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Background: Human papillomavirus (HPV) is a major risk factor for the development of cervical cancer (CC). Human leukocyte antigen (HLA) alleles have been associated with an increased or decreased risk of developing CC through infection with oncogenic forms of HPV.
Objectives: The aim of this study was to analyze the interaction between HPV and HLA for invasive cervical cancer.
Materials and Methods: It was found that HPV infection rates were 91.33% in CC, and 26.15% in controls using PCR-SBT method in China.
Results: Ten HPV genotypes including HPV-16, -58, -61, -6, -39, -81, -18, -33, -11 and -52 were detected in controls. Among the controls, 14.84% were positive for HPV-16, 2.47% for HPV-58, and 8.84% for other HPV types. It was found that 16 HPV genotypes including HPV-16, -18, -58, -33, -81, -31, -68, -39, -67, -6, -11, -26, -52, -62, -66, and -70 were detected in patients with CC. Among the CC specimens, 68.67% were positive for HPV-16, 6.33% for HPV-18, 3.33% for HPV-58 and 13.00% for other HPV types. In HPV-16 positive cervical cancers, 23.6% of them were belonged to prototype, 65.5% were Asian variant, 5.5% were African type 1 and 3.6% were European variants.
Our results indicate that HLA-DQB1*060101, DPB1*1301, D6S1043 alleles 112, 132 and D6S2764 allele 209 may confer susceptibility to CC, and DRB1*150101-DQB1*0602 haplotype and DRB1*070101-DQB1*0201 haplotype may contribute to the resistance to the development of CC among Chinese women. Our finding also implies that polymorphic amino acids at the putative antigen binding residues 9 and 37 of HLA-DQB1 alleles may play an important role in the development of cervical cancer. Conclusions: The study suggests that specific HLA class II alleles and haplotypes may influence the immune response to specific HPVencoded epitopes and affect the risk of cervical cancer in Chinese population from an area with a high incidence of this neoplasia.

Background: Different tests for human papillomavirus (HPV) screening are commercially available, detecting high-risk oncogenic HPV types with a pool of genotype-specific probes.
Objectives: The purpose of this study is to compare two commercial methods for HPV genotyping: Linear Arrays HPV genotyping test (Roche), capable of detecting and genotyping 37 different HPV types simultaneously, and the new INNO-LiPA HPV Genotyping Extra (Innogenetics), that detects 28 genotypes, including now HPV-26 (considered probable high-risk genotype) and HPV-82 (considered high-risk genotype), that were not included in the previous version. Both methods also include controls for cell adequacy. Materials and Methods: A total of 100 HPV DNA-positive cervical samples by hybrid capture method were genotyped.
Results: Multiple genotypes were found more frequently with Linear Arrays (2.2) than INNO-LiPA (1.7). Comparison analysis was limited to HPV genotypes common to both assays. There were concordant results (absolute agreement between assays) in 65 samples and compatible results (correspondence for some but not all genotypes) were found in 33 samples. In 21 samples additional types by Linear Arrays were detected. In13 samples additional types by INNO-LiPA were detected (in one sample there was additional type detected by Linear Arrays and INNO-LiPA method). Only two samples were considered as discordant (did not show any similarity between the tests) and these were negative by INNO-LiPA and positive by Linear Array (both HPV-73). Analyzing kappa values we have found excellent concordance for 6 genotypes (26, 35, 45, 58, 68, and 70) and very good for other 8 genotypes (6, 16, 31, 33, 51, 52, 53 and 66), Concordance was considered good (0.6-0.8) for 5 genotypes (18, 39, 40, 54 and 56), moderate value (0.4-0.6) for HPV-59 and weak agreement (0.4-0.2) for HPV-11.
Conclusions: Both genotyping methods are highly comparable and suitable for clinical and epidemiological studies, as they are partially automated and detect all HPV genotypes of clinical interest.

