Prenatal exposure to polycyclic aromatic hydrocarbons and growth parameters.

BACKGROUND AND OBJECTIVES: It has long been known that airborne polycyclic aromatic hydrocarbons (PAHs) can negatively affect pregnancy and birth outcomes, such as birth weight, fetal development, and placental growth factors. However, similar studies yield divergent results. Our goal was to estimate the amount of monohydroxylated PAH (OH-PAH) metabolites in the urine of pregnant women/mothers and their newborns in relation to birth outcomes, such as placenta weight, Apgar 5', and the growth parameters of children up to the age of two. METHODS: Two cohorts of children born in 2013 and 2014 during the summer and winter seasons in the Czech Republic in the cities Karviná (N = 144) and Ceské Budejovice (N = 198), which differ significantly in the level of air pollution, were studied. PAH exposure was assessed by the concentration of benzo[a]pyrene (B[a]P) in the air and the concentration of 11 OH-PAH metabolites in the urine of newborns and mothers. Growth parameters and birth outcomes were obtained from medical questionnaires after birth and from pediatric questionnaires during the following 24 months of the child's life. RESULTS: Concentrations of B[a]P were significantly higher in Karviná (p < 0.001). OH-PAH metabolites were significantly higher in the mothers' as well as in the newborns' urine in Karviná and during the winter season. Neonatal length was shorter in newborns in Karviná (p < 0.001), but this difference evened out during the next 3 to 24 months. Compared to Ceské Budejovice, newborns in Karviná showed significantly lower weight gain between birth and three months after delivery. The OH-PAH metabolites in mothers' or newborns' urine did not affect birth weight. The presence of seven OH-PAH (top 25% of values of concentrations higher than the median) metabolites in the newborns' urine is associated with decreased length of newborn. Nine OH-PAH metabolites decreased placenta weight, which was the most significant, while seven OH-PAH metabolites decreased Apgar 5'. CONCLUSION: We have shown a possible connection between higher concentration of OH-PAH metabolites in newborns' urine and decreased length, head circumference, placenta weight, and Apgar 5', but not birth weight.

Sentinel lymph node mapping in endometrial cancer - robotic vs. laparoscopic detection system.

OBJECTIVE: Comparison of systems to detect sentinel lymph node in endometrial carcinoma using indocyanine green. Robotic Firefly Da Vinci fluorescence imaging system (Intuitive Surgical Inc., Sunnyvale, CA, USA) vs. laparoscopic Novadaq Pinpoint near-infrared imaging system (Novadaq, Ontario, Canada). MATERIAL AND METHOD: Fifteen patients with stage I endometrial cancer underwent sentinel lymph node biopsy after intracervical application of indocyanine green. For all of them, the detection was performed sequentially using both evaluated devices. The detection rate, identification match and extent of imaging of the lymphatic system were evaluated. RESULTS: The detection rate of both systems verified on a set of patients was identical, the detected sentinel nodes were identical, and the lymphatic system was shown to the same extent. The quality of the display and overall user-friendliness is different due to the applied technologies. CONCLUSION: Both systems used in minimally invasive surgery provide excelent perioperative imaging of the lymphatic system.

Cervical tuberculosis in a postmenopausal patient.

OBJECTIVE: Description of a case of extrapulmonary genital tuberculosis of the uterine cervix in a postmenopausal patient. CASE REPORT: A 66-year-old patient with a history of metrorrhagia, an ulcerated process in the area of the uterine cervix and vagina, with infiltration of parametria, serosanguinolent discharge and progressive cachectization was admitted to the oncogynecological center of the Hospital of Ceské Budejovice, a.s. As part of the dia-gnostics, physical examination, colposcopy, targeted bio-psy, polymerase chain reaction (PCR) and microbio-logical examination, oncogynecological ultrasound and CT examination were performed. Clinically, the lesion acted as an advanced tumor. However, no malignant cells were detected in the bio-psy and the histopathological finding corresponded to a granulomatous inflammatory condition with giant cell histiocytic elements. Bacterial DNA of Mycobacterium tuberculosis complex was detected by PCR testing. The patient underwent controlled antituberculosis treatment with regular gynecological examinations. CONCLUSION: Tuberculosis of the uterine cervix occurs rarely. Its clinical manifestation may mimic the tumor process. Dia-gnosis is based on the identification of the causative agent and treatment consists of long-term controlled administration of antituberculotics, and in rare cases, combination with surgical  treatment.

