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The case of spoilage of flavoured and sweetened soft drink occurred in the Czech Republic in 2019. After drinking it, the consumer was admitted to a hospital with sickness. The spoilage was caused by mould and an odorous substance, 1,3-pentadiene. The mechanism of food spoilage, with the formation of 1,3-pentadiene arising from the decarboxylation of sorbic acid and mould growth, is described. This could be the second case history reported worldwide of an allergic reaction to penicillin explaining how penicillin might get into the beverage. We hypothesise three possible causes of the health problem experienced with allergic reaction to penicillin or other mycotoxin produced by Penicillium mould as the most probable one.

Objectives: The aim of the study was to obtain data on demands on the intensive care capacities to treat COVID-19 patients, and to identify predictors for in-hospital mortality. Methods: The prospective observational multicentre study carried out from 1 March till 30 June 2020 included adult patients with confirmed SARS-CoV-2 infection with respiratory failure requiring ventilatory support or high-flow nasal oxygen therapy (HFNO). Results: Seventy-four patients, 46 males and 28 females, median age 67.5 (Q1-Q3: 56-75) years, were included. Sixty-four patients (86.5%) had comorbidity. Sixty-six patients (89.2%) were mechanically ventilated, four of them received extracorporeal membrane oxygenation therapy. Eight patients (10.8%) were treated with non-invasive ventilation and HFNO only. The median of intensive care unit (ICU) stay was 22.5 days. Eighteen patients (24.3%) needed continuous renal replacement therapy. Thirty patients (40.5%) died. Age and acute kidney injury were identified as independent predictors of in-hospital death, and chronic kidney disease showed trend towards statistical significance for poor outcome. Conclusions: Sufficient number of intensive care beds, organ support equipment and well-trained staff is a decisive factor in managing the COVID-19 epidemic. The study focused on the needs of intensive care in the COVID-19 patients. Advanced age and acute kidney injury were identified as independent predictors for in-hospital mortality. When compared to clinical course and ICU management of patients with severe community-acquired pneumonia caused by other pathogens, we observed prolonged need for ventilatory support, high rate of progression to acute respiratory distress syndrome and significant mortality in studied population.

Objectives: The aim of the study was to investigate the variation in breast and cervical cancer screening attendance among Czech women by age and in regions in 2009-2017. Methods: The data from the health insurance company that covers around 50% of the Czech population were used to calculate age-specific attendance rates and standardized attendance rates by year and region. Results: In 2017, the attendance of all eligible women was 52% in breast cancer screening and 46% in cervical cancer screening. There were differences in attendance among groups of women. Women aged 45-49 had attendance rates in both screenings around 60%, while 39% of women aged 75-79 attended breast cancer screening, and 23% attended cervical cancer screening. In regions, attendance ranged from 38% to 70% in breast cancer screening and from 32% to 55% in cervical cancer screening. Conclusions: We identified the age-specific differences and regional variation in both breast and cervical cancer screening attendance among Czech women. Those with lower attendance may have a higher risk of dying from breast and cervical cancers. Mitigating this risk should be a priority of public health policies.

This publication analyses current literary knowledge on selected topics in the fields of oral health and pathology, with a particular emphasis on the potential roles of the oral microbiome and preventative approaches to oral afflictions. An important association with floral dysbiosis has been documented in important oral conditions, sometimes as a predisposing factor and at other times as a result thereof. However, much remains to be elucidated regarding the specific mechanisms at play, as well as their meaning in clinical practice. Continued research into the pathophysiology of certain oral diseases is of particular importance considering how widespread they are. A specific emphasis should be placed on understanding the exact mechanisms through which the microbiota facilitates health, and when disturbed, sickness. And perhaps of most importance is the implementation of knowledge already acquired on disease prevention if the burden of oral diseases worldwide is to decline in the future.

Objectives: The aim of the study was to investigate possible emergence of resistance to disinfectants in Bordetella pertussis strains isolated from patients with whooping cough in the Czech Republic in 2014 and 2015. Methods: In an EN1500-based study, clean and dry fingertips of volunteers were always contaminated with one of the two clinical isolates of B. pertussis. Clinical isolates of B. pertussis were obtained from the National Reference Laboratory for Pertussis and Diphtheria, National Institute of Public Health (NIPH), Prague, Czech Republic. Dry and contaminated fingertips were immersed in 10 ml medium and then rubbed with the fingers for 1 minute. After that, the hands were treated with isopropanol 60% v/v or tested products, and then the fingertips were rubbed again into 10 ml of pure medium for 1 minute. The suspensions obtained were immediately diluted and plated on charcoal medium. Results: Ethanol-based product A and propanol-based product B showed bactericidal activity after 30 s of contact. The confidence interval limit for product A and B was 0.12 and 0.19, respectively. Quaternary ammonium compound-based product C was found to be ineffective after 30 s of contact. The confidence interval limit for product C was 0.62. Conclusion: Products A and B were assessed as effective against clinical isolates of B. pertussis in accordance with EN 1500. Quaternary ammonium compound-based product C did not comply with the requirements of EN 1500.

