Initial attachment of Borrelia burgdorferi spirochetes to Vero cells.

BACKGROUND: Adhesion is the initial process in the establishment of any infection and can contribute to bacterial pathogenesis. Without the ability to adhere to host cell surface, there is no invasion, dissemination, or persistence and host colonization by many bacterial pathogens, including B. burgdorferi. During the infection, B. burgdorferi cells interact with cells of various origins. We are having limited information and knowledge regarding the borrelial invasion, intracellular existence and the host cell damage and the pathological effects to the host. We have investigated by electron microscope the adherence of motile Borrelia burgdorferi s.l. to Vero cells derived from the kidney of an African green monkey by electronmicroscopy. These cells have been shown as an interesting model for study of the toxic potential of many bacterial pathogens. METHODS: Adherence of the long-term in vitro passaged Borrelia burgdorferi sensu lato strains to a 24-hour monolayer of primate kidney epithelial Vero cells was studied using transmission electronmicroscopy. The reaction was read after incubation at 1-hour intervals. RESULTS: A vertical contact between borreliae and Vero cells was confirmed already after one hour of in vitro incubation. A cytotoxic effect of borreliae could be observed when the time of incubation was extended to 4 hour. The extent of attachment varied between the two borrelia strains tested. CONCLUSION: The optimal time for spirochetal adhesion in our model was 1 h postinoculation. Our results suggest that borrelia attaches to the tested cells by length and by the tip. The data showed that the extent of attachment varied between the two borrelia strains tested (Tab. 1, Fig. 4, Ref. 21).

[Validation of a new tool for identification of barriers to cervical cancer prevention in Slovakia]. / Validácia nového nástroja pre indentifikáciu bariér v prevencii rakoviny krcka maternice na Slovensku.

OBJECTIVE: The aim of the work was to validate the Slovak version of the CPC-28 questionnaire (Beliefs about Papanicolaou and Cervical Cancer). DESIGN: Original study. SETTING: Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, in co-operation with gynaecological centers in University Hospital Martin and district Martin, Slovakia. METHODS: The original English version of the CPC-28 questionnaire was translated into Slovak language. The questionnaire consists of 28 statements divided into six domains. Cronbach´s alpha coefficient was used to analyse the internal consistency of the questionnaire. Construction validity was evaluated by using Pearsons correlation coefficient. The results were processed in the statistical programs Epi Info 7.1.5. and Statistica 13, p-values < 0.05 were considered statistically significant. RESULTS: The Slovak version of the questionnaire was provided to 27 women. The women were given two questionnaires, and one of them was filled in immediately (test). After 14 days they filled in and returned second questionnaire (retest). The value of Cronbachs alpha was > 0.8 in all six domains which demonstrates the high internal consistency of the questionnaire. Pearsons coefficient was > 0.7 in all six domains and p-values < 0.001. CONCLUSION: The validated CPC-28 questionnaire in the Slovak language can be administered to women to collect data for identification of barriers to cervical cancer screening among women.

Trends in standardized mortality rates for select groups of cardiovascular diseases in Slovakia between 1980 and 2010.

OBJECTIVES: Reducing mortality due to cardiovascular diseases especially in people less than 65 years is one of the main targets of WHO preventive programs. This work aimed to analyse recent trends in cardiovascular mortality rates in Slovakia. STUDY DESIGN: A descriptive study was implemented with a Joinpoint analysis. METHODS: Analysis was of annual all circulatory, acute myocardial infarction mortality, and cerebrovascular disease mortality rates, between 1980 and 2010 for Slovakia. Data were stratified by sex and 10-year age group (age 25-85 years). The annual percentage change (APC) and significant changes in the trend were identified using joinpoint Poisson regression. RESULTS: The standardized mortality rate for all cardiovascular diseases declined in Slovakia between 1980 and 2010 by 25.7% and 30.5% for men and women, respectively. Joinpoint analysis of all cardiovascular disease mortality rates demonstrated statistically significant changes in trends of APC decline for both genders. For men, acceleration in the rate of decline between 2001 and 2010 was observed APC -2.2 (95% CI = -3.5, -1.2) following a slowing of the rate of decline between 1980 and 2001, when the APC reached -0.5 (95% CI = -0.8, -0.3). For women the trend was similar. Between 2003 and 2010 acceleration in the decline was demonstrated APC -2.8 (95% CI = -4.3, -1.4). CONCLUSION: The results of our analysis demonstrate the need to constantly address issues of cardiovascular diseases, as mortality rates in Slovakia are among the highest within the European Union countries in the long term.