The Impact of Cesarean and Vaginal Delivery on Results of Psychological Cognitive Test in 5 Year Old Children.

Background and objectives: The impact of cesarean and vaginal delivery on cognitive development was analyzed in 5 year old children. Materials and Methods: Two cohorts of 5 year old children born in the years 2013 and 2014 in Karvina (Northern Moravia) and Ceske Budejovice (Southern Bohemia) were studied for their cognitive development related to vaginal (n = 117) and cesarean types of delivery (n = 51). The Bender Visual Motor Gestalt Test (BG test) and the Raven Colored Progressive Matrices (RCPM test) were used as psychological tests. Results: In the comparison of vaginal delivery vs. cesarean section, the children delivered by cesarean section scored lower and, therefore, achieved poorer performance in cognitive tests compared to those born by vaginal delivery, as shown in the RCPM (p < 0.001) and in the BG test (p < 0.001). When mothers' education level was considered, the children whose mothers achieved a university degree scored higher in both the RCPM test (p < 0.001) and the BG test (p < 0.01) compared to the children of mothers with lower secondary education. When comparing mothers with a university degree to those with higher secondary education, there was a significant correlation between level of education and score achieved in the RCPM test (p < 0.001), but not in the BG test. Conclusions: According to our findings, the mode of delivery seems to have a significant influence on performance in psychological cognitive tests in 5 year old children in favor of those who were born by vaginal delivery. Since cesarean-born children scored notably below vaginally born children, it appears possible that cesarean delivery may have a convincingly adverse effect on children's further cognitive development.

Adverse childhood experiences, childhood relationships and associated substance use and mental health in young Europeans.

BACKGROUND: Adverse childhood experiences (ACEs) can increase risks of health-harming behaviours and poor health throughout life. While increases in risk may be affected by resilience resources such as supportive childhood relationships, to date few studies have explored these effects. METHODS: We combined data from cross-sectional ACE studies among young adults (n = 14 661) in educational institutions in 10 European countries. Nine ACE types, childhood relationships and six health outcomes (early alcohol initiation, problem alcohol use, smoking, drug use, therapy, suicide attempt) were explored. Multivariate modelling estimated relationships between ACE counts, supportive childhood relationships and health outcomes. RESULTS: Almost half (46.2%) of participants reported ≥1 ACE and 5.6% reported ≥4 ACEs. Risks of all outcomes increased with ACE count. In individuals with ≥4 ACEs (vs. 0 ACEs), adjusted odds ratios ranged from 2.01 (95% CIs: 1.70-2.38) for smoking to 17.68 (95% CIs: 12.93-24.17) for suicide attempt. Supportive childhood relationships were independently associated with moderating risks of smoking, problem alcohol use, therapy and suicide attempt. In those with ≥4 ACEs, adjusted proportions reporting suicide attempt reduced from 23% with low supportive childhood relationships to 13% with higher support. Equivalent reductions were 25% to 20% for therapy, 23% to 17% for problem drinking and 34% to 32% for smoking. CONCLUSIONS: ACEs are strongly associated with substance use and mental illness. Harmful relationships are moderated by resilience factors such as supportive childhood relationships. Whilst ACEs continue to affect many children, better prevention measures and interventions that enhance resilience to the life-long impacts of toxic childhood stress are required.

A rare case of ectopic pregnancy - retroperitoneal ectopic pregnancy.

