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1.
Cent Eur J Public Health ; 28(1): 70-73, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32228821

RESUMO

OBJECTIVE: Hepatitis E infection is one of the most frequent acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in recent years. Therefore, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the general population in Eastern Slovakia. METHODS: Detection of anti-HEV total antibodies samples was done by a commercial enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: Of 175 hospitalized patients included in the study, 76 (43.5%) showed positivity for anti-HEV total antibodies. No statistically significant differences were found in anti-HEV positivity between men and women or in the groups of different living areas (town/village - urban/rural). CONCLUSION: Prevalence of anti-HEV total antibodies of hospitalised patients was high. The risk factor significantly associated with antibody positivity was eating raw meat. Other factors, such as sex, age, living area and contact with animals were not associated with antibody positivity.


Assuntos
Hepatite E/epidemiologia , Hospitalização/estatística & dados numéricos , Ensaio de Imunoadsorção Enzimática , Feminino , Anticorpos Anti-Hepatite/isolamento & purificação , Vírus da Hepatite E/imunologia , Humanos , Masculino , Fatores de Risco , Estudos Soroepidemiológicos , Eslováquia/epidemiologia
2.
Bratisl Lek Listy ; 121(2): 129-132, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115965

RESUMO

OBJECTIVES: We aimed to study the prevalence of the early onset Type 1 diabetes in Slovakia during the years 1996-2017. BACKGROUND: Prevalence of Type 1 diabetes in young children is increasing worldwide. However, recent data from Slovakia are missing. METHODS: All children with newly diagnosed Type 1 diabetes included in the study were diagnosed in the Children Diabetes Centre in Bratislava during the years 1996-2017. The incidence of T1D in children aged below 3 and below 5 years was calculated and compared to the T1D incidence in older children. Incidence trends were calculated with the Poissed regression. RESULTS: Gender-adjusted incidence of T1D annually increased by 5.4 % (CI: 3.9-6.8; p < 0.001) in children <3 years, and by 3.4 % (95 % CI 2.2-4.6; p<0.001) in children <5 years during the last two decades. Moreover, the proportion of young children <3 years of age among all newly diagnosed children and adolescents increased over time (4.2±2.8 % in years 1996-1998; 12.2±5.8 % in years 2004-2008, and 13.7±7.4 % during the years 2013-2017). CONCLUSION: We found a significant increase in the incidence and proportion of T1D in young children during the last two decades. Similar data were also found in other European countries. This could be explained by changing environmental conditions (Fig. 1, Ref. 32).


Assuntos
Diabetes Mellitus Tipo 1 , Adolescente , Idoso , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/epidemiologia , Europa (Continente) , Humanos , Incidência , Lactente , Prevalência , Eslováquia/epidemiologia
3.
Int J Infect Dis ; 90: 111-115, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31707136

RESUMO

AIM: To obtain standardized epidemiological data for Clostridium difficile infection (CDI) in Slovakia. METHODS: Between October and December 2016, 36 hospitals in Slovakia used the European Centre for Disease Prevention and Control (ECDC) Clostridium difficile infection (CDI) surveillance protocol. RESULTS: The overall mean CDI incidence density was 2.8 (95% confidence interval 1.9-3.9) cases per 10 000 patient-days. Of 332 CDI cases, 273 (84.9%) were healthcare-associated, 45 (15.1%) were community-associated, and 14 (4.2%) were cases of recurrent CDI. A complicated course of CDI was reported in 14.8% of cases (n=51). CDI outcome data were available for 95.5% of cases (n=317). Of the 35 patients (11.1%) who died, 34 did so within 30 days after their CDI diagnosis. Of the 78 isolates obtained from 12 hospitals, 46 belonged to PCR ribotype 001 (59.0%; 11 hospitals) and 23 belonged to ribotype 176 (29.5%; six hospitals). A total of 73 isolates (93.6%) showed reduced susceptibility to moxifloxacin (ribotypes 001 and 176; p< 0.01). A reduced susceptibility to metronidazole was observed in 13 isolates that subsequently proved to be metronidazole-susceptible when, after thawing, they were retested using the agar dilution method. No reduced susceptibility to vancomycin was found. CONCLUSIONS: These results show the emergence of C. difficile ribotypes 027 and 176 with a predominance of ribotype 001 in Slovakia in 2016. Given that an almost homogeneous reduced susceptibility to moxifloxacin was detected in C. difficile isolates, this stresses the importance of reducing fluoroquinolone prescriptions in Slovak healthcare settings.


