Markers of oxidative damage of nucleic acids and proteins among workers exposed to TiO2 (nano) particles.

OBJECTIVE: The use of nanotechnology is growing enormously and occupational physicians have an increasing interest in evaluating potential hazards and finding biomarkers of effect in workers exposed to nanoparticles. METHODS: A study was carried out with 36 workers exposed to (nano)TiO2 pigment and 45 controls. Condensate (EBC) titanium and markers of oxidation of nucleic acids (including 8-hydroxy-2-deoxyguanosine (8-OHdG), 8-hydroxyguanosine (8-OHG), 5-hydroxymethyl uracil (5-OHMeU)) and proteins (such as o-tyrosine (o-Tyr), 3-chlorotyrosine (3-ClTyr) and 3-nitrotyrosine (3-NOTyr)) were analysed from samples of their exhaled breath. RESULTS: In the production workshops, the median total mass 2012 and 2013 TiO2 concentrations were 0.65 and 0.40 mg/m(3), respectively. The median numbers of concentrations measured by the scanning mobility particle sizer (SMPS) and aerodynamic particle sizer (APS) were 1.98 × 10(4) and 2.32 × 10(4) particles/cm(3), respectively; and about 80% of those particles were smaller than 100 nm in diameter. In the research workspace, lower aerosol concentrations (0.16 mg/m(3) and 1.32 × 10(4) particles/cm(3)) were found. Titanium in the EBC was significantly higher in production workers (p<0.001) than in research workers and unexposed controls. Accordingly, most EBC oxidative stress markers, including in the preshift samples, were higher in production workers than in the two other groups. Multiple regression analysis confirmed an association between the production of TiO2 and the levels of studied biomarkers. CONCLUSIONS: The concentration of titanium in EBC may serve as a direct exposure marker in workers producing TiO2 pigment; the markers of oxidative stress reflect the local biological effect of (nano)TiO2 in the respiratory tract of the exposed workers.

[The "Short Physical Performance Battery" in the Czech Republic -  the pilot and validation study in older persons]. / "Krátká baterie pro testování fyzické zdatnosti senioru" -  pilotní studie a validizace testu u starsích osob v Ceské republice.

INTRODUCTION: Population ageing increases number of seniors with decline of physical capabilities and functional deficits. Targeted interventions to maintain or increase physical performance are most effective before the development of full frailty, in so-called "prefrail" period. One of the assessment tools for evaluation of the physical performance and/ or frailty in older persons is the "Short Physical Performance Battery" -  SPPB. The aim of the study was to introduce the assessment battery to clinical practice in the CR and to evaluate its selected psychometric properties. METHOD: Original English SPPB was translated into Czech language and back translated to ensure linguistic accuracy. SPPB was applied in the selected sample of older persons and validated against other performance tools for cognition, self- care and nutrition status used in CR and selected psychometric properties evaluated. RESULTS: We examined 145 older persons (108 women, i.e. 74.48 % and 37 men, i.e. 25.52 %) mean age 80.38 years (54- 101 years, SD ± 8,47). We found good physical performance in 35 (24.1 %) older persons (SPPB 10- 12 points), 21 (14.5 %) were identified as prefrail (SPPB 7- 9 points) and 89 (61.4 %) as frail in high risk of future disability or already disabled (SPPB 6 points). We found statistically significant correlation of global SPPB score with nutritional status (MNA- Short Form), activities of daily living performance (ADL) and cognitive performance (MMSE) -  (Spearman correlation ρ = 0.51; 0.53 and 0.38 respectively). The Cronbachs a for SPPB variables scored 0.821, which is consistent with good internal consistency of SPPB battery. When evaluating 3 age groups [ 75 years (n = 41), 76- 85 (n = 62) and 86- 101 years (n = 42)] the most significant correlations were found between SPPB and MNA, ADL and MMSE in the young elderly (ρ = 0.74, 0.79 and 0.64 respectively) and they diminished with increasing age. CONCLUSION: We confirmed significant correlations between SPPB and self care activities, cognitive performance and nutritional status and good internal consistency of the battery. SPPB test is simple, easy to perform, with low time and cost requirements. It could be recommended for clinical practice in both community and hospitalized older patients to evaluate their overall physical performance and identify persons at risk of frailty and disability who may profit from targeted interventions.

