Normograde nasolacrimal placement of an ocular-lavage system for treatment of equine eye diseases.

The standard placement of a subpalpebral lavage system may not be feasible in some horses with eyelid disease. We describe placement of a commercially available, indwelling nasolacrimal lavage system that circumvents eyelid perforation. This novel approach provided for effective delivery of drugs to 1 horse with periocular and corneal disease.

Placement nasolacrymal normograde d'un système de lavage oculaire pour le traitement des maladies de l'oeil des équidés. Le placement standard d'un système de lavage subpalpébral peut ne pas être réalisable chez certains chevaux atteints de maladies oculaires. Nous décrivons le placement d'un système de lavage nasolacrymal à demeure qui évite la perforation de la paupière. Cette approche innovatrice a permis d'administrer des médicaments à un cheval atteint de maladie périoculaire et cornéenne.(Traduit par Isabelle Vallières).

Human exposure to polyhalogenated hydrocarbons and incidence of selected malignancies -central European experience.

This paper describes results of two ecological studies design to analyze the incidence of selected malignancies in two populations exposed to polychlorinated hydrocarbons, mostly PCBs and TCDDs/Fs by comparing data available in the National Cancer Registry of the Slovak Republic and National Oncological Registry of the Czech Republic databases for the Slovak Republic (approximately 5M inhabitants) and the Czech Republic (10,3 M inhabitants) to the data relevant for the population of Michalovce District, the Slovak Republic (approximately 112,000 inhabitants) and Uherske Hradiste, the Czech Republic (146,000 inhabitants). Those districts are recognized as PCB-contaminated areas due to production and industrial use of PCBs. Data were analyzed for the 10-year period 1987-1996. The age adjusted world standard ratio (WSR) incidence of thyroid, pancreatic, breast, ovarian, bladder, and brain tumors in females and thyroid, pancreatic, breast, bladder, brain, prostate and testicular tumors in males were compared. Neither PCBs nor TCDDs/Fs appear to contribute to the observed significantly lower incidence of breast and prostate cancer in the Michalovce District and lower bladder cancer incidence in Uherske Hradiste District. However, anti-estrogenic and anti-androgenic properties have been described for hydroxylated and methylsulfonyl PCB metabolites. These properties could contribute to a mechanism through which these metabolites might modulate the development of breast, prostate and bladder cancer. The results of our analysis points to substantial potential problems of risk assessment for cancer incidence in populations exposed to xenobiotics, or more generally, as it relates to a wide spectrum of confoundings of cancer risk factors.

Food consumption and feeding patterns of Czech infants and toddlers living in Prague.

OBJECTIVE: To describe feeding patterns during first two years of life and their relation to sociodemographic factors. DESIGN: Longitudinal study. SETTING: Prague, Czech Republic. SUBJECTS: Ninety-seven full-term healthy singletons enrolled at maternity ward, of which 90.7% completed the study. METHODS: Diet was assessed at 9, 12 and 24 months of age using a structured 3-day dietary record. Additional information was obtained from questionnaires completed at birth and at 6 months. RESULTS: The median duration of exclusive breastfeeding was 5 months, and that of total breastfeeding 9 months. Breastfeeding rate 47.4% at 9 months declined to 4.5% at 24 months. Total duration of breastfeeding was positively associated with maternal education and marital status but not with maternal age, gender or birth order. Breastfeeding frequency at 9, 12 and 24 months was 4.8, 4 and 3.7, respectively. The complementary food feeding frequency increased significantly with age (4.5, 4.7 and 5.9 times per day, respectively). All children at any age point consumed fruits, cereal and milk products. The proportion of children consuming meat and vegetables had increased with age but between ages 9 and 24 months, at least 23-38% children did not consume vegetables daily and 28-40% did not consume foods from meat/fish/poultry/eggs group daily. The proportion of children consuming milk and foods associated with the early complementary feeding period had fallen with age while the consumption of cereal foods other than porridge had increased. Values of indicators of adequate complementary feeding practices tentatively suggested in the context of WHO expert consultation had closely reflected breastfeeding rates. CONCLUSIONS: Breastfeeding duration is shorter than WHO recommends. It is influenced by maternal education and marital status. Compliance with complementary feeding recommendations is relatively good. Continued promotion of healthy infant and young child feeding practices is needed. Indicators evaluating complementary feeding practices should assess breastfeeding separately from other aspects. SPONSORSHIP: Ministry of Health, 1st Faculty of Medicine, Charles' University of Prague.