Assuntos
Infecções por Clostridium/epidemiologia , Infecções por Clostridium/microbiologia , Clostridium difficile/classificação , Adolescente , Idoso , Antibacterianos/farmacologia , Clostridium difficile/efeitos dos fármacos , Clostridium difficile/genética , Clostridium difficile/isolamento & purificação , Feminino , Humanos , Incidência , Lactente , Masculino , Moxifloxacina/farmacologia , Ribotipagem , Eslováquia/epidemiologia
4.
Physiol Res ; 68(Suppl 2): S157-S163, 2019 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-31842579

RESUMO

Drug-induced liver injury (DILI) is a common event in patients with rheumatic diseases (RD) on biological therapy (BT). We aimed at evaluating the prevalence and pattern of DILI. Consecutive RD patients treated with BT were followed for 6 months. ALT and ALP >the upper limit normal (ULN) and 3xULN injury Grade 2. 582 liver function tests (LFTs) in 199 patients were evaluated, median age 53y, 59.3 % females, RA in 108, AS 49, and PsA 42 patients. ALT Grade 1 elevation was observed in 25.6 %, transient in 18.6 %, persisting in 7 %, Grade 2 in 1.5 %, ALP Grade 1 in 3.5 %, transient in 2 %, persisting in 1.5 %. We report no case of ALP Grade 2 or Hy´s law (ALT>3xULN, bilirubin>2xULN). Patients with persisting ALT elevation had higher BMI (28.23 vs. 25.74, p=0.016), lower DAS28 (2.22 vs. 5.28, p=0.046). ALT Grade 1 injury was more frequent with solo tocilizumab compared with other agents (27.5 % vs. 13.6 %, p=0.01). DILI was frequent, in 18.6 % transient, in 7 % persisting, Grade 2 in 1.5 %, led to treatment alteration in 0.5 %, with higher prevalence on solo tocilizumab therapy. We report no new safety signals for BT in RD.


Assuntos
Terapia Biológica/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Doenças Reumáticas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Eslováquia/epidemiologia , Adulto Jovem
5.
Physiol Res ; 68(Suppl 2): S173-S182, 2019 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-31842581

RESUMO

Cholelithiasis is more common in patients with Crohn's disease (CD) than in the healthy population. The aim here was to examine risk factors for cholelithiasis in a cohort of CD patients and to compare the prevalence of cholelithiasis in a cohort of CD patients with that in a control group. This was a single-center retrospective case-control study. The cohort comprised all consecutive CD patients who underwent abdominal ultrasound from January 2007 to January 2018. The control group comprised age- and gender-matched non-CD patients referred for upper gastrointestinal tract dyspepsia. The study included 238 CD patients and 238 controls. The prevalence of cholelithiasis in the CD and control groups was 12.6 % and 9.2 %, respectively (risk ratio (RR), 1.36; p=0.24). Univariate analysis revealed that cholelithiasis was associated with multiple risk factors. Multivariate analysis identified age (OR, 1.077; 95 % CI, 1.043-1.112; p<0.001) and receipt of parenteral nutrition (OR, 1.812; 95 % CI, 1.131-2.903; p=0.013) as independent risk factors for cholelithiasis in CD patients. The prevalence of cholelithiasis in CD patients was higher than that in the control group; however, the difference was not statistically significant. Age and receipt of parenteral nutrition were independent risk factors for cholelithiasis in CD patients.


Assuntos
Colelitíase/epidemiologia , Doença de Crohn/complicações , Adulto , Colelitíase/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Eslováquia/epidemiologia
6.
PLoS Med ; 16(11): e1002962, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31714909