Objective: Comparison of 16, 18, 45 HPV DNA probe results with cervical cytology findings and evaluation according to followup cytology or/and histology findings.
Materials and Methods: 16,18,45 HPV DNA probe was done as an additional test using the Hybrid capture 2 test kit (Digene, USA) in previously high risk HPV DNA positive patients. Conventional cervical cytology samples were taken shortly prior or at the same time as HPV test, while histology diagnoses were done on biopsy, LLETZ or conisation samples. Follow up period was 6 to 12 months. Results: Out of 224 high risk HPV positive samples, 113 (50,4%) were 16, 18, 45 HPV positive and 111 (49,6%) were negative. Cytology findings were: 2 unknown, 31 negative, and 191 positive (57 ASCUS, 20 ASC-H, 64 LSIL, 50 HSIL+). Positive 16, 18, 45 HPV test was found in 14 (45%) patients with negative cytology, 22 (39%) with ASCUS, 14 (70%) with ASC-H, 31 (49%) with LSIL, 30 (60%) with HSIL+ cytology. Cytology follow-up was available in 57, and histology in 31 patients. Positive follow-up cytology at level of ASCUS was found in 23 (88%), and at level of ASC-H or HSIL+ in 15 (58%) patients with positive 16, 18, 45 HPV test (N=26). Positive follow-up cytology at level of ASCUS was found in 27 (87%) and at level of ASC-H or HSIL+ in 8 (26%) patients with negative 16, 18, 45 HPV test (N=31). Positive histology (CIN2+) was found in 20 (95%) positive 16, 18, 45 HPV (N=21) test and in 7 (70%) negative 16, 18, 45 HPV test (N=10). Negative, ASCUS, LSIL initial cytology (N=46) had HSIL+ follow up cytology or high grade histology in 9 (43%) cases of positive 16, 18, 45 HPV test (N=21), and in 4 (16%) cases of negative 16, 18, 45 HPV test (N=25). Out of the five carcinomas found, one was 16, 18, 45 HPV negative.
Conclusion: A higher percent of high grade initial and follow-up cervical cytology and histologicaly confirmed high grade cervical lesions showed positive 16, 18, 45 HPV test. Additional tests and longer follow-up should be applied to achieve more precise evaluation of this probe and its possible clinical application.

The treatment of HIV infection in Latvia by using highly active antiretroviral therapy (HAART) was started in 1996.
The prevalence and tendencies of HIV drug resistance among treated and treatment-naive patients in Latvia in the years 2006-2007 were evaluated in this study. Data of HIV genotyping, performed in 132 HIV-1 infected during years 2006-2007 by TRUGENE HIV-1 genotyping assay (BayerHealthCare-diagnostics) are included in the study.
Analysis of data showed that in the group of treatment-naive individuals majority carried wild type virus. Prevalence of resistance-associated mutations (RAMs) in the treatment-naive group according to IAS list was 28%. In most cases it was NRTI mutation A62V that is associated with multinucleoside resistance caused by Q151M, its effect in the absence of Q151M is not known. By many authors A62V is supposed to be a result of polymorphism in RT gene and is excluded from the list of resistance mutations. High prevalence of A62V is typical for HIV-1 subtype A. As majority of treatment-naive cases (89%) in this study were with HIV-1 subtypes A or AE, we excluded A62V mutation and estimated RAMs prevalence in group of treatment-naive HIV-infected individuals as 7%. Minor PI mutations were not included in analyses. In Europe published rates generally very between 5% and 15%.
In the group of treatment-experienced HIV infected people 25/75 were with HIV-1 subtype B, the rest part - with non-B subtypes: A/AE (35/75), CRF - 01AE (7/75), B/AE (4/75) and others. In treatment-experienced patients RAMs prevalence was estimated as 58.6%. Most frequently RAMs were found for nucleoside reverse transcriptase inhibitors (NRTI) (49.3%) followed by non-nucleoside reverse transcriptase inhibitors (NNRTI) (22.6%) and protease inhibitors (PI) (16%).
In the group of NRTI mutations M184V (26/75; 34.6%), A62V (12/75; 16.0%) and T215Y (8/75; 10.6%), in NNRTI mutations K103N (10/75; 13.3%), G190S (6/75; 8.0%), in PI group mutations L90M (6/75; 8.0%) and M461/L (6/75; 8.0%) occurred most frequently.
The following drug susceptibility was predicted according to the Trugen expert interpretations: in 33/75 (44%) patients no evidence of resistance, in 21/75 (28%) patients resistance to 1 drug class (NRTI - 16/75 NNRTI - 4/75, PI - 1/75), in 17 patients (22.6%) resistance to 2 drug classes (NRTI+NNRTI - 9/75, NRTI+PI - 7/75, NNRTI+PI - 1/75) and in 3/75 (4%) patients resistance to all 3 classes of drugs (NRTI+NNRTI+PI). We conclude, that prevalence of RAMs in treatment-naive HIV infected persons in Latvia is comparable with prevalence in Europe. The origin of predominated mutation A62V associated with NRTI at present is not clear. In more than half of treated HIV infected patients HIV resistance to at least one HAART class was predicted.