Objectives: This article investigates how the numbers of registered addict patients have changed in the last three decades in Hungary and whether the predicted HIV epidemic among intravenous drug users has occurred. Methods: Data were collected from the Annual Reports of the National Bureau of Statistics and National Epidemiological Centre as well as from the medical records of the author. Results: The total number of registered alcoholics decreased by about 75% during the investigated period. This decrease was more pronounced among males than females. After initial increase, the number of registered drug addicts showed stagnation with an about 50% drop-out rate. Fortunately, the anticipated HIV epidemic did not manifest. The negative effect of a poor political action upon the number of client visits could, however, be documented. Conclusion: In conclusion, negative trends are seen in the Hungarian addiction care. Numerous variables may be taken into consideration as affecting factors, but it is not yet clear to what extent these negative factors are responsible for trends. These data, however, warrant further investigations.

Objectives: The main goal of the study was to describe the demographic, epidemiological, clinical and laboratory characteristics of a monitored group of patients with psoriasis to assess the prevalence of cardiovascular comorbidities and to define the cardiovascular risk profile. Methods: One hundred and ninety outpatients aged over 18 were included in the prospective observational cross-sectional study. Demographic and clinical data were obtained from patients. The severity of psoriasis was evaluated using the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI). The results of laboratory testing were identified based on patient health records. Results: Based on an evaluation of psoriasis phenotypes, 150 patients (78.95%) suffered from plaque psoriasis, 18 (9.5%) from palmoplantar psoriasis, 11 (5.8%) from guttate psoriasis, 6 (3.2%) from generalized pustular psoriasis, and 5 (2.6%) from erythrodermic psoriasis. The personal medical history discovered the occurrence of arterial hypertension in 83 patients (43.7%), the occurrence of depression in 49 patients (25.8%), type 2 diabetes in 29 patients (15.3%), and dyslipidaemia in 48 patients (25.3%). Conclusion: It is noteworthy that psoriasis may be demonstrated as a multi-system disease which does not only affect the skin and its adnexa. The association of psoriasis with comorbidities may significantly increase morbidity and total mortality as well as the demands for health care provision.

Objective: The aim of this retrospective study was to estimate the prevalence of healthcare-associated infections (HAI), microbiological data including resistance patterns and impact of HAI on patients' survival. Methods: Two-centre study on 172 patients was performed. Medical records of patients hospitalized in the two COVID-19 intensive care units (ICU) localized in Bydgoszcz between 1 October 2020 and 30 March 2021 were analysed retrospectively. Data collection included demographics, microbiological, clinical variables, and patient outcome. All infections were defined according to the HAI-Net ICU protocol of the European Centre for Disease Prevention and Control (ECDC). Detailed data concerning bloodstream infection (BSI), pneumonia (PN) and urinary tract infection (UTI) were collected. Results: In 97 patients (56.4%), 138 HAI cases were identified. Patients with HAI statistically more often had been administered antimicrobial therapy prior to the admission to ICU (59.8% vs. 34.7%, p < 0.05), and needed catecholamines during hospitalization (93.8% vs. 70.7%, p < 0.001). The risk of HAI increased by 50% if antimicrobial therapy had been applied before the admission to ICU, and was three times higher if during the hospitalization in ICU catecholamines infusion was needed. Mortality was higher in patients diagnosed with HAI (72.2% vs. 65.3%) but the difference was not statistically significant (p = 0.34). Conclusions: Further investigation of co-infections in critically ill patients with COVID-19 is required in order to identify HAI risk factors, define the role of empiric antimicrobial therapy and proper prevention strategies.

Objective: Dental caries is the most widespread oral disease in the world, with multifactorial aetiology. It hinders not only the ability to eat good food, but also affects perfect speech and well-being. As the disease is almost completely preventable, and at its early stage well treatable, the prevalence of dental caries expresses the lack of public health literacy and skills in dental hygiene, and availability of adequate dental care. Children are especially vulnerable to dental caries, hence the WHO recommends regular monitoring of children's oral health and also appropriate controls for its continual improvement. We describe the part of the study targeted on dental health of Czech (CR) and Yemeni (YE) school children and its association with basic anthropometric markers of their nutrition. Methods: Total of 190 children aged 5-6 years (100 from CR and 90 from YE, 111 males, 79 females - 22.5% of the wider study on 5-15 years old children) were involved (after obtaining informed consent from their parents). The sample is not representative. All dental examinations were performed in accordance with the WHO criteria by the same examiner. Each individual tooth, whether primary or permanent, was identified as intact, untreated decayed, extracted or filled. Also, dmft/DMFT indexes for individual children were calculated. Anthropometric measurements were performed by standardized methods and the body mass index (BMI-for-age) was calculated. For the statistical evaluation of differences, the program MedCalc Software Inc., Belgium, was used, especially t-test, Pearson's correlation (rho with 95% confidence interval (CI) and Spearmen's rank correlation coefficient; p-values less than 0.05 were considered significant. Results: Dental caries prevalence and dmft scores (2.12-4.31) were found to be rather high among this age group of children, with no significant differences in relation to gender and country; only 30.0% or less of children were caries free. The decayed component was the major part of the dmft scores, and the evaluation of restorative index (ri%) indicates a high percentage of untreated caries and a high treatment need. Especially in Yemeni children dental caries is wholly untreated (ri 0.0 %), but also in the CR the dental care is rather poor (ri 38-41%). The levels of association(s) between oral health markers (dmft/DMFT) and BMI were inconsistent (both positive and negative), but without statistical significance. Conclusions: The high prevalence of poor dental health in these groups of Czech and Yemeni children and low or even no treatment urge effort to include WHO recommendations for practice into the national health policies. Prevention and control of dental caries can be promoted not only by dentists, targeting children and the whole family and their dental habits and lifestyle, with the cooperation of schools, paediatricians, general practitioners and with gynaecologists targeting new and expectant mothers, to increase their knowledge and skills.