RESUMO

BACKGROUND: Amniotic fluid embolism (AFE) remains one of the principal reported causes of direct maternal mortality in high-income countries. However, obtaining robust information about the condition is challenging because of its rarity and its difficulty to diagnose. This study aimed to pool data from multiple countries in order to describe risk factors, management, and outcomes of AFE and to explore the impact on the findings of considering United Kingdom, international, and United States AFE case definitions. METHODS AND FINDINGS: A population-based cohort and nested case-control study was conducted using the International Network of Obstetric Survey Systems (INOSS). Secondary data on women with AFE (n = 99-218, depending on case definition) collected prospectively in population-based studies conducted in Australia, France, the Netherlands, Slovakia, and the UK were pooled along with secondary data on a sample of control women (n = 4,938) collected in Australia and the UK. Risk factors for AFE were investigated by comparing the women with AFE in Australia and the UK with the control women identified in these countries using logistic regression. Factors associated with poor maternal outcomes (fatality and composite of fatality or permanent neurological injury) amongst women with AFE from each of the countries were investigated using logistic regression or Wilcoxon rank-sum test. The estimated incidence of AFE ranged from 0.8-1.8 per 100,000 maternities, and the proportion of women with AFE who died or had permanent neurological injury ranged from 30%-41%, depending on the case definition. However, applying different case definitions did not materially alter findings regarding risk factors for AFE and factors associated with poor maternal outcomes amongst women with AFE. Using the most liberal case definition (UK) and adjusting for the severity of presentation when appropriate, women who died were more likely than those who survived to present with cardiac arrest (89% versus 40%, adjusted odds ratio [aOR] 10.58, 95% confidence interval [CI] 3.93-28.48, p < 0.001) and less likely to have a source of concentrated fibrinogen (40% versus 56%, aOR 0.44, 95% CI 0.21-0.92, p = 0.029) or platelets given (24% versus 49%, aOR 0.23, 95% CI 0.10-0.52, p < 0.001). They also had a lower dose of tranexamic acid (median dose 0.7 g versus 2 g, p = 0.035) and were less likely to have had an obstetrician and/or anaesthetist present at the time of the AFE (61% versus 75%, aOR 0.38, 95% CI 0.16-0.90, p = 0.027). Limitations of the study include limited statistical power to examine factors associated with poor maternal outcome and the potential for residual confounding or confounding by indication. CONCLUSIONS: The findings of our study suggest that when an AFE is suspected, initial supportive obstetric care is important, but having an obstetrician and/or anaesthetist present at the time of the AFE event and use of interventions to correct coagulopathy, including the administration of an adequate dose of tranexamic acid, may be important to improve maternal outcome. Future research should focus on early detection of the coagulation deficiencies seen in AFE alongside the role of tranexamic acid and other coagulopathy management strategies.


Assuntos
Embolia Amniótica/etiologia , Embolia Amniótica/terapia , Adulto , Austrália/epidemiologia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , França/epidemiologia , Humanos , Incidência , Modelos Logísticos , Mortalidade Materna/tendências , Países Baixos/epidemiologia , Razão de Chances , Gravidez , Fatores de Risco , Eslováquia/epidemiologia , Inquéritos e Questionários , Ácido Tranexâmico/uso terapêutico , Resultado do Tratamento , Reino Unido/epidemiologia
7.
Lancet ; 394(10209): 1629-1637, 2019 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-31570255

RESUMO

BACKGROUND: Near-infrared spectroscopy (NIRS) intravascular ultrasound imaging can detect lipid-rich plaques (LRPs). LRPs are associated with acute coronary syndromes or myocardial infarction, which can result in revascularisation or cardiac death. In this study, we aimed to establish the relationship between LRPs detected by NIRS-intravascular ultrasound imaging at unstented sites and subsequent coronary events from new culprit lesions. METHODS: In this prospective, cohort study (LRP), patients from 44 medical centres were enrolled in Italy, Latvia, Netherlands, Slovakia, UK, and the USA. Patients with suspected coronary artery disease who underwent cardiac catheterisation with possible ad hoc percutaneous coronary intervention were eligible to be enrolled. Enrolled patients underwent scanning of non-culprit segments using NIRS-intravascular ultrasound imaging. The study had two hierarchal primary hypotheses, patient and plaque, each testing the association between maximum 4 mm Lipid Core Burden Index (maxLCBI4mm) and non-culprit major adverse cardiovascular events (NC-MACE). Enrolled patients with large LRPs (≥250 maxLCBI4mm) and a randomly selected half of patients with small LRPs (<250 maxLCBI4mm) were followed up for 24 months. This study is registered with ClinicalTrials.gov, NCT02033694. FINDINGS: Between Feb 21, 2014, and March 30, 2016, 1563 patients were enrolled. NIRS-intravascular ultrasound device-related events were seen in six (0·4%) patients. 1271 patients (mean age 64 years, SD 10, 883 [69%] men, 388 [31%]women) with analysable maxLCBI4mm were allocated to follow-up. The 2-year cumulative incidence of NC-MACE was 9% (n=103). Both hierarchical primary hypotheses were met. On a patient level, the unadjusted hazard ratio (HR) for NC-MACE was 1·21 (95% CI 1·09-1·35; p=0·0004) for each 100-unit increase maxLCBI4mm) and adjusted HR 1·18 (1·05-1·32; p=0·0043). In patients with a maxLCBI4mm more than 400, the unadjusted HR for NC-MACE was 2·18 (1·48-3·22; p<0·0001) and adjusted HR was 1·89 (1·26-2·83; p=0·0021). At the plaque level, the unadjusted HR was 1·45 (1·30-1·60; p<0·0001) for each 100-unit increase in maxLCBI4mm. For segments with a maxLCBI4mm more than 400, the unadjusted HR for NC-MACE was 4·22 (2·39-7·45; p<0·0001) and adjusted HR was 3·39 (1·85-6·20; p<0·0001). INTERPRETATION: NIRS imaging of non-obstructive territories in patients undergoing cardiac catheterisation and possible percutaneous coronary intervention was safe and can aid in identifying patients and segments at higher risk for subsequent NC-MACE. NIRS-intravascular ultrasound imaging adds to the armamentarium as the first diagnostic tool able to detect vulnerable patients and plaques in clinical practice. FUNDING: Infraredx.


