[Study on the Effects of Sex and Age on Proximal Femoral Fractures in Two Culturally Diverse Countries]. / Studie vlivu pohlaví a veku na zlomeniny proximálního femuru ve dvou kulturne rozdílných státech.

PURPOSE OF THE STUDY The pilot study deals with the current situation in proximal femoral fractures in culturally diverse regions, namely in Afghanistan (AFG) and in the Czech Republic (CZ). The study aimed to find out whether there are any differences in proximal femoral fractures in dependence on the selected criteria between the two culturally diverse areas. The study used the data of patients who underwent surgery for proximal femoral fracture at the Department of Orthopaedics of the 1 s t Medical Faculty of the Charles University and the Military University Hospital and at the Military Base Hospital Kabul. MATERIAL AND METHODS The study included patients aged 21 years or older who sustained a proximal femoral fracture in the period from October 2013 to February 2014. For the period concerned, the evaluation comprised 44 patients with a proximal femoral fracture from the Military Base Hospital Kabul, of whom 25 women and 19 men, and a total of 71 patients with a proximal femoral fracture from the Department of Orthopaedics of the 1st Medical Faculty of the Charles University and the Military University Hospital, of whom 43 women and 28 men. Based on the medical documentation, the following evaluation parameters were selected: age, sex, type of fracture. The data was processed using descriptive statistics, one-way and multifactorial analysis (ANOVA) and the POST-HOC test (Fisher LSD test, confidence interval = 95%) RESULTS The mean age of all the patients who suffered a fracture of proximal femur in AFG (58 years) was considerably lower (p < 0.001) than in patients in CZ (81 years). Similarly, a significant difference (p <0.001) was identified in the age of men and women treated for a proximal femoral fracture in both the countries. In AFG there was a statistically significant difference (p = 0.002) between the age of men and women, where women sustaining fractures were younger (54 years) compared to men (63 years). In CZ no significant age difference was reported (83 years vs 78 years). In AFG, the observed fractures occurred generally in their 6th and 7th decade, whereas in CZ only in their 9th decade. The incidence of proximal femoral fractures in Afghan women is the highest in their 5th and 6th decade. Pertrochanteric fractures and intracapsular fractures prevailed in both countries. The lowest age in both types of the fracture was reported in Afghan women (52 years in femoral neck fracture, p <0.001, 54 years in trochanteric fracture, p = 0.039). DISCUSSION Significant differences between the patients in AFG and CZ concern several factors. Afghanistan is a country with the lowest average life expectancy. In the Afghan population a major Vitamin D deficiency was confirmed. This is related to the conservative dress code, especially in women, when the Vitamin D synthesis is suppressed. That can cause the occurrence of osteoporosis in women at a considerably younger age than in the population in the Czech Republic, which is subsequently accompanied by an increased incidence of proximal femoral fractures. Similar results, however, were also obtained in men. One of the risk factors of osteoporosis development is also low physical activity throughout the lifetime. This risk factor is significant primarily in female population in the Muslim world. Afghanistan also faces serious malnutrition. All of that is reflected in low life expectancy in the given country, incidence of osteoporosis and injuries in this region. There is reasonable evidence that the mortality in a causal relationship with proximal femoral fracture is substantially higher in this region than in Western Europe. CONCLUSIONS The results of the pilot study showed that there are significant differences in age and frequency of fractures in dependence on sex and country. The obtained results can be considered valuable since there are virtually no scientific or professional studies on osteoporosis and fractures in the given area that would help physicians get ready for significant differences. These results may become a source of valuable information not only for medical practitioners coming to Afghanistan to help as volunteers in the framework of developmental assistance from all over the world, but also for physicians from Europe, with respect to the wave of migrants coming from this area. Key words: proximal femur, fracture, gender, age, Afghanistan, Czech Republic.

[Epidemiological Study of the Effects of Gender, Age, Mobility and Time of Injury on Proximal Femoral Fractures]. / Epidemiologická studie vlivu pohlaví, veku, mobility a doby úrazu na zlomeniny proximálního femuru.

