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Objective: We were interested in the prevalence of smoking amongst teen-age students, its possible causes, and their understanding of its associated health risks.
Methods: We constructed a questionnaire that was responded to by a total of 419 students from 5 high schools in Prague, Czech Republic. Students were classified as non-smokers, mild (1-10 cigarettes daily), moderate (11-20 cigarettes daily), and severe smokers (>20 cigarettes daily). The survey also contained questions about passive smoking, motivation for smoking, the understanding of its associated health risks, alcohol consumption, and drugs.
Results: We found that amongst 16-20 years old high school students there are 37.5% smokers (38.0% men, and 37.0% women). The majority are mild smokers (82.3%), 15.8% moderate smokers and 1.9% heavy smokers. 29.0% of non-smokers reported passive smoking; i.e. that 65.7% of students are exposed to harmful effect of tobacco smoke. The average onset of smoking is at 14 years of age. The youngest smoker started smoking at the age of 5 years. Parents of 52.0% of students smoke (69.4% of smokers and 41.6% of non-smokers). Most of students know about the risk of lung cancer and cardiovascular diseases (86-99%).
Conclusions: The prevalence of active and passive smoking among high school students is high. Parents smoking is significantly more frequent in teen-age smokers than in non-smokers. We consider the "teen-age" population together with their parents to be the key target for a successful antismoking campaign.

Goeckerman's therapy of psoriasis combines exposure to pharmaceutical coal tar and UV-B radiation. In the pilot study (15 patients had been diagnosed with psoriasis, the average time period in hospital therapy was 24 days, the average age of the patients was 29 years, 47% of them were smokers) a level of genotoxic risk from therapy was evaluated by using chromosomal aberration of peripheral lymphocytes. The study suggested the presence of an increased genotoxic risk from the therapy. The PASI scores (Psoriasis Area and Severity Index) were monitored.

Objective: To examine the secular trends of all AIDS opportunistic infections to occur first (OIs) in Greece, by year, by gender and by mode of transmission. Methods: The study included all AIDS defining conditions reported among Greek residents diagnosed with AIDS from 1981 to June 2003 and notified to the Hellenic Centre of Infectious Diseases Control. The analysis of trends in AIDS defining conditions in Greece has been performed only for the period 1993-2003. Results: From 1981 to the first six months of 2003, 2,394 AIDS cases, 2,361 adults and 33 children, have been reported. HIV wasting syndrome was the most frequent OI to occur first followed by PCP pneumonia and Kaposi sarcoma. The frequency at which OIs occurred first varied by sex. Kaposi sarcoma was more frequent in males while tuberculosis and oesophageal candidiasis were more frequent in females. The frequency at which OIs occurred first varied also by exposure mode. Kaposi sarcoma was more frequent among men who have sex with men but that was not the case for the remaining transmission categories.
From 1993 to the first six months of 2003 a downward trend was noticed only for chronic simplex disease. Since the introduction of HAART, an increasing trend was noticed for CMV disease, recurrent pneumonia, oesophageal candidiasis, Burkitt and immunoblastic lymphoma.
Conclusion: Further epidemiological studies are needed to assess the OIs trends in coming years in order to plan prevention strategies and future medical care needs.

HIV incidence is rising more rapidly in some areas of Central and Eastern Europe than anywhere else in the world. Carrying out effective HIV prevention programs requires the presence of "bridges" that can reach community populations most vulnerable to the disease. Nongovernmental organizations (NGOs) are in a natural role to conduct HIV prevention programs. The Directors of 29 HIV prevention NGOs representing almost all countries in Central and Eastern Europe participated in in-depth interviews by telephone. The broad topics of these interviews included descriptions of the three largest programs conducted by each NGO during the past six months, at-risk target populations served, major barriers faced, and funding sources that sponsored HIV prevention activities. NGO programs most often targeted injection drug users (IDUs); other stigmatized groups were less frequently served by NGOs in the sample. The most common types of prevention activities were needle exchange, HIV prevention peer education, and delivering AIDS presentations and distributing educational materials. Among the major barriers that hampered effective conduct of HIV prevention programs were a shortage of available financial resources, governmental indifference or opposition, and AIDS-related stigma. National governments rarely provided substantial funds for NGO programs, and most funding came from United Nations agencies or private foundations. The information sources reported to be most helpful in assisting NGOs in program development were sharing ideas with other NGOs, participating in conferences, and accessing information from the Internet. A number of programs reported by the NGO Directors were innovative, outstanding, and comprehensive. Five such exemplary programs are described in this article. HIV epidemics in the region are still potentially controllable. NGOs need immediate support so that they can carry out their community-based activities on a larger scale.

