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Objective: Trace elements are essential for the biochemistry of the cell. Their reference values have been found to differ considerably in pregnant women stratified by age, place of residence, anthropometric status, and length of pregnancy. In optimal amounts, these elements reduce the risk of pregnancy complications. Subclinical hypothyroidism in pregnancy is associated with adverse maternal and neonatal outcomes. The aim of the study was to determine the effects of zinc (Zn), copper (Cu), magnesium (Mg), and rubidium (Rb) on pregnant women in an iodine deficiency region and find the relationship with the thyroid status and nutrition. Methods: We evaluated the iodine status of 61 healthy pregnant women from an iodine deficient region in Bulgaria. Thyroid stimulating hormone (TSH) and thyroxin free (FT4) levels were measured using ELISA. Results: We found elevated levels of copper that differed the most between the first and second trimesters; Cu and TSH were found to be positively correlated (р < 0.05). Lower Cu levels were found in pregnant women consuming pulses more than 2-3 times a week (р = 0.033). The women consuming fish more than 2-3 times a week had higher levels of Rb. We found a pronounced iodine deficiency in more than half of the examined women in the first to third trimesters, without any effect of pregnancy on the ioduria (р=0.834). All second and third trimester cases were associated with severe ioduria (< 150 µg/L). Conclusion: The high Cu levels were associated with subclinical hypothyroidism (SCH) and less pulse consumption during pregnancy in an iodine deficiency endemic area. SCH was found in 24% of the pregnant women in such an area while in 13% of them SCH had progressed to overt hypothyroidism.

Objective: Clostridium difficile infection (CDI) has become one of the most common causes of hospital-acquired infections. Fidaxomicin is one of the latest antibiotics used in the treatment of CDI, however, treatment cost affects recommendations for its use in several countries. We have analysed the treatment of our patients with CDI, treated by fidaxomicin since it was introduced to the market in 2018 and became available in the second biggest Slovak hospital, University Hospital of L. Pasteur. Our aim was to determine efficacy and safety of fidaxomicin in the treatment of CDI in Slovak patients. Methods: We reviewed all courses of fidaxomicin use in our hospital (n = 60). Fidaxomicin was used for first recurrence (12 times), second recurrence (4 times), third recurrence (2 times), and fifth recurrence (1 patient). 41 patients received fidaxomicin first-line. Results: Success of fidaxomicin treatment was recorded at 86.7% within the whole cohort. In the recurrent Clostridium difficile infection (rCDI) subgroup, fidaxomicin was 63% effective with three patients dying (15.7%) and two patients developing subsequent rCDI. During the duration of the study, 6 patients in total died. Only one of three patients, with three or more recurrences of CDI, had no further presentations after eight weeks of completion of treatment. Conclusions: The biggest benefit from fidaxomicin treatment was shown in a cohort of patients with primary CDI infection demonstrating a low recurrence rate and significant reduction of fidaxomicin effectiveness in preventing a recurrence when treating patients with multiple rCDI.

Objectives: Measles cases are increasing remarkably in our country as well as all over the world. In this study, it was aimed to examine the epidemiological and clinical characteristics of measles cases detected in our hospital, as well as the measles seroprevalence in our region. Methods: A total of 7,452 individuals whose measles IgG and/or IgM antibodies were studied between December 2021 and March 2023 in the Medical Virology Laboratory in Başakşehir Çam and Sakura City Hospital were included in this retrospective study. Measles IgG and IgM antibodies were analysed by enzyme-linked immunosorbent assay. Demographic information, clinical symptoms and laboratory data of the participants were obtained from the hospital's electronic medical records. Results: A total of 102 measles cases were identified between December 2021 and March 2023. Of these cases, 77 (75.5%) patients were ≤ 18 years old. Of the 73 measles cases with vaccination information, 90% were unvaccinated. The measles seroprevalence rate was 72.8%. The lowest seroprevalence rate (4.8%) among the age groups was found in 8-11-month-old babies, the highest cases rate (35.7%) was detected in this age group. It was determined that measles immunity increased with age (r = 0.276, p < 0.001) and was over 89.3% over the age of 30. Conclusions: Measles immunity is insufficient in our region and measles remains an important public health problem until the age of 18. The recent increase in measles cases in our country and around the world shows that current vaccination programmes need to be implemented more decisively and strictly.

Objectives: Instrumental work diagnostic examinations can be used for capability assessment in evaluating work suitability, job selection, complex and occupational rehabilitation, and career counselling. According to the literature, assessments performed with work simulators and the International Classification of Functioning, Disability and Health (ICF) are suitable for monitoring changes in functional capacity. We propose that instrumental work diagnostic measurements - specifically, measurements conducted on the ErgoScope work simulator - along with the ICF, can be effectively used for the objective assessment of functional capacity and tracking changes over time.
Methods: At the request of an insurance company, a targeted examination was performed using the ErgoScope work simulator to determine the extent of force exertion. The measurement plan, evaluation of results, and ICF coding were prepared based on a methodology developed in our previous research with qualified assessors.
Results: The measurement results were recorded in an examination report. The examined individual was able to complete all tasks. If there was a difference in exertion between the two hands, the right hand/arm was always weaker.
Conclusion: Based on our experience, determining ICF qualifiers requires not only measurement data but also precise, documented observations from the examiner. Our study suggests that the measurement results obtained from ErgoScope work simulator examinations, along with ICF categories assigned by qualified assessors, are suitable for tracking changes in functional capacity. This methodology supports medical professionals in insurance medicine and occupational health services in making objective, data-driven decisions.