Ectopic pregnancy is a condition when fertilized egg implants outside the uterine cavity. The reported incidence is about 0.5-1% of all pregnancies. Retroperitoneal ectopic pregnancies (REP) are extremely rare and early diagnosis and treatment is very difficult. For the adequate management and elimination of risks of maternal morbidity and even mortality, timely diagnosis is of a key importance. A 38-year-old woman was referred to our department for RCUI due to missed abortion/anembryonic pregnancy. Re-RCUI was later indicated due to suspicion of residua post RCUI. Histological examination didn't confirm intrauterine pregnancy, ß-hCG blood levels were flat. Further ultrasonographic examination identified retroperitoneal ectopic pregnancy, most likely in the precaval lymph node. The surgical and subsequently histological examination confirmed this diagnosis. Our case describes successful management of rare retroperitoneal ectopic pregnancy. When common sites of ectopic pregnancy do not have any positive finding, then the presence of REP should be taken into consideration.

Effect of the DASH-diet and salt Kardisal® on blood pressure in adolescents with prehypertension (Cooperative multicentre interventional study).

BACKGROUND: In a cooperative multi-center interventional study of 60 probands with prehypertension and normal BMIs were followed for 3 months. DESIGN: The intervention included the DASH diet for 3 months in 30 probands plus sodium limited intake using the low sodium salt Kardisal® (60% NaCl, 40% KCl) (group A) and the DASH diet for 3 months in 30 probands without Kardisal® (group B). RESULTS: In group A (n=26 probands evaluated) the systolic blood pressure (median) decreased significantly from 138 to 129 mmHg (p<0.001), while the diastolic blood pressure had a statistically non-significant decrease. In group B (n=25 probands evaluated) the SBP decreased significantly from 135 to 132 mmHg (p<0.001), and the DBP decreased significantly from 85 to 69 mmHg (p<0.001). CONCLUSION: Despite a relatively short period on the DASH diet, the intervention produced a significant decrease in the blood pressure of prehypertensive adolescents. The additional use of a low sodium salt for home cooking was not found to have any advantages over the DASH diet alone.

The impact of air pollution to central nervous system in children and adults.

The aim of this paper was to review studies analyzing the associations between air pollution and neurodevelopment in children as well as the effect on adult population. Effect of prenatal exposure to polycyclic aromatic hydrocarbons (PAHs, benzo[a]pyrene, B[a]P) were already studied on cohorts from New York, Poland, China, and Spain. All results indicate changes of child behavior and neurodevelopment at the age of 3-9 years, decrease of IQ, increase of Attention Deficit Hyperactivity Disorder (ADHD), decrease of brain-derived neurotrophic factor (BDNF), reduction of left hemisphere white matter. Effect of traffic-related air pollution (TRAP) to neurobehavioral development in children, measured as PM2.5 (particulate matter <2.5 µm), PM10, elemental carbon (EC), black smoke (BC), NO2, NOx, were studied in USA, Spain, Italy, and South Korea. Increased concentrations of TRAP were associated with the increase of ADHD, autism, affected cognitive development; PM2.5 decreased the expression of BDNF in placenta. Increased concentrations of PM2.5 affected adults cognition (episodic memory), increased major depressive disorders. Increased concentrations of NO2 were associated with dementia, NOx with Parkinson's disease. Increased concentrations of PAHs, PM2.5 and NO2 in polluted air significantly affect central nervous system in children and adults and represent a significant risk factor for human health.

The impact of air pollution in the Southern Bohemia Region on fetuses and newborns.

