The Incidence of Pinworm (Enterobius Vermicularis) in Pre-school and School Aged Children in the Eastern Slovakia.

Helminth infections caused by Enterobius vermicularis have a cosmopolitan character and most often affect the paediatric pre-school and school age population. The presented study was conducted to determine the prevalence of E. vermicularis in the analyzed population of children in the Eastern Slovakia. The Graham's scotch tape method was used to investigate the presence of Enterobius vermicularis eggs in 390 specimens. The analyzed set consisted of 218 girls and 172 boys, divided by age into three groups - aged from 5 months to 2 years, aged from 3 to 6 years, and aged from 7 to 15 years. Investigation of perianal scotch tapes of children for the presence of E. vermicularis eggs revealed the prevalence of E. vermicularis was P = 3.59 %. Depending on the incidence of E. vermicularis infection, we detected no statistically significant difference (p> 0.05). The prevalence of E. vermicularis in boys was P = 4.07 %, and in girls P = 3.21 %. The highest prevalence of E. vermicularis was recorded in the group of children aged from 3 to 6 years (P = 5.03 %). Most of the samples were positive at age 4 and 5. The lowest prevalence was in the group of children aged from 5 months to 2 years (P = 0.97 %), and the prevalence of E. vermicularis in the group of children aged from 7 to 15 was P = 3.91 %. The difference in the incidence of E. vermicularis infection among different age groups of children was not statistically significant (p> 0.05). Enterobius vermicularis nematode infection and enterobiasis currently represents a major public health problem in Slovakia. At the present its occurrence is the most frequent in the paediatric population. Therefore it is important to introduce a targeted hygienic-epidemiological measure in children's collectives, what also should include proper and effective diagnostics and frequent recurrent therapy.

[Technical Options of Documentation of the Anterior Segment and the eye Fundus Findings within Mission]. / Technické moznosti vysetrenia a dokumentácie nálezov predného a zadného segmentu oka v rámci humanitárnych projektov.

Documentation of the anterior segment and the eye fundus with instruments that enable quality precision diagnostics is a common and important part of screening in humanitarian ophthalmology projects. It is the essential element in diagnosis, monitoring and management of eye diseases. In sub saharan countries within the screening for ophthalmologist are not available the modern technologies such as biomicroscope (slit lamp) or fundus camera. We describe our experience with photographs of anterior segment of the eye by using digital camera and Smartphone. The documentation of the eye fundus was recorded through 20D Volk spherical lens to Smartphone. MATERIAL AND METHODS: Within the screening projects in collaboration with St. Elisabeth University of Health and Social Sciences for eye diseases in the year 2014 in Bigugu, Rwanda and in 2015 in Mapuordit, South Sudan, we examined patients who were unable to reach ophthalmologic care. We used a flashlight, a direct ophthalmoscope, tables to determine visual acuity on illiterate, Schiøtz tonometer, Volk lens, Smartphone. Patients who underwent screening, and needed glasses, got from humanitarian collection already used dioptric eyeglasses or sunglasses. For documentation of the anterior segment we used a digital camera and for patients in whom it was necessary to document fundus findings detected by direct ophthalmoscopy we took the opportunity of Smartphone with 8 Mpix camera and the LED flash and Volk lens plus 20 Diopters. RESULTS: In 2014 within the project in Bigugu, Rwanda and in 2015 in Mapuordit, South Sudan, we examined patients in an improvised clinic without access to electricity.We examined in 2014 a total of 340 patients and in 2015 a total of 290 patients. Patient age was due to the unavailability of designated identification records estimated with the help of an interpreter. In both groups, the mean age of the patients was about 30 years. The most common diseases leading to blindness were cataract, trachoma, post-traumatic conditions. Infectious diseases and consequences of untreated infectious diseases were the cause of 20% of the permanent changes on the surface of the eye or the adnexa. In the group of HIV positive patients we did not mention pathological findings on the eye fundus. CONCLUSION: Anterior segment findings documentation with digital camera or mobile phone and fundus examination using a Smartphone and Volks lens with a value of plus 20D is inexpensive and manageable technique which can capture high quality and reproducible images. These techniques are suitable for photo documentation of anterior segment and also eye fundus screening within humanitarian projects of eye diseases in developing countries. KEY WORDS: anterior segment examination, eye fundus examination, Smartphone, digital camera, humanitarian screening projects of eye diseases.

[Anxio-depressive Syndrome -  Biopsychosocial Model of Supportive Care]. / Anxio-depresívny syndróm v onkológii -  biopsychosociálny model suportívnej terapie.