Smoking and pregnancy: prevalence, knowledge, anthropometry, risk communication.

Information about smoking impact on pregnancy as well as clear advice to stop and a treatment offer should be included into the health care of pregnant women. We contacted them within the first 3 days after delivery. In the sample of 265 women 23.8% (63/265) smoked during their pregnancy (51.9% with basic education only, 25.8% with high school and 5.0% with university education), and 7% of the sample (19/265) did not quit by the delivery. Only 68% of smokers (43/63) were asked about their smoking habits during the pregnancy by their gynaecologist, and both smokers and non-smokers had insufficient information about the impact of smoking on their baby (40% of smokers and 32% of non-smokers had no idea at all), the doctor was the source of this kind of information only in 5% (13/265) cases. Smokers' children had a lower average birth weight (3.084 g in smokers vs. 3.325 g in non-smokers, p=0.02) and were smaller (49.3 cm vs. 50.5 cm respectively, p=0.02). Smokers' bodyweight increased more than non-smokers' during their pregnancy (gaining 14.8 kg vs. 12.9 kg respectively, p=0.02), they also underwent the delivery at a lower age (27.6 vs. 30.0 years respectively, p<0.01) and after a non-significantly shorter duration of pregnancy (38.7 weeks vs. 39.0 weeks respectively, p=0.53). If 23.8% of pregnant women smoke and 90.6% of them would like to stop, it is a missed opportunity for education and treatment of tobacco dependence by their physicians.

Diet, smoking, and blood lipids in patients with combined familial hyperlipidaemia.

This study analysed the diet (based on a 7-day-record), smoking habits and basic anthropometric parameters of patients with familial combined hyperlipidaemia (N = 154, 52% men, 48% women, mean age 55.73 +/- 12.95). These data were correlated with blood lipids and lipoproteins. In high-risk patients' diets we found not quantitative, but mostly qualitative shortcomings: the average energy intake was 104% of the recommended daily intake (RDI), but 34% of the energy was derived from fats. The daily fat intake represented 137% of RDI, and 60 g were of animal and 24 g of vegetable origine. The protein intake was 120% of RDI (155% animal, 75% vegetable protein), the carbohydrate intake was only 86% and the fibre intake 71% of RDI. A very high intake both of cholesterol--139% of RDI and NaCl 151% of RDI--was recorded, while the intake of antioxidant vitamins C and E was only 82% and 35% of RDI, respectively. Current smoking was recorded in 51% of patients. Smokers had also a poorer diet: higher animal fat and protein, as well as a higher cholesterol intake, lower vegetable fat, protein, fibre and vitamin E intake. Surprisingly smokers were found to ingest more vitamin C than non-smokers. As to blood lipids: smokers vs. non-smokers had the following values in mmol/l (SD): total cholesterol 7.8 (+/- 1.3) vs. 7.7 (+/- 1.82), triacylglycerols 3.27 (+/- 2.13) vs. 3.2 (+/- 3.11), HDL-cholesterol 1.25 (+/- 0.39) vs. 1.36 (+/- 0.43), LDL-cholesterol 5.11 (+/- 1.39) vs. 4.95 (+/- 1.51), and, in g/l, apolipoprotein A1 1.8 (+/- 0.30) vs. 1.66 (+/- 0.35), apolipoprotein B 1.66 (+/- 0.35) vs. 1.52 (+/- 0.44), lipoprotein (a) 0.36 (+/- 0.27) vs. 0.43 (+/- 0.50), all without statistical significance. For smokers vs. non-smokers anthropometric data were as follows (mean, SD): body mass index (BMI) 27.74 (+/- 3.77) vs. 27.02 (+/- 3.30), waist/hip ratio (WHR) 0.895 (+/- 0.086) vs. 0.911 (+/- 0.093), and % of body fat 29.6 (+/- 7.4) vs. 27.9 (+/- 7.9). Our conclusions suggest, that lifestyle choice are of great importance for patients with this serious genetic lipid metabolism disorder and that it is important to recognise the danger of risk factor cumulation in connection with cardiovascular diseases.