Air pollution with increased concentrations of carcinogenic polycyclic aromatic hydrocarbons (c-PAHs, represented by benzo[a]pyrene, B[a]P) affect fetal development, reduce birth weights (LBW) of newborns, and increases intrauterine growth retardation (IUGR). The Southern Bohemia Region is believed to be one of the least air polluted regions in the Czech Republic. Monitoring air pollution in the city of Ceské Budejovice from 2011-2015, PM2.5 (particulate matter <2.5 µm) decreased from 20.3 ± 14.5 µg/m3 to 14.3 ± 8.6 µg/m3, but concentrations of B[a]P did not change between the years 2007-2015: 1.5 ± 0.6 ng/m3 vs. 1.4 ± 1.4 ng/m3. Higher B[a]P concentrations the winter induce genetic damage in newborns, increase frequency of micronuclei (chromosomal aberrations), deregulate genes for immunity in umbilical cord blood, and increase incidence of IUGR and LBW in newborns.

Oxidative stress in newborns by different modes of delivery.

OBJECTIVES: The aim of our study is to investigate the impact of the type of delivery - vaginal vs. cesarean section on oxidative damage determined as the lipid peroxidation (15-F2t-isoprostane (15-F2t-IsoP) in the cord blood of newborns and venous blood from mothers in two localities with different levels of air pollution: Ceske Budejovice (CB), a locality with a clean air, and Karvina, a locality with high air pollution. RESUTLS: In Karvina, the concentration of PM2.5 was higher than in CB in the summer 2013 (mean±SD: 20.41±6.28 vs. 9.45±3.62 µg/m3, p<0.001) and in the winter 2014 (mean±SD: 53.67±19.76 vs. 27.96±12.34 µg/m3, p<0.001). Similarly, the concentration of B[a]P was higher in Karvina than in CB in the summer 2013 (mean±SD: 1.16±0.91 vs. 0.16±0.26 ng/m3, p<0.001) and in the winter 2014 (5.36±3.64 vs. 1.45±1.19 ng/m3, p<0.001). Delivery procedures differed by the type of anesthesia; at the Cesarean section in CB was used general anesthesia in 73.8% vs. 20.8% in Karvina (p<0.001), epidural anesthesia in CB in 26.2% vs. 77.1% in Karvina (p<0.001), at vaginal delivery was local anesthesia used in CB in 58.9% vs. 14.1% in Karvina (p<0.001). In CB was oxidative stress higher after vaginal delivery (101.7±31.0 pg 15-F2t-isoP/ml plasma) vs. Cesarean section (83.9±26.9 pg 15-F2t-isoP/ml plasma, p<0.001), no difference between the type of delivery was observed in Karvina. CONCLUSION: No difference between the types of delivery was observed in mothers in CB as well as in Karvina. Oxidative stress in newborns in Karvina was significantly affected by the concentrations of PM2.5 and B[a]P in the polluted air.

Impact of Air Pollution to Genome of Newborns.

The Northern Moravia Region is the most polluted region in the Czech Republic by particulate matter (PM2.5) and carcinogenic polycyclic aromatic hydrocarbons (c-PAHs) as benzo[a]pyrene (B[a]P) by heavy industry and local heating. This specific situation was used to study the impact of air pollution on newborns in the exposed Karviná district and control district of Ceské Budejovice. Biological material from newborns and mothers was collected in summer and winter seasons. This project is highly detailed, analyzing the concentrations of PAHs in ambient air and diet, in human breast milk, in the urine of mothers and newborns, using biomarkers of genetic damage as DNA adducts and gene expression analysis, biomarkers of oxidative stress as 8-oxodG adducts and lipid peroxidation (15-F2t-isoprostane immunoassay). All 400 children, for whom the biomarker data at delivery were obtained, will be followed for morbidity up to 2 years of age. The Northern Moravia Region seems to be to be a model area for studying the long-term impact of human health exposure to c-PAHs. Our observations will indicate possible genetic and oxidative damage in newborns, which may significantly affect their morbidity.

Illegal drug use among female university students in Slovakia.