Objectives: The aim was to explore the patterns of the coronary heart disease (CHD) mortality rates over the past almost 50 years (1968-2014) in the Czech Republic, and to predict the mortality rates in 2015-2019. Methods: The number of deaths from CHD and the population size were stratified by sex and age. The mortality rates were age-standardized to European population. Their values in 2015-2019 were estimated using the joinpoint log-linear regression, local log-linear regression and negative binomial log-linear regression, separately for males and females. Results: A positive change in the trend of the age-standardized mortality rates from CHD was detected after the collapse of communism in 1989. In 1991-2000, the mortality trend was sharply downward, with an annual percent change of -5.8 % for males and -5.2 % for females. In 2000-2014, the decreasing trend was not so sharp (-1.3 % for males and -0.7% for females), yet it should continue in 2015-2019. The crude mortality rates for females are slightly higher than those for males since 2007, however, they are increasing for both sexes. The mortality rates are rising mainly in the age group of 85+ years (in 2014, 25.4% of CHD deaths of males and 54.4% of females occurred at the age of 85+ years). Conclusions: The age-standardized mortality rates are predicted to decrease in 2015-2019, but the crude mortality rates should increase due to increase in average life expectancy. The burden of deaths is moving to the age group of 85 years and older, mainly in females. A total of 26,039 CHD deaths were registered in the Czech Republic in 2014, and 29,653 are predicted for 2019, if the current trends continue.

Objectives: Premature birth is a serious pregnancy complication that is affected by many biological as well as psychosocial factors. Several studies have shown that a mother's positive relationship with her child's father reduces the mother's stress, anxiety and depression during pregnancy, promotes a healthier mother's lifestyle and thus has a positive effect on pregnancy as such. This research was therefore aimed at identifying possible differences in the incidence of premature births in mothers depending on the quality of the relationship with the father of their child. Methods: The research involved 210 mothers after childbirth in the period from October 2020 to September 2021. A questionnaire aimed at obtaining descriptive data about the mother and her child and a questionnaire aimed at determining the quality of the relationship - Quality of Relationship Inventory (QRI) were distributed. Mann-Whitney U tests were used to determine differences between groups. Results: Of 210 children, 44 (21%) were born prematurely, 154 (73.3%) mothers were married and 176 (83.8%) lived with the father of their child in the same household. The results showed that the degree of quality of the mother's relationship with the child's father is approximately the same for mothers who gave birth prematurely and for those who gave birth at term, so there were no differences in this factor between the two groups of mothers. Conclusion: The results of other researchers have shown the positive impact of partners on pregnancy and the overall well-being of the mothers. However, our research has not confirmed the positive effect of the quality of the relationship between mother and father of her child on reducing the incidence of premature births. Further research is needed to clarify how specifically and whether the quality of the relationship between parents can affect the incidence of premature births at all.

Objectives: The aim of this study is to determine the interdependence between life expectancy and numerous social indicators, i.e., to determine the factors that encourage an increase or decrease in life expectancy. Methods: Pearson coefficients as well as linear and logarithmic trends and correlations between the dependent variable of life expectancy and numerous independent variables were calculated and analysed. The calculations were carried out for all countries in the world for which data is available. Based on the strength of the correlations between life expectancy and numerous indicators, we have tried to determine the reasons for the different values of life expectancy in the various countries. Results: Important factors for achieving high life expectancy values are economic development and healthcare spending but the spread of "diseases of the modern era", such as obesity or diabetes, have a significant negative impact on life expectancy. Other important limiting factors for life expectancy are large income inequalities, a higher share of private healthcare expenditure in total healthcare expenditure and lower total healthcare expenditure. Less developed societies can significantly increase their life expectancy by providing clean water and safe sanitation and by combating various infectious diseases (especially HIV). Conclusions: Life expectancy is a meaningful indicator of the state of social development and accurately reflects the general state of a particular society. It has been shown that GDP per capita (PPP) is a key determinant of life expectancy, while other important factors play the role of a further modifier.

