Long-term trends of potential years of life lost due to main causes of death in the Slovak population, 2004-2013 / Tendências a longo prazo nos anos potenciais de vida perdidos devido às principais causas de óbito na população da Eslováquia, 2004-2013 / Tendencias a largo plazo de los años potenciales perdidos de vida, debido a las principales causas de muerte en la población eslovaca, 2004-2013

The aim of this study was to evaluate trends of potential years of life lost (PYLL) rates in the Slovak population and analyze the average annual percent change (AAPC) of PYLL rates regarding the most common causes of death between 2004 and 2013. National mortality and demographic data were obtained from the Statistical Office of the Slovak Republic, and 378,535 causes of death within the period were analyzed. The PYLL values in both genders and each disease category were added up across all age groups to form annual values. For the trend analysis, the AAPC indicator was proposed. The PYLL rate is age-standardized and expressed as a sum of all deaths per 100,000. In the period 2004-2013, the highest mean PYLL rates were observed in neoplasms in the whole population (2,103 per 100,000), as well as in females (2,088 per 100,000), with a permanent high significant increase of AAPC of PYLL in both genders. The second highest mean PYLL rate in the ten-year period was related to circulatory system diseases in total (1,922 per 100,000) as well as in females (1,449 per 100,000). In males, circulatory system diseases had the highest PYLL rate (2,397 per 100,000). The PYLL rates trend regarding external causes of morbidity and mortality showed the most notable decrease in the assessed period and the AAPC of PYLL showed significant negative values both in males (-2.5%; p < 0.001) and females (-4%; p < 0.001). Our results should contribute in developing intervention programs aimed at reducing the burden of premature mortality since the main causes of premature death are associated to well-known and preventable risk factors.

O estudo teve como objetivo avaliar as tendências nas taxas de anos potenciais de vida perdidos (APVP) na população eslovaca e a análise da variação percentual anual média (VPAM) nas taxas de APVP de acordo com as causas de óbito mais comuns no período de 2004 a 2013. A mortalidade nacional e os dados demográficos foram obtidos do Escritório de Estatística da República Eslovaca. Foram analisadas 378.535 causas de óbito entre 2004 e 2013. Para constituir os valores anuais, foram tabelados, em todas as faixas etárias, os valores de APVP em ambos gêneros e em cada categoria nosológica. Para a análise de tendências, foi proposto o indicador da VPAM. A taxa de APVP é padronizada para a idade e expressa como a soma de todos os óbitos por 100 mil. No período de 2004 a 2013, as médias mais altas de APVP foram observadas em neoplasias na população geral (2.103 por 100 mil) e na população feminina (2.088 por 100 mil), com um aumento significativo na VPAM dos APVP em ambos os gêneros. A segunda maior média de APVP no período de 10 anos foi devida a doenças cardiovasculares, tanto na população geral (1.922 por 100 mil) quanto na população feminina (1.449 por 100 mil). Na população masculina, as doenças cardiovasculares tiveram a maior taxa de APVP (2.397 por 100 mil). A tendência nas taxas de APVP por causas externas mostraram a redução mais importante no período avaliado, e a VPAM dos APVP comprovou os valores negativos significativos, tanto em homens (-2,5%; p < 0,001) quanto em mulheres (-4%; p < 0,001). Os resultados devem contribuir para o desenvolvimento de intervenções voltadas para a redução da carga de mortalidade prematura, considerando que as principais causas de morte prematura estão associadas a fatores de risco bem conhecidos e preveníveis.