Glycemic index (GI) and insulin index (II) scores of six cereal-based foods (biscuits and shortbreads) were determined and the relationship between the glycemic and insulin responses of the foods was examined. The study was conducted using recommended by FAO/WHO methodology using glucose as a standard food. We obtained a range of GI scores from 49 to 68% and II scores from 51 to 75%. The test foods' blood insulin responses were in parallel to their glycemic responses although in every case the level of II was higher than the level of GI. The foods' II scores were closely related to their GI scores (r=0.80).

Kojic acid (5-hydroxy-2-hydroxymethyl-4-pyranone) represents an attractive polyfunctional skeleton for development of biologically active compounds. The authors prepared a great variety of kojic acid derivatives and selected biological properties have been studied. Thus, kojic acid derivatives are promising compounds that might advantageously be used in human and/or veterinary medicine and also in preparation of new, even more biologically active preparations.

The aim of the study was to assess the change in function and residential status four months after hip fracture in patients over 50 years of age and living independently at home at the time of fracture. All consecutive hip fracture patients treated at Oulu University Hospital during 1989-1999 were followed up. Data collection was done on standardized hip fracture forms, which were filled in at admission and at four months postoperatively. The forms included demographic data, place of residence, locomotor ability, use of walking aids, data on the fracture and its treatment, hospital stay, place of discharge and pain.
At four months, 16.0% of the men and 14.3 % of the women were permanently institutionalized. Preoperatively, 81.1 % of the patients had been able to walk out of doors either alone or accompanied, while at 4 months, less than half of the patients (149 men, 391 women) were able to do so. Two thirds of the hip fracture patients had been able to walk without walking aids before the fracture, the corresponding proportion being one fifth at four months after the fracture. Cumulative mortality at 4 months was 9.9%, being higher among the male (15.5%, n=53) than the female patients (7.9%, n=75).
The original study population was also divided into two subgroups operated at different period of time (1989-92 and 1993-99), the functional results seemed to improve with time. Hip fracture leads to the institutionalization of every seventh patient able to live at home at the time of fracture and impairs markedly one's functional capacity. To restore the pre-fracture status as well as possible and to reduce the burden of the consequences of hip fracture, it might be beneficial to evaluate and improve the existing rehabilitation system.

Some previous investigations indicated that economic crisis (inflation in Serbia 1993/94) have great influence on increasing suicide rates in Serbia. After that suicide decreased, despite the war and bombing in 1999, specially among the elderly people. A total of 453 suicides were registered on the territory of south-eastern Serbia during 1995-2001 years. Of them 295 (65.1%) were aged over 60 years. Generally, linear trends of suicide among both genders from 1995 to 2001 decreased, but the slope of decreasing was grater among males than among females. The highest rates among the both genders were registered in the years with the maximum number of suicides, but the linear trends of rates have statistically important correlation with time (r > 0.5). Average annual suicide rate among males was 42.5, and among women it was 18.7. The highest average annual suicide rate among men was observed in the age group 75 years and over (93.3) , and the lowest in the age group 65-69 (20.6). Among males, in the all age group linear trends of suicide rates decreased, with the highest slope among 75 years and over and the lowest among 65-69 years. The highest suicide rate among females was registered in age group 75 years and over (25.6), the lowest in the age group 65-69 (13.5). The linear trends are similar as among males: downward trend was observed among all aged groups, with the highest slope among women 75 years and over. The most common way of suicide among men was hanging up (63%), poisoning and by firearms. There were no statistical differences between way of suicide and age groups. The most frequent way of suicide among females was hanging up (55%), poisoning (25%) and drowning (12%). There were statistically significant differences in drowning between age groups, 70-74 and 75 and over (p<0.05), and between poisoning and age groups 60-64 years and 75 years and over. Poisoning and drowning are statistically more frequent among women than among men.

