Risk behavioral survey in the sample of Slovak adolescents.

OBJECTIVE: The study was aimed to assess risky behavioral factors in the sample of Slovak adolescents. BACKGROUND: Health-risk behavior contributes to the leading causes of morbidity and mortality among youth and adults. MATERIALS AND METHODS: The Youth and Parents Risk Factor Behavior Survey (YABS), based on bilateral US-Slovak project, is an ongoing cross-sectional school-based survey initiated in Bratislava as a model region. There were 798 questionnaires for students distributed; the response rate was 64 %. The sample involved 525 adolescents aged 15‒19 years from eight selected secondary schools in Bratislava, 38 % boys and 62 % girls. More than 90 % of fathers and mothers were employed, but some families nevertheless experienced a lack of finances (48.1 %), almost 70 % of students were from complete families. RESULTS: The study revealed a very high prevalence of risky behavioral characteristics in this pilot sample of adolescents significantly related to age, gender, type of school, completeness of the family and lower parental education.  CONCLUSION: The most important health risk behaviors were identified (tobacco, alcohol, drug consumption, violence, risky sexual behavior, inadequate sleep, physical inactivity, and excessive IT devices use). Targeted intervention proposals will be suggested in future (Tab. 5, Ref. 42).

Lenalidomide and dexamethasone in treatment of patients with relapsed and refractory multiple myeloma - analysis of data from the Czech Myeloma Group Registry of Monoclonal Gammopathies.

Lenalidomide (LEN) is an immunomodulator with clinical activity against myeloma cells. Based on the pivotal phase 3 trials MM-009 and MM010, the combination of lenalidomide and dexamethasone(DEX) was approved for patients with multiple myeloma who received at least one prior therapy. Here, we evaluated LEN/DEX therapy in unselected population and subsequently in selected sub-groups of patients with relapsed/refractory multiple myeloma followed in the Registry of Monoclonal Gammopathies of the Czech Myeloma Group. Altogether 858 patients were treated with LEN/DEX in the Czech Republic and Slovakia until end of 2017. The analyzed sub-groups were defined as patients with high risk cytogenetic aberrations and patients with relapsed and refractory MM. The overall response rate (ORR; partial remission or better response, PR) in the whole group of patients was 46.3% for all lines of therapy, 26.4% for high-risk group and 32.1% for relapsed and refractory group. Medians of overall survival (OS) in the same cohorts were as follows: 25.6, 15.7 and 18.5 months, progression free survival (PFS) was: 11.2, 6.4 and 9.0 months respectively. The most common adverse events were hematologic and infectious. In conclusion we found that our results correlated with those found in other studies in terms of response rates, survival measures, and also of treatment toxicity.

Czech Registry of Monoclonal Gammopathies - Technical Solution, Data Collection and Visualisation.

BACKGROUND: The Registry of Monoclonal Gammopathies (RMG) was established by the Czech Myeloma Group in 2007. RMG is a registry designed for the collection of clinical data concerning diagnosis, treatment, treatment results and survival of patients with monoclonal gammopathies. Data on patients with monoclonal gammopathy of undetermined significance (MGUS), Waldenström macroglobulinaemia (WM), multiple myeloma (MM) or primary AL ("amyloid light-chain") amyloidosis are collected in the registry. DATA: Nineteen Czech centres and four Slovak centres currently contribute to the registry. The registry currently contains records on more than 5,000 patients with MM, almost 3,000 patients with MGUS, 170 patients with WM and 26 patients with primary AL amyloidosis, i.e. more than 8,000 records on patients with monoclonal gammopathies altogether. RESULTS: This paper describes technology employed for the collection, storage and subsequent online visualisation of data. The CLADE-IS platform is introduced as a new system for the collection and storage of data from the registry. The form structure and functions of the new system are described for all diagnoses in general; these functions facilitate data entry to the registry and minimise the error rate in data. Publicly available online visualisations of data on patients with MGUS, WM, MM or primary AL amyloidosis from all Czech or Slovak centres are introduced, together with authenticated visualisations of data on patients with MM from selected centres. CONCLUSION: The RMG represents a data basis that makes it possible to monitor the disease course in patients with monoclonal gammopathies on the population level.Key words: Registry of Monoclonal Gammopathies - RMG - registries - monoclonal gammopathies - CLADE-IS - data visualisation - database.

Laparoscopic splenectomy in pregnancy - from contraindication to golden standard.

