People deported during World War II to concentration camps suffered from malnutrition, lack of sleep, physical and mental exhaustion. Recently, the health condition of Holocaust survivors is often complicated as a result of physical punishments and different torture methods as well as mental hardships which they had suffered during deportation. The consequences often have psychosomatic nature thus the survivors are often receivers of health care. The topic of bibliography review is based on the need to objectivize and systematically evaluate subjective health issues of Holocaust survivors in connection with trauma related to the stay in a concentration camp. The aim is to offer a review of effects of the Holocaust on health of different body systems for survivors in concentration camps and Jewish ghettos in the course of World War II. Methods: To map the subjective problems of Holocaust survivors, evidence-based medicine (EBM) method has been used with the help of scientific database PubMed, CINAHL Plus with full text, ProQuest and other sources with specific key words and Boole operators. Prognostic type of clinical/review questions has been selected for the bibliography review, which is trying to predict the probability of relation or output of illness/condition and based on diseases or symptoms seriousness to find out expectancy for treatment/improvement of care. Results: 175 studies have been found in basic search with the use of key words both in English and in Czech language. The search has not been time-limited. The advanced search has focused on different body systems and health damage due to Nazi experiments. Fourteen studies have been used to complete the study. The research results have confirmed the significant effect of Holocaust trauma on body condition of the survivors. The reasons of this condition were insufficient nutrition, unsuitable and harmful hygienic, living and working conditions and brutality of the guards. According to the research, these factors have impacted all organ systems, mainly locomotion and cardiovascular ones. The results have shown a more frequent occurrence of osteoporosis, fractures of long bones and corresponding chronical pain of people of Jewish origin who had gone through different forms of torture during World War II. Other present symptoms include gastrointestinal problems, tumors mainly in the area of colorectum and lungs. Moreover, the stay in concentration camps had influence on women's menstrual cycle. Conclusion: The studies of Holocaust effects are an example of the influence of an extreme mental and physical burden on the body condition of the survivors' health. The results of the studies have shown a wide range of the effects also in mental and social areas.

Objectives: Vitamin D is a fat-soluble, prohormone vitamin that is important especially for bone mineralization and skeletal health. In recent years, vitamin D deficiency appeared as a worldwide problem, affecting many people in different ways including the Northern Cypriot population. The deficiency might be caused by the lack of exposure to sunlight, diet low in vitamin D, sedentary lifestyle, and also due to some genetic variations in the vitamin D receptor (VDR) gene. Methods: In this study, four common VDR polymorphisms and associations with vitamin D deficiency in the Turkish Cypriot population between ages 18-40 and working in office conditions was studied by PCR- RFLP analysis. Results: rs2228570 C>T variant was shown to be significantly associated with low serum vitamin D levels in the studied population. Conclusion: Together with the effect of rs2228570 C>T variant in the VDR gene, it is thought that the lifestyle changes in the Turkish Cypriot population might have caused the increased frequency of vitamin D deficiency in the young professionals.

Objective: The aim of this study was to analyse the long-term radiation effects on human sperm. Methods: In total, 104 samples of male donors from 2 regions of Ukraine were tested. Group 1 consisted of 32 donors from the Ivano-Frankivsk region, group 2 included 72 volunteers from the Zhytomyr region. The average age of donors in both groups was 35 ± 6 years (range 24-49). To assess the level of apoptosis, membrane mitochondrial potential, concentration of reactive oxygen species, and ploidy of sperm, flow cytometry was performed. Results: The individual equivalent dose of group 1 was < 0.4 mSv and of group 2 ≥ 0.4 mSv. Live spermatozoa with signs of apoptosis were significantly higher (p < 0.05) in group 2 in comparison to group 1 (15.6% and 11.2%, respectively). Spermatozoa without violating integrity were 73.2% in group 1 and approximately 16% higher than the indices of group 2. The percentage of dead necrotic spermatozoa was twice as high in men with a predicted equivalent dose of ≥ 0.4 mSv than in comparison group. A higher percentage of spermatozoa with low mitochondrial membrane potential, di- and tetraploid was found in group 2. Conclusions: An equivalent individual dose of ≥ 0.4 mSv can cause a decrease in mitochondrial potential, an increase in the production of spermatozoa with pathological ploidy, as well as to provoke increasing apoptosis in cells.

