[Occupational tuberculosis in Slovakia and in the Czech Republic]. / Profesionálna TBC na Slovensku a v Ceskej republike.

STUDY OBJECTIVE: To conduct a retrospective 15-year study to monitor trends in the number of employees at risk for occupational tuberculosis (TB) (levels III and IV) in the Slovak Republic, and in particular in the sector of economic activities Q (health care and social assistance). Furthermore, to analyze reported cases of occupational TB and to compare the incidence and sex-specific and age-specific prevalence with the data reported in the Czech Republic. MATERIAL AND METHODS: Data on the number of employees at risk of exposure to occupational TB were derived from the Automated Risk Classification System of the Slovak Republic. Data on cases of occupational TB were taken from health statistics (Institute of Health Information and Statistics/National Health Information Center in the Slovak Republic and the National Institute of Public Health in the Czech Republic). A retrospective analysis was conducted (for 1998-2012) of reported cases of occupational TB, selected from Article 24 of the List of occupational diseases (infectious and parasitic diseases except tropical infectious and parasitic diseases and diseases transmissible from animals to humans). The selection criterion was a TB diagnosis according to ICD-10. In the Czech Republic, the data were derived from Article 5.1.02 (tuberculosis), Chapter V. of the List of Occupational Diseases. The data obtained were analyzed by methods of descriptive statistics. RESULTS: The numbers of employees with a level III risk of exposure to occupational TB in the Slovak Republic declined by 30% over the 15 years of study and by 40% in category Q. In 2012, 2027 employees were classified in category III and 1442 of them belonged to group Q. Females accounted for 81-84% of employees at risk of exposure to occupational TB. Eighty-six and 181 cases of occupational TB were reported in the Slovak Republic and in the Czech Republic, respectively, in 1998-2012, with the incidence showing a downward trend in both countries. TB of the respiratory tract was reported most often (83.7% of the total of reported cases of occupational TB). As expected, more cases occurred in females than in males (1.9 times as many cases in females as in males in the Slovak Republic and three times as many cases in females as in males in the Czech Republic). The incidence of occupational TB was the highest in sector Q, with the highest absolute numbers reported in nurses. In 2012, the incidence rates of occupational TB were 0.22 cases per 100,000 sick benefit policy holders in the Slovak Republic and 0.13 cases per 100,000 sick benefit policy holders in the Czech Republic. CONCLUSION: The incidence of occupational TB has a downward trend in both countries, similarly to TB incidence in the general population. A negative aspect in both countries is the incidence of occupational TB at the middle productive age, in contrast to the population occupationally non-exposed to TB. Slovakia is surrounded by higher prevalence countries, with the exception of the Czech Republic. It cannot be ruled out that, in addition to the known factors influencing the prevalence of TB, including occupational TB, migration from eastern countries, including job search migration, can also play a role in increase in TB cases. It is vital to continue epidemiological surveillance and to reduce the risk of TB as much as possible also in healthcare settings by adhering to barrier nursing practices. Cases of active TB need early and adequately long, controlled treatment in order to reduce, among others, the incidence of multi-drug resistant TB.

The effect of the pulsatile electromagnetic field in patients suffering from chronic obstructive pulmonary disease and bronchial asthma.

Pulsatile electromagnetotherapy (PETh) stimulates biological tissues and processes; it modulates ion exchange across cell membranes and thus regulates the tone of smooth muscles. On the basis of these effects we hypothetized that PETh might treat COPD and bronchial asthma. We examined 117 (61 females, 56 males) adult patients who were decided in 4 groups. The 1st consisted of 16 patients with COPD who were treated by PETh and pharmacologically. The 2nd group (control) consisted of 24 patients with COPD who were treated only with medicaments. The 3rd group consisted of 37 asthmatics, treated by PETh and medicaments. The 4th group (control) consisted of 40 asthmatics treated only with medicaments. The effectiveness of PETh was assessed by lung function tests, which were performed using a Spirometer 100 Handi (Germany). We measured FVCex, FEV1, percentage of FEV1/FVCex, MEF25, 50, 75, PEF and registered the flow-volume loops. PETh was applied by apparatus MTU 500H (Therapy System, Czech Republic). It was administered 10 doses; once daily for 20 min, with a frequency of 4.5 Hz and a magnetic induction 3 T. The initial 3 doses were about 25% lower then the later doses. PETh was very effective in patients with COPD. The measured indexes improved about 200-660 ml or ml x s(-1), except FVC. PETh was less effective in asthmatics. Most indices improved without statistical significance, about 50-620 ml or ml x s(-1). The indices of FEV1/FVC and MEF25 deteriorated. The changes in controls without PETh were very small. (Tab. 2, Fig. 1, Ref. 19.)

