[Drugs and traffic accidents]. / Drogy a dopravní nehody.

BACKGROUND: The aim of the study was to map the prevalence of alcohol and other psychotropic substances in deceased participants of traffic accidents in the Czech Republic. METHODS AND RESULTS: The studied sample included persons autopsied in the departments of forensic medicine and forensic toxicology that died during traffic accidents and were toxicologically tested in 2003. Case definition involved alcohol cases with blood alcohol concentration (BAC) 0,2 g/kg and higher, with cannabis, detections of active THC metabolites only were taken into account; in cases where volatile substances (solvents) were detected we included into the definition only cases with substances not produced post mortem or in some physiological or pathological statuses. We identified 554 cases of whom 440 (79.4%) were males and 114 (20.6%) were females. 35.5% were in the age group 20 - 34 years. The sample has been classified into 4 categories (average age, % of males): pedestrians (45.4, 76.2), bicyclists (51.1, 82.0), drivers (36.3, 91.2) and others (36.1, 66.2). Alcohol was tested in 548 cases, 214 (39.1%) of those were found positive. 380 cases were tested for other psychotropic substances than alcohol; samples taken from 25 bodies (6.6%) were found positive for at least for one of these substances. 8 cases were positive both for alcohol and some other psychotropic substance - i.e. 3.7% out of 214 cases positive for alcohol were positive for other substance and 32.0% out of 25 cases positive at least for any other psychotropic substance were alcohol-positive. When focusing our analysis at the active participants of road traffic accidents only - pedestrians, bicyclists and drivers (altogether 397 cases) - we have found alcohol to be tested in 394 cases, out of which 158 (39.1%) were positive; as for other psychotropic substances, 314 cases were tested and 23 (7.3%) were positive at least for one of them. 7 cases were found positive for alcohol and other psychotropic substance simultaneously; this represents 4.4% out of 158 cases positive for alcohol and 30.4% out of 23 cases positive at least for one psychotropic substance other than alcohol. Average BAC in active participants of road traffic accidents positive for alcohol were 1.81%, (1.98%o in pedestrians, 1.78 %o in bicyclists and 1.64 %o in drivers). Prevalence of either alcohol or any other psychotropic substances is the lowest in the category of drivers - with the exception of active cannabinoid compounds. Alcohol was by far the most prevalent psychotropic substance, also cannabis, benzodiazepines and stimulants have been found in not negligible frequencies. CONCLUSIONS: The study confirms high prevalence of alcohol influence in deceased participants of traffic accidents. Prevalence of other psychotropic substances is lower by order, but it becomes also significant.

[Questionnaire study of general practitioners regarding experience and attitude to opioid substitution therapy]. / Dotazníková studie mezi praktickými lékari zamerená na zkusenosti a postoje k substituci opioidy.

UNLABELLED: General practitioners (GPs) in their surgeries and substitution treatment centres are the major providers of opioid maintenance treatment in a number of European countries. Although in the Czech Republic any GP has been allowed to prescribe buprenorphine (Subutex) since 2001, the opioid substitution treatment provided by primary care professionals has not been the subject of research to date. OBJECTIVE: To collect and analyze data on GPs' experience gained with opioid maintenance treatment in the Czech Reupblic, their attitudes and needs. METHOD: A structured questionnaire was distributed via the Bulletin of the Association of General Practitioners and district Association representatives. The validity of study results may be affected by a low respondence rate (10%) with 398 questionnaires only returned by mail. RESULTS: Twenty-eight (7%) GPs reported to have gained experience with buprenorphine which was most frequently prescribed in the regions with the highest prevalence of heroin users, i.e. in Prague and the Ustí nad Labem region (27% and 12%, respectively). Other regions, including wes- tern and southern Bohemia with relatively high prevalence of heroin users, showed lower buprenorphine prescription rates (0-6%). Most buprenorphine prescribers (78%) rated their experience as positive or highly positive. Availability and effectiveness were seen as the main pros of the substitution treatment. One third of the GPs who have not prescribed opioid maintenance treatment yet are considering doing so in the future. Greater awareness of drug abuse issues and availability of methodical guidance and consulting in opioid substitution treatment are going to become the most relevant factors in the future. Possible reportability of data on opioid maintenance treatment to a central registry does not seem to be a major obstacle to implementing the substitution treatment in the GPs' surgeries. Decision makers should take advantage of the GPs' potential to promote the opioid maintenance treatment in the Czech Republic.

Argyrophilic nucleolar organizer regions in breast cancer: prognostic significance.

109 cases of breast cancer were examined in order to assess correlation between the number and size of argyrophilic nucleolar organizer regions (AgNORs) on one hand and prognosis of the disease on the other hand. Results indicate that an indirect correlation exists between AgNOR counts and survival rate of patients. Cases with short survival were observed having significantly frequent AgNORs larger than 5 microns.