E-cigarette use, opinion about harmfulness and addiction among university students in Bratislava, Slovakia.

OBJECTIVES: The study aimed to investigate the use of electronic cigarettes (EC) among medical students, their knowledge and beliefs (opinion about harmfulness and addiction potential) on ECs, perceptions of the risk, as well as to assess the type of education and cessation training they received during their study at Faculty of Medicine, Comenius University in Bratislava, Slovakia. METHODS: This cross-sectional, anonymous online e-mailed survey was conducted among medical students via the Study Department by sending e-mails containing the survey link. Participants completed the online questionnaire adapted from the American Survey on Tobacco and Alternative Tobacco Products. It included questions about the personal use of EC, perceptions about the harms and their role in disease causation, education and cessation training, and practices related to conventional cigarettes (CC), EC, and alternative tobacco products (ATP). The e-mailed questionnaire filled in 577 medical students (71.9% women) from Comenius University in Bratislava, the average age was 23 ± 2 years. The sample comprised 486 (84.2%) Slovak and 91 (15.8%) foreign students. The data were analysed using the Statistical Package for Social Science (SPSS) version 25. RESULTS: There were 385 (66.7%) non-smokers, 111 (19.3%) ex-smokers and 81 (14%) current smokers in the study sample. EC currently use 13.5% of medical students, with a statistically significant intersexual difference (22.2% males vs. 10.12% females; OR = 2.53, 95% CI: 1.55-4.13), more foreign students than Slovak students (24.2% vs. 11.52%; OR = 2.44, 95% CI: 1.41-4.26), more smokers of conventional cigarettes than non-smokers (46.9% vs. 8.06%; OR = 10.07, 95% CI: 5.85-17.34). EC seems to be less harmful to 59.97% of students, mostly in the age group ≤ 24 (61.76% vs. 51.49%; OR = 1.46, 95% CI: 1.03-2.07), 41.25% of students consider EC to be less addictive, 55.6% think they do not get enough education on EC during their medical study. CONCLUSION: The results overall show the high consumption of tobacco products and the lack of knowledge and awareness among medical students, future health care providers. In health promotion and disease prevention, they should serve as a model for their patients and for the general public as well. Our study emphasizes the need for intervention in this field at medical faculties and for support of further monitoring in Slovakia and other countries and draws attention to the ongoing lack of EC regulation.

The Effect of a Single Dose of Dark Chocolate on Cardiovascular Parameters and Their Reactivity to Mental Stress.

Objective: This study investigated the effect of a single administration of dark or milk chocolate on blood pressure (BP), heart rate (HR), and double product (DP) in young healthy women at rest and during acute mental stress.Method: Measurements consisted of anthropometry, BP, and HR. Mean arterial BP (MAP) and DP were computed. The relative reactivity of individual variables was quantified as to their percentage change during the rest or test of mental arithmetic (MA) with respect to the respective baseline value. All subjects underwent two tests of MA-one before chocolate administration and the second one 2 hours after chocolate (1 mg/g of body weight) ingestion.Results: Two hours after ingestion at rest, dark chocolate administration resulted in a significant increase in relative values of systolic BP and DP by 5.1% ± 1.4% and 13.7% ± 3.2%, respectively, compared to the responses in the milk chocolate group (-2.4% ± 1.6% and 0.6% ± 3.4%, respectively, p < 0.04 for both comparisons) without changes in diastolic BP, HR, and MAP. During MA-induced acute stress, the relative magnitude of the reactivity of diastolic BP, HR, MAP, and DP decreased by about 10, 16, 8, and 23 percentage points, respectively, 2 hours after ingestion of dark chocolate compared to the relative reactivity determined before dark chocolate ingestion. Milk chocolate failed to affect any of the above-mentioned parameters at rest or during stress.Conclusions: The single oral intake of 85% dark chocolate increased relative values of systolic BP and DP at rest but buffered the reactivity of diastolic BP, HR, MAP, and DP during mental stress, which was not found after ingestion of milk chocolate. Thus, dark chocolate might have a beneficial effect during acute stress due to its ability to buffer cardiovascular reactivity in young healthy women.

Environmental noise and cardiovascular disease in adults: research in Central, Eastern and South-Eastern Europe and Newly Independent States.