PURPOSE OF STUDY Based on the selected criteria the study presents the evaluation of data of patients who underwent a surgery for proximal femoral fracture at the Department of Orthopaedic Trauma of the 1 st Faculty of Medicine and Military University Hospital Prague in the period 2013-2016. The paper aimed to determine whether there are any differences in proximal femoral fractures depending on the selected criteria. MATERIAL AND METHODS The study comprised 805 patients (562 women and 243 men) older than 21 years with proximal femoral fractures who were treated between January 1, 2013 and December 31, 2016. In the study, the patient s data on gender, age, a type of fracture (according to the AO classification), a level of mobility, time of injury and month of injury were analysed. The data was evaluated using the methods of descriptive statistics, one-way analysis of variance, two-way analysis by ANOVA and by following select POST-HOC test (Fisher LSD test) were utilized, 95% confidence interval was selected . RESULTS In the group of treated patients, the men were outnumbered by women (70% vs. 30%). In women the fractures occurred at a significantly (p < 0.001) older age (82 years) compared to men (77 years). Until the 8 th decade the fractures in men dominated, while from the 9th decade the fractures were more frequent in women. A sharp increase in the number of fractures in women was reported exactly in the 9th decade (56% of the total number of fractures in women). The group of women showed a significant difference (p = 0.027) between the age of femoral neck fractures and the age of trochanteric femoral fractures (80 years vs. 84 years). In both genders intracapsular and pertrochanteric fractures prevailed. In women and men with a limited mobility, fractures were sustained at the highest mean age (85 years in women, 84 years in men) compared to the other levels of mobility. In mobile patients, a significant difference (p < 0.001) was found between the age of women and men at which the fracture was sustained (79 years vs. 71 years). The largest significant difference (p < 0.001) in the age of fracture is seen in night time (84 years in women, 71 years in men). The highest number of injuries was suffered in the months of October to January, whereas the lowest number was reported in the period from June to July. DISCUSSION The epidemiological studies underline a notably higher incidence of proximal femoral fractures in women than in men, which was also confirmed by our study. The mean age of women with proximal femoral fracture was significantly higher compared to men. Similar conclusions have been drawn also by other studies. The incidence of fractures in dependence on the age group was the highest in women and men in their 9th decade, which compared to the previous studies was at a later age. This finding can be justified by aging of the Czech population, with the growing number of persons in the 9 th decade age group between 2012 and 2017 by 40,000. Nonetheless, men prevailed in fractures until the 9 th decade, while from the 9 th decade there is a marked growth in the number of these fractures sustained by women. This corresponds with the findings of other authors. As to the individual types of fractures (neck, trochanteric fracture) no difference was revealed in the percentage of women and men. In both genders intracapsular and petrochanteric fractures prevailed. Neither the level of pre-fracture mobility, nor the time of injury have been sufficiently monitored and evaluated with regard to the age of patients, therefore there is no adequate data to compare our results with. The lowest mean age at the time of injury was achieved by fully mobile men (71 years), which can be attributable to their sports and social activities performed at this age. The highest number of proximal femoral fractures was reported in the period from October to January, whereas their lowest number was reported in the period from June to July, which corresponds with the majority of other conducted studies in this area of research. CONCLUSIONS A considerably higher incidence of proximal femoral fractures in women was confirmed. The mean age of women with proximal femoral fracture was significantly higher than in men (82 vs. 77 years). Men prevailed in the number of fractures up to the 9 th decade, whereas from the 9 th decade the number of proximal femoral fractures in women significantly grew. In individual types of fractures (neck, trochanteric fractures), no difference in percentage of women and men was found. In both the genders intracapsular and pertrochanteric fractures significantly prevailed. The lowest mean age (71 years) at the time of injury was achieved by fully mobile men. The same age was identified in men also with respect to injuries sustained at night. The highest number of proximal femoral fractures was reported in the period from October to January, the lowest in the period from June to July. The knowledge of these seasonal variations can help plan the health care in the medical facility concerned. Key words: proximal femur, fracture, gender, mobility, day-time, seasonality.

Surveillance and characterisation of Cronobacter spp. in Czech retail food and environmental samples.

Cronobacter spp. (formerly Enterobacter sakazakii) are emerging, opportunistic pathogens that are linked with food-borne infections in neonates and infants. In the present study, 291 samples of food, 36 samples from a dairy farm and 140 samples of dust from vacuum cleaners were examined for the presence of Cronobacter spp. using chromogenic media and biochemical tests. Altogether, 72 Cronobacter spp. strains were isolated in accordance with the reference standard CSN P ISO/TS 22964 (2006). No Cronobacter spp. strains were detected in 10 samples of infant milk formula or in samples from a dairy farm. Twelve out of 20 positive food samples were dry products. The incidence of Cronobacter spp. in instant and powdered products and spices (12 positive isolates out of 82 samples) was significantly higher than that in other foods (P = 0.002), but lower than that in samples of dust (52 isolates; P < 0.001). The incidence of Cronobacter spp. in dust from restaurants, bars and hotels (13 positive isolates in 20 samples) was significantly higher than that in dust from households (P = 0.010). The polymerase chain reaction assay for the species-specific detection of the rpoB gene was performed in 49 isolates. Thirty-four Cronobacter spp. isolates were identified as Cronobacter sakazakii, nine isolates as Cronobacter malonaticus and one isolate as Cronobacter turicensis.