Objective: Heat shock proteins act as chaperones at the molecular level and therefore they have been investigated in numerous diseases associated with oxidative stress, including obesity. The aim of this study was to investigate the possible associations of genetic variability in the 3´-untranslated region of the HSPB7 gene (rs1048261) with anthropometric and dietary parameters in a cohort of lean and obese Central European subjects. Methods: A total of 708 Central European Caucasian individuals were enrolled in this study, 415 obese subjects and 293 non-obese subjects. The rs1048261 genotypes were established using a conventional PCR-based methodology. Results: Significant differences were observed in the total daily fat intake between subjects with AT and TT genotypes (82.6 ± 29.2 g vs. 74.1 ± 31.3 g, p = 0.023) and also borderline significance in daily proportion of fat in the diet between AA and TT genotypes (36.0 ± 4.4% vs. 33.3 ± 5.9%, p = 0.061). Based on the linear regression model we found association between rs1048261 genotype and body fat percentage. Conclusions: To the best of our knowledge, this is the first study which reports an association of defined genetic variability in the HSPB7 gene, rs1048261, with obesity and its associated anthropometric characteristics and dietary composition.

Objective: The aim of the cross-sectional study was to evaluate cardiovascular risk factors in the group of medical students with gender, overweight and obesity categorisation. Methods: Cross-sectional study included 364 medical students, 207 females and 157 males. We investigated anthropometric parameters, BMI, body fat percentage, WHR (waist-hip ratio), TCH (total cholesterol) and LDL-CH (LDL-cholesterol), SBP and DBP (systolic and diastolic blood pressure). The participants also completed questionnaires with socio-demographic characteristic, including smoking, unhealthy eating, self-perceived health, and physical activity status. Statistical analysis used t-test differences in arithmetic means and OR calculation with 95% CI. Results: Prevalence of increased blood pressure (> SBP/DBP 120/80 mmHg) among participants was 10.99% (SBP) and 9.07% (DBP). The results confirmed risk of "overweight + obesity" in 15.38% (using BMI evaluation) versus 18.54% cases (using body fat percentage evaluation). The results of the study confirmed statistically higher risk for males compared to females in the following parameters: SBP, DBP, BMI, body fat percentage, self-perceived health, unhealthy eating and body weight watching. "Overweight and obesity" group (BMI evaluation) confirmed all factors on statistically significant level a risky group: SBP, DBP, body fat percentage, TCH, self-perceived health, smoking, stress at university, and body weight watching. The outputs confirmed, on the other hand, low amount of clinical obesity (0.8%), clinical hypertension (BP > 140/90) 1.1%, and clinically higher cholesterol level (TCH > 5.2 mmol/l) in 8.7% participants. Conclusions: We confirmed higher prevalence or cardiovascular risk factors among males. Also, group of "overweight and obese" students had higher frequency of cardiovascular risk factors. Border limits for risk evaluation were strong, so on clinical level we can evaluate the group of medical students as healthy. In the group of young medical students, we confirmed lower frequency of risk factors compared to the Slovak population average.

Objectives: Smoking is a commonly recognized risk factor of civilization diseases. Despite many educational programmes concerning harmful effects of tobacco smoking, this habit is still very popular. Particularly alarming is a high percentage of pregnant women who smoke. Methods: The aim of the study was to analyse the prevalence of smoking among pregnant women depending on their place of residence. The research was conducted in randomly selected 30 outpatient clinics for women in Łodź and 16 outpatient clinics in rural communes of the Łodź province. The epidemiological analysis included 400 women. Collected data were processed statistically using the descriptive methods and statistical inference. Results: It has been demonstrated that smoking in the past was more popular among city residents than countryside residents (58.2% and 47.9%, respectively). Women living in the city smoked almost three times more frequently during the whole pregnancy than the respondents from the countryside (13.4% and 4.3%, respectively). Furthermore, every fifth respondent living in the urban area (f = 0.21) smoked over 10 cigarettes a day, and every fourth respondent from rural communes (f = 0.24) smoked from 5 to 10 cigarettes a day. However, in the month preceding the research, pregnant women from rural areas smoked slightly more frequently as compared to the subjects from the city. In the group of pregnant women who smoked in the past or who smoke at present, regardless from their place of residence, every other woman did not breastfeed her baby. 6.1% of city residents and 4.3% of countryside residents declared that they smoked during the breastfeeding period. Conclusions: Within the analysed population the influence of place of residence on the prevalence of active smoking, number of smoked cigarettes and giving up smoking during pregnancy and breastfeeding period has been evidenced.