Objectives: Screening of asymptomatic patients upon hospital admission became a key strategy to prevent nosocomial transmission of SARS-CoV-2 during the COVID-19 pandemic, particularly in facilities treating immunocompromised patients. Rapid antigen tests (RATs) were widely used due to their speed, but their reliability in detecting potentially infectious individuals remained debated. In parallel, the role of immunosuppression, especially in solid organ transplant (SOT) recipients, as a risk factor for asymptomatic positivity and prolonged viral shedding raised additional concerns. The aim of the study was to evaluate the diagnostic performance of rapid antigen testing compared to RT-PCR in asymptomatic patients admitted to a high-risk hospital, and the difference in SARS-CoV-2 PCR positivity between asymptomatic patients with and without a history of solid organ transplantation.
Methods: We retrospectively analysed 17,086 paired RAT and RT-PCR tests collected from 11,858 asymptomatic patients admitted to a tertiary care hospital between October 2020 and October 2022. Viral load was assessed via PCR cycle threshold (Ct) values. The sensitivity and specificity of RATs were calculated using PCR as the reference (Ct < 28).
Results: RATs showed a sensitivity of 83.5% and a specificity of 99.3% in detecting patients with high viral loads (Ct < 28). False negatives occurred predominantly in cases with low viral loads (Ct ≥ 28). SARS-CoV-2 PCR positivity was significantly higher in SOT patients (5.4%) than in non-transplant patients (3.2%) (p < 0.001), a difference that was consistent across viral variants.
Conclusions: RATs reliably identified the majority of asymptomatic patients with high viral loads who pose a risk of in-hospital transmission. SOT recipients represent a high-risk subgroup for asymptomatic SARS-CoV-2 carriage, underscoring the importance of rigorous admission screening protocols in specialized healthcare settings.

Objectives: The purpose of the current study was to analyse the risks of Lyme borreliosis (LB) among 1,070 forestry workers, the influence of responsible behaviour (use of repellents, skin self-inspection) on Borrelia screening result status, and the occurrence of immediate and mid-term symptoms after tick bites and LB positive serological screening test. Methods: The questionnaire was conducted as well as blood tests for LB disease by one-stage serological screening procedure using ELISA for specific B. burgdorferi IgM and IgG antibodies (EuroImmun AG company, Germany). Results: While 39.6% of foresters were LB positive among bitten foresters, as many as 27.0% were LB positive among those, who did not recall any tick attacks at all. Individuals with known history of tick bites had significantly higher odds (1.770×) of being LB positive (p < 0.05), while the use of repellents or skin self-inspection after visiting woods had no influence on LB results. The odds of skin discolouration after tick bites was significantly lower (0.682×) in case of LB positive test compared to LB negative test (p < 0.05), which can be explained by the fact that foresters could be unaware about erythema migrans appearance and timing, considering tick bite and developed later rash as completely separate events. Moreover, 69.1% of the bitten foresters with LB positive result developed no secondary symptoms (excluding those related to the skin), and the most frequent clinical symptoms were arthralgia (24.9%), followed by myalgia (7.6%), headache (5.7%), and damage to facial nerve (2.7%), which are non-specific and can be present in other illnesses. Conclusion: Therefore, the recommendations proposed would be the regular laboratory testing for LB of sensitive and at-risk population, who visits endemic woody areas, irrespective of all other factors involved.

Objectives: Childhood obesity has become a worldwide public health concern over the past decade, counting Bosnia and Herzegovina (BiH). The Childhood Obesity Surveillance Initiative (COSI) was established by the World Health Organization (WHO) to address the lack of standardized surveillance data on childhood obesity. However, BiH and its entity, Republic of Srpska (RS), are failing inclusion in such initiative, which hinders efforts to monitor and address the issue. Henceforth, the objective of this nationally funded study was to gather and analyse data on the prevalence of overweight and obesity among primary-school children in RS by implementing the COSI methodology. Methods: Weight, height, and BMI of first, second, and third grade children (aged 6-8), from 11 schools (N = 2,030) in the RS region was analysed according to the standardized COSI protocol. Results: The prevalence rates of overall overweight (OW) and obesity (OB) observed were 14.37% (OW 9.09%, OB 5.21%). No gender-related differences were noted (boys 14.36%, girls 14.88%). Conclusions: These findings highlight a concerning trend of increasing overweight and obesity prevalence with age among primary-school children in the RS.

Objectives: Oral health can affect quality of life in all course of life, which is a key factor of general health. Dental caries, periodontitis and oral cancer are of the highest burden of oral diseases. Rising prevalence of soft drinks and alcoholic beverages consumption due to easy access and socio-demographic altering has increased the concerns on oral health. In this review our purpose was to show effects of the most consumed beverages on oral health in people older than 15 years. Methods: The review was based on papers published in last 10 years, searched with combined key words related to types of drinks and specific oral health problems. We included 4 older studies due to lack of newer studies on subjected topics. Results: Sugar-free soft drinks are found less cariogenic and erosive than regular versions in limited number of studies. Alcohol consumption is shown as one of the risk factors of prevalence and severity of periodontitis and is proven to have synergistic effects along with tobacco on oral cancer risk. Consumption of soft drinks and alcoholic beverages was related with tooth loss whether dental caries or periodontal diseases. Conclusion: There is good evidence for association between soft drinks and oral health problems, but still no clear answer exists about strength of association between sugar-free soft drinks and dental caries. Also the knowledge about influence of alcohol is inadequate. Since consuming style affects erosive potential of drinks manufacturers should be required to add some recommendations on labels about drinking style.