El objetivo de este estudio fue evaluar las tendencias de las tasas de los años potenciales de vida perdidos (PYLL por sus siglas en inglés) en la población eslovaca y el análisis de la variación promedio del porcentaje anual (AAPC por sus siglas en inglés) de las tasas PYLL, de acuerdo con las causas más comunes de muerte, durante el período de 2004-2013. La mortalidad nacional y los datos demográficos se obtuvieron de la Oficina Estadística de la República Eslovaca; se analizaron 378.535 causas de muerte entre 2004 y 2013. Los valores de PYLL en ambos géneros y en cada categoría de enfermedad se contaron en todos los grupos de edad para formar valores anuales. Para el análisis de tendencia, se propuso el indicador AAPC. La tasa de PYLL se encuentra estandarizada por edad y expresada como la suma de todas las muertes por 100.000. En el período 2004-2013, las tasas medias más altas de PYLL se observaron en neoplasias en toda la población (2.103 por 100.000), así como en las mujeres (2.088 por 100.000) con un incremento significativo permanente alto de la AAPC en los PYLL en ambos géneros. La segunda tasa media más alta de PYLL, durante el período de diez años, se debió a las enfermedades del sistema circulatorio en total (1.922 por 100.000), al igual que en las mujeres (1.449 por 100.000). En hombres, las enfermedades del sistema circulatorio tienen la tasa más alta de PYLL (2.397 por 100.000). La tendencia de las tasas de PYLL, debida a causas externas de morbilidad y mortalidad mostró un notable decremento en el período evaluado y la AAPC de PYLL probaron los valores negativos significativos tanto en hombres (-2,5%; p < 0,001) como en mujeres (-4%; p < 0,001). Nuestros resultados deberían contribuir al desarrollo de la intervención en programas que tengan como meta reducir la carga de la mortalidad prematura, considerando que las causas principales de muerte prematura están asociadas a factores de riesgo bien conocidos y prevenibles.

Oxyurid nematodes of pet rodents in Slovakia - a neglected zoonotic threat / Nematódeos oxiurídeos de roedores de estimação na Eslováquia - uma ameaça zoonótica negligenciada

Abstract 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.

Resumo O papel dos roedores como reservatórios de helmintos de importância para a saúde pública não é bem conhecido. O potencial zoonótico de Syphacia spp. foi confirmado; portanto, o estudo teve como objetivo estimar a ocorrência de nematóides oxiurídeos em pequenos roedores de pet shops e clubes de reprodução na Eslováquia. Amostras fecais de 586 roedores mantidos em 133 gaiolas foram coletadas entre 2016 e 2018 e examinadas pelo método de flotação de Faust. Foram detectadas quatro espécies de nematódeos oxiurídeos, Syphacia muris, S. obvelata, Aspiculuris tetraptera e Paraspidodera uncinata, A. tetraptera foi encontrado nas amostras fecais de todas as espécies de roedores incluídas nesta pesquisa. O número de gaiolas positivas variou de 5,4% em hamsters a 70,0% em camundongos. A prevalência de Syphacia muris foi maior nos gerbilos da Mongólia, onde até 75,0% das gaiolas foram positivas; S. obvelata foi encontrada em 26,7% das gaiolas com camundongos, 25,0% das gaiolas com gerbilos da Mongólia e 3,2% das gaiolas com ratos. A alta prevalência de Syphacia spp. em todas as espécies animais aponta o risco de infecção para os seres humanos. Animais oferecidos para venda estão frequentemente em contato próximo com seres humanos; portanto, eles devem ser regularmente testados quanto a parasitas e, então, efetivamente desparasitados.

The Economic Burden of Selected Analgesic Drugs Prescription by Dentists in Slovakia

Objective: To analyse economic burden of selected analgesic drugs prescription by dentists in Slovakia over a 24-month period. Material and Methods: In this economic burden study, the data were provided from the largest public health insurance company in Slovakia. It was analysed 23,256 prescriptions of selected analgesic drugs (Acetylsalicylic Acid, Diclofenac, Nimesulide, Tramadol and Metamizole Sodium) by dentists in Slovakia. Results: The highest analgesics prescription by dentists was found in Diclofenac in 2016 with 11.2% prescription increase in 2017. The significant decrease of analgesic drug prescription by dentists in 2017 was observed in Tramadol (-29.9%). The economic burden of selected analgesic drugs by patients were €33,926 in 2017 with 21.3% significant decrease of average percentage differences (APD) in Tramadol and 84.6% significant increase of APD in Metamizole sodium in 2017. Patients participated 65.5% share in payment of selected analgesic drugs and Health Insurance Company participated only 34.5% share in payment of selected analgesic drugs in 2017. It was found increase of percentage analgesic drugs prescription in Diclofenac and Nimesulide and decrease of percentage drug prescription in Metamizole sodium from 1/2016 to 12/2017. Conclusion: Economic burden on analgesic drugs prescribed by dentist was low per Slovak inhabitant in calculated. Diclofenac was most frequent prescribed analgesic drug with the highest economic burden. We recommend prescribing cheaper analgesic drugs with a lower economic burden and with the same effect.