An attempt to demonstrate the increased resistance of selected bacterial strains during repeated exposure to UV radiation at 254 nm.

Evidence was provided that in a repeatedly irradiated bacterial suspension of Escherichia coli K12: AB 1157, 1886, 2463, under the described experimental conditions, gradually mutants more resistant to UV radiation survive. Under these circumstances it may happen that selection and an increase of bacterial clones with an increased UV resistance develop, manifested by a reduced effectiveness of UV radiation during repeated irradiation. Although the cumulating damage of DNA in microbes can lead to a reduction of their survival as well as a reduction of their absolute numbers, it can be hardly assumed that during practical use in air conditioning units or during disinfection of drinking water all bacteria will be destroyed. In that case even repeated UV irradiation is not necessarily a reliable disinfection tool.

Czech medical faculties and smoking.

At the 1st Medical Faculty of Charles University in Prague the prevalence of smoking was investigated among the faculty, staff, students and among health professionals in the country. We found 38.1% smokers (current and occasional) among malephysicians (N = 625), 25.6% smokers among women physicians (N = 394), 48.7% smoking nurses (N = 729) and 42.3% smokers among paramedical staff (N = 298). We have also followed up smoking habits among our students since 1989 (N = 1235). The number of smokers among them rose from 7% in 1989 to 18% in 1994. Students were also asked about their opinion on smoking as a risk factor for coronary heart disease which has a rising trend. Trying to coordinate the anti-smoking activity at all seven medical faculties in the Czech Republic, in collaboration with the Faculty of Medicine of Masaryk University in Brno, the National Centre for Health Promotion and the Czech Commission of EMASH, present the main points of the anti-smoking strategy at Czech medical faculties.

[Life style of medical students and risk factors for ischemic heart disease]. / Zivotní styl mediku a rizikové faktory ischemické choroby srdecní.

For three years some characteristics of life-style of medical students in the fifth year of The 1st Medical Faculty, Charles University, Prague, were followed with a view to risk factors of ischemic heart disease (ICHS). At the same time opinion of these students on the validity of these factors were established. Altogether it deals with 623 students of which they are 269 men and 354 women of average age 23.1 years in whom 12 risk factors were followed. The results show that medical students do not lead an exemplary life-style. For example, during the following three years there was actually a significant increase in number of smokers (from 7% to 22%) and corresponding to this the significance assigned to this risk factor has decreased.

[Ultraviolet rays and their biological effects]. / Ultrafialové zárení a jeho biologické úcinky.

In conjunction with contamination of the atmosphere by freons interest in geophysical and health aspects of "ozone holes"--seasonal incidence of increased intensity of UV radiation--is increasing. Its biological effects depend on the intensity, period of exposure and wavelength. There is a wide range of different damage, local as well as general. In addition to pigmentation of the skin and symptoms produced by an elevated histamine blood level we find also changes which may have more serious and permanent consequences. These changes include the number and structure of Langerhans islets, changes of the peripheral capillary walls, dimerization of pyrimidine and thymine in DNA. These changes contribute to the development of malignancies of the skin. After exposure of the eye changes of pigmentation are found, and depending on the dose, also development of conjunctivitis or retinal damage. Recently interaction of UV radiation with arsenic was investigated. Conversely therapeutic effects of UV radiation in combination with chemotherapy are used in dermatology, such as inhibition of contact sensitization.