Objectives: The aim of this study was to examine the frequency of fatalities in injuries in traffic accidents in Montenegro, identify contributing risk factors, and determine the most vulnerable participants in these accidents. Methods: The research was designed as a retrospective descriptive study. Participants were people admitted to the Urgent Centre of Clinical Centre of Montenegro due to injuries in traffic accidents that resulted in serious bodily injury or death in the period from 2011-2020. We presented data using descriptive statistics. The square test was used to examine the association between the outcome of traffic injury with sex, age, category of injury, type of traffic participant, and injury localisation. Additionally, we used logistic regression to estimate the best predictor value of these variables for outcome. Results: It was found that 44.7% of injured people died, the most frequent fatal outcome was registered in patients with central nervous system injuries (73.2%), then in patients with asphyxia (47.0%), and patients with bleeding (40.5%), χ² = 27.530, p < 0.001. The most frequently injured traffic participants were drivers, but the highest number of deceased were among cyclists. Also, logistic regression showed that the category of injury was the most predictive impact on outcome in traffic-injured correspondents (p < 0.001). Conclusion: Among the injured, the highest number are drivers, and the fatal outcome mostly depends on the injury category. Nearly half of those injured in traffic accidents die, especially those with central nervous system injuries and cyclists. Therefore, special attention should be given during public health campaigns related to traffic accident prevention, focusing on this injury and this category of traffic participants.

Human immunodeficiency virus 2 (HIV-2) is a retrovirus related to HIV-1. It is believed to have evolved from the simian immunodeficiency virus (SIV). The disease caused by HIV-2 is manifested by a slower progression compared to HIV-1. Data from West Africa show that 37% to 50% of HIV-2 infected people have undetected or very low viremia and if left untreated, have a much more gradual decline in CD4 T lymphocytes, thus longer survival. However, treatment should not be postponed even in this case, because the course of immune reconstitution inflammatory syndrome (IRIS) in people with HIV-2 is more severe than in HIV-1, and also the year-on-year increase in the number of CD4 T lymphocytes is approximately half that of HIV-1. Approximately 6% of people living with HIV-2 (PWH2) can be defined as non-progressors and 9% as elite controllers. However, most untreated PWH2 develop AIDS.

Objective: Childhood overweight and obesity has been a major global problem for a long time, with a steadily increasing prevalence of obesity and a growing number of cases of serious health complications associated with childhood obesity. The main objective of the study is to assess the prevalence of overweight and obesity in boys and girls before the COVID-19 pandemic in the Czech Republic. Methods: Body height, weight, BMI, and body composition (fat free mass, skeletal muscle mass, body fat, visceral fat area) were assessed in a cohort of 4,475 subjects (2,180 boys and 2,295 girls) aged 6-15 years. Somatic status was assessed by standardized anthropometry and body composition was determined by bioelectrical impedance. The subjects were classified according to BMI in percentile bands (up to 3rd percentile, P3-10, P25-75, P75-90, P90-97, above 97th percentile). Statistical analysis was performed using the software TIBCO Statistica 14.0.015. Results: During growth, statistical differences in the proportion of fat-free mass and fat fractions were found between boys and girls. In boys, there is an increase in muscle mass, in girls, there is an increase in the proportion of fat fraction. Sexual differentiation is pronounced during pubertal growth. By their BMI, 10.32% of the boys and 7.36% of the girls were categorized as overweight, and 8.12% of the boys and 7.71% of the girls were categorized as obese. Using bioelectrical impedance analysis and the percentage of fat fraction, 21.61% of the boys and 21.87% of the girls were categorized as obese; 5.96% of the boys and 8.19% of the girls were found to have visceral adipose tissue posing a health risk (more than 100 cm²). From 2002 to 2019, there was a significant increase of 3.72% in the overweight category for boys and 1.36% for girls, while the obesity category showed an increase of 3.62% for boys and 4.91% for girls. Conclusion: The results confirm the increasing negative trend of overweight and obesity in the BMI and the relative body fat categories in children aged 6-15 years. Greater attention and monitoring of the effectiveness of preventive measures is needed to slow and stop the obesity epidemic which has health, social and economic impacts on the entire society.

Objectives: Various tools and methods have been proposed to measure physical activity, with the International Physical Activity Questionnaire (IPAQ) being one of the most popular self-reported tools. The study's aim was to test the validity of IPAQ-SF among Greek male and female adults, aged 18-65 years.
Methods: A total of 134 adults (98 males) were randomly selected and participated in the study. The mean age of participants was 37.9 years (SD = 11.6), with 73.1% being male. Translation and back-translation was performed to ensure cultural adaptation. The validity of IPAQ-SF was ascertained using fitness measures (maximum oxygen uptake, VO₂ max, velocity of VO₂ max, maximum heart rate, and heartbeat at 1 min).
Results: Based on the IPAQ-SF, participants engaged in vigorous physical activity for an average of 3 days per week (mean = 68.8 minutes/day), moderate activity for 2.6 days per week (mean = 56.2 minutes/day), and walking for 3.7 days per week (mean = 24.4 minutes/day). The median total MET-minutes/week was 2,751. IPAQ-SF demonstrated moderate validity as modest positive correlations were observed between MET-minutes/week and VO₂ max (rho = 0.3096, p < 0.001), and vVO₂ max (rho = 0.2511, p = 0.008). IPAQ-SF demonstrated higher validity among females and individuals with BMI ≥ 25 kg/m², with correlations reaching 0.5201 (p < 0.001) for VO₂ max in participants with overweight/obesity.
Conclusion: The present validation study suggests IPAQ-SF utility for monitoring physical activity levels in populations with overweight or obesity, while further refinement may be necessary to improve its applicability across all demographic groups.