The authors reviewed published data dealing with the effectiveness of school programs in tobacco control. Most of the evaluated school programs showed at least partial effect including namely improved knowledge level, decreased prevalence of smoking initiation and continuation. Less successful was achieving of behavioural changes and social resistance. Effect of the school programs can be significantly amplified by combination with other interventions such as mass media campaigns, parent involvement and extracurricular activities.
The main problem of the studies in this field is a relatively short follow-up time not allowing considering findings as relevant evidences for long-term effects of school programs. However, even assuming only time limited decrease of prevalence of smoking among intervened students, such temporary effect leads to the decrease of a lifetime cigarette exposure having beneficial health effects.
Considering social, demographic and cultural aspects of the epidemiology of smoking habit, evidence based data in this field, relevant for Central and Eastern Countries, are required. Such situation calls for authentic trials and studies respecting specific conditions in these countries.

Purpose: This issue is an attempt to assess patients' role as regards their compliance, respectively their non-compliance. The authors try to elucidate the factors concerning the patient-physician interrelation and patient-pharmacist interrelation that influence the non-compliance in order to increase the compliance rate.
Methods: Standard individual questionnaires and interviews were developed and applied to study an attitude to compliance and non-compliance among different categories of patients, suffering from chronic diseases.
Results: The obtained results show that the main reasons, influencing the patients' non-adherence to physicians' advise are: the high price of the drugs, the overburdened daily regimen, negligence, distrust towards the treatment and others. The insufficient information in the patient's leaflet together with the inappropriate drug form appears to be the main factors that cause non-compliance. This happens especially in the cases, when the patients are treated with more than one drug in different drug forms and particularly it concerns elderly people.
Even though the compliance among the patients investigated was comparatively high (50% to 92%), possibility for improvement still exists if the treatment that have to be initiated could be individualised. Thus the level of compliance will be improved and increased.
Discussion: The results from the data analysis show a great variation in the level of compliance among the chronic patients in Bulgaria. It ranges from 50 to 92%, depending on the type of the chronic disease and on the age of the patients. This fact shows the necessity for improvement of the different factors that has to begin as soon as possible.

The minireview is focused on novel findings concerning mechanism of action, lipid formulations, polymer conjugates, and structural modifications of amphotericin B.

Determinants of total homocysteine involve demographic (age, sex, ethnic origin), genetic (enzymatic defects of metabolic homocysteine pathways) and acquired factors (deficiency of B-group vitamins, state of health, lifestyle).
Plasma levels of total homocysteine and serum levels of vitamin B12, folic acid, vitamin B6 were measured in adult apparently healthy Romany minority subjects (n=119) and compared with those levels in apparently healthy subjects of majority Slovak population (n=146).
Mean homocysteine level was similar in both groups (9.92 µmol/l in the Romany vs. 9.61 µmol/l in majority group). Hyperhomocysteinemia was only observed in 3% of both ethnic probands. Vitamin B12 level was equal (301 µmol/l in the Romany and 311 µmol/l in majority group). Deficient levels were found in 4% of the Romany subjects and 9% of the majority subjects. Folic acid level was significantly lower in Romany group (11.3 nmol/l vs. 14.8 nmol/l) with deficiency in 42% of the Romany subjects vs. 28% in the majority subjects. This finding is a consequence of lower consumption of fruit, vegetables, pulses and whole grain products in the Romany group. Vitamin B6 deficiency was found in 68% of the Romany subjects and 40% of majority subjects. This vitamin is homocysteine determinant under excessive methionine intake (overnutrition with predominance of animal protein intake). As was demonstrated in a dietetic questionnaires, the Romany subjects are more frequent consumers of meat and eggs. This nutrition regime should indicate an increased homocysteine level under vitamin B6 deficiency.
The results of normal homocysteine levels in the Romany population under condition of higher folic acid and vitamin B6 deficiencies, smoking and higher alcohol consumption may suggest a more effective homocysteine metabolism in relation to different ethnic origin.