Effect of lead in water on the absorption of copper, iron, manganese and zinc by sheep (Ovis aries) infected with sheep tapeworm (Moniezia expansa).

The sheep tapeworm (Moniezia expansa) and its host Ovis aries were analyzed by inductively coupled plasma optical emission spectrometry (ICP-OES) for their copper, iron, manganese, zinc and lead levels. Element concentrations in cestode parasites were compared to those in various organs (liver, kidney, and muscle) of sheep. Tapeworms in the small intestine of sheep that were administered 2g of Pb(CH(3)COO)(2) per os daily (7 days) had significantly higher lead concentrations than sheep tissues. Cu levels significantly increased after Pb administration in sheep muscle and sheep tapeworms. Contrarily, Zn content significantly decreased in sheep muscle, but significantly increased in sheep tapeworms. However, Mn content significantly decreased after Pb administration in sheep tapeworms. Furthermore, Fe content significantly decreased after Pb administration in sheep liver and kidneys.

The initial discovery of thorny-headed worms in sheep.

Acanthocephalans belonging to the species Acanthocephalus lucii were found in the colon of a lamb from ecological farms in the Czech Republic. The main determination features used for these acanthocephalans are the shape and size of the hooks as well as the number of hooks on the proboscis. Three immature specimens measured 5.0-13.2mm in length; the appearance of the acanthocephalan body (in the studied material) suggests that passage through this unusual host causes the cystacanths to slightly increase in length. In the case of the lambs examined, the infection may be acquired through the accidental ingestion of the intermediate host - waterlouse (Asellus aquaticus).

Shedding of Toxoplasma gondii oocysts by Felidae in zoos in the Czech Republic.

In 1995 and 1996, the shedding of Toxoplasma gondii oocysts was monitored in the faeces of Felidae in six zoos in the Czech Republic. In all, 2287 samples of faeces from 19 species of Felidae were examined. In Ostrava Zoo, four episodes of shedding of Toxoplasma-like oocysts were identified, using a flotation examination, in a pair of wild cats (Felis silvestris), six episodes in a wild cat held separately, and three episodes in a pair of Amur leopard cats (F. euptilurus). After the passage of sporulated oocysts through laboratory mice, T. gondii was confirmed in the pair of wild cats (three episodes), in the wild cat held separately (three episodes) and in the pair of Amur leopard cats (one episode). In Jihlava Zoo, one episode of shedding of T. gondii oocyst was identified in Geoffroy's cat (Oncifelis geoffroyi) using flotation and isolation examination. The possible sources of toxoplasmosis of the Felidae in zoos are discussed.

[First report of demodicosis in goats in the Czech Republic]. / První nálezy demodikózy koz v Ceské republice.

The first case of demodectic (Acari: Demodecidae) mange in the Czech Republic was diagnosed in a domestic White Shorthaired goat hospitalized in our clinic. A total of 128 solid protruding nodules, similar in size to lens or pea, were found on lateral parts of the neck and trunk and on proximal part sof the limbs. A pasty, creamy mass containing immature and adult mites could be pressed out of the nodules. Parasitological examinations identified the mites as Demodex caprae Railliet, 1895 (Fig. 1). Antiparasitic treatment was started with the pyrethroid deltamethrine (Butox 7.5 Pour On, Roussel Uclaf) although demodectic mange is not given in the spectrum of its applications. Ten ml of the drug were poured onto the back of the animal twice within an interval of 7 days. The next drug tested was another pyrethroid, Neostomosan sol. ad us. vet. (Sanofi Santé Animale) containing tetramethrine and transmix as the effective ingredients and recommended by the manufacturer for the treatment of canine and feline demodicosis. The animal was bathed twice within an interval of 14 days in a 1 : 400 dilution as recommended by the manufacturer. The mites survived the treatments with both drugs and their motility was not affected. The size of nine of the nodules (4.5 to 6.8 mm), measured before and after the treatments, remained unchanged. The third drug tested was amitraz (Taktic, Hoechst) known to be effective against canine demodicosis (Ectodex, Hoechst). Seven baths with 10-day intervals in the drug diluted 1 : 400 resulted in the decrease of the number of nodules to 83 (by 35.2%). The diameters of 7 of the measured nodules diminished by approx. 1.6 mm. No movements of the mites were observed on Day 56 after the treatment, but the immature stages probably survived because new nodules and allergy developed after the patient had been released from the clinic. The unsatisfactory effect of amitraz can be explained by the limited penetration of the drug into the nodules surrounded by fibrous tissue. Demodectic mange was subsequently diagnosed in one highly pregnant animal housed together with the patient. Further cases of demodicosis were detected by intentional examinations in the districts of Nový Jicín and Olomouc (three cases in the latter). It is apparent that the infection may remain undetected at current health checks, although it is world-wide spread and causes considerable losses to the hide-and-skin industry.