BACKGROUND: Acute stress in patients experiencing cancer diagnosis and the post-traumatic stress disorder in cancer survivors results in impaired overall quality of life mainly due to associated psychological and physical alterations, including anxiety, depression, sleep disturbances, cognitive dysfunctions, fatigue, pain, cachexia and others. Recent studies revealed a new insight into molecular mechanisms contributing to the development of cancer-related co morbidities. It has been shown that adverse psychosomatic reactions including cancer depression to emotional cancer distress result from neuroendocrinne dysfunctions, disruption of the hypothalamus- pituitary-adrenal axis and sympathetic nervous system, serotonin-dopamine interactions and circadian sleep- wake rhythm disruption. AIM: The aim of the present study was to evaluate clinical studies oriented toward elucidation of the hypothesis that cancer-related anxio- depressive syndrome is the major disorder leading to the development of accompanying psychosomatic disruptions. MATERIAL AND METHODS: The data of the biopsychosocial approach in the treatment of cancer presented in the current literature were collecting using appropriate electronic databases and were elaborated in the form of meta-analysis of 24 selected publications. RESULTS: According to relevant clinical studies, psychosocial interventions and psychopharmacological treatment has been shown to reduce cancer symptomatology and to improve the ability of patients to cope with the disease. Thus, one of the key pillars of supportive care in oncology is stress reduction. Cognitive- behavioral interventions and group psychosocial therapies have shown to reduce stress from the diagnosis and treatment, to palliate depression and to help in restoring the circadian rhythm. Psychopharamacological interventions are the most useful approaches in the reduction of stress-induced cancer comorbidities. In the presented study, a plausible role of stress reduction in the protection of cancer patients from posttraumatic and anxio- depressive syndrome, physical and psychical suffering, from decrease of patients quality of life, ability to cope with the disease and cooperate in cancer treatment has been analyzed. CONCLUSION: Implementation of the biopsychosocial model of cancer care needs further cooperation between behavioral scientists and clinical oncologists attempted to elucidate further possibilities of psychosocial and pharmacological interventions leading to the regulation of stress-induced alterations of the neurotransmitter system and neuroendocrinne dysfunctions reduction of cancer-related co morbidities and improvement of patients survival time.

Psychosocial support needs of Slovak breast cancer survivors one and three years after breast conserving surgery.

OBJECTIVE: To assess psychosocial support needs among Slovak breast cancer survivors treated by breast conserving surgery. METHODS: Patients responded the EORTC QLQ 30.3 questionnaire and the self-elaborated BCPN (Breast Cancer Psychosocial Needs) questionnaire one and three years after breast conserving surgery (BSC) and modified radical mastectomy (MRM). RESULTS: Assessment of psychosocial distress related to breast cancer treatment have shown a remarkable time-related increase in scores of emotional distress symptoms among breast cancer patients treated with breast-conserving surgery. Analysis of psychosocial support needs of these patients has shown, that a substantial part of breast cancer survivors are feeling inadequate beneficial psychosocial support from health care providers (informational support), social oncology workers, and psychologists (emotional support). Insufficient targeted psychosocial support involved individual as well as group intervention (provided by breast cancer patients surviving the disease for long time). CONCLUSION: Unmet psychosocial needs from health care providers has been perceived as a major factor harming patients ability to cope with the disease and to maintain their family, marital and social functioning (Tab. 2, Fig. 1, Ref. 22).

Effect of Tokaj wine in combination with water and 10% alcohol solution on long-life and development of alcohol progeria in Wistar SPF rats.

Whole-life consumption of the pure Tokaj wine (The Furmint variety) with documented antioxidative activity significantly elongated (p<0.05) the life of laboratory animals in comparison to the control group consuming water and in comparison to group consuming ethanol (10%). Whole-life intake of ethanol (10%) diluted with water neither shortened nor elongated life of laboratory animals in comparison to control group consuming water. An increased dosing of the Tokaj wine combined with water shortened life expectation (p<0.001). Obviously mixing of wine and water increases the absorption of toxic elements influenced by an acid medium through the change of anions to cations, but also increased appetite resulting into obesity on the basis of hyperphagia.

Predictors of inferior outcome in community acquired bacterial meningitis.

The aim of this study was to assess mortality and sequellae within cases from Nationwide survey of community acquired meningitis and identify risk factors for inferior outcome. Risk factors such as underlying disease (diabetes mellitus, cancer, trauma, neonatal age, splenectomy, alcoholism, sepsis, other infections), etiology, clinical symptoms and outcome (death, improvement and cured after modifications of ATB therapy, cured without change of therapy, cured with neurologic sequellae) were recorded and analysed with univariate analysis (chi2 or t test for trends, CDC Atlanta 2004). Analysing risk factors for inferior outcome (death or cured with neurologic sequellae), we compared patients who died or survived with neurologic sequellae to all patients with community acquired bacterial meningitis. Univariate analysis showed that trauma (p<0.05), alcohol abuse (p<0.05), diabetes, S. aureus (p<0.05) and gram-negative etiology (A. baumannii, Ps. aeruginosa or Enterobacteriaceae) (36% vs. 11,9%, p<0.05) were predicting inferior outcome. Analysing risk factors for treatment failure (death or failed but cured after change of antibiotic treatment) prior sepsis (34.1% vs. 13.9%, p<0.01) and gram-negative etiology (25% vs. 11.9%, p<0.02) were statistically significant predictors of treatment failure. Neisseria meningitis had less failures (p<0.05). Concerning infection associated mortality again diabetes mellitus (p<0.05), alcoholism (p<0.05) staphylococcal and gram-negative etiology (p<0.05) were significant predictors of death. N. meningitis had surprisingly less treatment failures (appropriate and rapid initial therapy). Neurologic sequellae were more common in patients with alcohol abuse (p<0.05), craniocerbral trauma (p<0.05) and less common in meningitis with pneumococcal etiology (p<0.05).