Laparoscopy has been holding its strong position within visceral surgery for decades. For several diagnoses, laparoscopy became the method of first choice. Laparoscopic splenectomy is a standardized procedure in patients indicated mostly due to haematological disorders. Apart from bleeding disorders, pregnancy used to be recognized as a contraindication to laparoscopic surgery. Splenic cysts are extremely rare during pregnancy; only seven cases have been described in literature. The authors had to deal with a patient treated and observed by haematologist for haemorrhagic splenic cyst and hypersplenism. Because of her low compliance, the patient did not undergo splenectomy in the past. Due to the gradual progression of disease and furthermore because of her pregnancy, the question of splenectomy became semi-urgent. The patient underwent laparoscopic splenectomy in second trimester, while not only the surgery alone, but also her early postoperative period and remaining pregnancy passed off uneventful. The authors suggest that even in pregnancy, the patients suffering from serious haematological disorders necessitating splenectomy could safely benefit from the advantages of laparoscopic approach, which also in these cases could become a gold standard (Fig. 2, Ref. 13).

[Immunohistochemical detection of ZAP-70 protein and its importance in the diagnostics of B-CLL]. / Imunohistochemická detekcia proteínu ZAP-70 a jej význam v diagnostike B-CLL.

Chronic B-lymphocytic leukemia (B-CLL) is one of the most frequent diseases of the lymphatic system in adults. It is known for its variable course--from benign to prospectless forms. Reliable prognostic markers are needed to precify the diagnosis and the correct therapy. The ZAP-70 protein, as a prospective marker, can be highly expressed in leukemic cells of B-CLL patients. It is related to a worse prognosis requiring intense therapy from the beginning. The present study includes 20 cases of bone marrow trephine biopsy from patients with diagnosed B-CLL and 20 control cases without neoplastic infiltration. The specimens were investigated with standard immunohistochemical technique and with the use of the amplification system (DakoCytomation). The results were evaluated semiquantitatively as negative (less than 5%), positive (above 30%), and irregularly positive (5-30% of positive leukemic cells) and consecutively correlated with clinical evaluation of prognosis of the patient. The evaluation of the positivity was controlled also by morphometric analysis by determination of the area of ZAP-70 positivity related to the whole area of nuclei in the section. In the control specimens the ZAP-70 positivity was restricted to T-lymphocytes only. The level of the nuclear positivity of ZAP-70 protein detected in transformed B-lymphocytes showed significant correlation with the worse or the better clinical prognosis, respectively. Cases with irregular positivity did not show unambiguous clinical correlation. The use of the amplification system allowed to apply lower concentration of the primary antibody, reduction of background staining and increased the contrast of the findings leading to reduction of irregularly positive cases from 30% (with routine histochemistry) to 10%. It can be concluded that ZAP-70 represents a valuable prognostic marker for the chronic B-lymphocytic leukemia. Its evaluation by histochemistry is a suitable method for clinical praxis. Problematic may be the evaluation of borderline irregularly positive cases, in which the use of the histochemical amplification system is helpful. Strictly determined criteria are needed for limitation of inaccurate interpretation of the results.

Community noise annoyance assessment in an urban agglomeration.

In urban areas community noise is one of the important factors in producing deterioration of both well-being and the quality of life. The aim of the study was to compare two noise annoyance surveys and two noise annoyance scales in the period of 15 years in selected areas of Slovak capital Bratislava, to calculate risks of community noise annoyance and disturbance in the observed samples. Noise annoyance risks were calculated by bivariate and stratified analysis in the form of odds ratio and Mantel-Haenszel weighted odds ratio from 2x2 and 2xn tables. The use of validated five-grade scale of noise annoyance assessment gives higher possibilities for more detailed analysis, allows to calculate the indicator--percentage of highly annoyed subjects (% HA), the rate of highly annoyed individuals. The percentage of highly annoyed subjects was 18% in the year 2004, which is comparable with recently published studies. The percentage of respondents that were not at all annoyed by road traffic noise has been decreased during the 15 year period by 10% (42% vs 32%). The increase of subjective community noise annoyance risks has been observed after 15 years as well. The sample from the year 2004 has been more annoyed by road traffic noise, neighbourhood noise, noise from entertainment facilities, noise from industry and railway noise. The highest risk increase has been observed in the entertainment facilities noise annoyance (OR(MH) =1.51; 95% CI = 0.90-2.52 vs OR(MH) = 4.47; 95% CI = 2.75-7.33). Using of standard five-grade noise annoyance questionnaire gives higher possibilities for data analysis in the studies investigating the influence of environmental noise annoyance on selected population groups (Tab. 3, Ref. 7).

Positive and negative trends in university students' food intake.

