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

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

Short term oxidative DNA damage by hyperbaric oxygenation in patients with chronic leg ulcers.

INTRODUCTION: Hyperbaric oxygen therapy (HBO) is successfully used for the treatment of a variety of conditions and diseases. HBO therapy can be valuable for treating selected cases of hypoxic diabetic leg ulcers and chronic venous insufficiency. Exposure to high concentration of oxygen is known to induce damage to cells, possibly due to an increased oxygen radical production. Reactive oxygen species also cause DNA damage. METHOD: The Comet assay method has been used to determine DNA damage. Number of DNA strand breaks obtained by the single cell gel electrophoresis in nucleuses of lymphocytes was isolated from venous blood. Nucleuses of lymphocytes were incubated by bacterial repair endonucleases, which detect and remove damaged parts of DNA (SBs, FPG, AlcA, ENDO, and H2O2). MATERIAL: 27 patients were investigated in this study; diabetes mellitus was diagnosed in 15 of them, and chronic venous insufficiency in 12. They were exposed in average 27 times in a hyperbaric chamber to a pressure of 2.5-3ATA of 100 % oxygen. Lymphocytes were isolated from venous blood before treatment and at different time after treatment (24 hours, 7 days, 14 days, 6 weeks). RESULTS AND CONCLUSION: Results of DNA damage evaluation at different time periods suggest there are no significant changes if compared to initial DNA damage values. HBO treatment can be used as adjuvant treatment because no significant risk is manifested with this therapy (Tab. 1, Fig. 7, Ref. 52).

The new therapy procedures for viper attack.

In Slovak Republic and the region of Central and Eastern Europe the viper is the only species of venomous snake living in wild. During the last nine observed years (1993-2002) the Toxicological Information Center (TIC) was consulted in 81 cases of individuals attacked by snakes. 51 of these cases were by viper, rattlesnake 6, and green mamba once. 23 cases were by non-venomous snakes; adder 22 times and royal snake once. The viper and adder attacks occurred in the wild and the other cases with snake keepers. None of affected individuals died. Our contribution contains the new recommended therapy procedures for viper attack.

[Atypical mercury poisoning]. / Atypická intoxikácia kovovou ortutou.

A case report documenting rare intravenous intoxication with metal mercury. Because of early diagnosis and treatment only minimal clinical symptoms were detected in the patient.

On the mechanism of acute toxicity of phosmet.

Rats were given single oral doses of phosmet (LD50 or 3/4 LD50). Changes of hematological parameters were studied in several time intervals; the main interest was paid to disturbances in blood clotting. Both light and electron microscopy were used to evaluate histopathological changes in selected organs (liver, lungs, spleen, stomach). Marked changes could be observed in all blood clotting parameters studied, other findings were not standard. The pathological picture was dominated by endothelial damage to the blood vessels and findings of thrombocytic clots in microcirculation of all organs examined. Together with hemocoagulation changes, they could be considered as reflecting the compensated stage of diffuse intravascular coagulopathy. In addition, damaged alveolar endothelium and interstitial edema could be observed in the lungs together with hepatic steatosis, damaged proximal renal tubuli, release of cellular elements from the splenic pulp and decomposition of megakaryocytes as well as serious exfoliation of the superficial layers of the gastric mucosa. The pathohistological alterations coincided with changes in organ weights.