Since December 2019, the new SARS-CoV-2 coronavirus causes COVID-19 disease worldwide, which occurs mainly in unvaccinated elderly and polymorbid patients with a more severe course and increased risk of complications and death. Vaccination and specific therapy for the disease using mainly new antiviral drugs are the way to reduce the number of infected, hospitalized patients with a more severe course. We present a case report of an at-risk polymorbid 57-year-old man who refused vaccination and standard treatment for COVID-19 disease based on misinformation from the community. He self-treated himself with high dose of ivermectin. The patient died at home 14 days after the onset of symptoms.

Objective: The aim of the study was to compare the occurrence of occupational diseases (ODs) in the automotive industry in the Czech Republic and the Slovak Republic and to analyze their determinants. Methods: The aggregated and anonymized data on ODs from the period 2001-2017 were used. A questionnaire survey was conducted in the Czech Republic (response rate 70.6%) and in the Slovak Republic (response rate 57%). The occurrence of ODs according to socioeconomic factors, the size of enterprises and their position in the global production networks was evaluated. The quality and scope of the occupational health services were also taken into consideration. Results: Workers older than 40 years were at a significantly higher risk of ODs than the younger ones. In the Czech Republic, it corresponded to OR 2.77 (95% CI 2.41-3.19), in the Slovak Republic to OR 2.01 (95% CI 1.34-3.01). The risk of ODs in women was significantly higher than in men - in the Czech Republic it corresponded to OR 3.20 (95% CI 2.79-3.67), in the Slovak Republic to OR 2.43 (95% CI 2.05-2.87). The difference between the two states did not reach statistical significance in any of the studied factors. In both states, no ODs were reported from the microenterprises. Conclusion: Given the results of the study, it can be recommended to focus on the ergonomics of assembly work in the automotive industry. Special attention should be given to the provision of occupational health services, especially in microenterprises.

Objectives: Measuring malnutrition is difficult in all settings and confused with the signs of aging. Mini nutritional assessment is an effective tool designed to identify older adults who have a risk of developing malnutrition. Methods: Three hundred and one free-living elderly who lived with their family or alone were included in the study. Nutritional screening was performed with mini nutritional assessment and mini nutritional assessment short form. Dietary intake was assessed by a 3-days weighted food record. Results: According to mini nutritional assessment in the 65-74 years young-old group, malnutrition, risk of malnutrition, and normal nutrition was 2.4%, 39.5%, 58.2%, respectively, and in the 75-84 years old-old group it was 10.2%, 48.7%, 41.0%, respectively, and in the older than 85 years oldest-old group 92.3%, 7.7%, 0%, respectively. The lowest nutritional intake by recommended dietary allowance was zinc and the highest intake was sodium. Neither young-old group nor old-old group nor oldest-old group met the B12 and zinc requirements. Conclusions: The free-living elderly at an age of 85 years and above are, accompanied by the existence of factors which may mask their weight losses, under a severe risk of malnutrition unless they receive adequate medical care and attention.

Objectives: Soft drinks are a major component of daily caloric and sugar intake. This is especially true for children and adolescents. The WHO as well as many other institutions currently recommend to increase research on the determinants of soft drink consumption. We submit a current systematic review on this topic. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we included all quantitative observational studies that comprise samples from developed countries in the age range 0-18 years and are listed in PubMed, Sociological Abstracts and the Social Sciences Citation Index. Publication period was not limited. The second and the last author screened all 10,392 hits independently with both reviewers being blinded. Interrater reliability (agreement and Cohen's kappa) was 97%/0.73 for the selection of titles, 91%/0.83 for abstracts and 91%/0.80 for full texts. Results: Results of 43 included studies, published between 2001 and 2017, show that children and adolescents consuming soft drinks tend to be older, male and of lower social status. Important contextual factors promoting consumption include constant availability at home, at schools or elsewhere as well as restrictions by parents and rules concerning drinks during meals or generally at home. The association between media consumption and soft drink consumption is particularly striking. Other factors in the food environment (choice of food and alternative drinks at home, having meals together, motivation, knowledge about nutrition and healthy eating) are of minor importance. Conclusions: When introducing interventions parents should play a major role because they serve as physical and social gatekeepers for this early risk factor of juvenile obesity.