The adverse effects of noise on health have been intensely explored in the past 50 years. However, the scope of research conducted in the Central and Eastern Europe, South-East Europe, and Newly Independent States is not well-known. The aim of this review was to present studies on cardiovascular effects of environmental noise in adults published since 1965 and to point out the most important issues that need to be addressed in the future. More than 100 papers on noise and health and about 20 papers on cardiovascular effects of environmental noise in adults were identified by literature search. The authors reviewed scientific international and local journals, conference proceedings, and local reports published in national languages. The major endpoints were high blood pressure, ischemic heart disease, and myocardial infarction. The target populations were adults. Experimental and exposure-assessment studies, field, empirical studies, social surveys, and epidemiological studies are presented. The major sources of environmental noise were road and air traffic. The results were presented in tables and the most relevant articles were briefly discussed. The importance of this review is that it refers to some countries that no longer exist in the same political and governmental systems. The strength of this paper is that it includes publications that were not evaluated in earlier systematic reviews. Strategies for future noise-related research on national and global level are proposed.

The Prevalence of Insulin Resistance and the Associated Risk Factors in a Sample of 14-18-Year-Old Slovak Adolescents.

The prevalence of cardiometabolic risk factors has increased in Slovakian adolescents as a result of serious lifestyle changes. This cross-sectional study aimed to assess the prevalence of insulin resistance (IR) and the associations with cardiometabolic and selected lifestyle risk factors in a sample of Slovak adolescents. In total, 2629 adolescents (45.8% males) aged between 14 and 18 years were examined in the study. Anthropometric parameters, blood pressure (BP), and resting heart rate were measured; fasting venous blood samples were analyzed; and homeostasis model assessment (HOMA)-insulin resistance (IR) was calculated. For statistical data processing, the methods of descriptive and analytical statistics for normal and skewed distribution of variables were used. The mean HOMA-IR was 2.45 ± 1.91, without a significant sex differences. IR (cut-off point for HOMA-IR = 3.16) was detected in 18.6% of adolescents (19.8% males, 17.6% females). IR was strongly associated with overweight/obesity (especially central) and with almost all monitored cardiometabolic factors, except for total cholesterol (TC) and systolic BP in females. The multivariate model selected variables such as low level of physical fitness, insufficient physical activity, breakfast skipping, a small number of daily meals, frequent consumption of sweetened beverages, and low educational level of fathers as significant risk factors of IR in adolescents. Recognizing the main lifestyle risk factors and early IR identification is important in terms of the performance of preventive strategies. Weight reduction, regular physical activity, and healthy eating habits can improve insulin sensitivity and decrease the incidence of metabolic syndrome, type 2 diabetes, and cardiovascular disease (CVD).

Factors Associated with Non-Attendance at Dental Preventive Care in Slovak High School Students.

This study aimed to determine the factors associated with the avoidance of dental preventive care in high school students and their parents in the framework of The Youth and Parents Risk Factor Behavior Survey in Slovakia, the ongoing cross-sectional school-based survey of students and their parents or legal representatives. The data were collected using two separate standardized questionnaires: (i) the questionnaire for students (n = 515) and (ii) the questionnaire for parents (n = 681). The study group included 57 high school students (54.4% males) who did not visit the dentist for preventive care in the previous year. The control group included 458 students (35.8% males) who visited a dentist for preventive care at least once in the previous year. A significantly higher number of males (54.4%), older adolescents, and young adults (21.8%; 20.0%) were not visiting dental preventive care regularly. Incomplete family (56.1%), stressful situations at home (17.5%), and feeling unwell were the factors contributing to the avoidance of dental preventive care. More than 34.5% of adolescents and young adults were not visiting either dental preventive care or pediatric preventive care (adjusted odds ratio (AOR) = 5.14; 95% confidence interval (CI) = 2.40, 10.99). Children of divorced mothers and mothers with household income lower than EUR 900 had significantly higher dental care avoidance in bivariate analysis. A significantly higher percentage of fathers from the exposed group were not visiting dental preventive care regularly (47.8%, p < 0.05). The results of the study can be used as an educational intervention step focusing on the parental influence on adolescent and young adults' behavior and as a challenge for the improvement of dental preventive care in older adolescents and young adults.

Long-term trends of potential years of life lost due to main causes of death in the Slovak population, 2004-2013.