Evaluation of Tooth Brushing in Slovak Patients with Sclerosis Multiplex

Objective: To analyse issue of teeth brushing according to age, gender and length in Slovak patients with multiple sclerosis disease (MS). Material and Methods: In this descriptive study, the questionnaires were collected in neurologists from December 2016 until September 2017. The study sample consisted of 103 MS patients (44.7% of men) in a mean age of 38.4 ± 9.95 years. The study sample of MS patients was divided into two sub-groups. The first sub-group consisted of MS patients who were restricted in teeth brushing (n=56) and the second group of MS patients, which had no restrictions in teeth brushing (n=47). Descriptive statistics were used to calculate the absolute and relative frequencies, mean and standard deviation. A two-sample ttest was used to compare of the proportion between sub-groups with restrictions and sub-group no restrictions in teeth brushing. The statistically significant level was determined at p<0.05. Results: The significant higher mean age (40.4 ± 10.8 years) was found in MS patients who had restrictions in teeth brushing (p=0.043). Females described often no restrictions in teeth brushing than males (59.6% vs. 40.4%; p<0.05). Length in MS disease (≤3 years) has significant impact on patients in who were not found restrictions in teeth brushing (31.9%; p=0.037). Conclusion: We recommend individual doctor approach to MS patients in older age and using of electric toothbrushes in MS patients who have hand functioning restrictions.

Hashimoto's thyroiditis - an independent risk factor for papillary carcinoma / Hashimoto's thyroiditis - an independent risk factor for papillary carcinoma

Abstract Introduction: The link between Hashimoto's thyroiditis and thyroid carcinoma has long been a topic of controversy. Objective: The aim of our study was to determine the prevalence of thyroid carcinoma and Hashimoto's thyroiditis coexistence in histopathologic material of thyroidectomized patients. Methods: In a retrospective study, the clinicohistopathologic data of 2117 patients (1738 females/379 males), who underwent total or partial thyroidectomy for thyroid gland disorder at a single institution from the 1st of January 2005 to the 31st of December 2014 were analyzed. Results: Thyroid carcinoma was detected in 318 cases (15%) and microcarcinoma (thyroid cancer ≤10 mm in diameter) was found in permanent sections in 169 cases (8%). Hashimoto's thyroiditis was detected in 318 (15%) patients. Hashimoto's thyroiditis was significantly more often associated with thyroid carcinoma and microcarcinoma compare to benign condition (p = 0.048, p = 0.00014, respectively). Coexistence of Hashimoto's thyroiditis and thyroid carcinoma/thyroid microcarcinoma did not affect tumor size (p = 0.251, p = 0.098, respectively), or tumor multifocality (p = 0.831, p = 0.957, respectively). Bilateral thyroid microcarcinoma was significantly more often detected when Hashimoto's thyroiditis was also diagnosed (p = 0.041), but presence of Hashimoto's thyroiditis did not affect bilateral occurrence of thyroid carcinoma (p = 0.731). Conclusion: Hashimoto's thyroiditis is associated with significantly increased risk of developing thyroid carcinoma, especially thyroid microcarcinoma.