Objectives: The present study investigates the determinants of oncology patients' Health-Related Quality of Life (HRQoL) in Bulgaria. Looking at some patients' characteristics, including control variables in the estimated model - demographics and the time from the disease onset, it studies the relevance of HRQoL diverse factors: some of them are related to the physical and psychological dimensions of the patients' illness experience, such as the levels of pain and anxiety/depression; some other concern more specifically the patients' therapeutic path, i.e., the feeling of participation in the therapy, their perceived uncertainty in illness (predictability and complexity), and the quality of the information received from the nurses and other medical personnel. Methods: A questionnaire collecting information on HRQoL, uncertainty in illness and patients' experience with the hospital treatment has been administered to 306 oncology patients at four oncology centres in Bulgaria. Data has then been employed in the estimation of a Tobit model: the dependent variable selected has been the variation in the Visual Analogue Scale (VAS) score. The econometric model takes into account the characteristics of censoring in the dependent variable. Results: Overall, the coefficients estimated, and the regression itself showed a good level of significance. Some dimensions of EuroQol-5D (EQ-5D) questionnaire - pain and anxiety/depression - have a significant impact on HRQoL, as well as some features of uncertainty in illness, as unpredictability and complexity. As expected, the longer the time elapsed from the diagnosis, the higher the reported HRQoL; the value of the information provided to the patients by the nurses as well as physicians is also relevant. Conclusions: This study presents an analysis of the impact of uncertainty in illness, feeling of participation in the therapy, and communication with the hospital personnel on oncological patients' HRQoL, which increases the scanty evidence referring to the patient-centred care in the Bulgarian hospital setting. Further deepening might concern a wider sample, including data collected at other medical centres and/or in other geographical areas in Bulgaria as well as in other European countries.

Objectives: The paper proposes to identify the determinants of patients' rights awareness in mothers and to examine the relationship of health literacy with awareness of those rights. Methods: Our results are based on data from a convenience sample of 894 non-health professional ethnic Hungarian mothers from Hungary, Romania and Slovakia. Health literacy is measured with the HLS-EU-16 questionnaire. Results: Analysis of variance reveals a significant association of health literacy with patient rights awareness. Our results show that health literacy is the highest among patients who filed a complaint through formal channels and/or took legal measures to restore their rights upon violation. A logistic regression model is built to identify the likelihood of having high patient rights awareness, that is, acting formally for the restoration of rights upon infringement. The model controls for covariates. When controlled for covariates, the likelihood of having high patient rights awareness increases with age, and is higher for mothers with highest education, for inhabitants of larger towns, as well as for those with adequate health literacy. Conclusions: The findings of our study have implications for health policy, as they reveal significant inequalities in patient rights culture.

Objectives: Emerging evidence suggests that the use of safer nicotine products (SNPs), such as e-cigarettes and heated tobacco products (HTPs) poses significantly lower health risks than continued smoking, particularly over the short and medium term. However, it remains uncertain whether the public has been adequately informed about these relative risks. This study assesses the perceived relative harm of e-cigarettes compared to conventional cigarettes in Ukraine. Methods: Two nationally representative surveys were conducted in February 2021 and December 2022. Participants, irrespective of their smoking status, were asked whether they agreed with the statement that "using e-cigarettes is more harmful than smoking conventional cigarettes". The surveys also included questions about tobacco product usage, the most dangerous substances in cigarettes, and smoking cessation methods. The data were statistically analysed by deriving design-based weighted point estimates and 95% confidence intervals for the proportions within each response category. Results: In 2022, 38.1% (95% CI: 35.3-40.9) of adults believed that e-cigarettes were more harmful than cigarettes and the perception of relative harm remained relatively unchanged between the two surveys. Furthermore, 56.2% (95% CI: 50.0-62.2) of current cigarette smokers agreed with this statement, while only a small percentage of vapers (e-cigarette users) 7.4% (95% CI: 1.5-30.0) perceived e-cigarettes as more harmful than conventional cigarettes. Among non-smokers and dual users the share was 33.4% (95% CI: 30.0-36.9) and 32.7% (95% CI: 25.1-41.5), respectively. Conclusion: Our findings indicate that in Ukraine the perception that e-cigarettes are more harmful than cigarettes, or the lack of knowledge regarding relative risks, prevails. This highlights the importance of accurate risk communication to promote a harm reduction approach to tobacco use.

Objectives: Chronic back pain is the most common cause of incapacity for work. The purpose of the study was to determine the effectiveness for activating the function of the deep stabilization system (DSS) in patients with chronic low back pain. Methods: The effectiveness of three different methods was compared: Pilates method (PM), dynamic neuromuscular stabilization and balance aids on deep stabilization system function and pain perception in the lumbar spine. The group consisted of 75 patients. Results: The results show differences in the effectiveness of the methods depending on the observed characteristics. The least significant differences were observed when comparing the Pilates method to balance aids. No statistically significant difference was observed in four out of five areas. The only area where a statistically significant effect of the exercise method got recorded was the intra-abdominal pressure test (p < 0.05). The lowest change was recorded in the measured values using the intra-abdominal pressure test at PM, and the highest change was recorded in Thomayer's values at dynamic neuromuscular stabilization. Conclusion: By comparing the three methods it was noted that each of them has its own positive reaction to the pain and the muscular apparatus. The most appropriate method to affect DSS function appears the dynamic neuromuscular stabilization (DNS) concept, where was the most significant improvement in DSS activation and the most significant reduction in chronic low back pain.