The aim of this study was to evaluate trends of potential years of life lost (PYLL) rates in the Slovak population and analyze the average annual percent change (AAPC) of PYLL rates regarding the most common causes of death between 2004 and 2013. National mortality and demographic data were obtained from the Statistical Office of the Slovak Republic, and 378,535 causes of death within the period were analyzed. The PYLL values in both genders and each disease category were added up across all age groups to form annual values. For the trend analysis, the AAPC indicator was proposed. The PYLL rate is age-standardized and expressed as a sum of all deaths per 100,000. In the period 2004-2013, the highest mean PYLL rates were observed in neoplasms in the whole population (2,103 per 100,000), as well as in females (2,088 per 100,000), with a permanent high significant increase of AAPC of PYLL in both genders. The second highest mean PYLL rate in the ten-year period was related to circulatory system diseases in total (1,922 per 100,000) as well as in females (1,449 per 100,000). In males, circulatory system diseases had the highest PYLL rate (2,397 per 100,000). The PYLL rates trend regarding external causes of morbidity and mortality showed the most notable decrease in the assessed period and the AAPC of PYLL showed significant negative values both in males (-2.5%; p < 0.001) and females (-4%; p < 0.001). Our results should contribute in developing intervention programs aimed at reducing the burden of premature mortality since the main causes of premature death are associated to well-known and preventable risk factors.

Social Noise Exposure in a Sample of Slovak University Students.

PURPOSE: Social noise exposure is currently an emerging problem in adolescents and young adults. Various leisure time activities may be responsible for hearing impairment (temporary or permanent hearing threshold shift or hearing loss). The study aimed to quantify environmental noise from various sources-voluntary (social) noise (personal music players (PMPs), high-intensity noise exposure events), and road traffic noise and to detect hearing disorders in relation to individual listening to PMPs in the sample of young adults living and studying in Bratislava, the capital city of Slovakia. METHODS: The study included 1003 university students (306 men and 697 women, average age 23.1 ± 2) living in Bratislava for 4 or more years; 347 lived in the student housing facility exposed to road traffic noise (LAeq = 67.6 dB) and 656 in the control one (LAeq = 53.4 dB). Respondents completed a validated ICBEN 5-grade scale "noise annoyance questionnaire". In the exposed group a significant source of annoyance was road traffic noise (p < 0.001), noise from entertainment facilities (p < 0.001), industrial noise (p < 0.001), and noise from neighboring flats (p = 0.003). The exposure to PMPs was objectified by the conversion of the subjective evaluation of the volume setting and duration. With the cooperation of the Ear, Nose and Throat (ENT)specialist, we arranged audiometric examinations on the pilot sample of 41 volunteers. RESULTS: From the total sample of respondents, 79.2% reported the use of a PMP in the course of the last week, and the average time was 285 minutes. There was a significant difference in PMP use between the road traffic noise-exposed (85.6%) and the control group (75.8%) (p = 0.01). Among PMP users 30.7% exceeded the lower action value (LAV) for industry (LAeq,8h = 80 dB). On a pilot sample of volunteers (n = 41), audiometry testing was performed indicating a hearing threshold shift at higher frequencies in 22% of subjects. CONCLUSIONS: The results of the study on a sample of young healthy individuals showed the importance of exposure to social noise as well as to road traffic noise and the need for prevention and intervention.

Maternal Body Mass Index and Gestational Weight Gain and Their Association with Pregnancy Complications and Perinatal Conditions.

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013-2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0-25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9-6.0 for overweight and AOR = 13.2; 95% CI 7.7-22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2-2.9 for overweight and AOR = 2.4; 95% CI 1.4-4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0-1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0-2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3-2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.

Self-Reported Exposure to ETS (Environmental Tobacco Smoke), Urinary Cotinine, and Oxidative Stress Parameters in Pregnant Women-The Pilot Study.