[Patients with familial combined hyperlipidemia and smoking]. / Pacienti s familiární kombinovanou hyperlipidémií a kourení.

BACKGROUND: Evaluation of the negative impact of active smoking on lipid and lipoprotein serum levels and the relationship with body mass index (BMI) and waist/hip ratio (WHR). METHODS AND RESULTS: The group was formed by 178 (77 men and 101 women), mean age 54 years (SD 6.2 attending the lipid out-patient department at the Third Medical Clinic, First Medical Faculty, Charles University Prague. Attention was paid to whether the patients were treated with hypolipidaemic agents or not. A statistically significant difference (p < 0.05) was found between smokers and non-smokers as regards total cholesterol (mean values and SD) in the group of 80 treated women (smokers 7.84 mmol/l, SD 1.21). Significantly higher values of LDL cholesterol in smokers as compared with non-smokers (6.00 mmol/l SD 2.08 vs. 4.8 mmol/l, SD 1.26) were recorded in the group of treated women. Other results were also to the disadvantage of smokers (with the exception of non-treated women), though the difference was not statistically significant: non-treated female smokers had a higher LDL cholesterol (4.24 mmol/l, SD 1.42) as compared with non-treated non-smokers (5.3 mmol/1, SD 0.60). In treated men the LDL cholesterol value in smokers (5.20 mmol/l SD 1.20) were also higher than in non-smokers (4.54, SD, 1.15). Triacylglycerols in women (smokers vs. non-smokers): in the group of treated women 3.11 mmol/l, SD 4.86 vs 1.94 mmol/l SD 1.08, in the group of non-treated women 3.74 mmol/l, SD 4.77 vs. 1.94 mmol/l, SD 0.74. Triacyglycerols in men (smokers vs. non-smokers): in the treated men 3.87 mmol/l SD 3.54 vs. 2.62 mmol/l, SD 1.63, in the non-treated men 10.62 mmol/l, SD 9.86 vs. 2.86 mmol/l, SD 1.63. HDL-cholesterol in women (smokers vs. non-smokers): in the treated group 1.24 mmol/l SD 0.46 vs. 1.39 mmol/l, SD 0.35, in the group of non-treated men 1.54 mmol/l, SD 0.37, vs. 2.86 mmol/l, SD 1.64. HDL cholesterol in men (smokers vs. non-smokers): in the treated group 1.15 mmol/l, SD 0.30 vs. 1.27 mmol/l, SD 0.31, in the non-treated group 1.09 mmol/l, SD 0.40 vs. 1.15 mmol, SD 0.28. In female smokers treated and non treated and in non-treated male smokers the WHR values were higher, in treated smokers lower despite the surprisingly higher BMI. CONCLUSION: Active smoking has an adverse impact on serum lipid and lipoprotein levels in patients with familial combined hyperlipidaemia.

[Negative aspects of the Western life style and possibilities of intervention in patients with familial combined hyperlipidemia]. / Negativní aspekty západního zivotního stylu a moznosti intervence u pacientu s familiární kombinovanou hyperlipidémií.

BACKGROUND: Evaluation of the effect of intervention on changes in the lifestyle of patients with combined familial hyperlipidaemia (CFH). METHODS AND RESULTS: The group comprised 154 patients with CFH where changes in the lipid profile, diet, basic anthropometric data and smoking were recorded 3-6 months following intervention. In addition to little willingness to have a check-up examination the authors recorded significant shortcomings in the lifestyle of these patients with a high cardiovascular risk: a large number of smokers (51%), serious shortcomings in the composition of the diet (excessive intake of animal fats a proteins, inadequate intake of vegetable proteins, dietary fibre and vitamins, in particular E and C), overweight and a high percentage of body fat. CONCLUSIONS: While the attention devote to pharmacotherapy with hypolipidaemic agents is justified we should not forget systematic intervention as regards changes in lifestyle. This appeal is even more urgent in conjunction with the low motivation and willingness of patients to change their lifestyle. Special attention should be focused on smokers (in addition to effect on lipids also greater cumulation of risk factors).