Objectives: The acute respiratory syndrome, known as COVID-19, is characterised by high morbidity and increased mortality. Genetic factors may partially explain the differences in susceptibility to and severity of COVID-19. Methods: We have analysed common functional polymorphisms within the OAS1 (rs4767027), TMPRSS6 (rs855791), DPP4 (rs3788979), and ZNF335 (rs3848719) genes in SARS-CoV-2 positive subjects (n = 521, different disease severity) and in population controls (n = 2,559 subjects, COVID-19 status unknown). Results: Neither DPP4 nor ZNF335 were associated with disease susceptibility or severity in the Czech population in any of the models used for calculation. T allele carriers of the OAS1 polymorphism seem to be protective against symptomatic COVID-19 (p = 0.002 calculated for trend; asymptomatic, symptomatic, hospitalised). Similarly, within the TMPRSS6, minor TT homozygotes associated with lower plasma Fe concentrations were underrepresented in the overall patient group (p = 0.044; OR = 0.77, 95% CI: 0.59-0.99), and the difference was mainly driven by the severe COVID-19 subjects. In general, risky homozygotes of these two polymorphisms were less frequent than expected in the group of hospitalised COVID-19 survivors. Conclusions: Common variants within OAS1 (rs4767027) and TMPRSS6 (rs855791) play some role in COVID-19 pathology in the Czech Caucasian population. Whether the depletion of minor allele carriers of these two variants is associated with increased COVID-19 mortality, needs to be analysed in an external confirmatory study.

Objectives: The General University Hospital in Prague (GUH) is one of the largest hospitals in the Czech Republic. The prevalence of smoking among hospital staff is monitored as part of its Health Promoting Hospitals (HPH) network membership. Methods: This study employed a cross-sectional design, utilizing anonymous questionnaires distributed to all hospital employees in the years 2012 and 2023 through the hospital's electronic system (response rates 25% and 28%, respectively). Data were analysed using chi-square tests to compare smoking prevalence across time and among subgroups based on profession, sex and age group. Results: The total prevalence of smoking decreased from 38.4% in 2012 to 14.5% in 2023. Among all doctors, the rates fell from 15.86% to 6.75% (p < 0.001). For male doctors, the figures changed from 17.05% to 9.27% (p = 0.012), while for female doctors, the rates decreased from 15.22% to 5.24% (p = 0.001). Among nurses, the smoking prevalence declined from 44.59% to 17.64% (p < 0.001). Conclusion: The statistically significant reduction in smoking rates (p < 0.05) among both doctors and nurses is encouraging; however, there remains room for improvement. An increase in the use of other tobacco products was observed, particularly among nurses.

Objectives: Chemsex is a phenomenon highly relevant to public health concerns. Our primary aim is to describe the Czech chemsex scene regarding substances used, sexual behaviour, mental health, sexual life satisfaction, internalization of homonegative attitudes, and prevalent chemsex patterns. Methods: The data from the European Men Who Have Sex With Men Internet Survey (EMIS) 2017 were used. The mental health of chemsex users was assessed by the Patient Health Questionnaire 4 (PHQ4), internalized homonegativity was measured using the Short Internalized Homonegativity Scale. A sample of 87 men who have sex with men (MSM) chemsex users and a comparison group of 261 MSM were selected from the total sample of 1,688 respondents. Mann-Whitney and χ² tests were used to compare groups. Results: Active chemsex users made up 5% of the sample (87 of 1,688), with an average age of 37 years. Chemsex users were more likely to engage in condomless sex with non-steady partners (χ² = 46.8, p < 0.001), and had dramatically more STIs, such as HIV (χ² = 52.9, p < 0.001), HCV (χ² = 25.9, p < 0.001), and syphilis (χ² = 41.5, p < 0.001). Chemsex users frequently injected drugs (n = 19, 20%). More than half (n = 48; 55%) of chemsex users had sober sex in the last 4 weeks. Chemsex culture was associated with riskier substance use, both in terms of mode and frequency. The mental health of chemsex users in our sample did not differ significantly from the comparison group (χ² = 0.2, p < 0.7). Chemsex users did not conceal their sexual identity more often than the comparison group, on the contrary, 69% (n = 59) of them were out to most significant others, compared to 53% (n = 134) in the comparison group (χ² = 8.8, p < 0.05). In addition, we did not find differences in the degree of internalized homonegativity (χ² = 0.9, p < 0.4). Chemsex users were clearly and significantly more satisfied with their sex life than the comparison group (Mann-Whitney U test, p < 0.001). Conclusions: In our sample, chemsex use was not associated with a negative impact on health or wellbeing. Our results suggest that chemsex is not a homogeneous phenomenon. Many different patterns and subcultures exist, some of them are riskier, some safer than others.