Background: It has been suggested that flat penile lesions (FPL) form the reservoir of hr HPV in men and might contribute to the viral spread. The implementation of an easy-to-make hr HPV diagnostic test into the routine patients examination would improve the hr HPV diagnosis, knowledge for its prevalence in men and male-female transmission, develop strategies for its prevention (i.e., the HPV vaccine usefulness in men).
Objectives: The goal of the study was to investigate the presence of HR HPV infection in FPL in the male Russian Caucasians. Materials and Methods: A total of 50 men, mean age 31.6 (17-52) years were enrolled in the study (no STIs routinely tested at the time of examination) in September-December 2007 in a STI clinic (St. Petersburg). FPL were visually inspected after acetic acid application, following the protocol provided by the Dutch collaborators. Penile swabs were collected. hr HPV types were screening for 14 oncogenic types, with following genotyping by type-specific PCR (AmpliSens hr HPV-genotype, Central Research Institute of Epidemiology, Moscow, Russia).
Results: In the study population FPLs were visualized in 32% and HR HPV prevalence was found in 38%, respectively; concordance between the FPL visualization and hr HPV detection was found 26% (p = 0.001). Men with FPL had more sexual partners during previous 6 months (2.87 vs 1.86).
Conclusions: The visualization of FPL needs to be included into the routine male patients check-up: hr HPV infection was found in 81.3% men with FPL.
The first HPV-related FPL study in Russia has been initiated. At the moment we are in progress to: 1. extend the cohort; 2. confirm the findings by the internationally validated well-known GP5+/GP6+ test with subtyping (Amsterdam) and investigate the HPV distribution in men with: 3. co-infections, and 4. chronic urological diseases.

Materials and Methods: The study was made on 450 female patients with unspecifical inflammatory symptomatology for whom we have made colposcopic exam and HPV detection/genotyping. Results: We found the subsequent types of lesions:
- clean cervix ( 40 cases from which 9 HPV+),
- simple ectopia (22 cases from which 3 HPV +),
- ectopia with evolution reshuffling (48 cases from which 14 HPV+),
- ectopia with stabilized reshuffling (36 cases from which 10 HPV+),
- abnormal white tissue (86 cases from which 38 HPV+), - mosaic tissue (154 cases from which 36 HPV+),
- spotted tissue (9 cases from which 5 HPV+),
- leucoplasia (4 cases from which 3 HPV +),
- iodine negative areas (INA) unrevealed by colposcopy (9 cases from which 7 HPV+),
- iodine positive areas (IPA) (8 cases from which 4 HPV+), - colpitis (16 cases from which 6 HPV+),
- condilo-papilomas (16 cases from which 4 HPV+),
- neoplastic exofyts (2 cases from which 2 HPV +).
Conclusions: The analyses we have made, show:
- HPV infection with aggressive genotypes (16 and 68) in patients especially 26-30 years old - normal colposcopy;
- ectopia prevails in 15-25 years old patients who had more frequently HPV-53 and 54;
- abnormal white tissue has been shown frequently in 21-25 years old patients with HPV types - in most cases - 16 and 54; - HPV-16 prevails in the female patients 26-35 years old with mosaic, spotted tissue and leucoplasia lesions;
- condilo-papilomas and neoplastic exofytic lesions were found in patients over 40 years of age with HPV types - in most cases - 6, 16 and 18.