Objectives: Many jobs are associated with psychological or social risk factors. Knowledge of occupational diseases is essential for adopting rational control measures. The aim was to study and describe frequent social, psychological and physiological risk factors for nurses. Methods: Psychological and social risks were evaluated in nurses with regular or irregular shifts. In addition, differences between nurses or nursing assistants were studied. The Copenhagen Psychosocial Questionnaire, Eating Attitudes Test, Profile of Mood State, Athens Insomnia Scale, Trait Anxiety Inventory, and Minnesota Leisure Time were administered. Results: Nursing assistants presented higher levels of body mass index and food restriction than nurses, nevertheless, nurses showed increasing tension in work. In nursing, shift work increases psychosocial risks, insomnia, eating disorders, and trait anxiety. Conclusions: In conclusion, nurses and nursing assistants in health centres and hospitals show high levels of exposure to psychological and psychosocial risks that are unfavourable to their health.

Objective: Tick-borne encephalitis virus (TBEV) is most commonly transmitted to humans via the bite of an infected tick. Alimentary infection through the consumption of TBEV-contaminated dairy products is also well-documented and is responsible for some diseases in endemic areas. The aim of the study was to emphasize the risk of contracting tick-borne encephalitis (TBE) by consuming raw milk and dairy products and to describe TBE epidemics in Slovakia for the period 2012-2016. Methods: The data on epidemics were obtained from the Annual Reports for the period 2012-2016 available on the website of the Public Health Authority of the Slovak Republic. Medical records of patients hospitalized during epidemics were provided by the Department of Infectology and Travel Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, and the Louis Pasteur University Hospital in Košice. Results: During the period 2012-2016, 13 smaller or larger TBE epidemic outbreaks were recorded in the Slovak Republic. The two outbreaks of TBE reported in 2012 were associated with the consumption of raw goat's milk and dairy products. The first case was an outbreak involving 12 infected people in the Lučenec District. The second case was a family outbreak in the Žilina District, where 3 persons out of 4 family members were infected. In 2013, one epidemic was reported involving 5 persons following the consumption of sheep's cheese from a farm in the Prešov District. One outbreak with 11 cases was reported in 2014. The investigation confirmed its association with the consumption of sheep's cheese in a restaurant located in the Ružomberok District. In 2015, 4 epidemics were described related to the consumption of goat's/sheep's milk and cheese (Žilina District, Krupina District, Kysucké Nové Mesto District, Trenčín District). In 2016, there were 5 TBE epidemics related to the consumption of milk and dairy products. The largest TBE epidemic outbreak in the last 5 years occurred in the Košice District. In this outbreak approximately 500 people were exposed, and 44 contracted the disease. Infected persons confirmed consumption of sheep's cheese from a farm. Conclusions: Consumption of milk and dairy products made only from pasteurized milk, as well as the immunization of humans and animals are the most effective preventive measures against TBE.

Objective: During last years, a significant increase of HIV infection transmitted through sexual intercourse among young adults has been reported in the Czech Republic. The issue of prevention, where sexual education belongs to an important preventive tool, is much more topical than ever before. The level of knowledge and attitudes related to HIV/AIDS among adolescents has not been assessed so far. The aim of our study was to explore this field in a nationally representative sample. Methods: Information was obtained using an anonymous questionnaire that was filled in by 1,627 adolescents 13 to 15 years old selected from a representative sample of 25 elementary and grammar schools in the Czech Republic. Results: Based on the survey results, good knowledge regarding primary HIV/AIDS prevention was noted in the majority of respondents who however tended to stigmatize HIV positive people. Conclusion: The study has confirmed the importance of school as the main source of information (reported by 50.8% of respondents). The result of our study can serve as a starting point in assessment and comparison of the effect of various educational programmes.

Growth references are important for paediatric health monitoring. It is critical to understand differences in growth interpretation and potential consequences when using available growth references. This study compares the growth of Czech breastfed children with the current WHO growth standards 2006 and the Czech references 1991, 2001. A total of 960 infant/parent pairs in the Czech Republic were recruited through paediatric practices. Anthropometric data were collected during infants' first 12 months of life and parent questionnaires were gathered during a preventive visit at 18 months. Czech breastfed infants were longer with a greater head circumference at all percentiles compared to the WHO standards and were similar to the national references. The percentile weight-for-age and weight-for-length values of infants (≤6 months) were lower, and higher (6-12 months) compared to the WHO standards. The infant growth in the sample differed from both the WHO standards as well as the national references. Our findings indicate that the growth of Czech breastfed children differs from the current national references. These discrepancies were smaller compared to the WHO standards. The results of the study were used for new growth assessment guidelines to optimize feeding recommendations for Czech infants. The adoption of the WHO standards in the Czech Republic is not recommended.