The aim of this work was to study and monitor the patterns in incidence of childhood type 1 diabetes in Slovakia. The incidence of type 1 diabetes per 100,000/year from 1985 to 2000 was determined in children 0 - 14 years old. A total of 1,818 cases were diagnosed during this time. Poisson regression models were used to study incidence trends. The overall incidence of type 1 diabetes varied from 5.62/100,000 per year in year 1986 to 14.46/100,000 in year 1998. This represents a 2.57-fold increase. The incidence increased with age and was the highest among children 10-14 years of age. The incidence of type 1 diabetes in Slovakia is increasing very dramatically, especially in age group 0 - 4 years.

Thiobenzanilides substituted in thioacyl moiety with one or more hydroxy groups are interesting for their biological effects depending on the substitution pattern. New findings in mechanisms of action of 2-hydroxybenzanilides insert 2-hydroxybenzanilides and their analogues, e.g. substituted thiobenzanilides, among interesting compounds in the development of new potential antimicrobial drugs. The present review paper with 32 references links up with our previous communications which reviewed biological activity of 2-hydroxybenzanilides and related compounds, and includes the research of mono-, di-, and trihydroxythiobenzanilides carried out in the last period.

In selected localities of České Budějovice and Český Krumlov districts, well known by stable high incidence of tick-borne encephalitis (TBE) human cases but with low incidence of Lyme borreliosis, monitoring of Borrelia burgdorferi sensu lato (s.l.) in Ixodes ricinus ticks was performed. Research was also aimed at the spread of I. ricinus to mountain areas of this region (National Park Šumava), as well as at investigating this tick for B. burgdorferi s. l. genospecies and TBE virus infection. Altogether 498 nymphs, 88 females and 11 males of I. ricinus from lower locations and 58 nymphs from mountain locations (760 - 1080 m above sea level) were tested by polymerase chain reaction. In lower locations total prevalence of Borrelia burgdorferi s.l. in Ixodes ricinus ticks was 35 %.
Single infection of Borrelia afzelii, B. garinii and B. burgdorferi sensu stricto (s.s.) was found in 59, 50 and 63 ticks, respectively (i.e. in 12.8, 11.2 and 14.1 %). Double infection was found in 42 ticks (6.0 %) and triple infection in three ticks (0.4 %). The high frequency of B. burgdorferi s.s. exceeds the as yet reported occurrence in Central Europe. These circumstances are discussed. In mountain locations B. afzelii was found in five ticks, that including two co-infection with B. garinii, in elevations of 762 m and 1 024 m above sea level, respectively. This fact signals a real danger of human infections in a region that was previously deemed to be without risk. Moreover, this region is more and more the target destination of tourist activities. The results also suggest that the penetration of infection can be rapid and formation and establishment of natural focus of Lyme borreliosis might be rather quick.

The aim of the present study was to investigate consumers' knowledge, preference habits and use of the over-the-counter (OTC) analgesics. Our survey indicates the preferences of respondents in consultation with medical specialists (medical doctors and pharmacists) and their sources of information about drugs. A questionnaire survey was conducted during the periods March/April and July/August 2002 in 11 community pharmacies situated in Sofia (capital) and two towns in different regions in Eastern Bulgaria. From 250 questionnaires 222 were filled in correctly and analyzed (response rate 89%). Metamizole (dipyrone) is the most popular OTC analgesic - 35% of the questioned patients prefer it to relieve the pain. In the second place is paracetamole (acetaminophen), but patients prefer to use it mainly for symptomatic treatment of cold/flu and influenza-like symptoms. More than 50% of patients have indicated that medical doctor recommended them the chosen OTC analgesic and in case of health problems during the therapy they prefer to consult him. They had more confidence in medical doctors' than pharmacists' recommendations and consultation. The main conclusion is that the pharmacists do not have the main say in the choice of OTC analgesics and their rational and correct use.