BACKGROUND: Exposure to ETS (environmental tobacco smoke) is one of the most toxic environmental exposures. OBJECTIVE: To investigate the association of ETS with physiological, biochemical, and psychological indicators, as well as with urine antioxidant capacity (AC) and oxidative damage to lipids in a pilot sample of healthy pregnant women. METHODS: Exposure to ETS was investigated via a validated questionnaire, and urine cotinine and the marker of oxidative damage to lipids via 8-isoprostane concentrations using an ELISA kit. Urine AC was determined by the spectrophotometric Trolox-equivalent antioxidant capacity (TEAC) method. From a sample of pregnant women (n = 319, average age 30.84 ± 5.09 years) in 80, the levels of cotinine and oxidative stress markers were analyzed. RESULTS: Among the 80 pregnant women, 5% (7.4% confirmed by cotinine) reported being current smokers and 25% reported passive smoking in the household (18.8% confirmed by cotinine). The Kappa was 0.78 for smokers and 0.22 for ETS-exposed nonsmokers. Pregnant women in the ETS-exposed group had significantly reduced AC compared to both the nonsmoker (ETS-) and the smoker groups (p < 0.05). Nonsmokers had significantly lower levels of 8-isoprostane than smokers (p < 0.01) and ETS-exposed nonsmokers (p < 0.05). Correlations between urine levels of cotinine and AC were positive in ETS-exposed nonsmokers. CONCLUSION: A harmful association of active and passive smoking and oxidative stress parameters among pregnant women has been indicated.

Exposure to Environmental Tobacco Smoke in Relation to Behavioral, Emotional, Social and Health Indicators of Slovak School Children.

Environmental tobacco smoke (ETS) exposure has been shown in general as a major environmental risk factor and deserves attention in vulnerable population groups. The aim of the project is to analyze the relationships among the ETS and behavior and health in 6−15-year-old children in Slovakia. The status of physical and mental health of children in relation to exposure to tobacco smoke was examined in a representative group of 1478 school children. The methods used, included anonymous questionnaires filled in by parents, Columbia Impairment Scale (CIS), Behavior Problem Index (BPI) and anthropometry. The prevalence of ETS exposure is the highest in the capital (27%) and southern cities. A significant association was found between ETS and age, socio-economic status, incompleteness of the family, level of mother’s education and a higher prevalence of respiratory diseases (26.7%). The relationships of ETS with emotional (CIS scores ≥ 16) and behavioral functions (BPI score ≥ 14) were significant in children exposed to mother’s or father’s smoking at home. In the multivariate analysis these associations were not significant; the factors such as income and completeness of the family were dominant. The results showed mostly the predominant impact of social factors on the physical and mental health status of Slovak school children.

Determinants of ETS exposure in a sample of Slovak pregnant women.

Environmental tobacco smoke (ETS) is one of the greatest and the most frequent environmental toxic exposures presenting a high risk to children and to their mothers as well. The aim of the study was to find determinants of the household ETS in the sample of pregnant women living in the household with smokers and to assess their physical and mental health. The survey was distributed to women being seen for follow-up at the obstetric/gynecology departments in hospitals and at gynecological out-patient departments in Bratislava, Slovakia. The medical outcomes short form-12 (SF-12) was included to quantify the mental and physical health of mothers. From the total sample of 617 women, 35.5% (219) were pregnant, 88.6% of them (194) non-smokers, 27.8% (54) lived with a smoking partner, the average mental component summary (MCS) score was 50.8±9.1 and physical component summary (PCS) score was 41.6±10.3. The average age was 31.3±5.1 years. In the sample of 309 non-pregnant non-smoking mothers 23% (71) lived with a smoking partner; the average age was 31.7±4.8 years. The average PCS score was 47.8±8.7 and MCS score 49.1±9. Non-smoking, pregnant women living with a smoker have fewer years of education (p=0.0003) and lower MCS scores (48.50±9.8) (p=0.03). Non-smoking, non-pregnant women living with a smoker are older (p=0.0042), with lower income (p=0.0145), have fewer years of education (p=0.002) and lower PCS score (45±9.1) (p=0.0056). Multivariate analyses revealed the decrease of MCS score in pregnant women and the decrease of PCS score in non-pregnant women living with a smoker. Our results show that living with a smoker is independently associated with worse physical and mental health in a selected sample of Slovak women, which represents an important argument for intervention in families.

Long-term trends of potential years of life lost due to main causes of death in the Slovak population, 2004-2013 / Tendências a longo prazo nos anos potenciais de vida perdidos devido às principais causas de óbito na população da Eslováquia, 2004-2013 / Tendencias a largo plazo de los años potenciales perdidos de vida, debido a las principales causas de muerte en la población eslovaca, 2004-2013