Immunological and biochemical markers in preeclampsia.

A basic precondition for the development of preeclampsia is the presence of placental trophoblast cells in the maternal blood circulation. On the other hand, while trophoblast cells are present in the blood of all pregnant women, preeclampsia occurs in only 2-5% of them. Evidently, other factors play a crucial role. The aim of this study was to compare a set of selected immunological factors (anti-cardiolipin autoantibodies, trophoblast-induced cell-mediated immunity, C3 and C4 complement components) and biochemical factors (serum immunoglobulins IgA, IgG, IgM) among three groups of women with uncomplicated pregnancy, gestational hypertension, or preeclampsia. Blood samples were taken 2-12h before delivery. In the preeclampsia group, there was a significantly higher number of women positive for anti-cardiolipin autoantibodies, trophoblast-induced cell-mediated immunity was elevated, serum IgG was elevated and C4 complement component was reduced. We conclude that both elevated autoimmune reactivity and the higher immune reactivity to trophoblast may contribute to the onset of preeclampsia.

Transient anorexia, hyper-nociception and cognitive impairment in early adjuvant arthritis in rats.

OBJECTIVE: Rheumatoid arthritis (RA) is associated with enhanced pro-inflammatory cytokine levels, pain, anorexia, and cognitive changes. The enhanced production of cytokines appears before the full manifestation of the disease. So far, any experimental data on behavioral effects of early arthritis are lacking. In the present series we describe anorexia early changes in, pain hyper-sensitivity and altered cognitive behavior during the first four days of adjuvant arthritis in rats (AA), when no clinical signs are yet apparent. METHODS: AA was induced to male Lewis rats by a single injection of complete Freund's adjuvant (cFA) at the base of the tail. Plasma leptin and ghrelin were measured using specific RIA methods. Gene expressions for food-regulatory peptides, neuropeptide-Y (NPY) and interleukin-1ß (IL-1ß) in the hypothalamic arcuate nuclei (nARC), were quantitated by TaqMan real-time PCR. Pain sensation was measured on all four limbs and tail by the plantar test. Cognitive functions were tested in the Morris water maze (MWM). RESULTS: Levels of orexigenic ghrelin as well as mRNA expression of orexigenic NPY in nucleus arcuatus (nRC)re significantly enhanced on day 2 of AA only. Reduced body weight and food intake persisted by day 4 with the most profound reduction on day 2. The mRNA for anorexigenic IL-1ß in the nARC was significantly enhanced on days 2 and 4. Enhanced pain sensitivity was observed on day 2, as was the cognitive impairment given by longer time to find the hidden platform, longer time spent in thigmotaxis zone, and longer trajectory. The less effective strategy used to find the hidden platform was observed up to the day 4 of AA. CONCLUSIONS: Early stage of AA brings about reduced body weight, food intake, and activation of central orexigenic pathways. The observed anorexia could be ascribed to the over-expression of anorexigenic IL-1ß which dominates over the NPY orexigenic effects. On day 2 of AA higher pain sensitivity and cognitive impairment appear. All the observed change tend to recover by day 4 of the disease.

[Long-term functional effect of the photo screening in ocular diseases causing amblyopia]. / Dlouhodobýy funkcní efekt fotoscreeningu amblyogenních ocních vad.

Amblyopia represents the most common cause of insufficient monocular visual acuity in productive age.To begin the treatment in the early childhood is understood as the fundamental anticipation to achieve the optimal result. The research work concerns about the development of screening methods. Our retrospective study was not focused toward the efficacy of the screening itself, but it had to establish, how the participation of the suckling babies in the screening program influences the chance of good vision. The data analyzed in this study were obtained from retrospective review of medical records of two groups of patients of the Center for functional visual disorders. Four hundred and nineteen (419) patients with positive finding in the photo screening, selected by chance, were included into the study (SC group). In the second group, there were included 263 randomly selected patients who did not pass the photo screening procedure and to the first examination were referred by the pediatrician (PLDD group).The average age at the time of the first examination was 13 months in children from the SC group and 23 months in children from the PLDD group respectively.The difference was statistically highly significant. In both groups, the severity of the amblyopia related to the comparable degree of anisometropia and the degree of the involvement of binocular functions in strabismus related to the comparable degree of hypemetropia were compared. The data were evaluated according to the age of the child patients at the time of the examination used for the purpose of this study as well. The obtained data show, that the decrease of the visual acuity of the amblyopic eye in case of equal anisometropia is significantly higher in two to three years old children who were not screened. In older children, the results in the in the SC and PLDD groups did not significantly differ. The results of our study indicate that later (before the age of three years) beginning of systematic pleoptic treatment related to the absence in the screening program is not worsening the chance to good visual acuity at the age of six years in case of moderate to mid-severe amblyopia. The first examination indicated by the pediatrician later, at the time of evident signs of strabismus, may decrease the chance to the good functional results of the complex strabological treatment at the age of six years.