Etiology and resistance patterns of respiratory isolates in Kenyan adults with AIDS from slum population.

We investigated regularly swabs of adults dispenzarised at Mary Immaculate Clinic of Trnava University in Nairobi providing free health care for about 50 000 population of Mukuru Slums. 20 patients who were treated for AIDS by our clinic (those who started HAART before Free National AIDS Cooperation Programme - NASCOP) were assessed after 1, 2 and 3 years (18 of 20 completed the survey, other 2 loss of follow up, probably died. Exposure to other molecules can select resistant mutants. Previous exposure to TMP/SMX was similar in both groups and therefore was not responsible for the difference between resistance patterns.

Point prevalence study of the spectrum of infectious diseases and antimicrobial drug use in homogenous slum population of Mukuru in Nairobi.

We performed a prospective point prevalence study with a simple prospective protocol and analyzed spectrum of infections (ID) etiology and antimicrobial therapy in all cases coming for one month (June 2006). Respiratory tract infections represented 33% of all visits followed by diarrheal infections (197 cases) and sexually transmitted disease (86), skin and soft tissue infection (68), AIDS (40) and malaria (26) cases. Majority of isolates were St. aureus (only 3 MRSA), C. albicans and NAC (19), (only 2 Fluconazol resistant) and S. pneumoniae (8) (2 penicillin resistant).

Neuroinfections and antimicrobials: do we need new molecules or new strategies?

Within last 15 years, analyzing patterns of etiology and resistance in organisms causing neuroinfections, emergence of resistance has been observed in Slovakia in S. haemolyticus to teicoplanin (11%), Ps. aeruginosa and A. baumannii to meropenem (20%) and Candida spp. (non-albicans Candida spp.) to fluconazol (20%). There are no new antibiotics against carbapenem resistant Ps. aeruginosa and Acinetobacter baumannii.

Infectious embolisation to the central nervous system from endocarditis: analyses of 99 cases.

Within a cohort of 606 cases of infective endocarditis, 263 were complicated and 99 embolizing, of them 32 to the central nervous system (CNS). Significant predictors of CNS embolisation were inappropriate therapy (p<0.01) and enterococcal etiology (p<0.01). Mortality in patients with CNS emboli was 65% what was significantly higher than in cases without embolisation - 15% (p<0.01).

Trends in risk factors and etiology of 606 cases of infective endocarditis over 23 years (1984-2006) in slovakia.

The aim of this study was to assess trends in risk factors, etiology, outcome and treatment strategies for endocarditis over 23 years in Slovakia. A prospective survey of 606 cases of infective endocarditis (IE) was conducted from 1984-2006. Rheumatic fever as well as previous dental surgery showed decreasing trends within the last 23 years. Also embolic complications of IE declined along with increasing rates of surgically treated patients. No significant changes in etiology were detected apart from the fact that culture-negative endocarditis increased from 10.7% to 55.4% between 1998-2001. Surgically treated patients increased from 22.7% (1984-1990) to 50.1% (2002-2006) and mortality dramatically decreased from 26.7% (1984-1990) to 5.3% (2002-2006). Staphylococcus aureus and coagulase-negative staphylococci were the leading causes (22.4% - 48%) followed by viridans streptococci (12.2%-18.2%) were a relatively stable trend over 23 years of IE in Slovakia.

Four years of monitoring antibiotic resistance in microorganisms from bacteremic patients.

From the second semester of 2002 to the end of the first semester of 2005, a total of 2544 bacterial strains were isolated from the blood stream of patients with clinical sepsis and bacteremia hospitalized in six University Hospitals in the Slovak Republic. Almost 30% of strains were coagulase-negative staphylococci (CONS), about 14% were Staphylococcus aureus and, of the Gram-negative bacteria, up to 9% were Klebsiella pneumoniae. All CONS, S. aureus and Enterococcus spp. strains were found to be still susceptible to vancomycin, but the resistance of CONS and/or S. aureus to macrolides and fluoroquinolones dramatically increased during the period of this study. Among Gram-negative bacteria, increasing levels of resistance to higher generation cephalosporins, to fluoroquinolones resistance in Pseudomonas aeruginosa and Acinetobacter spp. to meropenem was recorded, which is alarming. The results were periodically submitted to cooperating hospitals with proposals for rationalizing the prophylactic and general use of indicated antibiotics as well as for improving hospital hygiene measures and anti-epidemic practices.