Resumo: Introdução: A relação entre a tireoidite de Hashimoto e o carcinoma de tireoide tem sido um tema de controvérsia por um longo tempo. Objetivo: Determinar a prevalência da coexistência de carcinoma de tireoide e tireoidite de Hashimoto no exame histopatológico de amostras de pacientes tireoidectomizados. Método: Em um estudo retrospectivo, foram analisados os dados clinico-histopatológicos de 2.117 pacientes (1.738 mulheres/379 homens), submetidos à tireoidectomia total ou parcial por distúrbio da glândula tireoide em uma única instituição, de 1º de janeiro de 2005 a 31 de dezembro de 2014. Resultados: O carcinoma de tireoide foi detectado em 318 casos (15%) e o microcarcinoma (câncer de tireoide ≤ 10 mm de diâmetro) foi encontrado em secções permanentes em 169 casos (8%). A tireoidite de Hashimoto foi detectada em 318 (15%) pacientes e foi associada ao carcinoma da tireoide e ao microcarcinoma com maior frequência em comparação com condições benignas (p = 0,048, p = 0,00014, respectivamente). A coexistência de tireoidite de Hashimoto e carcinoma/microcarcinoma não influenciou o tamanho do tumor (p = 0,251, p = 0,098, respectivamente) ou a multifocalidade tumoral (p = 0,831, p = 0,957, respectivamente). O microcarcinoma de tireoide bilateral foi detectado com maior frequência quando a tireoidite de Hashimoto também foi diagnosticada (p = 0,041), mas a presença de tireoidite não influenciou na ocorrência bilateral de carcinoma (p = 0,731). Conclusão: A tireoidite de Hashimoto está associada a um aumento significativo do risco do desenvolvimento de carcinoma de tireoide, especialmente microcarcinoma da tireoide.

Economic Burden of Selected Diagnostic Imaging Methods in Oral Cancer

Objective: To analyse of proportion and economic burden of selected diagnostic imaging methods of oral cancer according to quarters and average percentage differences in the Slovak population in the period 2016-2017. Material and Methods: In this descriptive study, the data were retrieved from the information system of the largest public health insurance company on our request, which archives the cost and proportion of diagnostic imaging methods of oral cancer in Slovak population. It was evaluated 48,995 of selected diagnostic imaging methods (Computed Tomography [CT], Magnetic Resonance Imaging [MRI] and X-Ray) in the period 2016-2017. Results: The most frequently used diagnostic imaging method of oral cancer was magnetic resonance imaging method every quarters in 2016 and 2017 (53.7-54.7%) with slightly increasing trend in period 2016-2017. Mean economic burden of selected diagnostic imaging methods of oral cancer were 1,974,900€ for MRI method, 598,187€ for CT method and 5,394€ for RTG method in 2017. Decreasing trend of economic burden of diagnostic imaging method was found in MRI method and CT method in period 2016-2017. Conclusion: Our economic burden study provides a useful source for public health professional and clinicians in better understanding the economic burden of diagnostic methods in oral cancer.

Potential Years of Lost Life of the Lip, Oral Cavity and Pharynx Neoplasms in Slovak Population - 2010-2015

Objective: To analyse Potential Years of Life Lost (PYLL) rates trends of lip, oral cavity and pharynx neoplasms in the Slovak population by age and gender. Material and Methods: The study analyses PYLL rates (age-standardized) of lip, oral cavity and pharynx neoplasms (C00-C14) per 100,000 in the period of six years (2010-2015). The study sample was divided into two age sub-categories (all ages: 0-69y. and working group: 20-69y.) National mortality data (C00-C14) (3,138 mortality causes) were analysed from the Statistical Office of the Slovak Republic. Results: The highest PYLL rate was found in sub-category 20-69 years in males (378 per 100,000) in 2012 and in females (64 per 100,000) in 2013. The highest PYLL rate was observed in sub-category all age groups in males (296 per 100,000) in 2012 and in females (50 per 100,000) in 2013. The PYLL rates of lip, oral cavity and pharynx neoplasms had in the period 2011- 2015 upward trend in both sexes, however, in the 2014 was found the opposite trend. In 2015 the highest PYLL rates (non-standardized) in both sexes was found in age subcategory 55-59y. Conclusion: Our study should contribute to the development of oral cancer intervention programs.