[Knowledge about cervical cancer among respondents in Slovakia and the Czech Republic - Aurora Project]. / Vedomosti respondentov na Slovensku a v Cechách o karcinóme cervixu - projekt Aurora.

OBJECTIVE: The Aurora Project, aimed at promotion of cervical cancer prevention, was realised with the support of the European Commission. The project included 14 partners from 11 EU countries. The objective of this contribution was to analyse the level of knowledge on cervical cancer among respondents in the project partner countries and to compare the situations in Slovakia and the Czech Republic. Data were obtained within one of the project outputs: Work Package 2 (WP2) Dissemination of Aurora Project Objectives and Results. METHODS: The questionnaire used included 10 questions (available at the project website www.aurora-project.eu) and has been translated into 11 languages of the project partners. In total, 2111 questionnaires were analysed (91.7% response rate), among them 246 were from Slovakia and 305 from the Czech Republic. Descriptive statistical methods and the χ2 test were used to analyse data. RESULTS: The level of knowledge in Slovak and Czech respondents was comparable in answers to seven questions. Statistically significant differences were observed in answers to questions about anatomy and cervical cancer therapy. Answers to the question, 'What are the symptoms of cervical cancer in the early stages?', should be considered as crucial to understand attitudes of the lay population towards prevention. There were 7% of women in the Czech Republic and 16% in Slovakia with the opinion that there is some clinical manifestation of such a condition. This means that women with such an opinion have no reason to visit a gynaecologist while no signs of a disease are present. The period during which they do not attend a preventive check-up is sufficient for the development of precancerous lesions or even cancer. CONCLUSION: Recommendations of doctors play a key role in primary and secondary prevention of the disease. An important part of interventions includes information campaigns and educational programmes. The internet is another important source of information, especially for younger generations. Together, these can contribute to increased participation in preventive check-ups by education of the general public. Thus, the disease can be detected early and the development of cervical cancer prevented.

[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.

[Does transabdominal amniocentesis in the 2d trimester affect fetoplacental circulation?]. / Ovplyvnuje transabdominálna amniocentéza v II. trimestri fetoplacentárnu cirkuláciu?

In a prospective study the authors focused attention on Doppler sonographic examination of the foetoplacental circulation and whether it is influenced by transabdominal amniocentesis. They examined 124 pregnant women subjected during the 17th or 18th week of pregnancy to amniocentesis in the out-patient department. Before amniocentesis and soon after it they examined the flow in the uterine artery on the right and in the umbilical artery. From five consecutive cycles they evaluated the S/D ratio and RI in both vessels and compared the results. They did not record any complications during amniocentesis. Evaluation of the results of both investigated parameters before and after amniocentesis did not reveal any statistically significant differences in the investigated vessels. Based on the assembled results, the authors assume that transabdominal amniocentesis, despite its invasive character, does not influence the foetoplacental circulation and does not have a negative impact on the course of pregnancy.

[Uterine artery flow in pregnancy with 1st trimester hemorrhage]. / Prietok v a. uterina u tehotných s krvácaním v 1. trimestri gravidity.

The authors examined in a prospective study in 25 pregnant women blood flow in the uterine artery during haemorrhage in early pregnancy with the diagnosis of imminent abortion. The control group was formed by a group of 25 women with intact pregnancy, in the first trimester. For examinations an ultrasound apparatus ATL MK 600 was used, the authors evaluated the S/D ratio and RI from five consecutive cycles. The mean values of the S/D ratio in the investigated group were 4.85 +/- 0.22, in the control group 4.41 +/- 0.24 which is a statistically significant difference. Similarly the mean RI values in the investigated group were 0.79 +/- 0.01, in the control group 0.77 +/- 0.02--the difference is statistically significant. The results confirmed the assumption that by monitoring of the blood flow in the uterine artery in women with bleeding during the first trimester of pregnancy it is possible to detect relatively early risk patients.