Objectives: This article describes and comments on contemporary legal regulations concerning the supply of medicines during pandemics in terms of public procurement. Methods: Suggestions are made for removing existing legislative shortcomings, clarifying the diction of existing laws or rendering precision to legal regulation of public procurement given purchases of medicines during periods of imminent threats of pandemics and duration of pandemics. Results: The author reflects on improving legislation concerning the lack of clarity and the doubts concerning the contemporary legal order of the Czech Republic, with reference to speeding up and simplifying public procurement procedures for incident-free purchases of necessary medicines in time of pandemic crisis situation and then effectively supporting the struggle against any pandemic infection. Conclusion: The issues raised should be addressed since better legislation can significantly contribute to the containment of pandemics and their consequences for individual and public health.

Objective: Vitamin D deficiency is a global health problem. The aim of this study was to determine the proportion of Czech children with vitamin D deficiency and examine related factors. Methods: The study subjects were 419 healthy children aged 5 and 9 years. Severe vitamin D deficiency was defined as a serum 25(OH)D level of < 25 nmol/L (3% of children), deficiency as that of 25-50 nmol/L (24% of children), insufficiency as that of 50-75 nmol/L (40% of children) and sufficiency as that of > 75 nmol/L (34% of children). Results: Serum 25(OH)D levels varied mainly with season. The highest levels of 25(OH)D were reached in autumn (median: 79.0 nmol/L), followed by summer (median: 67.8 nmol/L) and winter (median: 56.0 nmol/L). The lowest median value (49.8 nmol/L) was detected in spring. Conclusion: Children with sufficiency 25(OH)D levels were more frequently exposed to the sun and exposed a larger part of their body to the sun while spending time outdoors. Levels of 25(OH)D were also associated with using vitamin D supplements within six weeks before sampling.

Objective: The aim of this seroepidemiological study was to determine the current prevalence of antibodies against tick-borne encephalitis virus (TBEV) in the representative group of Slovak population with included potential risk factors for TBEV. Methods: Representative group consisted of 428 persons (also with possible exposure to risk factors for tick bite or raw milk consumption). Serum samples were screened by commercial enzyme-linked immunosorbent assay (ELISA). The persons involved in the study completed questionnaires with general demographic, epidemiological and clinical data. During the analysis, we used linear regression to interpret the influence between selected variables. Results: We detected 1.2% prevalence of positive IgG and 1.6% prevalence of positive IgM antibodies in all tested groups. Our results also confirmed that the following risk factors such as tourism, hunting, fishing, and consumption of raw milk are significantly associated with the prevalence of specific antibodies against TBEV. Conclusion: The results of seroprevalence obtained by this study confirm the possibility of infection with TBEV among respondents exposed to possible contact with ticks.

Objectives: The aim of our study was to investigate the correlation between several clinical parameters and the appearance of atopic manifestations (atopic eczema, food allergy, wheezing bronchitis, allergic rhinoconjunctivitis) in the first four years of life. Methods: A total of 139 unselected full-term newborns were included in a prospective follow up from birth to age 4. Cord blood total immunoglobulin E (cIgE) and cord blood absolute eosinophil count (cEo), positive family history of allergy, maternal smoking during pregnancy, mode of delivery, and duration of exclusive and overall breastfeeding were evaluated as predictors for appearance of atopic manifestations. Results: We found that children with a positive family history of both mother and father are 19.03 times more likely to develop atopic manifestations and those with a positive family history of only mothers are 12.55 times more likely to develop atopy compared with children with a negative family history. Neonates with cord blood eosinophilia had 5.30 times higher chances for developing atopic manifestations. No statistically significant associations were found between cIgE (p = 0.099), mode of delivery (p = 0.379), maternal smoking (p = 0.661), exclusive (p = 0.867) and overall breastfeeding duration (p = 0.675) and the presence of atopic manifestations up to age 4. Conclusions: A positive medical history, especially of mothers and cEo, seem to be predictive in screening for the onset of allergic diseases.

Objective: The aim of the study was to evaluate results of purified protein derivates (PPD) test applied at the Tuberculosis Dispensary between 2012-2015 in Hatay, Turkey, where a large number of Syrian refugees have migrated since the Syrian civil war began in 2011. Methods: PPD test records from the Electronic Tuberculosis Management System at the Tuberculosis Dispensary from 2012-2015 were analyzed based on nationality, age groups, BCG scar availability, and PPD reaction. The annual risk of tuberculosis infection (ARTI) was calculated based on years for each age group in Turks and Syrian refugees and the trend was evaluated. Student-t, Chi-square, and Mantel-Haenszel tests were used in statistical analyses, p < 0.05 was considered significant. Results: In total, 5,255 PPD tests were made, 15.5% were Syrian refugees. BCG scar was missing in 48.5% of Turks and 87.3% of refugees (p < 0.001). The 0-5 age group represented the lowest rate (Turks 3.2%, refugees 4.3%) and the 19-64 age group represented the highest rate (Turks 51.1%, refugees 54.1%) of positive PPD reaction among individuals without BCG scar. Among individuals without BCG scar, more positive PPD reactions developed in refugees of the 6-18 group than in Turks (Turks 16.9%, refugees 46.4%, p < 0.001). Among individuals with BCG scar, more positive PPD reactions developed among refugees of the 0-5 (Turks 7.8%, refugees 24.0%, p = 0.049) and 19-64 (Turks 36.6%, refugees 58.8%, p = 0.028) age groups. ARTIs between 2012-2015 were 0.2%, 1.0%, 1.3%, and 1.4% among Turks, (except 2012) 2.3%, 0.3%, 2.4% among refugees in the 0-5 age group, 1.1%, 2.0%, 1.7%, and 1.5% among Turks, and 8.5%, 6.6%, 7.3%, and 2.4% among refugees in the 6-18 age group, respectively. Conclusion: Higher positive PPD reactions and ARTIs were found among Syrian refugees, more specifically in the 6-18 age group.