The Average Annual Percent Change Analyzes of Preventive Dental Care in the Slovak Republic, 2014-2016

Objective: To analyse of the average annual percent change (AAPC) of registered dental patients, patients with preventive dental care and patients requiring dental treatment in the period of 2014-2016 in the Slovak Republic. Material and Methods: Data from registered dental patients (n=14,736,888), patients with preventive dental care (n=8,212,441) and patients requiring dental treatment (n=5,262,323) in the period of 2014-2016 were obtained from the Statistical Office of the Slovak Republic; 28,211,652 dental patients were analysed. The Theil-Sen estimator of trend line based on median and its significance was tested by nonparametric Wilcoxon test using statistical software R package. Results: The significant decrease (-4.11%) of the AAPC rates of registered dental patient (p<0.05) during the entire period (2014-2016) can be observed in age subcategory 15-18 years, while in age subcategory 19+ years the nonsignificant increase (1.08%) of the AAPC rate of registered dental patients in the same period was achieved. In the period of 2014-2016, the highest AAPC rate of patients with preventive dental care with the significant decrease was found in age subcategory 6-14 years (-17.19%; p<0.001). The AAPC rate of patients requiring dental treatment proved the significant negative values in age subcategory 0-5 years (-7.26%; p<0.01), in age subcategory 6-14 years (-9.33%; p<0.001), in age subcategory 15-18 years (-8.81%; p<0.01). Conclusion: The highest decrease AAPC rate of registered dental patients was observed in age subcategory 15-18 years. The statistical significant decrease AAPC rate of patients with preventive dental care was found in children ≤ 18 years. In patients requiring dental treatment (≤ 18 y.) was observed decrease AAPC rate.

Gender and Age Differences in Patients' Satisfaction with Dental Care in the Slovak Republic: A Cross-sectional Questionnaire Study

Objective: To analyze the level of quality of healthcare satisfaction/dissatisfaction according to gender and age in terms of time spent with the doctor, communication, general satisfaction, interpersonal and financial aspects, technical quality and access/availability/convenience. Material and Methods: The standardized "Patient Satisfaction Questionnaire" (n=445) was collected in dental clinics in the Slovak Republic in the period of 2014-2015. The study sample was divided into subgroups according to gender (males: n=236; females: n=209) and age (<35 years: n= 243; ≥36 years: n=202). A scale from 1 (maximum dissatisfaction with quality of healthcare) to 5 (maximum satisfaction with quality of healthcare) was evaluated. Results: The highest significant satisfaction level of quality of healthcare (expressed as a mean score) were found in females in the subscale time spent with doctor (<35 y.) (2.90±0.69; p<0.042); the lowest satisfaction level was found in females (<35 y.) in the subscale general satisfaction (2.53±0.36; p=n.s.). Females (≥36y.) were significantly more satisfied with health care quality in the subscale communication than males (2.72±0.34 and 2.62±0.3, respectively; p=0.046). Males (<35 y.) were significantly less satisfied in the subscale technical quality compared to females (2.54±0.27 and 2.65±0.26, respectively; p=0.002). Conclusion: For the future, it is necessary to specify the next reasons for patients' satisfaction/dissatisfaction with dental care.

Genetic diversity of bovine Mycobacterium avium subsp. paratuberculosis discriminated by IS1311 PCR-REA, MIRU-VNTR, and MLSSR genotyping