In the time period 1992-2004 the food intake data (24 hour recall, frequency questionnaire) in 3 417 students of Medical Faculty Comenius University in Bratislava (1257 men and 2160 women, the mean age 22.38 +/- 1.34) were obtained. The aim of this study was to evaluate the food intake and its trends in university students. Students' food consumption has not been in agreement with recommended dietary allowances (RDAs). The meat consumption was structurally unbalanced, though quantitatively sufficient (99% RDA); milk intake (75% RDA) was insufficient, fruit (65% RDA) and vegetable intake (62% RDA) even critical. On contrary, cereal products intake was excessive (130% RDA). Men eat more meat (p < 0.001), milk (p < 0.001), eggs (p < 0.01), cereals (p < 0.001) and fat (p < 0.001) than women. Women eat more fruit, vegetable and sugar than men. In the time period 1992-2004, students' meat consumption has decreased about 18%, milk and eggs about 23%, fruit about 42% and cereals intake has decreased about 45%. The fruit and vegetable intake structure has substantially improved (higher content of fresh fruit, fewer preserved products). In spite of a higher health awareness in students and tendency towards proper diet, their food intake has been negatively influenced by decreasing purchasing power in Slovak population (Tab. 2, Fig. 1, Ref. 15).

Stress and health-related behaviour, personality characteristics and blood pressure in older school children.

BACKGROUND: Frequent stress contributes to physical and psychical disorders already in school-age children. Subjective evaluation of stress level is considered adequately informative for differentiating eustress and distress. OBJECTIVES: Assessment of the extent of stress and connections with health-related factors and characteristics is a precondition for health promotion and stress prevention in school children. METHODS: In a cross-sectional study we analysed data from 213 older school children (107 boys and 106 girls) aged 10 and 14 years. Use was made of a self-evaluation questionnaire to assess the stress level, behavioural factors, feeling of health, 7-day report of data on diet and physical activity, J.E.P.I. test (Eysenck, 1971) evaluating neuroticism and extroversion. Sport activities were expressed as FIT value (product of frequency, intensity and time of exercises) and daily energy balance as ratio of average daily energy intake and energy expenditure. RESULTS: The girls felt stress more frequently than boys (38.7% vs 24.3%, p < 0.03). School stress was significantly more frequent than home stress. The stressed students more negatively evaluated their health and physical performance. The relation between stress degree and neuroticism score was confirmed. Sport and physical activities were significantly lower in boys with high stress load. Any closer relations between frequency of stress and health risk behaviour, sleep as well as school performance and blood pressure failed to be confirmed. CONCLUSION: The results have indicated the need of lowering school stress. One of effective ways is to promote physical activity in the life of children. (Tab. 3, Fig. 1, Ref. 24.)

Did the nutrition of Slovak medical students change? A comparison after 15 years.

OBJECTIVE: Authors aimed at positive and negative changes evaluation in nutrition and nutritional status of university-medical students comparing the situation in years 1984 and 1999. They were trying to determine, how was the nutrition of current medical students influenced by food consumption changes in the Slovak population and price liberalization of the food-stuffs as well. MATERIAL AND METHODS: Seven day reports from the year 1984 (199 students) and from the year 1999 (228 students) were processed using Food Research Institute, Food Composition Database and Programme. The quantity and quality of consumed food-stuffs and beverages were evaluated as well as energy and biologic value of students nutrition. Nutritional status of students was assessed by BMI (body mass index--kg/m2). Men and women (years 1999 vs. 1984) were separately evaluated by standard statistical methods. RESULTS: Lower energy, fat, cholesterol, animal protein and salt intake were observed in students in the year 1999; on the contrary, carbohydrates, sucrose, fibre, magnesium, vitamins C and E intake increased in comparison with the year 1984. The differences were mostly significant in women. Big changes in food consumption (1999 vs. 1984) were observed. Current students eat less meat (less pork, beef, fish, but more poultry), eggs and potatoes and women also less milk and dairy products than in the year 1984. On the contrary, the consumption of vegetable, fruits, legumes and non-alcoholic beverages increased. Alcohol intake decreased significantly. Students eat the most on Sunday, the least on Friday; women eat more rationally. Nutritional status in man was not changed, the percentage of slim women increased (p < 0.05). CONCLUSION: The food of current students (1999) is more varied, with the balanced content of plant and animal sources and with lower energy density than in the year 1984. Negative consequences of price liberalization in medical student nutrition are lower in comparison with Slovak global nutritional trends and they reflect the higher health awareness, eventually better socio-economic family background.