Objective: The purpose of this study was to determine the prevalence and clinical effect of untreated dental caries in Roma children from eastern Slovakia using dmft/DMFT index and SiC index, association between dental caries development and oral hygiene, dietary habits and preventive dental care. Methods: Dental caries were assessed by recording the dmft index (for primary dentition) and the DMFT index (for permanent dentition) that are used to assess the state of teeth, which expresses the current state of teeth or its development in an individual or the entire population. The SiC index was calculated as the mean dmft of one-third of the population with highest caries scores. The normality of data distribution was tested by Shapiro-Wilk test. P-value < 0.05 was considered statistically significant. Chi-square test was used to compare proportions (oral hygiene, dietary habits and preventive dental visit). Data were analysed using ordered logistic regression and t-test. The study includes questionnaire containing 5 questions about dietary habits, oral hygiene and preventive dental visit. Results: The results of presented study confirmed higher average values of DMFT (3.24) in the population of 12-year-old Roma children and lower average values of dmft (2.5) in the second group (p < 0.05). The value of SiC index represented 6.10 in the group of six-year-old and 7.66 in twelve-year-old children. Logistic regression was performed to test the magnitude of the association between dental caries and related factors. There was statistically significant association between average value dmft/DMFT and dietary habits, oral hygiene, and preventive dental visit in both study groups. Conclusion: The study revealed insufficient oral hygiene of the Roma children population. Systematic implementation of preventive examinations for oral hygiene and health programmes are needed to promote oral health. The study represents a pilot study of the SiC index values in Roma minority population from eastern Slovakia.

Objectives: The aim of this study was to detect Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare, Mycobacterium contamination and to explore the aerosol transmission of mycobacteria in public buildings in China. Methods: A total of 552 environmental samples, namely 165 aerosol, 199 water, 70 air duct dust, and 118 soil samples, were collected from 39 public buildings and analysed using nested polymerase chain reaction. Results: The positivity rate of Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare in air samples were 0.6% and 1.8%, respectively. There was significant difference in the positivity rate of Mycobacterium aerosol among the three types of public building (χ² = 6.108, p = 0.047). No positive results of Mycobacterium tuberculosis complex and M. avium and M. intracellulare were obtained from cooling, tap, shower, or fountain water. The positivity rate of Mycobacterium for water samples was 31.7% (63/199). The positivity rate of Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare, Mycobacterium in soil samples were 1.1%, 34.6% and 43.6%, respectively. There was significant difference in the positivity rate of M. avium and M. intracellulare (χ² = 47.219, p < 0.001) and Mycobacterium (χ² = 33.535, p < 0.001) in the different origins of soil samples. Conclusions: Mycobacteria are widespread in public buildings. Mycobacterium tuberculosis complex, M. avium and M. intracellulare were simultaneously present in the air ducts of central air conditioning systems and indoor air in public buildings, which indicates that aerosol transmission is a potential route.

Objective: Our aim is to evaluate influenza vaccination rates among the elderly and individuals with underlying chronic disease, and factors that affect vaccination uptake. Methods: The study comprised individuals aged 18-65 years with underlying chronic diseases, and individuals aged over 65 years. Literature-based questionnaires prepared by the researcher regarding vaccination were completed through face-to-face interviews by the principal investigator. Results: A total of 818 participants were included in the study, 257 (31.4%) were males. The mean age of participants was 57.47 ± 14.11 years; 274 (33.5%) were aged 65 years and over. One hundred and three (12.6%) participants stated that they received vaccinations against influenza annually, and 144 (17.6%) stated that they had vaccination against influenza in the 2015/16 or 2016/17 season. Fifty-two (19%) participants aged more than 65 years stated that they received vaccinations against influenza annually, 75 (27.4%) stated that they had vaccination against influenza in the 2015/16 or 2016/17 season. The most commonly determined reasons for not receiving vaccination were not knowing that it was necessary (34%) and believing that vaccination was not necessary because they were healthy (26%). Statistically significantly more participants who gained their knowledge from a physician were vaccinated than those whose knowledge came from other sources (p < 0.05). Participants who considered that they had sufficient information about influenza were vaccinated more frequently, the results were statistically significant (p < 0.05). Conclusion: Informing target risk groups about influenza vaccination by physicians and increasing awareness about influenza may contribute to increasing vaccination rates.

Objectives: This study aims to identify the differences in the use of HPV vaccination between female medical students in the Czech and Slovak Republics and their possible causes. Methods: We performed a cross-sectional survey among female students of general medicine in all faculties of medicine in the Czech and Slovak Republics. Results: We obtained 630 questionnaires from the Czech Republic and 776 questionnaires from the Slovak Republic. In the Czech Republic, 65.4% of female medical students underwent HPV vaccination, while in the Slovak Republic, the figure was 21.1%. In the Czech Republic, residency and religion of students did not influence their rate of vaccination. However, in the Slovak Republic, village residency with less than 5,000 inhabitants lowered the probability of vaccination with OR = 0.56 (95% CI: 0.38-0.84), and the Catholic religion lowered the probability of vaccination with OR = 0.40 (95% CI: 0.28-0.57). Czech students were informed about the possibility of vaccination by a paediatrician in 55.7% of cases, while the figure for Slovak students was 26.8%. In the Czech Republic, 75.7% of students participated in regular cervical oncologic screening, while in the Slovak Republic, the figure was 57.7%. Vaccination of relatives would be recommended by 86.5% and 80.5% of Czech and Slovak students, respectively. Conclusions: The adoption of an oncologic prevention programme and the more extensive propagation by paediatricians are probably the medical reasons for the higher HPV vaccination among Czech students. Demographic factors - village residency and religion - are also important.