Assuntos
Síndrome Coronariana Aguda/etiologia , Placa Aterosclerótica/diagnóstico por imagem , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Ultrassonografia de Intervenção/métodos , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/cirurgia , Idoso , Cateterismo Cardíaco/métodos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Morte , Feminino , Humanos , Itália/epidemiologia , Letônia/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/cirurgia , Países Baixos/epidemiologia , Intervenção Coronária Percutânea/métodos , Placa Aterosclerótica/complicações , Placa Aterosclerótica/patologia , Eslováquia/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
8.
Rev Bras Parasitol Vet ; 29(1): e014319, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576975

RESUMO

The role of rodents as reservoirs of helminths of public health importance is not well known. The zoonotic potential of Syphacia spp. has been confirmed; therefore, the study aimed to estimate the occurrence of oxyurid nematodes in small rodents from pet shops and breeding clubs in Slovakia. Fecal samples of 586 pet rodents kept in 133 cages were collected between 2016 and 2018 and examined by Faust´s flotation method. Four species of oxyurid nematodes, Syphacia muris, S. obvelata, Aspiculuris tetraptera and Paraspidodera uncinata were detected. A. tetraptera was found in the faecal samples of all rodent species included in this survey. The number of positive boxes varied from 5.4% in hamsters to 70.0% with mice. The prevalence of Syphacia muris was highest in Mongolian gerbils where up to 75.0% boxes were positive; S. obvelata was found in 26.7% of boxes with mice, 25.0% of boxes with Mongolian gerbils and 3.2% of boxes with rats. The high prevalence of Syphacia spp. in all animal species points out the infection risk for humans. Animals offered for sale are often in close contact with human beings; therefore they should be regularly tested for parasites and then effectively dewormed.


Assuntos
Fezes/parasitologia , Doenças Negligenciadas/veterinária , Oxiuríase/veterinária , Oxyuroidea/isolamento & purificação , Animais de Estimação/parasitologia , Doenças dos Roedores/parasitologia , Animais , Cricetinae/parasitologia , Gerbillinae/parasitologia , Cobaias/parasitologia , Camundongos/parasitologia , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/epidemiologia , Oxiuríase/diagnóstico , Oxiuríase/epidemiologia , Oxyuroidea/classificação , Animais de Estimação/classificação , Prevalência , Ratos/parasitologia , Doenças dos Roedores/diagnóstico , Doenças dos Roedores/epidemiologia , Eslováquia/epidemiologia
9.
Bratisl Lek Listy ; 120(9): 695-698, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31475557

RESUMO

OBJECTIVES: The objective of the study was to evaluate prevalence of depression and anxiety among college students studying at Comenius University in Bratislava. The secondary aim was to evaluate the impact of depression and anxiety on various domains of social functioning. METHODS: The data were collected through a cross-sectional online survey. The sample consisted of 1,331 students. We administered scales measuring the depression, anxiety, satisfaction with life, and social functioning as part of a larger survey. RESULTS: When using a customary cut­off score for PHQ-9 and GAD-7, a proportion of 35.5 % and 25.5 % of students were above the threshold for depression and anxiety, respectively. When using more stringent criteria, the prevalence rates for depression and anxiety were 16.4 % and 9.3 %, respectively. Both conditions co­occur in 6.8 % of students. Symptom domains were related to satisfaction with life and social functioning. CONCLUSION: Depression and anxiety are prevalent among college students. We found that symptoms of mood and anxiety disorders were associated with lower satisfaction with life and lower level of functioning at school as well as in social and family lives. The implications for mental health policies at universities are discussed (Tab. 2, Ref. 27).