Background: Type-specific DNA/RNA diagnosis is important for disease prognosis and treatment.
Objectives: Molecular detection of HPV DNA corroborated with E6/E7 viral mRNA and viral load as a predictive value for disease progression.
Materials and Methods: 78 patients over 29 years with ASCUS and LGSIL were selected from a cohort of 352 women enrolled in a study on HPV prevalence in different areas in Romania. HPV typing, viral mRNA levels and viral load were determined in cervical-brush specimens at baseline and in the samples obtained at 6-12 months interval after their cytological/colposcopy examinations. As negative controls, cervical specimens from 12 patients (age 29-43) without HPV infection (negative in InnoLipa and cytology tests) were used.
Results: At baseline, the selected women were HPV negative (26,9%) or presented HPV-16, -18, -31, -33, -45, -66 types as unique infection (28,1%) or co-infections. The distribution of HPV mRNA type was as follows: HPV-16 - 29%, HPV-18 - 13.8%, HPV-31 - 13.8%, HPV-33 - 13.8%, HPV-45 - 3.44%. After 6-12 months of clinical management, 58.9% of patients were HPV DNA negative. 3 HPV DNA negative women at baseline (no mRNAs detected), became HPV DNA positive (type 16 as unique infection or co-infection with type 33). Three woman positive for mRNA at base-line became HPV DNA negative after treatment, but they need to be monitored for a longer period. In patients with ASCUS cytology, 4 subjects presented significant viral loads in both samples; only in one case, the viral load was higher in the second sample.
Conclusions: Our results indicated that viral persistence, an important factor in cervical lesions evolution, might be associated with viral type, viral load and mRNA presence but the patients monitoring must be extended for a longer period of time.

Objectives: To determine the proportion of high risk patients followed at a tertiary care lipid clinic who met recommended lipid targets and to identify predictors of reaching goal lipid levels.
Research design and methods: A retrospective cohort study of 502 high risk patients followed between 1983 and 2003. Clinical and demographic data and fasting lipid profiles were extracted from each patient's first two clinic visits as well as the most recent visit.
Results: All patients in this study were at high risk of cardiovascular events due to dyslipidemia. At "Visit 1", only 55 (11.0%) of patients were at target TC/HDL-C < 4.0, and 97 (19.3%) of patients met target LDL-C < 2.5 mmol/l. At "Visit 3", 229 (45.8%) patients reached TC/HDL-C target, and 216 (43.2%) patients were at LDL-C target. The mean change in lipid values between Visit 1 and Visit 3 was significant (p = 0.0002) for LDL-C and (p < 0.0001) for TC/HDL-C. The use of statins, niacin, or salmon oil were all significantly associated with reaching TC/HDL-C target and LDL-C target, as well male gender, diabetes mellitus and peripheral vascular disease were also associated with reaching LDL-C target. Increasing age and lower body mass index were associated with reaching goal TC/HDL-C.
Conclusions: The mean absolute changes in lipid values were significant and median lipid levels approached target levels in patients followed at specialized clinic, however the majority of high risk patients are not meeting goal lipid levels.