[The extent of the incidence of sarcocystosis in cattle and pig farms]. / Extenzita výskytu sarkocystózy v chovech skotu a prasat.

The extensity of a chronic form of sarcocystosis was studied in certain age categories of cattle and pigs. The incidence of sarcocysts was investigated microscopically after 0.25% trypsin action in the muscles of bovine gullet and diaphragmal columns of pigs. Bovine fetuses and sucking calves did not have any sarcocysts. The first cases of positive findings were recorded in calves on milk diet (18.33%). The infestation rate of adult cattle is high in this country and reaches the level of 90%. The disease extensity in pigs is lower by an order and it did not exceed the level of 4%. There were found no significant differences (the mean 81.85%) in the infection rate in the cows coming from various regions of the CSR if the incidence of the disease was evaluated geographically. Larger percent differences were recorded between cattle and pig herds, mostly in the South Moravian Region, if evaluated by the districts and farms. The results of the investigation of 1273 head of cattle and 335 head of pigs coming from various farms were processed statistically. We tested the sarcocyst incidence in the muscular tissue in relation to the ways of housing and seasonal changes. Considerably lower rates of sarcocystosis infestation on the large cattle and pig farms were demonstrated. In the other case no relationship was proved. The samples taken in all year seasons could be evaluated in the same objective way. We discuss potential preventive measures of this parasitosis-zoonosis.

[Development of sarcocystosis in experimentally infected calves]. / Vývoj sarkocystózy u experimentálne invadovaných telat.

In seven calves we studied experimental invasions by sporocysts of the Sarcocystis cruzi (S. bovicanis) species, isolated from faeces of dingo dogs. Out of clinical changes, an increase in body temperature to 39.6 to 40.5 degrees C is characteristic in the fourth to the eighth week of disease, relaxed attitude of animals, progressive thinning down, anaemia of mucous membranes, diarrhoea and total dehydration. The post-mortem examination completes this observation with generalized hyperplasia of lymphatic nodes to haemorrhagic lymphadenitis and small petechial haematomata on serous coats, particularly on epicardium. Schizonts in the endothelium of capillaries in various organs were evaluated as specific lesions, demonstrated within 26 days from invasion in one calf. From 46 days after invasion we found muscular cysts in three other calves. The titres of sera in all experimental calves obtained with the NFR method are also evaluated as specific. Invaded calves died gradually between the 26th and 59th day, control calves were slaughtered and no sarcocysts were found.

[Detection of sarcocystosis in heifers and pigs using the indirect immunofluorescence method and trypsinization of muscle tissue]. / Detekce sarkocystózy skotu a prasat metodou neprímé imunofluorescencní reakce a trypsinací svalové tkáne.

The incidence of sarcocystosis was studied in cattle and pigs of different age categories by means of the methods of muscular tissue trypsinization and indirect immunofluorescence reaction (IFR). On the whole, 173 head of cattle and 107 pigs were examined. In the category of calves, a positive serological reaction was proved in 75% of cases, and positivity in the trypsinization of muscular tissue was found only in 15% of cases. In the category of beef bulls 64% of cases were serologically positive and 96% were positive in the trypsinization test. In the category of cows 70.84% of cases were positive serologically and 85.42% by trypsinization. In fattened pigs serological positivity was demonstrated in 10.53% of cases but the direct determination of sarcocysts failed in all cases. On the other hand, trypsinization of sows was positive in 8% and IFR was negative in all cases. The discussion deals with the correlations of all results obtained by the above diagnostic methods.

[Methods of direct detection of sarcocysts and their diagnostic reliability]. / Metody prímé detekce sarkocyst a jejich diagnostická spolehlivost.

The methods of the direct determination of sarcocysts in bovine muscle were studied. The results obtained with the compression, histological, homogenization and digestion methods were compared and evaluated. The criteria included capture rate, labor requirement, economic requirements, expediency and diagnostic reliability. The compression method was found to be the cheapest but, at the same time, the least reliable. The highest capture rate and diagnostic reliability were found in the digestion method with trypsin used as the diagnostic agent.