BACKGROUND: This study is focused on the issue of illegal drug use among female university students preparing to become teachers. The main aim was to determine the frequency of drug abuse in a group of young women (n=215, mean age 20.44 years). MATERIAL/METHODS: Using survey methods, we determined that 33.48% of female university students in Slovakia use illegal drugs and 66.51% of students have never used illegal drugs. Differences between these groups were determined using statistical analysis, mostly in 4 areas of survey questions. RESULTS: We determined that education of parents has a statistically significant influence on use of illegal drugs by their children (χ2=10.14; P<0.05). Communication between parents and children and parental attention to children have a significant role in determining risky behavior (illegal drug use, χ2=8.698, P<0.05). Parents of students not using illegal drugs were interested in how their children spend their free time (68.53%). We confirmed the relationship between consumption of alcohol and illegal drug use (χ2=16.645; P<0.001) and smoking (χ2=6.226; P<0.05). The first contact with drugs occurs most frequently at high school age. The most consumed "soft" drug in our group of female university students is marijuana. CONCLUSIONS: Our findings are relevant for comparison and generalization regarding causes of the steady increase in number of young people using illegal drugs.

Mothers' dilemma - conducting delivery on the limits of the foetus viability. Case Report.

Ethical questions concerning problems of conducting delivery of enormously immature foetuses are subjected to intensive discussion and call for a permanent and wide consideration with the participation of all specialists, who are involved in the problem. The discussions have persisted over tens of years and became intensive particularly at the moment of defining the foetus viability. In the present contribution, the author illustrates the discussion by two selected case reports exemplifying the practical impact of conducting deliveries of enormously immature foetuses on the physician and particularly on the family.

Qualitative analysis of selected literature sources addressing the issue of homelessness.

OBJECTIVES: The objective of this article is to answer the main research question, which reads: "How is the issue of homelessness presented in the relevant literature?" Basic terms related to homelessness and homeless people are defined at the beginning of the article. Homelessness is a complex social problem, with many factors contributing to its origin and development that can, in principle, be divided into objective and subjective factors. METHODS: A qualitative research strategy was chosen to address the main research question. Analysis of documents using content analysis was used as the research tool. The research sample consisted of three articles, two chapters, and two subchapters in a monograph. The three analyzed sources were in English, three in the Slovak language, and one in the Czech language. RESULTS: It was found that the issue could be viewed from both health-related and social perspectives. None of the authors, whose publications were analyzed, preferred a "purely" health-related or a "purely" social welfare view of the issue of homelessness. We identified three types of perspectives (approaches) related to the care of homeless people: health & social, preferred health care, and preferred social care. Both components of care are more or less represented in each of the three types of care. CONCLUSION: It can be concluded that the issue of homelessness cannot be viewed from a single perspective (either health or social), since it requires an interdisciplinary approach and cooperation of both healthcare professionals and social welfare experts to address the unfavorable social situations associated with homelessness.

Interdisciplinary collaboration between medical and non-medical professions in health and social care.

OBJECTIVES: This paper addresses the issue of interdisciplinary collaboration between medical and non-medical professions in health and social care. The introduction defines basic terms such as interdisciplinary cooperation, interdisciplinary team, and health and social care. Additionally, it highlights the significance and contribution of interdisciplinary collaboration in the care of the patient/client in health and social care. The aim of the paper is to identify factors influencing the process of interdisciplinary collaboration between, in particular, social workers and physicians. In compliance with the main goal of the research, the following partial goals were included: 1) to identify factors that limit the process of interdisciplinary collaboration between social workers and physicians, and 2) to identify factors which support the process of interdisciplinary collaboration between social workers and physicians. METHODS: Based on the research goals, a systematic review was selected as the research method for the paper. The research dataset consisted of articles obtained from the following databases: EBSO, PUBMED/MEDLINE, SCIENCE DIRECT and SCOPUS. The databases were search using the following keywords: interprofessional cooperation, interdisciplinary, collaboration, social work, and physicians/doctors. RESULTS: Using the results, the following factors supporting interdisciplinary collaboration were identified: acknowledgement of colleagues' expertise, recognition of roles, positive level of communication, and mutual respect. Factors that limit interdisciplinary processes included the following: varying professional perspectives, theoretical differences, lack of knowledge, and poor communication.