Objective: Prostate adenocarcinoma (CaP) is one of the most common malignancies in men in Slovakia and in the world. The disease accounts for more than 22% of all tumors in the male population. Screening studies show an increase in the diagnosis of CaP without improvement in overall or CaP-specific mortality. The main goal of the work is to evaluate the incidence of CaP in the group of patients examined and treated during the period from 2014 to 2019 at the urological outpatient clinic of the Railway Hospital (RH) in Košice, and to evaluate the risks and treatment options. Methods: Men aged 40 to 75 years underwent a preventive examination in 2014-2019 at the urology outpatient clinic, RH Košice. The number of screened patients was 3,943. Epidemiological parameter, diagnosis-related examinations (prostate specific antigen - PSA examination, digital rectal examination, and ultrasonography examination) as well as the frequency of examinations were monitored during the specified period on the basis of documentation. The number of prostate biopsies, incidence of prostate cancer and relation to PSA values were also monitored, as well as the classification of prostate cancers according to the degree of risk. Initial treatment in individual patients was also evaluated. Results: PSA values in patients who underwent biopsy ranged from 3.6 ng/mL to 2,000 ng/mL. We observed positive digital rectal examination in 52 patients. Of the number of patients examined, 231 (61.28%) were positive biopsies. There were negative biopsies with the finding of benign prostatic hyperplasia in 92 patients or chronic prostatitis in 54 patients, i.e., 146 (38.72%). According to the criteria for risk assessment based on the PSA value and the result of the histological examination, we diagnosed 109 low-risk patients, 57 medium-risk patients and 24 high-risk patients. Conclusion: CaP is detected by prevention about 10 years before it develops clinically. The main aim of preventive examinations should be to detect, in particular, high-risk forms of early-stage prostate cancer and to improve the quality of life of men. Due to the results of extensive studies, it is necessary to continue the active search for prostate cancer. This reduces the risk of metastatic forms of CaP.

Objective: The aim of this study was to evaluate the perception of the respondents in selected areas of testing for COVID-19 during the first waves of this disease with an emphasis on the age categories. Methods: The research sample consisted of 806 Slovak respondents and the collection of data took place in February 2021. The study examined six areas, of which five focused on the perception of testing and one area focused on examining the risk of population behaviour. All areas were examined in the first as well as in the last testing for COVID-19. In terms of age, we focused on 4 age categories: up to 24 years, 25-44 years, 45-59 years, and over 60 years. Data were obtained by online survey, using descriptive analysis and nonparametric analysis of differences. Results: The results of the analysis show that age is a socioeconomic characteristic that is of great importance for the creation and implementation of epidemiological processes and programmes and therefore epidemiologists should pay increased attention to it when creating prevention programmes. Younger people perceived testing more positively than older ones, even though the course of the disease caused by COVID-19 is much more severe in older people. The difference in the perception of testing between age categories was confirmed in the first as well as in the last test study. Respondents perceived the last test more negatively and thus they showed slightly riskier behaviour compared to the first test. Conclusions: We perceive testing as an efficient way in the fight against pandemics generally, but we point out that testing should be well accomplished in a managerial way, otherwise testing can have a negative impact on society's confidence.