The aim of this study was to evaluate trends of potential years of life lost (PYLL) rates in the Slovak population and analyze the average annual percent change (AAPC) of PYLL rates regarding the most common causes of death between 2004 and 2013. National mortality and demographic data were obtained from the Statistical Office of the Slovak Republic, and 378,535 causes of death within the period were analyzed. The PYLL values in both genders and each disease category were added up across all age groups to form annual values. For the trend analysis, the AAPC indicator was proposed. The PYLL rate is age-standardized and expressed as a sum of all deaths per 100,000. In the period 2004-2013, the highest mean PYLL rates were observed in neoplasms in the whole population (2,103 per 100,000), as well as in females (2,088 per 100,000), with a permanent high significant increase of AAPC of PYLL in both genders. The second highest mean PYLL rate in the ten-year period was related to circulatory system diseases in total (1,922 per 100,000) as well as in females (1,449 per 100,000). In males, circulatory system diseases had the highest PYLL rate (2,397 per 100,000). The PYLL rates trend regarding external causes of morbidity and mortality showed the most notable decrease in the assessed period and the AAPC of PYLL showed significant negative values both in males (-2.5%; p < 0.001) and females (-4%; p < 0.001). Our results should contribute in developing intervention programs aimed at reducing the burden of premature mortality since the main causes of premature death are associated to well-known and preventable risk factors.

O estudo teve como objetivo avaliar as tendências nas taxas de anos potenciais de vida perdidos (APVP) na população eslovaca e a análise da variação percentual anual média (VPAM) nas taxas de APVP de acordo com as causas de óbito mais comuns no período de 2004 a 2013. A mortalidade nacional e os dados demográficos foram obtidos do Escritório de Estatística da República Eslovaca. Foram analisadas 378.535 causas de óbito entre 2004 e 2013. Para constituir os valores anuais, foram tabelados, em todas as faixas etárias, os valores de APVP em ambos gêneros e em cada categoria nosológica. Para a análise de tendências, foi proposto o indicador da VPAM. A taxa de APVP é padronizada para a idade e expressa como a soma de todos os óbitos por 100 mil. No período de 2004 a 2013, as médias mais altas de APVP foram observadas em neoplasias na população geral (2.103 por 100 mil) e na população feminina (2.088 por 100 mil), com um aumento significativo na VPAM dos APVP em ambos os gêneros. A segunda maior média de APVP no período de 10 anos foi devida a doenças cardiovasculares, tanto na população geral (1.922 por 100 mil) quanto na população feminina (1.449 por 100 mil). Na população masculina, as doenças cardiovasculares tiveram a maior taxa de APVP (2.397 por 100 mil). A tendência nas taxas de APVP por causas externas mostraram a redução mais importante no período avaliado, e a VPAM dos APVP comprovou os valores negativos significativos, tanto em homens (-2,5%; p < 0,001) quanto em mulheres (-4%; p < 0,001). Os resultados devem contribuir para o desenvolvimento de intervenções voltadas para a redução da carga de mortalidade prematura, considerando que as principais causas de morte prematura estão associadas a fatores de risco bem conhecidos e preveníveis.

El objetivo de este estudio fue evaluar las tendencias de las tasas de los años potenciales de vida perdidos (PYLL por sus siglas en inglés) en la población eslovaca y el análisis de la variación promedio del porcentaje anual (AAPC por sus siglas en inglés) de las tasas PYLL, de acuerdo con las causas más comunes de muerte, durante el período de 2004-2013. La mortalidad nacional y los datos demográficos se obtuvieron de la Oficina Estadística de la República Eslovaca; se analizaron 378.535 causas de muerte entre 2004 y 2013. Los valores de PYLL en ambos géneros y en cada categoría de enfermedad se contaron en todos los grupos de edad para formar valores anuales. Para el análisis de tendencia, se propuso el indicador AAPC. La tasa de PYLL se encuentra estandarizada por edad y expresada como la suma de todas las muertes por 100.000. En el período 2004-2013, las tasas medias más altas de PYLL se observaron en neoplasias en toda la población (2.103 por 100.000), así como en las mujeres (2.088 por 100.000) con un incremento significativo permanente alto de la AAPC en los PYLL en ambos géneros. La segunda tasa media más alta de PYLL, durante el período de diez años, se debió a las enfermedades del sistema circulatorio en total (1.922 por 100.000), al igual que en las mujeres (1.449 por 100.000). En hombres, las enfermedades del sistema circulatorio tienen la tasa más alta de PYLL (2.397 por 100.000). La tendencia de las tasas de PYLL, debida a causas externas de morbilidad y mortalidad mostró un notable decremento en el período evaluado y la AAPC de PYLL probaron los valores negativos significativos tanto en hombres (-2,5%; p < 0,001) como en mujeres (-4%; p < 0,001). Nuestros resultados deberían contribuir al desarrollo de la intervención en programas que tengan como meta reducir la carga de la mortalidad prematura, considerando que las causas principales de muerte prematura están asociadas a factores de riesgo bien conocidos y prevenibles.