Subjective Social Status in select Ukrainians, Vietnamese, and Mongolians living in the Czech Republic.

OBJECTIVES: This article discusses methods of examining subjective social status (SSS), which is based on the concept of social determinants of health described by Wilkinson and Marmot in 1998. METHODS: SSS research was conducted with Cooperation from the Scientific and Technical Research (COST) program, with financial support from the Czech Ministry of Education, Youth and Sports. This study is part of a project entitled the "Health and Social Status of Immigrants and Asylum Seekers in the Czech Republic" (registration number OC 10031), which was started in 2010 and concluded in May 2011. The study included 246 respondents of which: 69 (28.1%) had emigrated from Vietnam; 93 (37.8%) from the Ukraine; and 84 (34.1%) from Mongolia. In terms of qualitative strategies, 13 individual immigrants and asylum seekers were personally interviewed. This research was thus conceived as being both quantitative-qualitative, which included the use of the appropriate technical tools (i.e., questionnaires and interviews with select immigrants and asylum seekers). SSS was determined using the Pearson's chi-square test, as well as through correspondence and cluster analyzes. Sign schemes were used to detect select significant relationships in contingency tables. The minimum significance level chosen was α ≤ 0.05. RESULTS: When examining the SSS of select nationalities, differences were observed in the perception of subjective social status. The correspondence analysis results clearly show that Ukrainians best perceived their social status (within the selected parameters). One measure of subjectively perceived social status related to Czech language proficiency (i.e., one criterion was the comprehension of spoken Czech; e.g., whether the respondent could read or speak Czech, or how they assessed their own Czech proficiency). CONCLUSION: The SSS study clearly revealed typical links among select nationalities living in the Czech Republic, and highlighted risks related to the degree of integration (and its relationship to social exclusion). This study served as a pilot project for follow-up research conducted by the second COST project entitled: "Social Determinants of Health and their Impact on the Health of Immigrants Living in the Czech Republic" (registration number LD 13044 COST). The follow-up study included 1 000 respondents of Slovak, Vietnamese, Ukrainian, Russian and Polish nationality and is currently underway at the Faculty of Health and Social Studies at the University of South Bohemia in the Czech Republic. The methodological tools used were taken from the COST pilot project (which is the topic of this article) and were adjusted as needed (i.e., both objective and subjective criteria were used for examining social status).

Medical and salutogenic approaches and their integration in taking prenatal and postnatal care of immigrants.

OBJECTIVES: To compile a proposal of the system of taking complex prenatal, perinatal and postnatal care of pregnant immigrants in the Czech Republic with taking into account medical and salutogenic approaches. MATERIAL AND METHODS: The research was implemented by the form of a controlled interview and was based on a questionnaire comprising 50 questions focused on the evaluation of taking the prenatal, natal and postnatal care of immigrants. The data were accumulated among immigrants from Vietnam, Mongolia and Ukraine. RESULTS: It is possible to conclusively state that no principal dissatisfaction with taking care of pregnant women in the Czech Republic compared to native countries was demonstrated. There is a difference in a more considerable participation of midwives in the prenatal and natal care compared to the native countries. Failures in taking care of mothers-immigrants in the Czech Republic are considered to be the poor communication, particularly in association with the language barrier, limited possibilities of the participation of family members in the delivery and persisting unsuitable behaviour of certain healthcare professionals. CONCLUSION: In the Czech Republic, the medical care is at a higher level compared to native countries. For the improvement of the salutogenic attitude, it is necessary to take into consideration certain results and provide their application to practice.

Medical and salutogenic approaches and their integration in taking prenatal and postnatal care of Czech women.