Increased serum levels of B cell activating factor (BAFF) in subsets of patients with idiopathic inflammatory myopathies.

OBJECTIVE: To investigate serum levels of B cell activating factor (BAFF) in patients with myositis and correlate these to autoantibody profile, clinical phenotype and treatment. METHODS: BAFF levels in sera from 49 patients with dermatomyositis, 44 with polymyositis, 6 with inclusion body myositis and 30 matched controls were measured by ELISA. Specific autoantibodies were detected by line blot and western blot assays. RESULTS: Serum levels of BAFF were significantly higher in patients compared to healthy controls (p = 0.003). Patients with anti-Jo-1 autoantibodies had higher BAFF levels than control individuals (p<0.003) or patients without any specific autoantibodies (p<0.05). Patients with dermatomyositis had higher BAFF levels compared to polymyositis (p<0.05). Patients with interstitial lung disease (ILD) had higher BAFF levels than patients without ILD (p<0.05) or controls (p<0.01) but this could be explained by presence of anti-Jo-1 autoantibodies. BAFF levels correlated with serum creatine kinase (CK) (rs = 0.365, p = 0.0005) but not with C-reactive protein (CRP) levels. A negative correlation of BAFF levels with glucocorticoid daily dose for all patients (rs = -0.292, p = 0.003) and with cumulative glucocorticoid doses in early myositis cases (rs = -0.659, p<0.001) was recorded. CONCLUSION: Our finding of elevated serum levels of BAFF in patients with myositis with described phenotypes together with the correlations between levels of BAFF and CK and a negative correlation with dose of glucocorticoids, indicate that BAFF could be a potential therapeutic target in such cases.

Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer.

The goal of this study was to determine the sensitivity, specificity, and accuracy of transrectal ultrasound (TRUS) in comparison to magnetic resonance imaging (MRI) in the evaluation of tumor volume, early parametrial infiltration, and identification of residual tumor in early-stage cervical cancer. Patients in whom an early-stage cervical cancer was diagnosed by clinical examination were enrolled in the study. Only those patients who were examined by both MRI and TRUS with following surgical treatment were included. Imaging results were compared with pathology findings. Altogether, 120 patients were consecutively enrolled from January 2004 to February 2006. Data from 95 patients were evaluated. Correlation coefficient for TRUS- and MRI-derived volumes versus volumes at pathology reached R = 0.996 and R = 0.980, respectively. The accuracy for detecting tumor in 95 patients was 93.7% for TRUS and 83.2% for MRI (P

[Pancreatic fistulas following distal resection procedures]. / Pankreatické fistuly po distálnych resekciách.

In this case review, the author analyses causes of pancreatic fistules in patients who underwent pancreatic resections. He presents a conservative therapeutic approach, which may be combined with invasive endoscopic and surgical methods. Considering the high morbidity rate of the disorder, it is recommended to perform a preventive pancreatojejunoanastomosis already during the primary treatment of the pancreas.

[Compression therapy of leg ulcers]. / Kompresívna liecba vredov predkolenia.

The authors present a group of 76 patients with chronic venous insufficiency in the stage or crural ulceration. After staging of the disease (C 6, E prim, E sec, A sup. pr. ref., P re) in the first stage they used a conservative approach, the method of compressive bandages: either an elastic bandage or zinc-glue bandage (Varolast). 49 patients were cured by conservative treatment (64.5%) in the course of 5 months. 12 patients were indicated for surgery (15.8%). Thus the authors cured finally 80.2% patients. A relapse was recorded in 6 patients (7.8%) and in 9 patients treatment failed (11.8%). For treatment with zinc-glue bandages they recommend patients without obstruction in the deep venous system, with large chronic ulcers and associated oedema of the whole leg.