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Estudos Transversais , Humanos , Transtornos do Humor/epidemiologia , Satisfação Pessoal , Prevalência , Eslováquia/epidemiologia , Estudantes , Universidades
10.
Artigo em Inglês | MEDLINE | ID: mdl-31412549

RESUMO

Increasing employment opportunities for segregated Roma might prevent major economic losses and improve their health. Involvement of the private sector in Roma employment, on top of intensified governmental actions, is likely to be a key to sustainable improvement, but evidence on this is scarce. Our aim was to determine the potential outcomes of such a partnership regarding increased employability and the resulting improved well-being and health. We therefore investigated a Roma employment project called Equality of Opportunity, run since 2002 by a private company, U.S. Steel Kosice, in eastern Slovakia. We conducted a multi-perspective qualitative study to obtain the perspectives of key stakeholders on the outcomes of this project. We found that they expected the employability of segregated Roma to increase in particular via improvements in their work ethic and working habits, education, skills acquisition, self-confidence, courage and social inclusion. They further expected as the main health effects of increased employability an improvement in Roma well-being and health via a stable income, better housing, crime reduction, improved hygienic standards, access to prevention and improved mental resilience. Social policies regarding segregated Roma could thus be best directed at increasing employment and at these topics in particular to increase their effects on Roma health.


Assuntos
Emprego/estatística & dados numéricos , Promoção da Saúde/métodos , Parcerias Público-Privadas/estatística & dados numéricos , Roma , Segregação Social/psicologia , Adulto , Emprego/psicologia , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Roma/psicologia , Roma/estatística & dados numéricos , Eslováquia/epidemiologia , Determinantes Sociais da Saúde
11.
Vet Ital ; 55(2): 169-172, 2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31274179

RESUMO

The purpose of this study was to examine the prevalence of antimicrobial resistance among 180 Escherichia coli strains isolated from 200 wild pheasants caught in rural areas of the Czech Republic (Eastern Moravia) and Slovakia (Western Region). The isolates were also classified into phylogenetic groups by the multiplex PCR method. Our findings demonstrated that 130 strains were resistant to ampicillin (72%), 160 strains to cephalothin (89%), and 40 strains to tetracycline (22%). Ten strains were found to be resistant to chloramphenicol and sulfamethoxazole/trimethoprim (5.6%). In turn, all strains were sensitive to cefoperazone/sulbactam, ciprofloxacin, colistin, gentamicin, and piperacillin/tazobactam. Ten of the 180 isolates (5.6%) exhibited multi-resistant phenotypes, including resistances against beta-lactams, aminoglycosides, tetracyclines, sulphonamides, and chloramphenicol. As far as we know, this is the first report describing antimicrobial resistance in E. coli from pheasants.


Assuntos
Doenças das Aves/epidemiologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/veterinária , Escherichia coli/efeitos dos fármacos , Galliformes , Animais , Antibacterianos/farmacologia , Doenças das Aves/microbiologia , República Tcheca/epidemiologia , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Prevalência , Eslováquia/epidemiologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-31336849

RESUMO

BACKGROUND: Oral health strongly affects overall health and is related to many factors. The aim of our study was to analyse oral health related behaviours (OHRBs) and gum bleeding among Slovak adolescents and assess the effect of socioeconomic factors on the outcomes. METHODS: Data from the Health Behaviour in School-aged Children study (HBSC) were used (N = 8896, age range = 10-16 years, M = 13.4; SD = 1.4; 50.9% boys). Sociodemographic and socioeconomic indicators and frequency of OHRBs (dental hygiene, toothbrush changing, preventive check-up) and gum bleeding were collected. Effects of sociodemographic and socioeconomic variables on outcome variables were analysed by binary logistic regression. RESULTS: We found that prevalence of OHRBs slightly decreases with age, and worse outcomes were reported by boys compared to girls (OHRB odds ratio range 0.45-0.75, (95% C.I. range 0.40-0.91), gum bleeding 1.38 (95% C.I. 1.19-1.61), p < 0.05). OHRBs were in most cases significantly associated with socioeconomic variables, lower affluence predicts worse outcomes (odds ratio range 0.76-0.88 (95% C.I. range 0.68-0.96), p < 0.05). CONCLUSION: Our study provides representative findings on ORHBs in Slovakia and shows important associations of socioeconomic factors related to adolescents' oral health issues.