Objective: Approximately 25% of the Czech population is currently obese. Obesity rates are expected to increase in the future. Obesity not only raises the risk of health complications for individuals, but increasing rates also represent a significant and steadily growing economic burden for healthcare systems and society as a whole. The aim of this study was to evaluate the therapeutic efficacy of three methods of bariatric surgery: laparoscopic greater curve plication (LGCP), laparoscopic sleeve gastrectomy (LSG), and Roux-en-Y gastric bypass (RYBG) in patients with type 2 diabetes mellitus (DM). This study examined the influence of bariatric surgery on body weight and BMI, changes in serum glucose and markers of lipid metabolism. Methods: This study evaluated outcomes in 74 patients with type 2 DM who underwent LGCP, LSG or RYGB. Patient selection followed guidelines of the International Federation for the Surgery of Obesity, i.e. BMI ≥ 40 kg/m² or BMI ≥ 35 kg/m² with associated comorbidities or BMI < 35 kg/m². For each of the procedures, the hypotheses were tested with the Bonferroni method. Results: Statistically significant weight loss, 20.2 ± 9.3 kg on average, occurred by 12 months after surgery, with maximum weight reduction of 38 kg. Over the 12-month period, average fasting glycaemia decreased by 2.58 mmol/L after LGCP, by 2.01 mmol/L after LSG, and by 4.64 mmol/L after RYGB. Triacylglycerol (TGC) values decreased significantly with all procedures. The mean decrease was 1.35 mmol/L after LGCP and 1.06 mmol/L after LSG. The greatest TGC concentration decrease, 1.92 mmol/L, occurred after RYGB. Average concentrations decreased below 1.7 mmol/L. There was a statistically significant difference in body weight and BMI reduction between LGCP and LSG groups, as well as between LGCP and RYGB groups. A significant difference in the glucose decrease was observed between the LSG and RYGB groups, which can be explained by the fact that glycaemia and HbA1c levels were different between these groups prior to surgery. Conclusions: The best results from the carbohydrate metabolism point reached the malabsorption method RYGB. However, the other two restrictive methods also achieved very good results. In particular, the LGCP method has not only the effect on weight reduction but also on metabolic functions and consequently points to potential healthcare expenditure savings.

Objective: Many sub-Saharan African countries have massively scaled-up their antiretroviral treatment (ART) programmes, but many national programmes still show large gaps in paediatric ART coverage making it challenging to reduce AIDS-related deaths among HIV-infected children. We sought to identify enablers of paediatric ART coverage in Africa by examining the relationship between paediatric ART coverage and socioeconomic parameters measured at the population level so as to accelerate reaching the 90-90-90 targets. Methods: Ecological analyses of paediatric ART coverage and socioeconomic indicators were performed. The data were obtained from the United Nations agencies and Forum for a new World Governance reports for the 21 Global Plan priority countries in Africa with highest burden of mother-to-child HIV transmission. Spearman's correlation and median regression were utilized to explore possible enablers of paediatric ART coverage. Results: Factors associated with paediatric ART coverage included adult literacy (r=0.6, p=0.004), effective governance (r=0.6, p=0.003), virology testing by 2 months of age (r=0.9, p=0.001), density of healthcare workers per 10,000 population (r=0.6, p=0.007), and government expenditure on health (r=0.5, p=0.046). The paediatric ART coverage had a significant inverse relationship with the national mother-to-child transmission (MTCT) rate (r=-0.9, p<0.001) and gender inequality index (r=-0.6, p=0.006). Paediatric ART coverage had no relationship with poverty and HIV stigma indices. Conclusions: Low paediatric ART coverage continues to hamper progress towards eliminating AIDS-related deaths in HIV-infected children. Achieving this requires full commitment to a broad range of socioeconomic development goals.