The Economic Burden of Selected Analgesic Drugs Prescription by Dentists in Slovakia

Objective: To analyse economic burden of selected analgesic drugs prescription by dentists in Slovakia over a 24-month period. Material and Methods: In this economic burden study, the data were provided from the largest public health insurance company in Slovakia. It was analysed 23,256 prescriptions of selected analgesic drugs (Acetylsalicylic Acid, Diclofenac, Nimesulide, Tramadol and Metamizole Sodium) by dentists in Slovakia. Results: The highest analgesics prescription by dentists was found in Diclofenac in 2016 with 11.2% prescription increase in 2017. The significant decrease of analgesic drug prescription by dentists in 2017 was observed in Tramadol (-29.9%). The economic burden of selected analgesic drugs by patients were €33,926 in 2017 with 21.3% significant decrease of average percentage differences (APD) in Tramadol and 84.6% significant increase of APD in Metamizole sodium in 2017. Patients participated 65.5% share in payment of selected analgesic drugs and Health Insurance Company participated only 34.5% share in payment of selected analgesic drugs in 2017. It was found increase of percentage analgesic drugs prescription in Diclofenac and Nimesulide and decrease of percentage drug prescription in Metamizole sodium from 1/2016 to 12/2017. Conclusion: Economic burden on analgesic drugs prescribed by dentist was low per Slovak inhabitant in calculated. Diclofenac was most frequent prescribed analgesic drug with the highest economic burden. We recommend prescribing cheaper analgesic drugs with a lower economic burden and with the same effect.

Evaluation of Tooth Brushing in Slovak Patients with Sclerosis Multiplex

Objective: To analyse issue of teeth brushing according to age, gender and length in Slovak patients with multiple sclerosis disease (MS). Material and Methods: In this descriptive study, the questionnaires were collected in neurologists from December 2016 until September 2017. The study sample consisted of 103 MS patients (44.7% of men) in a mean age of 38.4 ± 9.95 years. The study sample of MS patients was divided into two sub-groups. The first sub-group consisted of MS patients who were restricted in teeth brushing (n=56) and the second group of MS patients, which had no restrictions in teeth brushing (n=47). Descriptive statistics were used to calculate the absolute and relative frequencies, mean and standard deviation. A two-sample ttest was used to compare of the proportion between sub-groups with restrictions and sub-group no restrictions in teeth brushing. The statistically significant level was determined at p<0.05. Results: The significant higher mean age (40.4 ± 10.8 years) was found in MS patients who had restrictions in teeth brushing (p=0.043). Females described often no restrictions in teeth brushing than males (59.6% vs. 40.4%; p<0.05). Length in MS disease (≤3 years) has significant impact on patients in who were not found restrictions in teeth brushing (31.9%; p=0.037). Conclusion: We recommend individual doctor approach to MS patients in older age and using of electric toothbrushes in MS patients who have hand functioning restrictions.

Economic Burden of Selected Diagnostic Imaging Methods in Oral Cancer

Objective: To analyse of proportion and economic burden of selected diagnostic imaging methods of oral cancer according to quarters and average percentage differences in the Slovak population in the period 2016-2017. Material and Methods: In this descriptive study, the data were retrieved from the information system of the largest public health insurance company on our request, which archives the cost and proportion of diagnostic imaging methods of oral cancer in Slovak population. It was evaluated 48,995 of selected diagnostic imaging methods (Computed Tomography [CT], Magnetic Resonance Imaging [MRI] and X-Ray) in the period 2016-2017. Results: The most frequently used diagnostic imaging method of oral cancer was magnetic resonance imaging method every quarters in 2016 and 2017 (53.7-54.7%) with slightly increasing trend in period 2016-2017. Mean economic burden of selected diagnostic imaging methods of oral cancer were 1,974,900€ for MRI method, 598,187€ for CT method and 5,394€ for RTG method in 2017. Decreasing trend of economic burden of diagnostic imaging method was found in MRI method and CT method in period 2016-2017. Conclusion: Our economic burden study provides a useful source for public health professional and clinicians in better understanding the economic burden of diagnostic methods in oral cancer.