Assuntos
Comportamentos Relacionados com a Saúde , Saúde Bucal , Higiene Bucal/estatística & dados numéricos , Autorrelato , Escovação Dentária , Adolescente , Comportamento do Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Prevalência , Instituições Acadêmicas , Eslováquia/epidemiologia , Classe Social , Fatores Socioeconômicos
13.
Ceska Gynekol ; 84(2): 129-139, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31238683

RESUMO

OBJECTIVE: Analysis of maternal morbidity and mortality in Slovak Republic in the years 2007-2015. DESIGN: Prospective epidemiological perinatological nation-wide. SETTINGS: 1st Department of Gynaecology and Obstetrics Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. METHODS: The analysis of selected maternal morbidity and mortality data prospective collected in the years 2007-2015. RESULTS: Cesarean section rate progressively increased from 24.1% in the year 2007 up to 30.8% in the year 2013 and up to year 2015 decreased to 30.2%. Vacuum-extraction frequency was 1.3% in the year 2007 and to the year 2015 increased up to 1.6%. Forceps frequency was the same in the year 2007 and 2015: 0.6%. In the years 2008-2015 frequency of perineal tears 3th and 4th degree increased from 0.44% to 0.68% and frequency of episiotomies decreased from 74.7% to 57.2%. In the years 2012-2015 incidence of total severe acute maternal morbidity per 1,000 births was 5.85, peripartum hysterectomy 0.78, severe postpartum bleeding 2.03, transport to anaesthesiology department/intensive care unit 1.26, eclampsia 0.2, HELLP syndrome 0.6, abnormal placental invasion 0.38, uterine rupture 0.45, severe sepsis in pregnancy and puerperium 0.14 and frequency of nonfatal amniotic fluid embolism was 2/100,000 maternities. Total maternal mortality ratio in this period was 11.5 and pregnancy-related deaths ratio 9.9 per 100,000 live births. CONCLUSION: The highest cesarean section rate in Slovakia, 30.8 %, was in the year 2013, but in the next years slowly decreased. Frequency of episiotomies decreased in followed period too. Incidence of severe acute maternal morbidity was 5.85 per 1,000 births. Maternal mortality ratio in Slovakia was one of the highest in European Union and not corresponding with good level of perinatal mortality. Improving of cesarean section rate and episiotomy, incidence of severe acute maternal morbidity and maternal mortality still need to be improved in Slovak Republic.


Assuntos
Cesárea/estatística & dados numéricos , Eclampsia/epidemiologia , Histerectomia/estatística & dados numéricos , Mortalidade Materna , Ruptura Uterina/epidemiologia , Adulto , Episiotomia/estatística & dados numéricos , Feminino , Humanos , Incidência , Morbidade , Mortalidade Perinatal , Períneo/lesões , Período Pós-Parto , Gravidez , Estudos Prospectivos , Eslováquia/epidemiologia , Vácuo-Extração/estatística & dados numéricos
14.
Ann Agric Environ Med ; 26(2): 217-221, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31232048

RESUMO

INTRODUCTION AND OBJECTIVE: The incidence of Lyme borreliosis (LB) is increasing in many countries in Europe, including Poland and Slovakia. The aim of the study was to analyze the exposure to tick bites and undertaking LB prevention activities among students of medical fields of studies in Poland (PL) and Slovakia (SK). MATERIAL AND METHODS: The study was conducted among 611 students from Poland (296 students) and Slovakia (315 students). The applied research tool was the questionnaire. It consisted of questions about exposure to ticks (occurrence of an episode of tick bites, bite site, methods used for tick removal) and the frequency of undertaking preventive actions (using repellents, checking the body after returning from green areas). Pearson Chi-square statistics were calculated to assess significant differences between students from the study countries PL/SK and gender in each country. RESULTS: Among surveyed students the episode of a tick bite was reported by 352 persons (57.6%). Students from PL most frequently removed ticks with tweezers with a swift, steady movement (26.6%), while students from SK removed the tick by applying a fatty substance so that it would come off by itself (30.1%). Most of the surveyed students, being outdoors, did not apply ticks repellents (34.7%) or used them rarely (48.9%). At the same time, 49.4% of students stated that they always checked the body to search for any attached tick after returning from green areas. CONCLUSIONS: Considering the fact that the surveyed people were the students of medical fields of studies, and in the future became qualified medical personnel, the frequency of using the analyzed methods of prophylaxis of LB appears to be too small. The results obtained can help in the education of students of medical fields.


Assuntos
Doença de Lyme/prevenção & controle , Picadas de Carrapatos/prevenção & controle , Adulto , Animais , Feminino , Humanos , Incidência , Doença de Lyme/epidemiologia , Masculino , Polônia , Eslováquia/epidemiologia , Estudantes/estatística & dados numéricos , Picadas de Carrapatos/epidemiologia , Carrapatos/fisiologia , Adulto Jovem
15.
Eur J Pediatr ; 178(8): 1243-1253, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31203446