Objectives: The aim of the analysis was to determine the probable places of coronavirus transmission in association with the work and compare the situation between 2020 and 2021. Methods: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period from March 2020 - December 2021. Results: 2,483,219 COVID-19 cases were officially confirmed (732,202 during 2020 and 1,338,790 in 2021), from them 140,368 (6%) represented work-related disease, 520,830 cases (21%) work-related contact, and 1,822,021 (73%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (458,341 cases), in descending order - clerk, machinist, teacher, craftsman, worker/agency worker, driver, sales worker/cashier, warehouse worker/expediter, nurse, manager, food worker, paramedic, and social worker. Comparing 2020 and 2021, there was a difference in the ranking of occupations by incidence of disease. In 2021, the risk of infection acquiring increased for the occupations clerk, machinist, craftsman, worker/agency worker, manager, and food worker, while it decreased for the health professions (nurse, other paramedic, physician) and for social worker; 5,514 cases of COVID-19 were recognized as an occupational disease in 2020 and 2021, from them 5,483 cases (99.4%) in the health and social care economic activity sector. Conclusion: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which 27% cases of COVID-19 are related to work (cases of work-related disease and work-related contact represented together the closest relationship to work). Different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control. The use of personal protection of the mouth and nose with respirators/muffs is essential to reduce the risk of airborne transmission.

The North Atlantic Treaty Organization (NATO) is the premier and only security alliance uniting 30 countries and growing with many partner states in the provision of collective security and against threats posed by conflict and natural disasters. Security of countries and communities is increasingly threatened by a broad spectrum of unconventional types of war and disease threats - from hybrid and asymmetric to multi-domain and peer-to-peer/near-peer conflict. The NATO Centre of Excellence for Military Medicine (MILMED COE) is the centre of gravity for medical best practices and promotion of medical doctrine across the NATO alliance. Disaster medicine is multidisciplinary and in NATO, multinational, requiring best practices that are driven by data and evidence to prevent death on the battlefield and prepare for future conflicts. "Vigorous Warrior" is a live military and disaster medicine exercise series using both civilian and military actors across all sectors of health focused on health security and identifying lessons learned to ready the alliance for future threats. In this brief report, we make the case that the Vigorous Warrior exercise exposes gaps, highlights challenges and generates an evidence base to make NATO military medicine systems more robust, more efficient and in provision of best medical practices. We specifically argue that clinical data capture must be duplicated and continuous across the alliance to ensure evidence-based medicine stays current in NATO military medical doctrine.

Objectives: The objective of this study was to evaluate the effect of long-term treatment of patients with osteoporosis being actively managed by medical staff and following the therapeutic methods and principles of treatment of osteoporosis. Methods: The medical records of patients which were examined in an osteological outpatient office first time in the year 2009 were reviewed. The results of densitometry examinations were compared with the results from the year 2019. Patients regularly absolved densitometry, properly and regularly took prescribed medicaments for either anti-osteoporotic treatment or for supplementation of vitamin D and calcium. The cohort consisted of 100 patients. Next, we split the group into 3 categories - less than 65 years of age, 65-75 years of age and lastly over 75 years of age. By default, we assessed and compared the T-scores (deviation from the average value of bone density of 30 years old healthy person) in the area of the proximal femur and in the area of the lumbar spine. The bone mineral density (BMD) values in g/cm² and their relation to corresponding T-score from set area were also reviewed. Results: Based on the results of densitometry, osteoporosis was diagnosed in 41 patients, manifest osteoporosis in 14 and osteopenia in 36, nine patients had their bone density value within the normal range. The average T-score values of "total hip" were -1.42, "neck" -2.08, BMD values of "total hip" were 0.802 g/cm², "L1-L4" -2.05, "L total" -1.45, and BMD of "L total" was 0.886 g/cm². In the time of the last examination, the T-score (disregarding the type of treatment) raised from the initial value by 40.16% in the area of lumbar spine, by 56.69% in the area of "total hip", and by 40.16% in the area of "neck". While sorting the cohort based on age, we detected a similar effect of active management of treatment in each of the 3 categories. Conclusion: Cooperation of the patients during the treatment of a chronic disease requiring long-term usage of medicaments is often problematic and it is necessary to devote adequate attention to it. The solution to improve the treatment can be active management of the patient by the medical facility or by the medical staff.