The Average Annual Percent Change Analyzes of Preventive Dental Care in the Slovak Republic, 2014-2016

Objective: To analyse of the average annual percent change (AAPC) of registered dental patients, patients with preventive dental care and patients requiring dental treatment in the period of 2014-2016 in the Slovak Republic. Material and Methods: Data from registered dental patients (n=14,736,888), patients with preventive dental care (n=8,212,441) and patients requiring dental treatment (n=5,262,323) in the period of 2014-2016 were obtained from the Statistical Office of the Slovak Republic; 28,211,652 dental patients were analysed. The Theil-Sen estimator of trend line based on median and its significance was tested by nonparametric Wilcoxon test using statistical software R package. Results: The significant decrease (-4.11%) of the AAPC rates of registered dental patient (p<0.05) during the entire period (2014-2016) can be observed in age subcategory 15-18 years, while in age subcategory 19+ years the nonsignificant increase (1.08%) of the AAPC rate of registered dental patients in the same period was achieved. In the period of 2014-2016, the highest AAPC rate of patients with preventive dental care with the significant decrease was found in age subcategory 6-14 years (-17.19%; p<0.001). The AAPC rate of patients requiring dental treatment proved the significant negative values in age subcategory 0-5 years (-7.26%; p<0.01), in age subcategory 6-14 years (-9.33%; p<0.001), in age subcategory 15-18 years (-8.81%; p<0.01). Conclusion: The highest decrease AAPC rate of registered dental patients was observed in age subcategory 15-18 years. The statistical significant decrease AAPC rate of patients with preventive dental care was found in children ≤ 18 years. In patients requiring dental treatment (≤ 18 y.) was observed decrease AAPC rate.

Gender and Age Differences in Patients' Satisfaction with Dental Care in the Slovak Republic: A Cross-sectional Questionnaire Study

Objective: To analyze the level of quality of healthcare satisfaction/dissatisfaction according to gender and age in terms of time spent with the doctor, communication, general satisfaction, interpersonal and financial aspects, technical quality and access/availability/convenience. Material and Methods: The standardized "Patient Satisfaction Questionnaire" (n=445) was collected in dental clinics in the Slovak Republic in the period of 2014-2015. The study sample was divided into subgroups according to gender (males: n=236; females: n=209) and age (<35 years: n= 243; ≥36 years: n=202). A scale from 1 (maximum dissatisfaction with quality of healthcare) to 5 (maximum satisfaction with quality of healthcare) was evaluated. Results: The highest significant satisfaction level of quality of healthcare (expressed as a mean score) were found in females in the subscale time spent with doctor (<35 y.) (2.90±0.69; p<0.042); the lowest satisfaction level was found in females (<35 y.) in the subscale general satisfaction (2.53±0.36; p=n.s.). Females (≥36y.) were significantly more satisfied with health care quality in the subscale communication than males (2.72±0.34 and 2.62±0.3, respectively; p=0.046). Males (<35 y.) were significantly less satisfied in the subscale technical quality compared to females (2.54±0.27 and 2.65±0.26, respectively; p=0.002). Conclusion: For the future, it is necessary to specify the next reasons for patients' satisfaction/dissatisfaction with dental care.

Association between Sweet Consumption and Oral Health in European Population

Objective: To evaluate the association between frequency sweet consumption of drink (food) and teeth number, prevalence of dental check-ups and teeth pain in European population. Material and Methods: In this descriptive study, the data was evaluated from Eurobarometer database 72.3. It was involved 30.292 of citizens from EU-27 (European Union) countries in Eurobarometer research. The necessary conditions for the including of European countries in our research were complete information about: (i) frequency of sweet consumption (%) in each EU-27 countries, population percentage who has all natural teeth (%) in each EU-27 countries, (iii) prevalence of dental checkups (%) in each EU-27 countries and (iv) frequency teeth pain in each EU-27 countries. Results: The highest proportion of often teeth pain (9.0%) was in Romania. Positive association between often sweet consumption of drink (food) and often teeth pain was found. Negative association between often sweet consumption of drink (food) and inhabitants' percentage who have all natural teeth was found. Negative association between often sweet consumption of drink (food) and prevalence of dental check-ups was observed. Conclusion: Our results about the impact sweet consumption of drink (food) on oral health are applicable in oral health programs. It is necessary to include more world countries (more European citizens) into linear regression model of oral health.