Aims: University students' wellbeing and health promoting and damaging behaviours are important and comprise many parameters. The purpose of this study was to assess a range of health behaviours and lifestyle characteristics of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these parameters between males and females, and across the participating universities. Methods: A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), nutrition, dietary intake and food consumption patterns, as well as the importance of healthy eating, three levels of physical activity, restful sleep, tobacco smoking, use of illicit substance (recreational drugs), frequency of binge drinking and problem drinking. The data was collected in 2007-2008. Results: While females generally reported lower use of tobacco, illicit substances and alcohol (binge drinking/problem drinking) and consumed more fruits and vegetables, male students had a higher level of physical activity, consumed less sweets and had more restful sleep. When lifestyle characteristics of students were compared between the different universities we observed some clustering of the parameters under study, whereby favourable health practices would be exhibited at some universities; and conversely, the clustering of less favourable practices exhibited at other participating sites. Conclusions: We conclude that only a minority of students exhibited positive health practices above recommended levels and the level of binge drinking and problem drinking was high. This calls for increased awareness of university administrators, leaders and policy makers to the risky health habits of their students. The observed clustering effects also indicate the need for local (university-specific) health profiles as basis and guidance for relevant health promotion programmes at universities.

Similar to some other Central European countries, Croatia has low HIV prevalence among injecting drug users (IDUs) but high hepatitis C (HCV) prevalence. This may indicate different patterns of risk behaviour in this region than in other parts of Europe. The main objectives of this study were to assess the seroprevalence of HIV and hepatitis B and C and related risk factors among IDUs in the three largest Croatian cities (Zagreb, Split, Rijeka) and within the national prison system, as well as to apply a multiplier-method population size estimation of IDUs in Zagreb, Split and Rijeka. Recruitment sites were selected in collaboration with the local public health institutes, NGOs, Centers for treatment municipalities and the judiciary system. Participants were recruited during September and October 2007. Trained peer-recruiters were used to recruit IDU participants at treatment and harm reduction centres as well as pre-identified social, commercial and street based venues. Participants completed the study questionnaire and provided venous blood samples for HIV, hepatitis B and hepatitis C testing. The study included 601 participants, of whom 121 were recruited in Split, 130 in Zagreb, 150 in Rijeka and 200 in the prison system. The prevalence of positive anti-HCV tests was 65% in Split, 51% in Zagreb, 29% in Rijeka and 44% in the prisons. The prevalence of anti-HBcAg was 31% in Split, 13% in Zagreb, 9% in Rijeka and 24% in prison. No case of HIV infection was found. The estimated population sizes were 2,805 for Zagreb area, 3,347 for Split and 1,370 for Rijeka area, however confidence intervals were very large, indicating the need for larger samples. A high frequency of positive markers on hepatitis B virus and C virus in the population of injecting drug users in Croatia has been confirmed with this research, as well as a low prevalence of HIV infection. This may be related to relatively low levels of injecting risk behaviour and injecting frequency although it is not possible to make strong conclusions on risk behaviour, as participants were mostly recruited in harm reduction programmes. This research should be followed by targeted activities for reducing risks of infectious diseases among injecting drug users in the Republic of Croatia and future research at the national level.

Objective: To interpret the gradual increase in HIV detection rate in Poland during 1993-2007, separating effects due to epidemic maturation from effects possibly due to new outbreaks or implemented measures. Methods: Data from routine HIV/AIDS case-based surveillance reported until the end of 2007 (HIV cases) or 2008 (AIDS cases) was used. Cases aged 15 or above at the time of report of HIV infection were included. Age, cohort and period effects were analyzed using Poisson based model with intrinsic estimator, adjusting for sex and late presentation. Results: We showed no calendar period effect from 1996 until 2005-2007, when a 21% significant increase over the average level occurred. Cohorts born in 1965-1980 are the most affected and the risk is above average for ages 18-47. Conclusions: Until recently the increase in HIV detection rate was due to maturation of epidemic, with HIV affected cohorts replacing older unaffected ones (no calendar period effect). The recent increase coincided with increased testing in general population and increased prevalence in diagnostic testing of men who have sex with men, suggesting important changes in HIV epidemic in Poland.