To study the influence of low-level sarin inhalation exposure on immune functions, inbred BALB/c mice were exposed to two low concentrations of sarin for 60 minutes in the inhalation chamber and then infected with Francisella tularensis LVS on the 7th day following the exposure to sarin. 24 hours after infection, the level of some isotypes of antibodies (IgM, IgA) against tularaemia was significantly decreased regardless of the sarin concentration used while the lymphoproliferation was significantly increased regardless of the mitogen and sarin concentration used. Later, the level of some isotypes of antibodies (IgM, IgA) against tularaemia and the vitality of Francisella tularensis LVS was significantly increased in the case of exposure of mice to clinically symptomatic concentration of sarin (7 days after infection) while the lymphoproliferation was significantly decreased regardless of the concentration of sarin when specific tularaemic antigen Ag4 was used as a mitogen (3 weeks after infection). Thus, the results indicate that not only symptomatic but also asymptomatic dose of sarin is able to alter the host resistance and reaction of immune system, especially at 24 hours and 7 days following infection with Francisella tularensis LVS. Nevertheless, the alteration of immune functions following the inhalation exposure to a symptomatic concentration of sarin seems to be more pronounced.

This study responds to the priorities of the National Health Strategy aimed at control and mitigation of the hazardous effects of the workplace factors on cardio-vascular diseases of people in active working age from the branch "Mining industry".
The aim of this work is to study the vegetative balance (by analysis of heart rate variability - AHRV) and the correlations with the state of miners' hearing functions.
Sixty eight miners (diggers and mate-diggers) from mining industry were studied. This paper treats the results of AHRV examination of 25 miners who have no major and additional causes, leading to hearing injury - traumas, other diseases, medicines, etc.
The analysis of heart rate variability was made by computer analysis of heart rate and variability. Standard ECG electrodes at bi-polar breast lead-off were used for recording ECG signals. The echo-cardiographic signal was converted by an ECG converter board into epochs of cardiac events (R-R intervals) for 10 minutes. The principal indices of heart rate variability were analysed.
The obtained results provide the ground for further comprehensive studies on different workers contingents from other industries in order to detect workers with initial changes in the hearing analyser and to establish the corresponding pathogenetically based registration, monitoring, and treatment system.
The studies conducted for monitoring the dynamic of vegetative equilibrium reflect the degree of disturbed heterostasis by chronically manifested sympatic activity in miners, diagnosed by AHRV indices.
The revealed significant relationships between hearing changes and AHRV indices prove the presence of an extra-aural paraprofessional effect and statistically significant relations with the changes in the critical organ.
The revealed highly significant correlations between AHRV indices and hearing show a significant relationship between the physiological vegetative level (assessed by AHRV) and the hearing status at chronic exposure to work-related stress factors in miners.
The chronic sympathicotonia is an additional pathogenic factor (besides acoustic stress) manifested by spastic changes in the microcirculation of the cochlear neuroreceptor elements.

Since members of hydroxypyrone series posses iron chelating properties, kojic acid (KA), 5-hydroxy-2- (hydroxymethyl)-4H-pyran-one, a fungal metabolite of natural origin, has been suggested to might play a role in iron-overload diseases and in oxidative stress conditions involving transition metal. In our experiments in vivo models of iron-overload were used to study iron-chelating properties of KA and its effect on oxidative damage in mice and rats. The treatment of iron-preloaded rats (25 mg Fe.kg-1 b.w., i.p., daily for five days) with 0.5% KA in drinking water for four weeks did not lower the iron concentration accumulated in the liver, neither diminished the induced hepatic lipid peroxidation in iron-loaded rats. The GSH level decreased in KA-treated group. Similarly, in iron-loaded mice model experiment, the following oral treatment with KA (100 mg.kg-1) daily for 7 days did not decrease the level of Fe accumulated in the liver and the lipid peroxidation even enhanced after KA treatment. Though in our experiments in vivo the ability of kojic acid to affect iron kinetics in the organism could not be proved, kojic acid as a molecule of natural origin may serve as a template for the preparation of new biologically active derivatives possessing capability of chelating iron.

Obesity is one of today's most serious and amplified public health problems. Surprisingly, obesity constituted a health problem through the Byzantine Empire (3rd to 15th century AD) as well; the extent of the problem was then very much alike to that one seen in modern industrialized and developing countries of today. In this report we perform an historical throwback in Byzantine years in order to explore the link regarding the aspects of obesity in these years and in modern era.

In this report, a case of spontaneous missed abortion caused by Ascaris lumbricoides is presented and data from the literature are reviewed. A 26-year-old pregnant woman was presented with abnormal genital bleeding, abdominal pain.