Objectives: Mental stress, low health literacy (HL) and nutrition literacy (NL) are associated with serious negative health outcomes. The aim of this study was to investigate HL and NL levels, in relation to levels of perceived stress, in adults. Methods: This cross-sectional study was conducted in the urban area of the Attica region, Greece. The sample consisted of 1,281 individuals, aged ≥ 18 years. The European Health Literacy Questionnaire 47, the Greek version of the Nutrition Literacy Scale and the Perceived Stress Scale 14 were used. Socio-demographic characteristics were also assessed. Nonparametric Mann-Whitney U and Kruskal-Wallis tests, Pearson chi-square and multiple linear regression models were used. Results: The sample's perceived stress mean value (SD) was 26.47 (7.27) with women scoring statistically significantly higher than men. The mean HL and NL scores were 32.28 (8.28) and 22.11 (5.67), respectively. Linear regression analysis has shown that perceived stress was significantly negatively associated with HL (p < 0.001) but not with NL levels (p = 0.675) after adjusting for a series of confounding variables. Conclusions: Low health literacy seems to be very significantly associated with high levels of perceived stress. The reasons behind this association require further investigation.

Objective: Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. Methods: The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N ~ 1.800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories: low, lower-middle, upper-middle, and high. Results: In comparison with women, men had a higher smoking prevalence (OR = 1.41, 95% CI = 1.09-1.84), higher consumption of cigarettes (B = 4.11, 95% CI = 1.97-6.26), and higher rate of smoking initiation (OR = 1.38, 95% CI = 1.10-1.74), but they did not differ in the quit rate (OR = 0.85, 95% CI = 0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR = 2.59, 95% CI = 1.36-4.97; OR = 2.23, 95% CI = 1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. Conclusions: Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.

Objectives: Smoking during pregnancy is causally associated with reduced birth weight and is strongly related to preterm birth. This study analyses the differences in birth outcomes between non-smokers and women who continued to smoke during pregnancy. Methods: We conducted a study of 1,359 mothers who gave birth in 2017-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants have been reported from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a newborn being less than 2,500 g and as for premature birth we referred to childbirth before pregnancy week 37. Two groups of mothers were classified according to the smoking habit during pregnancy and statistically processed in IBM SPSS Statistics 23.0. Results: Infants born by women who smoked during pregnancy had the lower birth weight (2,769.0 grams on average) compared to non-smokers (3,224.1 grams) (p < 0.001). The differences in prevalence of premature birth have not been confirmed as statistically significant. Women who continued smoking during pregnancy were significantly more likely to be very young (OR = 5.9; 95% CI: 3.9-8.9; p < 0.001), unmarried (OR = 9.3; 95% CI: 6.1-14.0; p < 0.001), of lower level of education (OR = 39.6; 95% CI: 22.6-69.5; p < 0.001), and more likely to consume alcohol (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01), and drugs (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01) during pregnancy. When pregnant, they were most likely to see a doctor for the first time after the first trimester (OR = 0.1; 95% CI: 0.1-0.2; p < 0.001) and were more likely to see a doctor less than 8 times (OR = 6.1; 95% CI: 4.2-8.8; p < 0.001) during pregnancy. Conclusion: Tobacco prevention and cessation campaigns should focus on improving pregnancy outcomes in the future.

Objectives: The aim of this study was to examine the prevalence of overweight/obesity in 15-19 years old adolescents in the Province of Vojvodina, Serbia, and to evaluate the association between obesity and socio-demographic factors. Methods: A cross-sectional study was conducted in high schools in the territory of Vojvodina, Serbia. The sample consisted of 986 high-school students (47.4% girls and 52.6% boys). Body height, body weight, and waist circumference were measured. Obesity was defined as a body mass index (BMI)-for-age value > x̅ + 2 SD, and overweight as a BMI-for-age value > x̅ + 1 SD and ≤ x̅ + 2 SD. Waist-to-height ratio (WHtR) of ≥ 0.5 was considered high risk. Socio-demographic data was collected using a questionnaire developed for this study. Univariate and multivariate logistic regression analyses were implemented. Results: The prevalence of overweight and obesity in adolescents was 19.6% and 10.1%, respectively. Boys were more likely to be obese than girls (OR = 1.87; 95% CI: 1.37-2.56). Adolescents living in suburban areas had a greater chance of obesity compared to those living in urban areas (OR = 1.84; 95% CI: 1.15-2.94), as well as those who attended trade schools compared to gymnasium students (OR = 1.92; 95% CI: 1.20-3.07). The lower level of the father's education was a significant predictor of obesity. Predictors of high-risk WHtR were gender, high school type, and the father's education level. Conclusions: Obesity and abdominal obesity are highly prevalent in adolescents in Vojvodina, more in boys. Gender, community type and the level of the father's education were confirmed as significant factors that influenced both obesity and abdominal obesity. This study could help to customize health promotion policies for adolescents in Vojvodina.