Objective: Metabolic syndrome is a combination of clinical risk factors for cardiovascular disease as well as for diabetes. Metabolic syndrome arises from insulin resistance accompanied with abnormal adipose deposition. The aim of our cross-sectional time trends study was to characterize the prevalence of metabolic syndrome and its five risk determinants among the clients of Health Advice Centres of Regional Public Health Authorities in Slovakia. The study was stratified by gender and age groups during the 10 year period from 2003-2012. Methods: Prevalence data were estimated in adults and children (≥ 10 years, N = 79,904) from the nationwide electronic database of Health Advice Centres of Regional Public Health Authorities in Slovak Republic "Test of healthy heart" from 2003 to 2012. Results: The overall prevalence of metabolic syndrome was 30.2% in males and 26.6% in females, abdominal obesity was confirmed in 48.3% of males and 53.9% of females. Increased triglyceride level has higher prevalence among males (33.3%) compared to females (24.2%). Blood pressure (BP) values and fasting glucose values were significantly higher in males (58.2%) than females (41.9%). During the 10 year period from 2003 to 2012, we confirmed an increased trend in the age-adjusted prevalence of metabolic syndrome. Abdominal obesity and elevated triglycerides had also increased time trends prevalence in both sexes. The prevalence of people without risk determinants of metabolic syndrome had a time decreasing trend. A surprising finding is a decrease in the proportion of persons with suboptimal HDL-cholesterol. The proportion of people with elevated BP and glucose showed little change during the reporting period. Conclusion: The increasing prevalence of metabolic syndrome, abdominal obesity, and elevated triglycerides highlights the urgency of addressing these health problems as a healthcare priority to reduce cardiovascular mortality in the Slovak Republic.

Background: Numbering about 90,000, nurses represent the largest group of health care providers in the Czech Republic. Therefore, nurses can make a significant impact in the treatment of tobacco dependence, particularly in applying brief interventions to smokers. Methods: During 2014, 279 nurses from the Czech Republic participated in an e-learning education programme consisting of two Webcasts with additional web-based resources about smoking cessation in relation to health and treatment options in daily clinical practice, particularly regarding brief intervention methods. Before viewing the e-learning programme, and three months after viewing it, the nurses completed a questionnaire documenting their interventions with smokers and their knowledge, attitudes and opinions regarding nurses' roles in smoking cessation. Results: The responses in all of the following categories significantly improved: usually/always asking patients about smoking from 58% to 69% (OR 1.62, CI=1.14-2.29, p=0.007); recommendations to stop smoking from 56% to 66% (OR 1.46, CI=1.03-2.06, p=0.03); assessing willingness to quit from 49% to 63% (OR 1.72, CI=1.23-2.42, p=0.002); assisting with cessation from 21% to 33% (OR 1.85, CI=1.26-2.71, p=0.002); and recommending a smoke-free home from 39% to 58% (OR 2.16, CI=1.54-3.04, p<0.001). The increase in arranging follow-up from 7% to 10% did not constitute a statistically significant improvement, however, this finding is understandable in relation to the status of nurses in the Czech Republic. However, nurses' confidence in helping smokers to quit smoking, their senses of responsibility and determining the appropriateness of these interventions remains inadequate. Conclusion: The nurses' brief intervention skills improved significantly after the completion of the e-learning programme, even though reservations remain among this group. The systematic education of nurses aimed at smoking cessation intervention and analyzing their motivation for treatment may contribute to improved nursing care, and thus lead to a reduction of smoking prevalence in the general population.

Objectives: Smoking is the leading cause of premature mortality and morbidity. The aim of this study was to provide the first national description of organizational capacity and involvement in tobacco control (TC) measures outlined by the WHO Framework Convention on Tobacco Control (FCTC) within the Czech Republic. Methods: Data were collected in a national cross-sectional survey of all 14 organizations engaged in TC activities within the Czech Republic. Organizational capacity (defined as skills, supports, partnerships, resources, and leadership) to implement TC activities, and level of involvement in key FCTC measures were assessed and compared across organizations. Results: Despite the high economic costs of tobacco use, few organizations were involved in TC activities. 50% of all organizations involved in TC activities were non-government or non-profit organizations. Less than one third of organizations reported having a sufficient number of staff or adequate funding to work effectively. Skills for chronic disease prevention (CDP) practice including assessment, identifying relevant practices, developing and implementing initiatives were rated more favourably than skills to evaluate these activities. Level of involvement was ranked highest for activities that focused on creation of smoke-free environments and lowest for activities that focused on raising taxes and sales to minors. Organizations tended to be more involved in individual, rather than population-level prevention strategies. Inadequate funding, insufficient number of staff dedicated to working on TC, and lack of political will were major barriers. Conclusions: This paper provides the first national description of organizational capacity and level of involvement in FCTC measures within the Czech Republic.