The aim of this study was to describe the genetic diversity of Mycobacterium avium subsp. paratuberculosis (MAP) obtained from individual cows in Korea. Twelve MAP-positive fecal DNA samples and 19 MAP isolates were obtained from 10 cattle herds located in 5 provinces in Korea. In addition, 5 MAP isolates obtained from the Czech Republic and Slovakia and 3 isolates from Australia were genotyped for comparison with the domestic isolates. The most prevalent strains in Korea were of the “bison-type” genotype (23 of 31 fecal DNA/isolates) and were distributed nationwide. The remaining MAP isolates (8) and all of the foreign isolates were identified as “cattle-type”. The bison-type strains which were discriminated only as INMV 68 in variable-number tandem repeats of mycobacterial interspersed repetitive units (MIRU-VNTR) typing. Multilocus short sequence repeat (MLSSR) typing differentiated the bison-type strains into 3 different subtypes. The cattle-type strains were divided into 3 subtypes by MIRU-VNTR and 8 subtypes by MLSSR. The allelic diversities in the MIRU-VNTR and MLSSR results were calculated as 0.567 and 0.866, respectively. These results suggest that MIRU-VNTR typing cannot provide a sufficient description of the epidemiological situation of MAP. Therefore, an alternative method, such as MLSSR, is needed for typing of MAP strains to elucidate the molecular epidemiology of MAP infections. Overall, this study is the first epidemiological survey report in Korea using both MIRU-VNTR and MLSSR typing methods, and it has provided basic data necessary to elucidate the characteristics of MAP infections in Korea.

Complications of Liver Resection in Geriatric Patients

Abstract: Introduction and aims. Liver resection is the treatment of choice for many primary and secondary liver diseases. Most studies in the elderly have reported resection of primary and secondary liver tumors, especially hepatocellular carcinoma and colorectal metastatic cancer. However, over the last two decades, hepatectomy has become safe and is now performed in the older population, implying a paradigm shift in the approach to these patients. Material and methods. We retrospectively evaluated the risk factors for postoperative complications in patients over 65 years of age in comparison with those under 65 years of age after liver resection (n = 360). The set comprised 127 patients older than 65 years (35%) and 233 patients younger than 65 years (65%). Results. In patients younger than 65 years, there was a significantly higher incidence of benign liver tumors (P = 0.0073); in those older than 65 years, there was a significantly higher incidence of metastasis of colorectal carcinoma to the liver (0.0058). In patients older tan 65 years, there were significantly more postoperative cardiovascular complications (P = 0.0028). Applying multivariate analysis, we did not identify any independent risk factors for postoperative complications. The 12-month survival was not significantly different (younger versus older patients), and the 5-year survival was significantly worse in older patients (P = 0.0454). Conclusion. In the case of liver resection, age should not be a contraindication. An individualized approach to the patient and multidisciplinary postoperative care are the important issues.

Impact of Orthodontic Treatment on Oral Health-Related Quality of Life in the Slovak Republic: A Cross-Sectional Study

Objective: To determine the level of Oral Health-related Quality of Life satisfaction in orthodontic patients compared with the control group. Material and Methods: In this cross-sectional study, the standardized questionnaire "Oral Health-related Quality of Life" (OHRQoL) was used. The 37 statements in the questionnaire are divided into four subscales; the total satisfaction score has been evaluated as well. 146 orthodontic patients (42.5% men) aged 8-72 years were divided into four subgroups: (i) patients treated by dental crowns and implants (DCI), (ii) subjects with dental prosthesis (DP), (iii) patients treated by dental braces (DB), and (iv) patients treated by dental retainer (DR). The control group consisted of 49 dental patients without any orthodontic treatment (51.0% men in mean age 20.0±8.2 years). Mean scores and levels of satisfaction (%) were evaluated in all subgroups and in all subscales. Results: The lowest rate of patients OHRQoL satisfaction was observed in the DP subgroup; the highest satisfaction level was found in the DCI subgroup. The highest rate of patient OHRQoL satisfaction in the study group was observed in subscales social well-being and functional limitation, and the highest level of dissatisfaction in a subscale emotional well-being. High significant differences between study and control groups were found in terms of a higher satisfaction level in a control group. Conclusion: The most dissatisfied were the oldest patients with dental prosthesis with the highest level of dissatisfaction in the emotional well-being subscale.