[Pedal bypass in the treatment of arterial occlusive disease of the lower extremities in diabetics]. / Pedálny bypass v liecbe uzáverovej choroby artérií dolných koncatín u diabetikov.

BACKGROUND: The increase of the number of diabetics in the population and prolongation of their survival increases also the number of patients suffering from diabetic foot syndrome. Terminal complication of diabetic foot syndrome is diabetic gangrene, which is the cause of 50% of major amputations performed in Slovak republic. The problem of major amputations is not only medical, but also economic one. Adequate treatment can reduce the number of amputations by 50%. One of the possibilities to improve the prognosis of a diabetic suffering from obliterative macroangiopathy is the treatment by distal bypass, because with the regard to the characteristic distribution of the lesions to leg arteries is the classic vessel surgery (aortofemoral and femoropopliteal/femorocrural bypasses) inefficient. After the introduction of this treatment at our department preliminary results and some prognostic factors of the surgery success were evaluated. AIM OF THE STUDY: To evaluate the efficiency of pedal bypass as a method of treatment for peripheral obliterative atherosclerosis in diabetics and to determine the predictive value of paraclinical investigations and angiography. METHODS: Retrospective analysis of clinical, paraclinical and functional parameters of patients in whom pedal bypass was indicated, focused on the analysis of angiography. RESULTS: Of the 142 patients hospitalised with diabetic foot complications 32 were indicated for pedal bypass. All the patients were in the IV stage according to Fontain, the range of gangrene reached in average 2.7 grades of Wagners scale. Early success--i.e. functional artery reconstruction after hospital discharge was achieved in 18 patients (56%). Positive criteria for early success of the surgery involve short interval from gangrene development and serum albumin level above 26 g/l as an indicator of the nutritional state. Favourable angiographic criteria were: passage free arteries of dorsum pedis (ADP, ATP, a. plantaris, ATA) in the length of 10 cm free from focal stenoses, presence of numerous collaterals of legs and dorsum pedis, opacification of metatarsal and digital arteries. CONCLUSION: Pedal bypass is an efficient method of treatment for obliterative processes of lower extremities in diabetics with involvement of leg arteries. On the basis of our results this procedure can be recommended after careful preoperative staging and analysis of angiography as the method of treatment. It is necessary to perform the operation as soon as possible regarding the worsened nutritional and healing potential of the organism in the case of gangrene. Providing the surgery is properly indicated and performed it significantly improves the life quality of the patient. (Tab. 5, Fig. 1, Ref. 22.)

[Comprehensive treatment of crural ulcers]. / Komplexná liecba vredov predkolenia.

The authors present 65 patients treated in the stage C6 of chronic venous insufficiency. Conservative therapy was performed in the cases with large ulcers associated with crural edema. Recovery was observed in 47 cases (73%) during 5 months. Recurrence authors in 3 patients (5%) and the treatment was not successful in 7 cases (10%). In 8 patients primary or secondary surgical treatment was performed. The average period of treatment was 1.6 months. (Tab. 1, Ref. 24.)

[Hernias in scars]. / Hernie v jazve.

The authors evaluated a group of patients operated at the Surgical Clinic in 1992-1996 on account of a hernia in a scar by the Mayo plastic operation. During a mean follow-up period of 33 months 44% patients were re-operated or had a relapse. The results confirmed data reported in the literature of 30-50% relapses of hernias in scars when synthetic nets are not used. With regard to the unfavourable results the authors use since November 1997 synthetic nets in plastic operations of hernias.

[Atypical abdominal abscesses]. / Atypické abscesy brucha.

In case-histories of four patients the authors present an account on atypical abdominal abscesses which are late symptoms of advanced malignity of the large bowel or inflammatory intestinal disease. They discuss whether it is suitable to use percutaneous drainage or surgery. The latter holds despite the higher mortality a permanent place in the solution of serious intraabdominal infections, in particular if combined with malignity.

[Amputation of the lower extremities for non-traumatic causes in Slovakia in 1995]. / Amputácie dolných koncatín pre neúrazové príciny na Slovensku v roku 1995.