Aim: To determine the mortality in a cohort of very young injecting drug users (IDUs), and the factors associated with it. Design: A database linkage prospective (follow-up) cohort study. Setting: A convenience sample of clients of 2 low-threshold facilities, 1 drug treatment clinic, and one special facility for children with severe behavioural disorders, who were all younger than 19 and older than 15, was interviewed one or more times in 1996-8 and asked to agree with their being interviewed again after 10 or more years. Participants: 151 (65 male, 86 female) IDUs recruited in October 1996 - December 1998. Measurement: Database linkage study compared unique identifiers (IDs) of the recruited subjects with the general register of deaths to determine the life status, and the causes of death of those deceased. Where necessary, we examined the death protocols directly. Findings: Altogether, 8 deaths were registered between recruitment and 31st December 2008 (1,660 person-years). All the deceased were male, and all their deaths were "unnatural" - that is, caused by drug overdose or accident. This translates into the crude mortality rates for the whole cohort being 4.8 deaths per 1,000 person-years (PY), and into a specific mortality ratio in the males SMR=14.4 with the peak at the age of 15-20 (SMR=60.1), declining to SMR=8.2 at the age of 25-30. Except gender, we found no "predictors of death" in this high-risk cohort. Conclusion: The overall mortality in the cohort was substantially higher than in the general population; in the male part of the cohort of young injecting drug users it was excessively high in the first three years after recruitment, and caused by external causes exclusively; the mortality in the female sub-cohort was zero, i.e. lower than in the general population of the same age range. Our findings suggest a need to develop targeted prevention of overdoses and other unnatural deaths in young male drug injectors.

Objective: As HIV/AIDS prevalence rises in Eastern Europe, assessment of local epidemics in the bordering Central European region, especially South Eastern Europe, is vital in order to meet treatment and prevention needs. Understanding current medical and social needs and barriers to care experienced by HIV-positive patients in these regions may provide insight into how to best respond to the local epidemics, increase patients' access to treatment, and reduce loss to follow-up. Design: This study assesses the patient characteristics, barriers to care, and current medical and social needs of HIV-positive patients in Albania. Semi-structured interviews were used in this cross-sectional study. Methods: We interviewed 79 of 85 patients (93% response rate) followed at the University Hospital Center of Tirana (UHCT) HIV/AIDS Ambulatory Clinic, which represented the majority of patients under HIV care in Albania during 2009. Results: The local HIV epidemic seems to be comprised mainly of heterosexual men who have spent an average of 3.6 years abroad. The vast majority of patients under care at UHCT HIV/AIDS Ambulatory Clinic had experienced barriers to care associated with social stigma (97.4%), lack of knowledge of HIV medical care (76.6%), and medical provider's lack of knowledge of HIV (70.9%). Social needs of the patients were also overwhelmingly unmet (90.0-95.7%). Conclusions: In addressing HIV/AIDS in Albania, it will be crucial to educate the healthcare sector in ways to identify and address barriers to care and current medical and social needs of HIV-positive patients.

Background: Surveillance of infectious disease markers in the blood donor population is important in recognizing trends in prevalence and incidence of transfusion related infections in asymptomatic volunteer blood donors. Subjects and Methods: It was a cross sectional study. Samples were collected from volunteer blood donors and questionnaire was designed to collect the risk factors data. The prevalence of hepatitis C antibodies among 1,000 apparently healthy blood donors were determined. Objective: To estimate the prevalence of virus C hepatic infection and to illustrate the various socio-economic, behavioural and medical factors related to infection with Hepatitis C (HCV) among apparently healthy individuals. It contributed to analysis of the particularities of Egyptian blood donors and helped to better understand the challenges and solutions of blood safety. Results: The prevalence of HCV was 16.8%. There was an association of positive anti-HCV test with socio-demographic, medical and behavioural risk factors. Conclusion: This study provided comprehensive and reliable information on the possible risk factors affecting spread of Hepatitis C in the area.