OBJECTIVE: To compile a proposal of the system of taking complex prenatal, perinatal and postnatal care of pregnant women and their children in the Czech Republic with taking into account medical and salutogenic approaches. MATERIAL AND METHODS: A questionnaire was prepared comprising questions for mothers and making it possible to exactly use specified data from their healthcare documentation. The method thus consisted of a secondary data analysis and subsequent contact with mothers. This was implemented in the form a qualitative and narrative interview. The study included 541 women from five Czech regions. RESULTS: In this group, there was a high level of the preventive care with persisting preference of prenatal consulting rooms conducted by physicians. Most deliveries occurred in institutions in the presence of physicians. In the groups evaluated, there were, however, no significant differences. In spite of this, the evaluation of delivering women indicated that there is a high level of the perinatal care in terms of the medical approach. However, the salutogenic care calls for increasing the active participation of midwives in the prenatal, perinatal and postnatal care and extension and intensification of activities particularly in the psychosocial area. CONCLUSION: In the group monitored, there were no significant correlations of determined perinatal interventions with the method and result of the delivery and condition of the mother and newborn. It is to mention that the medical perinatal care is at a high level.

Blood pressure relation to body composition and age: analysis of a nurse-led investigation and consultation program.

BACKGROUND: Blood pressure (BP) increases with age and obesity. We have assessed the relative contribution of age and fatness to BP regulation in a healthy population investigated by nurse practitioners. MATERIAL AND METHODS: Preventive investigation and counseling was offered at the entrance hall of the regional authority´s office in the town of Nitra by 2 nursing specialists who investigated 120 men and 276 women. In men the mean body mass index (BMI) was 26.8 kg/m2, mean weight was 84.4 kg, mean fat percentage was 23.3, mean age was 46.1 years, mean systolic BP was 133.1 mmHg, and mean diastolic BP was 82.5 mmHg. In women the mean BMI was 24.8 kg/m2, mean weight was 67.3 kg, mean fat percentage was 29.4, mean age was 45.4 years, mean systolic BP was 127.7 mmHg, and mean diastolic BP was 78.5 mmHg. Correlation analysis was performed and in multiple regression analysis we used BP values as the dependent variable and fat percentage and age as independent variables. Normality of variables distribution was checked and found satisfactorily. RESULTS: Most of the subjects had an untreated component of metabolic syndrome. There was a correlation between BP values, age, and percent body fat. BP was regulated only to a certain degree by fatness and age, with the influence being relatively small. Our results showed that BP was more influenced by fatness than age, and body fatness was more related to higher systolic than to diastolic BP. CONCLUSIONS: Age and fatness could explain BP values by only 3-30%, although BP was more influenced by fatness than by age. Nurse practitioners can effectively detect and motivate people with metabolic syndrome.

The relationship between family socioeconomic condition and childhood injury frequency in selected locations in the Czech Republic.

BACKGROUND: Childhood injury rates are monitored worldwide because they markedly affect morbidity and mortality of children. There are numerous works that point out the relationship between family socioeconomic status and injuries, where lower socioeconomic levels are linked to higher numbers of injuries. MATERIAL/METHODS: The goal of this work was to evaluate the relationship between family socioeconomic status and childhood injuries in the Czech Republic. The research was carried out between 1/7/2009 and 31/12/2010. A 2-part questionnaire was used to gather information. The first part, "Injury/poisoning of children," included information on the injury itself; the second part, "Family functionality," concerned family socioeconomic situations. We collected a total of 874 questionnaires in the South-Bohemian region and 132 questionnaires from a selected county in the North-Bohemian region. A database identical with the questionnaire assignment was established, comprising all the data accumulated. RESULTS: The injury rate in families living in poor socioeconomic situations in locality 8 was statistically significantly higher compared to families in good socioeconomic situations. The number of home injuries was 205. Families with incomes that were twice the subsistence level had more child protective measures in their households. There was a statistically significant relationship between the number of child protective measures and injury frequency in families. Children in families having higher incomes (twice that of subsistence level) were more likely to suffer injuries related to organized sports as compared to those in families having lower incomes. CONCLUSIONS: The literature and research data show that preventive programs have the largest effect on reduction in childhood morbidity and mortality with respect to injuries.