RESUMO

In contrast to the dichotomous classification of metabolic syndrome, continuous metabolic syndrome scores enable to assess cardiometabolic burden in metabolic syndrome-free individuals. Using receiver operating characteristics analysis, discrimination power of continuous metabolic syndrome score calculated from population-based Z-scores or individual measures corrected to the accepted international standards for presence/absence of metabolic syndrome was assessed. Calculated cutoff values were used to estimate the proportions of metabolic syndrome-free subjects presenting high cardiometabolic risk. Clinical data were collected from 2331 (52% females) 16- to 20-year-old subjects. Receiver operating characteristics analyses showed an acceptable performance of both scores to classify metabolic syndrome presence: area under the curve (97-98%), sensitivity (95-100%), and specificity (86-96%). Compared with the prevalence of metabolic syndrome, proportions of metabolic syndrome-free subjects on high cardiometabolic risk, e.g., presenting continuous scores ≥ cutoff points, were about 3-fold higher in males, and 4-fold higher in females. Both scores correlated significantly with markers of cardiometabolic risk.Conclusion: Continuous cardiometabolic syndrome scores are practical tools to evaluate cardiometabolic risk in subjects not presenting metabolic syndrome. Accuracy, simplicity, and ability to classify metabolic syndrome-free subjects on high cardiometabolic risk make continuous metabolic syndrome score derived from international standards convenient for use in research and clinical practice. What is Known: • Dichotomous classification of metabolic syndrome is simple but not suitable for assessment of cardiometabolic burden in metabolic syndrome-free subjects. This prompted implementation of continuous scores, which are generally sample-specific. Score based on internationally accepted standards allows for comparison between populations and studies. • The performance of different continuous metabolic syndrome scores to assess the prevalence of metabolic syndrome-free subjects presenting high cardiometabolic burden has not been compared yet. What is New: • We compared the discrimination power of sample-specific Z-score-derived continuous metabolic syndrome score and that calculated based on internationally accepted standards for presence or absence of metabolic syndrome in young subjects. • The prevalence of metabolic syndrome-free subjects presenting high cardiometabolic risk was estimated using the cutoff points of continuous metabolic syndrome scores derived from the analyses of receiver operating characteristic curves.


Assuntos
Doenças Cardiovasculares/diagnóstico , Síndrome Metabólica/diagnóstico , Índice de Gravidade de Doença , Adolescente , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Prevalência , Curva ROC , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Eslováquia/epidemiologia , Adulto Jovem
16.
J Physiol Pharmacol ; 70(1)2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31172969

RESUMO

The incidence of tuberculosis (TB) in some countries increases continuously, especially caused by mycobacterial strains resistant to various anti-tuberculotic drugs (AT). The emergence and spread of drug-resistant tuberculosis (multidrug-resistant - MDR-TB, and extensively drug-resistant - XDR-TB) suggest the crucial role of pharmacotherapy protocol tailored to the respective patient with MDR-TB or XDR-TB (a personalized approach) and requirements for fast and precise diagnostics of the degree of resistance. The aim of this study was to characterize a molecular basis of resistance to AT, and to identify the presence of the resistance using conventional susceptibility testing and molecular genetic methods using PCR tests in Slovakia during years 2009 - 2017. Furthermore, we focused on evaluation of the relationship between the level of resistance, the clinical status, and some laboratory markers of patients with drug-resistant TB. Totally 1157 strains isolated from patients in 2009 - 2017 were tested for resistance using classical methods and in resistant strains, the molecular-genetic tests were performed. Increased incidence of recurrence, prolonged time required to culture conversion, increased mortality during treatment, plasma C-reactive protein concentrations and sedimentation rate, broader spectrum of AT used, as well as higher incidence of adverse effects (sufficiently controlled with symptomatic treatment) were observed with higher degree of resistance. Contrary, the number of patients who achieved remission decreased. Rapid and precise identification of MDR-TB or XDR-TB strains using both classical and molecular-genetic testing is an essential tool for personalized drug treatment and prevention of resistance spread and worsening. Both tests should be used for correct diagnosis of resistant TB. Higher level of resistance required more aggressive therapeutic approach, associated with adverse effects and prolongation of the culture conversion time, as well as increased risk of relapse. Effective pharmacotherapy led to significant decrease of CRP levels in all groups of patients. The most frequent adverse effects of ATs - impairment of liver and kidney functions - were effectively managed by symptomatic treatment.