Objective: The aim of the study was to identify similar WHO European countries in COVID-19 incidence and mortality rate during the first 12 peak weeks of pandemic outbreak to find out whether exact coherent parts of Europe were more affected than others, and to set relationship between age and higher COVID-19 mortality rate. Methods: COVID-19 cases and deaths from 28 February to 21 May 2020 of 37 WHO European countries were aggregated into 12 consecutive weeks. The fuzzy C-means clustering was performed to identify similar countries in COVID-19 incidence and mortality rate. Pearson product-moment correlation coefficient and log-log linear regression analyses were performed to set up relation between COVID-19 mortality rate and age. Mann-Whitney (Wilcoxon) test was used to explore differences between countries possessing higher mortality rate and age. Results: Based on the highest value of the coefficient of overall separation five clusters of similar countries were identified for incidence rate, mortality rate and in total. Analysis according to weeks offered trends where progress of COVID-19 incidence and mortality rate was visible. Pearson coefficient (0.69) suggested moderately strong connection between mortality rate and age, Mann-Whitney (Wilcoxon) test proved statistically significant differences between countries experiencing higher mortality rate and age vs. countries having both indicators lower (p < 0.001). Log-log linear regression analysis defined every increase in life expectancy at birth in total by 1% meant growth in mortality rate by 22% (p < 0.001). Conclusion: Spain, Belgium and Ireland, closely followed by Sweden and Great Britain were identified as the worst countries in terms of incidence and mortality rate in the monitored period. Luxembourg, Belarus and Moldova accompanied the group of the worst countries in terms of incidence rate and Italy, France and the Netherland in terms of mortality rate. Correlation analysis and the Mann-Whitney (Wilcoxon) test proved statistically significant positive relationship between mortality rate and age. Log-log linear regression analysis proved that higher age accelerated the growth of mortality rate.

Objectives: Our recent studies showed that in children in the Batumi region, Georgia, underdiagnosis of asthma is 65%, and that not all children with known asthma had a history of allergic disorders. So, we decided to assess the association of known diagnosis of paediatric asthma with asthma-like symptoms and non-respiratory allergic symptoms and diseases using questionnaire-derived data provided by respiratory health survey. Methods: Subjects of the cross-sectional population-based study were 3,239 urban and 2,113 rural children aged 5-17 years whose respiratory status was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. For children with a known diagnosis of asthma, the occurrence of respiratory symptoms suggestive of asthmatic tendency and of allergic symptoms and diseases was measured and statistical association of known asthma with the respiratory and allergic symptoms was expressed as odds ratios (OR) and their 95% confidence intervals (95% CI). Results: Respiratory and all allergic symptoms and diseases, except for eczema, were statistically significantly (p < 0.05) more prevalent in children with asthma than in children without asthma. Based on the distribution of asthma vis-à-vis asthmatic tendency without or with allergic symptoms and allergic diseases the following odds ratios expressing likelihood of asthma were obtained: for asthmatic tendency: OR = 18.09 (95% CI: 11.82-27.68), for any allergic symptom: OR = 6.85 (95% CI: 4.69-10.02), for any allergic disease: OR = 10.75 (95% CI: 7.36-15.70), for asthmatic tendency with coexisting any allergic symptom: OR = 18.94 (95% CI: 12.96-27.68), for asthmatic tendency with coexisting any allergic disease: OR = 25.65 (95% CI: 17.47-37.67), and for asthmatic tendency with coexisting any allergic symptom and allergic disease: OR = 27.02 (95% CI: 18.18-40.15). Conclusions: The findings support the view that in epidemiological setting questionnaire-based studies on asthma seems to more readily identify cases in children with more severe clinical presentation of the disease and with coexisting allergic disorders, perhaps reflecting diagnostic practices of consulting paediatricians.

Objectives: We aimed to study the effect of seasonal influenza (flu) vaccination on the susceptibility to coronavirus disease 2019 (COVID-19). Methods: A total of 203 healthcare workers of a pandemic centre of Istanbul, Turkey, were included in this retrospective study. According to the presence or absence of flu vaccination, participants were divided into group 1 and group 2. A comparison of the rate of COVID-19 was done between these two groups. Also, the mean age and the sex ratio of females/males were evaluated and compared between these two groups. Results: Group 1 participants (n = 65) were older than participants in group 2 (n = 138) (p < 0.05). Despite of this, interestingly, the COVID-19 infection rate was lower in the 1st group (in comparison to the 2nd group) (p < 0.05). Conclusion: Our study results showed that, even if low, the flu vaccination may have a protective effect on the susceptibility to COVID-19 infection. Using this beneficial adjuvant effect of the vaccine may help us in this unpredictable battle with the COVID-19 pandemic. Further studies are needed to confirm this assumption.

Objective: Despite advancing technology, national TB surveillance systems are still inadequate in terms of patient detection around the world. It was aimed to investigate suspicious cases detected by active surveillance method in pathology laboratories and to evaluate the effectiveness of this method in terms of finding new TB cases. Methods: This is a descriptive cross-sectional study. It was administrated in Samsun, Turkey, between January 2012-December 2017. Within the scope of active surveillance, pathology laboratories were regularly visited and reported cases with granulomatous inflammation were assessed. The obtained patient list was compared with the records of the Electronic Tuberculosis Management System (ETMS). Patients who were not included in these records were invited to the dispensary and evaluated for TB. They were also referred to the relevant hospitals for diagnosis if necessary. Frequency values and descriptive statistics were calculated using SPSS method. Results: It was found that 35.6% of 703 patients with the diagnosis of granulomatous inflammation were previously diagnosed, treated or currently undergoing treatment in the ETMS registry. As a result of the assessment of remaining 453 cases, 46 patients (10.1%) were newly diagnosed with TB. Newly diagnosed TB patients were reported, and their treatment started. Conclusion: As a result, active surveillance method conducted in pathology laboratories are used to detect unknown or late reported TB cases and allows to start treatment without further delay.