Despite worldwide anti-smoking campaigns, cigarette smoking prevalence is increasing in the third-world countries. It is now regarded as the most important public health issue. Here, we study the current smoking situation and investigate the impact of cigarette smoking on semen quality and hormonal levels among adult people. Furthermore, we suggest various strategies to reduce smoking consumption among young individuals. A cross-sectional data from 804 adult smoker subjects (male n=530 and female n=274) aged between 15 and 45 years were analyzed. One hundred and eleven males were agreed for further evaluation of their semen quality and hormones compared with 93 age-matched non-smoking males. This study showed that the major factors initiating smoking among women were friends' influence (49%), life pressures (16%) and parental imitation (14%). The major reasons in men was friends' influence (65%). Furthermore, 61% of women and 89% of men smoke in public implying social acceptance or even en-couragement of this habit. This study also found that low-income Jordanians consume more tobacco materials than those in the middle- and higher income. Furthermore, smokers had significantly lower (p<0.001) sperm concentration and motility values and higher (p<0.001) serum testosterone and luteinizing hormone (LH) levels than non-smokers.

Slovakia is characterised by an unusually high number of patients affected by genetic Creutzfeldt-Jakob disease (CJD) with E200K mutation at the PRNP gene. Penetrance of the mutation is incomplete (59%). Therefore, for the onset of the clinical manifestation, an influence of other endo- or exogenous factors could not be excluded. Experimental data suggest that copper and manganese levels may play an important role in the pathogenesis of prion diseases. The highest number of Slovak genetic CJD patients originates from Orava - the northern region of central Slovakia. Manganese is a dominant pollutant in Orava. The objective of this study was to clarify a possible exogenous influence of environmental Mn/Cu imbalance on the CJD clustering. Mn and Cu levels were analysed in the brain tissue of genetic CJD cases (from Orava and from control regions of Slovakia), as well as of sporadic CJD patients and controls. Analyses demonstrate i) significantly higher Mn level in focally accumulated, "clustering" genetic CJD cases in comparison to all other groups, ii) Cu status differences between compared groups were without statistical sig-nificance; decreased concentrations were found in genetic cases from extrafocal genetic CJD areas, iii) Mn/Cu ratios were increased in all CJD groups in comparison to controls. Metal ratios in clustering gCJD cases were significantly higher in comparison to sporadic cases and also to controls, but not to the extrafocal genetic CJD subgroup. These results indicate that more important than increasing Mn level in pathogenesis of CJD appears to be the role of the Mn/Cu imbalance in the CNS. The imbalance observed in the cluster of genetic CJD cases is probably a result of both: the excessive environmental Mn level and the disturbance of Mn/Cu ratios in the Orava region. Presented findings indicate an environmental Mn/Cu imbalance as a possible exogenous CJD risk co-factor which may, in coincidence with endogenous (genetic) CJD risk, contribute to the focal accumulation (cluster) of genetic CJD in Slovakia.

402 subjects with diabetes mellitus have been vaccinated of the total of 34,000 vaccinees immunized during the study period of 9 and half months. Altogether 229 diabetic patients (56.97%) have been vaccinated against tick-borne encephalitis (TBE) and 74 (18.4%) against viral hepatitis (41 types A+B, 30 type A, 3 type B). The average age in four most commonly administered vaccines (FSME IMMUN 0.5 ML, Twinrix Adult, Typhim Vi, and Havrix 1440) was 65, 52, 56, and 54 years, respectively. Live attenuated vaccines have been given to 6 patients with diabetes (1.49%) - 5 travellers to endemic countries received the yellow fever vaccine Stamaril (1 female, 4 male) and one male patient varicella vaccine Varilrix. Among the least common vaccines in diabetic patients were those against invasive pneumococcal and meningococcal infections. Not a single unexpected side effect has been observed following the vaccination procedure in any diabetic patient. Based on the results of this retrospective study we can conclude that vaccination in diabetic patients is free of any risk - provided that there are no other contraindications, e.g. allergy to vaccine components or severe acute febrile illness. In the case of unstable glycaemia and significantly impaired immune system due to diabetes mellitus, vaccination with live attenuated vaccines should be carefully considered and measured against the risks of exposure to each and every specific infectious agent. There is no reason to be afraid of vaccination in diabetic patients provided that general contraindications are respected. On the contrary, this risk group can benefit from vaccination more remarkably since it may have some life-saving potential.