Assuntos
Farmacorresistência Bacteriana Múltipla/genética , Mycobacterium tuberculosis/genética , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Adulto , Antituberculosos/farmacologia , Antituberculosos/uso terapêutico , DNA Bacteriano/análise , Humanos , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/isolamento & purificação , Fenótipo , Eslováquia/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
17.
J Laryngol Otol ; 133(5): 430-435, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31006395

RESUMO

OBJECTIVE: This study aimed to determine the incidence of metastatic squamous cell carcinoma in patients with an isolated cervical cystic mass, and to describe the clinical features that might predict the origin of cystic tumours. METHOD: Adult patients with isolated lateral cervical cystic masses who were scheduled for surgery from 1st January 2010 to 31st August 2016 in two tertiary care referral centres in Slovakia were analysed retrospectively. RESULTS: The incidence of cystic metastases in the whole cohort and in patients aged over 40 years were 9.9 per cent and 18.5 per cent, respectively. The incidence in patients aged over 40 years (18.5 per cent) was statistically significant (p = 0.003). CONCLUSION: The incidence of cystic squamous cell carcinoma metastases in lateral cervical cysts in patients aged over 40 years is high enough to call for excisional biopsy with frozen section, panendoscopy with direct biopsies, tonsillectomy and even neck dissection in cases of histologically confirmed carcinoma.


Assuntos
Cistos/patologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Pescoço/patologia , Lesões Pré-Cancerosas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Eslováquia/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-30999607

RESUMO

Environmental health is among the priority areas of public health, and the current professional communities are intensively engaged with it. The main objective of the study is to quantify regional disparities of preventable mortality in Slovakia and to study the extent of the influence of selected environmental factors on changes in the development of its values. A cross-sectional linear regression model is used to quantify effects of environmental factors on the preventable mortality. Also, cluster analysis is used to identify regions with similar levels of air pollution. Environmental factors were selected based on the study of the World Health Organization. From the point of view of the influence of environmental factors on preventable mortality in the case of men, statistically significant connection to sewerage, SO2 production, and production of particulate matter was demonstrated. In the case of women, equally important factors showed connection to sewerage and SO2. The results of this study point to significant regional disparities in preventable mortality and a different degree of impact of environmental factors. Preventable mortality is above the Slovak average in most of the least-developed districts. Even in this group, there are significant differences.


Assuntos
Mortalidade , Material Particulado/toxicidade , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Saúde Pública , Eslováquia/epidemiologia , Organização Mundial da Saúde
19.
J Neuroimmunol ; 330: 123-129, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-30875612

RESUMO

In this study, we analysed the association of rs703842 in CYP27B1 gene with multiple sclerosis (MS) risk and disability progression in a group of 496 MS patients and 521 controls. For the first time in Central European Slovak population, we found the rs703842 allele C to be protective factor against MS development (p = 1.09 × 10-5). Moreover, the risky genotypes TT and TC were showed to be associated with an increased MS risk, and this was aggravated by the homozygous carriage of the HLA-DRB1*15:01 allele (OR = 2.82 vs. 4.86, p < .0001). No association of rs703842 with MS disability progression or calcidiol serum level was found.


Assuntos
25-Hidroxivitamina D3 1-alfa-Hidroxilase/genética , Alelos , Predisposição Genética para Doença/genética , Variação Genética/genética , Cadeias HLA-DRB1/genética , Esclerose Múltipla/genética , Adulto , Feminino , Estudos de Associação Genética/métodos , Predisposição Genética para Doença/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/epidemiologia , Eslováquia/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-30621086

RESUMO

The aim of the paper is to analyse the effect of key factors affecting the risk of workplace injuries and to identify the most common workplace accidents regarding injured body parts with respect to anthropometric data measurements of the population. Data associated with workplace accidents over the years 2000⁻2016 were drawn from the records of the state enterprise Forests of the Slovak Republic, situated in Banská Bystrica. Gathered data were processed and entered into the database complemented by the data on accidents of the self-employed working in the forestry industry. A total of 1874 workplace accidents in the state enterprise were recorded and statistically evaluated during the analysis period. A method for contingency table was used to analyse correlation between qualitative (categorical) variables in the dataset. A Poisson regression model was used to determine the injury rate. Forest harvesting is considered the most risky phase of the process of harvesting, processing, and transport. The highest number of workplace accidents (31.8% of all recorded workplace accidents) occurred during the forest harvesting phase during the analysis period. Timber skidding, with 16% of recorded accidents, was the second highest-risk phase. The workplace injury rate in the forest industry in Slovakia decreased over the course of the years 2000⁻2016. Head and facial injuries were those with the highest rate (67.1% injuries of these body parts) during the phase of harvesting and skidding.


Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Agricultura Florestal/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Local de Trabalho/estatística & dados numéricos , Adulto , Pesos e Medidas Corporais , Bases de Dados Factuais , Humanos , Masculino , Pessoa de Meia-Idade , Eslováquia/epidemiologia
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