Health status of workers of a thermal power station exposed for prolonged periods to arsenic and other elements from fuel.

The Nováky Power Station (NPS) has been using since 1953 as fuel coal with a high content of As and with a low content of other metals. This involves a constant risk for the workers as well as pollution of the surroundings. The authors described 16 cases of chronic As intoxication in NPS workers after 22.3 +/- 8.4 years of exposure (especially stokers, maintenance workers, boiler cleaners). Among clinical symptoms prevailed sensory and motor polyneuropathy (13 cases), pseudoneurasthenic syndrome (10 cases), toxic encephalopathy (6 cases) and nasal septum perforation (2 cases). After 1989 the intoxications with As did not occur any more due to technical measures and health protection of the workers. The authors present a review of actual results of clinical, haematological and biochemical investigations and tests for metals (AAS methods) in biological materials of workers at risk in NPS (n = 70), exposed on average for 11.9 +/- 0.5 years, of average age 35.91 +/- 1.7 years (mean +/- SE) and compared the results to a matched control group of blood donors not exposed to metals (n = 29). In NPS workers significantly lower Hb values, higher serum creatinine, higher serum beta 2-microglobulin, higher As content in hair as well as higher serum Mn and Pb concentrations compared with the C-group were found. The exposed group had significantly lower serum Se concentrations (0.64 +/- 0.025 mumol/l (mean +/- SE) compared to Se levels of persons from an adjacent district. The authors stress the necessity of individual evaluation of the metal concentrations in relation to clinical findings. With prolonged exposure the situation can become more urgent not only because of chronic poisoning but also because of the cancerogenic effects of these elements on the human organism.

Contribution to occupational angiopathy diagnosis using special examination method.

The authors presented 1642 cases of professional diseases caused by vibrations (VD) and 435 cases of extremity overload disease (EOD) diagnosed in the years 1974-1993. In addition to the standard rheoplethysmography there were evaluated the results of digital laser Doppler flowmetry (Moor instruments, UK) in 104 workers exposed to vibration (EV) and 25 controls with the age and smoking habit standardisation. In the selected subgroup were used continual measurements of digital blood pressure (Finapress, Ohmeda), digital LD flux and speed and the measuring of digital skin and central body temperature simultaneously. The records before and after 10 min of local cooling test (Rejsek method) and postocclusive hyperemic tests were summarized (computer evaluation, program STATGRAPHICS, T-test). Vasoconstriction to local cooling persisted in EV for longer time. The records of digital skin flux and speed, digital blood pressure reactions of EV were significantly different (EV/controls) also in the 10th min after cooling. Postocclusion hyperemic tests revealed good functional capacity also in EV. Advantages and disadvantages of methods were discussed. The results found by non-invasive methods in VD were in good relation to images obtained by means of radionuclides (clearance and cumulative tests). Cumulative tests (after 99m--pertechnetate i.v.) can be used in the selected differential diagnostic cases of angiopathies to help to distinguish degree of angiospastic and angioparalytic changes in the hands of VD, and also in special cases at angiopathies connected with EOD.

Content of the selected trace elements (Al, As, Cd, Cu, Fe, Hg, Mn, Ni, Pb, Zn) in blood, urine and hair of blood donors without occupational exposure to these metals.