The international longitudinal prospective ELSPAC study also includes women from the Czech Republic: the results sum up data from 4530 women from City of Brno and District of Znojmo who had different exposure to active and passive smoking. Anamnestic data were collected by fulfilling the internationally unified questionnaires during pregnancy and at the 2^nd month after delivery. Gynaecologists, obstetricians and pediatricians, using the unified procedures, were collecting objective data in the course of the pregnancy, delivery, monitoring health status of women and newborns. Significant differences were found between smoking and non-smoking women in the prevalence of alcohol and marihuana consumers both before and during pregnancy and after delivery. In personal health history, smoking women more often reported their self-perceived poor health, panic and loss of self-control during the delivery. In the current pregnancies, smoking women suffer more often with placenta praevia, placental abnormalities, fetal growth retardation and fetal malformations. On the other hand, the prevalence of preeclampsia was decreased among smokers. The children of mothers who were moderate/heavy smokers during pregnancy, had on average by 245 g lower birth weight, 1.22 cm shorter body length and by 0.66 cm smaller head circumference than those of non-smokers. These measures were on average also decreased in the groups of newborns whose mothers were light smokers or non-smokers heavy exposed to environmental tobacco smoke. On the contrary, the average gestational age was similar both in case of active smoking, passive smoking, and non-smoking women. In spite of the fact that most of smokers would give up smoking after getting pregnant, it is necessary to place the antismoking interventions and nutrition advisory service within the routine duty of physicians.

While familial cases of Creutzfeldt-Jakob disease are extremely rare all over the world, 3 familial clusters were observed between 1983-2000 in a relatively small area situated in the North of Slovakia. Prevalence of CJD in this area exceeded the overall prevalence in Slovakia more than 8 times. The majority of CJD patients admitted consuming sheep brain. Most patients lived in small secluded villages with rather common familial intermarriage. CJD affected both sexes equally. All patients were prior to the disease mentally normal individuals. Shortly after the onset of CJD their mental status deteriorated remarkably with an average survival rate of 3.6 months.

In the period of 1990-1994 an increase of all causes mortality for 35-74 years old males was observed both in Pécs and in all Hungary. From 1994 to 1997 the mortality decreased. Similar changes, but of smaller dimension, were observed in the female population. The increasing mortality of the early 1990s is attributed primarily to the extra psycho-social stress of this period. The data of the population survey at Pécs in 1995-96 were compared to the data of earlier surveys. The mean blood total cholesterol levels and the prevalence of smoking decreased from 1990 to 1996. The prevalence of hypertension and male obesity increased. Physical inactivity, unhealthy diet and lack of improvement of diet still represent significant health problems. High prevalence of increased γ-glutamyl transferase indicate high prevalence of excess alcohol consumption. The risk factor profile of 18-25 year old males is very unfavourable. Smoking prevalence in females aged 26-35 years exceeds that of males of the same age group. Preventive efforts should be focused to young males and females.

A 36-year-old man, an unemployed waiter, a regular patron of two bars living in a Czech city suffered for about a year from disorders caused probably by tuberculosis (TB). When hospitalised, diabetes mellitus and extensive lung TB were diagnosed. TB was found also at the post mortem examination when the patient died one week later. Screening of his contacts by tuberculin skin tests (2TU RT23 W. Tw.80) provided data for analyzing the usefulness of tuberculin tests for monitoring of propagation of TB infection among BCG vaccinated population with high TB prevalence in the past. A statistically significant difference was found in tuberculin reactivity between 543 contacts and 232 individuals who had not reported contact with the patient. A skin reaction of 12 mm and more was found in 55.6 % contacts while only in 2.6 % of those included in the second group. The high tuberculin reactivity was proved in the individuals exposed to massive TB infection. Neither BCG vaccination, nor possible previous contact with TB in the past seemed to influence the actual tuberculin reactivity in the group of non-contacts. Furthermore, it is indicative of the fact that unknown TB sources are rare among the Czech population. The high tuberculin reactivity is suggestive of a fresh infection and justifies the tuberculin testing and the application of chemoprophylaxis.