The authors submit a questionnaire-based epidemiological study from 61 surgical departments in Slovakia, focused on the problem of amputation of the lower extremities. The objective of the study was to evaluate indirectly the standard of care of diabetic feet in Slovakia. In the study 61 surgical departments participated with a catchment area comprising 4,814,000 insured persons, i.e. 85% of the Slovak population. In these patients a total of 2116 amputations on account of non-traumatic causes were performed (44/100000 population). This number included 1578 diabetic patients (74.6%). Minor amputations were performed 1044 times, incl. 92.2% in diabetic subjects. Major amputations were made 1072 times, incl. 57.3% in diabetics. The prevalence of major amputations in 1995 was 21.8/100000 population. The authors recorded a 2.65 fold increase of the total number of amputations since 1985. They recorded dissatisfaction with the small number of revascularization operations-total 294 (13.9%) which is only one quarter of the desirable number. The authors submit their study as the basis for a systemic solution of care of the diabetic foot in Slovakia and as a challenge for its improvement.

[Long-term results of super-selective vagotomy: evidence for justification of laparoscopic vagotomy]. / Dlhodobé výsledky supraselektívnych vagotómií: dôkaz o oprávnenosti laparoskopických vagotómií.

Based on the evaluation of long-term results of supraselective vagotomies (5-20 years after surgery) the authors consider laparoscopic vagotomy by Taylor's method justified in the primary treatment of duodenal ulcers. It was revealed that after open (laparotomic) supraselective vagotomy more than 80% of the patients are for prolonged periods free from complaints. The authors draw attention to the advantages of laparoscopic vagotomies, they discuss their causes and possible relapses of ulcers.

[Sclerotherapy of varicosities of the lower extremities]. / Skleroterapia varixov dolných koncatín.

The authors used ambulatory sclerotherapeutic treatment in 910 patients whom they also followed up. All these patients suffered from primary and relapsing varicosities of the lower extremities. A favourable effect was recorded in 82% of the patients. A relapse was recorded in 13.2% of patients, where subsequent operation was recommended. Complications after sclerotherapy were recorded in 4.5% patients.

[Carcinoids of the appendix]. / Karcinoidy apendixu.

Based on a group of six patients with carcinoid of the appendix treated at the Surgical Clinic of Dérer's Hospital in Bratislava in 1988/93, the authors discuss the diagnosis and treatment of clinically silent carcinoids (< 2 cm). Appendectomy was performed and the mesoappendix was removed. The prognosis of these patients is good, after five years 100% of the patients survive. The carcinoid syndrome is a symptom of an advanced tumour or secondaries in the liver where comprehensive treatment (surgery + metastasectomy + chemotherapy) is indicated. One third of the patients survive after five years.

[Inguinal hernia surgery in 1993 in Slovakia]. / Operácie inguinálnych hernií v roku 1993 na Slovensku.

The authors present an account of a survey (by questionnaires) focused on surgery of inguinal hernias. The recovery rate of questionnaires was 84%. The standard techniques in surgery of child hernias are Gross (29%) and Girard (29%). In primary hernias more than 50% are made by Bassini's and Girard's plastic operation. So far the worldwide accepted plastic operation of Shouldice is rarely used 14%. In the techniques of relapsing hernias also inadequate plastic operations are used; the ratio of Lichtenstein's plastic operation which has the lowest relapse rate is only 4.5%.

[Analysis of district evolution from the point of view of annual components of relative population growth]. / Analyza vyvoje okresu z hlediska jednoletych komponent prirozene meny a migraci.

"This article characterizes the population evolution within the 76 districts of the Czech Republic based on annual time series of crude measures of natality, mortality, emigrations and immigrations since 1951. It aims at evaluation of the individual development of relative population growth distributed by both components of natural change and migrations. Extrapolation of annual component measures until 2000 based on principles of exponential smoothing (discounted weighted linear regression) is the [focus] of the article." (SUMMARY IN ENG AND RUS)

Optimization of demographic models with Poissonian response.

"The general solution of related estimation and inference problems we can specify as application of Fisher scoring algorithm for maximum likelihood estimators with constraints (in Section 2).... Application to regional fertility patterns (in Section 3) yields the simultaneous solutions of tasks about structural fertility differentiations which have not been presented with correct stochastic evaluation.... The functions used for approximations of age-specific fertility schedules coincide with the most usual types of curves described in demographic literature...." (SUMMARY IN CZE)