The trace element content in biological samples from blood donors (BD) has not been studied in detail so far. In everyday practice minimum attention is paid to the occupational history of blood donors from different social strata. In addition to clinical and elementary haematological and biochemical examinations, the authors assessed levels of Al, As, Cd, Cr, Cu, Fe, Hg, Mn, Ni, Pb, and Zn using atomic absorption spectrophotometry (AAS) in two groups of BD--from the Orava (n = 19) and Prievidza region (n = 29). The examined blood donors were never exposed to the risk of metal exposure. No significant differences were found in age and smoking habits between the groups. In analyses electrothermic atomization (AAS-GTA) was mostly used. Hg in urine was assessed, using the technique of hydride vapour formation (VGA). Comparing the results of both BD groups, using Student's t-test, some significant differences between the two regions were found in As, Pb, Cr, Cd, Mn, Ni levels. The authors discuss the possible influence of artificial metal sources from the plants contaminating the environment of the regions for prolonged periods (power plant using coal containing As, metallurgy plant producing ferrochromium and ferromanganese alloys and lead metallurgy plant. Blood levels of metals in BD compared with control groups of the non-exposed population (data obtained from the literature) were within a similar or often lower range. In BD studied very low values of Hg in urine were found (0.015 +/- 0.004 mumol.l-1, 0.021 +/- 0.001 mumol.l-1 of urine -mean +/- SE) with the maximum recorded value of 1.0 mumol Pb.l-1 of blood.

Levels of selected elements (Fe, As, Cd, Pb, Zn, Mn) in biological samples from ferrochromium workers.

A long-term exposure to metals poses the question of whether the impaired health condition is caused exclusively by the quantitatively dominant exposure metal. In 67 workers exposed to ferrochromium alloys on average 12.5 +/- 1.09 years (mean +/- SE), the subgroups of ferrochromium workers and operators of dust removing equipment, average Cr values in urine were 0.233 +/- 0.032 mumol.l-1 (mean +/- SE). In the control group (K) the average Cr values were 0.034 +/- 0.004 mumol.l-1 of urine (mean +/- SE). The levels of plasmatic Fe were assessed photometrically; the levels of Fe, As, Cd, Pb, Mn and Zn in hair, urine and blood were assessed by atom-absorption spectrophotometry (Varian). The results were compared with the control group not significantly different in age (t-test). All the values were correlated with age, years of exposure and the number of cigarettes smoked during life. The values of the single selected metals in furnace workers and operators of dust removing devices were not higher than the limits set for the groups of workers exposed to metals. But compared to the original biological background, there was observed a significant Cd increase (hair, blood, urine) year by year. Average values of As, Pb, Fe, and Mn in hair of the exposed workers were also higher compared to the group K. As and Mn values in hair were increasing up with the years of exposure (r = 0.465, p < 0.05; r = 0.580, p < 0.001). No expected higher values of plasmatic Fe were found. Zn values in hair were falling down with the years of exposure as well as with age, in all groups including the group K. The authors discuss the possible causes of the quantitative changes in the selected metals in connection with professional exposure and non-professional effects (especially smoking). Higher cancer incidence of the organs affected has not been observed so far in the study plant. (Tab. 2, Fig. 8, Ref. 41.)

[The effect of extrarenal factors on certain functions of the kidney and urinary tract. A radionuclide study]. / Vplyv mimooblickových faktorov na niektoré funkcie obliciek a mocových ciest. Rádionuklidová stúdia.

The authors present their experiences concerning the effect of extrarenal factors on the results of radionuclide examination. Functional and functional-morphological examinations of the kidneys and urinary tract can be negatively affected particularly by emotional stress, orthostasis, dehydration, increased kidney motility, address administered drugs during examination (diuretics), drug treatment of the primary disease, muscular strain, cold, pain, increased pressure in the vicinity of the kidney, hypertension, hypotension, as well as further conditions. Radionuclide methods can objectify these processes, the given negative effects can however be presumed to occur also at other examination procedures of the kidney and urinary tract. The conditions of examinations have thus to be optimized and standardized. The examining physician has to know which drugs the patient is receiving and he has to know their effect on renal function.

[The effect of acetylsalicylic acid on some parameters of peripheral circulation in children (author's transl)]. / Der Einfluss von Azetylsalizylsäure auf einige Kennziffern der peripheren Zirkulation bei Kindern.

Acetylsalicylic acid in a single dose of 10 mg/kg orally affected the skin temperature of the hand of febrile and afebrile children. In the afebrile group the rise of skin temperature after 1 hour (p less than 0,05) and 2 hours (p less than 0.01) was not accompanied by significant change of the sublingual or axillar temperature. In the febrile group the rise of the skin temperature of the 3rd finger after 1 hour (p less than 0,001) and 2 hours (p less than 0.001) was accompanied by a significant decrease of the sublingual and axillar temperature and by a decrease of pulse rate. The changes were more pronounced after 1 hour after administration of the drug. Similarly, the acetylsalicylic acid enhanced the relative blood flow through the skin of the finger of hand.