Are barriers in accessing health services in the Roma population associated with worse health status among Roma?

OBJECTIVES: The health of Roma has been found to be poorer than that of the majority population. The aim of this study was to explore the differences between Roma and non-Roma regarding perceived barriers in accessing health services. Furthermore, we aimed to assess the association between self-rated health status and Roma ethnicity and explore to what degree barriers in accessing health services explain this association. METHODS: We used data from the cross-sectional HepaMeta study conducted in 2011 in Slovakia. The final sample comprised 452 Roma (mean age 34.7; 35.2 % men) and 403 (mean age 33.5; 45.9 % men) non-Roma respondents. RESULTS: Roma ethnicity was found to be significantly associated with poorer self-rated health status. A considerable part of this association can be explained by barriers in accessing health services as perceived by Roma. CONCLUSIONS: Worse health in Roma is partially mediated by worse access to health services, apart from a large educational gap between Roma living in settlements and the majority population. Interventions should focus not only on health literacy among Roma but also on the health care system and health care professionals.

Pathological findings in cornea tissue of patients with penetrating keratoplasty.

The aim of this clinical study was to examine corneas extracted from the patients during penetrating keratoplasty for the presence of immunoglobulins and inflammatory cells that can be warning for the graft failure. Individual clinical diagnoses were correlated to the presence of the inflammatory signs in corneal tissue. The signs of inflammation in corneal layers were detected especially in group of patients classified as viral keratitis but were also found in corneas of patients with degenerative diseases of the cornea. Depending on the number of keratoplasties no statistical difference in analysed parameters was found. Inflammatory process represented by slight positive presence cellular infiltration and/or immunoglobulins could be present in corneal tissue also in absence of acute manifestation. Histological and immunohistochemical evaluation of corneal tissue from patients undergoing penetrating keratoplasty could improve estimation of correct diagnosis. Subsequently prompt adequate therapy could improve worse prognosis of corneal graft with evident immune process.

Preliminary clinical experience with the preparation and therapeutic use of autologous osteoblasts and chondrocytes.

Particular results of autologous osteoblasts preparation from patient's bone marrow and autologous chondrocytes from cartilage, both for therapeutic application are given. Osteoblastic cells were cultivated from fresh bone marrow in the presence of dexamethasone in alpha MEM medium containing 10% of patient's and 10% of fetal bovine sera and other necessary additives without any cytokine stimuli. Alkaline phosphatase cell surface activity was used as a marker for quick osteoblastic phenotype confirmation. Autologous chondrocytes were enzymatically separated from fresh knee cartilage. Pieces of cartilage, 2 mm(3) in volume, were sufficient for live cellular graft preparation. Viability of chondrocytes obtained by this approach was more than 90%. In both cases, in osteoblasts as well as in chondrocytes, the amount of cells obtained during the 4 week culture, was sufficient for clinical use.