Backgrounds: Thalassaemia is becoming serious public health problem throughout the Mediterranean region, Middle East, Indian subcontinents and also South East Asia. Its' global prevalence is about 2 per 1,000 newborns while its' prevalence in Iran is 8-4 per 1,000 newborns. The aim of this study was to compare the Health Related Quality of Life (HRQOL) of thalassaemia patients with the HRQOL of healthy children in terms of essential core domains for pediatric HRQOL measurement. Methods: This cross sectional study has been done in Yazd, Iran. 60 thalassaemia patients were selected randomly as case group and 120 healthy children as control group who were matched with respect to age and gender. The health related quality of life was measured with a self - administrated short - form questionnaire of Medical Outcomes study (SF-20). The SF-20 measure contains three dimensions about function (physical, social and role) and well-being (mental health, health perception and pain). Results: The results of this study showed significant difference between all dimension of SF-20 and QOL of patients in the case and control group (p<0.001). The QOL in the case group was 75.05 (SD=9.38), but in the control group was 93.4 (SD=6.42) out of 100. Conclusions: The effect of thalassaemia on the HRQOL in affected children has been related to reduction of their physical, social and mental capabilities.

The authors evaluated surveillance of acute respiratory infections (ARI), influenza and influenza-like illnesses (ILI) in the Slovak Republic (SR). They analyze morbidity, age-specific morbidity, complications, mortality, number of influenza viruses isolations and vaccination coverage rates in the SR in the years 1993-2008. They focus mainly on the analysis during the epidemic. Most epidemics have been caused by influenza virus A subtype H3N2. The age group mostly affected by morbidity during the year were children at the age of 0-5, while during the epidemic, the highest morbidity was recorded among school children at the age of 6-14. A complicated clinical course of the disease was reported in 1,422,836 patients (5.1%). Since the 2002/2003 influenza season, the sentinel physicians have participated in taking biological material, which ensures monitoring of influenza viruses circulating in the SR. As of the 2006/2007 season, the ARI/ILI have been reported separately in the SR in accordance with the monitoring requirements set by the European Influenza Surveillance Scheme (EISS) project, and the calculation of morbidity is done from the number of persons, who are in care of the reporting physicians: Vaccination coverage in SR is still very low in comparison with other European Union (EU) countries.

The article is dealing with current state of Czech health policy in relation to migration. Overall migration information, available data on migrants' health status as well as accessibility of healthcare are provided. Some health risks connected with migration are mentioned and discussed. Authors concluded that the most urgent problem of Czech health policy in relation to migrants remains the insufficient guarantee of legal entitlement to health care. This concerns a large group of migrants with long-term residence, since the current legal regulation is disadvantageous to migrants coming from countries outside the EU.

Background: In eastern Europe, the high prevalence rates of HIV and the hepatitis C virus (HCV) are concentrated among injecting drug users (IDUs). Harm reduction programmes such as needle and syringe programmes and opioid substitution therapy (OST) have been shown to be effective in preventing these infections. However, structural barriers can limit their effectiveness by hindering access.
Methods: Through use of a semi-structured online survey sent to 65 professionals in the region, this study explores the prevalences of age restrictions, user fees or a lack of confidentiality for these programmes as well as HIV/HCV testing programmes.
Results: Twenty respondents reported that age restrictions were not widespread in the 11 reporting countries, apart from for OST. User fees were found to be very common in HCV testing and varied for other services. It was stated to be common to inform parents of young IDUs who receive HIV services, but not to inform public authorities when IDUs enter harm reduction programmes.
Conclusion: Where access to services is limited or confidentiality is compromised, as reported in this pilot study, it is crucial that health-care guidelines and national legislation are reformed to ensure access to these evidence-based interventions.