Gender and BMI Differences in Adult Craniofacial Parameters in Caucasian Population: A Pilot Study

Objective: To determine the association between age and selected craniofacial parameters according to the Body Mass Index (BMI) and gender in Caucasian population in central Europe. Material and Methods: Data were collected in maxillofacial surgeries in Slovak Republic in period 2013 - 2016. The study sample was divided into younger (≤ 22 years; n = 49) and older sample (˃ 23 years; n = 55). Patients were analyzed by directed anthropometry and 3D scan. Data were organized using the Statistical Package for Social Sciences (SPSS) software and presented through descriptive and inferential statistics (two-sample T-test and Fisher's exact test). The significance level was 5%. Results: In younger and older study sample according to BMI was not found significant effect on evaluation selected craniofacial parameters. In the category BMI > 25.0 [kg.m-2] younger study sample had higher mean values in bizygomatic breadth (13.6 ± 2.2 cm vs. 12.9 ± 0.9 cm; p = 0.287) than older study sample, while in older study sample was found higher bi-gonial breadth (11.9 ± 1.4 cm vs. 10.8 ± 0.9 cm; p = 0.169) than younger study sample. Males in age ˃ 23 years had significant distance between two Gonion (bi-gonial breadth) (11.7 ± 1.3 cm) than males in age ≤ 22 years (10.9 ± 1.0 cm). Higher total facial height was found in category males > 23 years (12.5 ± 0.7 cm) in compare with category males ≤ 22 years (12.1 ± 0.5 cm) (p = 0.018). Conclusion: The patient age should be considered in analysed of soft tissue proportions (bi-gonial breadth and total facial height).

Mortality of therapeutic fish Garra rufa caused by Aeromonas sobria

<p><b>OBJECTIVE</b>To investigate a case of mass mortality of Garra rufa (G. rufa) from a fish hatchery farm in Slovakia.</p><p><b>METHODS</b>Causative bacterial agent was swabbing out of affected fish skin area and subsequently identified using commercial test system. Antibiotic susceptibility was determined by the disk diffusion method.</p><p><b>RESULTS</b>Infected G. rufa was characterized by abnormal swimming behaviour, bleeding of skin lesions and local haemorrhages. Despite of using recommended aquatic antibiotic treatment no improvement was achieved and Aeromonas sobria (A. sobria) was identified as a causative agent of fish mortality. Due to massive fish mortality, antibiotic susceptibility of pure isolated culture of A. sobria was evaluated employing eight antibiotics against human infections. A. sobria was resistant only against one antibiotic, namely ampicilin.</p><p><b>CONCLUSIONS</b>These results indicate that A. sobria can act as a primary pathogen of G. rufa and may be a potential risk factor for immunodeficient or immunoincompetent patients during the ichthyotherapy.</p>

Analysis of the direct and indirect costs of treatment of imported malaria in the Slovak Republic / Análise dos custos diretos e indiretos do tratamento da malária importada na República Eslovaca

This study analyzed the approximate cost of treatment of patients hospitalized with a diagnosis of imported malaria in Slovakia. Between 2003 and 2007, 15 patients with imported malaria were hospitalized. The mean direct cost of the treatment was 970.75 euros and the mean indirect cost was 53.15 euros. For the patient with the highest cost of treatment, the use of mefloquine prophylaxis would have represented only 0.5 percent of the total direct cost of treating the disease. Despite the partial resistance of plasmodia, malaria chemoprophylaxis is unequivocally a cheaper choice than subsequent treatment of malaria.

Análise do custo aproximado do tratamento dos doentes hospitalizados na Eslováquia com malária importada. Entre 2003 a 2007, foram internados 15 doentes com malária importada. Os custos médios diretos do tratamento foram avaliados em 920,75 euros e indireto em 53,15 euros. No doente com o custo mais elevado de tratamento, a utilização da profilaxia com mefloquina representaria somente 0,5 por cento do total dos custos diretos do tratamento da doença. Apesar da resistência parcial do plasmódio, a quimioprofilaxia da malária é inequivocamente uma opção mais econômica do que o tratamento posterior da malária.

A Survey on the Mode of Working of Estheticians in OECD Member Nations andSome Asian Countries in Relation to Medical Service / 대한피부과학회지

In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.