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Journal Article 2011; 32(5): 716-721 PubMed PMID: 22167137 Citation  Keywords:  Adiponectin:blood, Aged, Brain Ischemia:epidemiology, Female, Ghrelin:blood, Humans, Intracranial Arteriosclerosis:epidemiology, Intracranial Embolism:epidemiology, Leptin:blood, Male, Middle Aged, Risk Factors, Sex Distribution, Stroke:epidemiology, Stro.   

OBJECTIVES: Fat tissue is an important endocrine organ that produces a number of hormones and cytokines (leptin, adiponectin, resistin, plasminogen activator inhibitor-1, Tumour necrosis factor TNF α) with essential roles in regulation of many physiological functions.

METHODS: We targeted implications of adipokines in ischemic stroke patients. Patients with acute stroke were examined (n=145) and the results were compared with the control group (n=68). We have examined potential associations between leptin, adiponectin and ghrelin, and different types of stroke and traditional risk factors.

RESULTS: Significantly higher levels of leptin and lower levels of adiponectin and ghrelin were confirmed in the stroke group. The level of leptin in women with stroke was three-times higher than in men, and the leptin levels positively correlated with obesity in both sexes. Ghrelin levels correlated mildly with triglyceride levels, and were dominant in men with cardioembolic stroke. Adiponectin levels were not different between men and women with acute stroke, and correlated with atherothrombotic and lacunar stroke types in men.

CONCLUSIONS: Adipokines and ghrelin play an important role in ischemic stroke, but their function in stroke subtypes seems to be different and sex influenced. More research is required to confirm our results....

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Journal Article 2011; 32(5): 711-715 PubMed PMID: 22167134 Citation  Keywords:  Acute Disease, Adiponectin:blood, Aged, Aged, 80 and over, Blood Glucose:metabolism, Body Mass Index, Brain Ischemia:epidemiology, Female, Humans, Isomerism, Lipids:blood, Molecular Weight, Risk Factors, Stroke:epidemiology,.   

OBJECTIVE: An association between cerebral infarct risk factors and serum adiponectin levels (both total and separate isoforms) has previously been identified. The aim of this study was to assess circulating levels of all forms of adiponectin in the course of an ischemic stroke.

MATERIAL AND METHODS: Adiponectin and its isoforms (HMW, MMW and LMW) were measured in serum samples taken from 38 women in the first 24 hours of cerebral infarct and 38 controls matched for gender, body mass index (BMI) and age. In addition, biochemical parameters (glucose, insulin, lipid profile) and clinical data (blood pressure, weight, and height) were evaluated.

RESULTS: A significant reduction in serum levels of adiponectin and all examined fractions of this adipokine was observed in women suffering from acute ischemic stroke, compared with the matched controls.

CONCLUSIONS: Differences in the serum adiponectin array between stroke subjects and controls were identified and further studies are required to investigate the clinical implications of this finding....

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Journal Article 2011; 32(4): 453-457 PubMed PMID: 21876501 Citation  Keywords:  Adult, Cervix Uteri:anatomy & histology, Female, Fertilization in Vitro, Humans, Infant, Newborn, Mass Screening:methods, Predictive Value of Tests, Pregnancy, Pregnancy Trimester, Third, Premature Birth:diagnosis, Risk Factors, Sensitivity and Specificit.   

OBJECTIVES: To verify the relation between pregnancy duration and cervical length (CL) at 22-24 wks of spontaneous and IVF singleton gestations and to assess its predictive value for preterm delivery (< 37 wks).

MATERIAL & METHODS: CL at 22-24 wks was performed according to FMF recommendations in 344 women who conceived spontaneously and in 107 IVF singleton pregnancies. The results of CL in both groups were divided into subgroups: ≤ 29 mm, 30-34 mm; 35-39 mm; 40-44 mm; 45-49 mm and ≥ 50 mm. They were subsequently correlated with mean durations of gestation within subgroups and parameters of accuracy were calculated. Correlation and regression analysis was performed.

RESULTS: The average age of women in both groups was 28.1 y.o. (SD=4.2 years) and 33.4 y.o. (SD=4.1 years), respectively. The mean gestation age at delivery was 38.9 wks (SD=2.1 wks) vs. 37.9 wks (SD=2.3 wks) and the rate of prematurity equaled 7% vs. 15%, respectively. Regardless the method of conception there is a positive correlation between the CL and the duration of gestation. The regression analysis showed that the significant increase in pregnancy duration was correlated with CL ≥ 35 mm (correlation coefficient greater for spontaneous vs. IVF: rxy=0.418 vs rxy=0.341; p<0.001). All CL parameters of accuracy were better for spontaneous in comparison to IVF pregnancies.

CONCLUSIONS: IVF singleton pregnancy carries additional risk factors for preterm delivery. Therefore mid-gestational cervical length is less sensitive predictor than in spontaneous singleton gestations....

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Journal Article 2011; 32(4): 491-495 PubMed PMID: 21876490 Citation  Keywords:  Animals, Borrelia burgdorferi:classification, Borrelia burgdorferi Group:classification, DNA, Bacterial:analysis, Humans, Ixodes:microbiology, Lyme Neuroborreliosis:epidemiology, Nymph:microbiology, Polymerase Chain Reaction, Risk Factors, Slovakia:epidem.   

OBJECTIVE: Lyme borreliosis (LB) is the most disseminated tick-borne disease in the Northern hemisphere, and infestation with ticks is one of the essential factors influencing transmission of the disease to humans. This work intends to compare the occurrence of borrelia circulating in indigenous ticks and in patients suffering from neurological diseases.

MATERIALS & METHODS: The total of 660 nymphs and 567 adult ticks from the Bratislava and Košice areas was examined over the years 2001-2004, and the cerebrospinal fluid (CSF) of 82 neurological patients suffering from suspected Lyme borreliosis infection was investigated in the 2007-2009 period, using the polymerase chain reaction method (PCR).

RESULTS: PCR investigation proved presence of borrelia in 23.3% of the total 1227 ticks; of these, co-infection was found in 2.7% of all ticks. Borrelia garinii (9.9%) and B. valaisaina (9.2%) were the prevalent types. PCR investigation of the CSF samples of 32 patients with clinically diagnosed Lyme borreliosis showed the presence of B. burgdorferi s.l. in 17 cases. Positive results were found also in patients with unclear or different diagnoses. In cases where the genospecies could be identified, B. garinii was most frequently found (8x), followed with B. burgdorferi s.s. (4×) and B. afzelii (3×).

CONCLUSIONS: The high infestation level of ticks with borrelia, mainly with B. garinii which is the most-often documented borrelia species identified in neurological patients, is indicative of a high risk of this contamination in Slovakia. B. garinii were found also in our neuroborreliosis patients, whereas their proof in the CSF of patients with suspected neuroborreliosis or with a different clinical diagnosis pointed upon their persistence after an infectious experience. However, knowledge of not only the genospecies but also of the genotypes capable of eliciting an invasive disorder would be necessary for better clarification of the relationship between borrelia and their peccant capacity. Identification of the invasive borrelia types circulating in nature, and clarification of the vector vs. human infection incidence relationship is of importance from the aspect of detailed knowledge of the epidemiology of this disease....

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Journal Article 2011; 32(3): 317-321 PubMed PMID: 21712790 Citation  Keywords:  Atherosclerosis:blood, Cardiovascular Diseases:blood, Cholesterol:blood, Enzyme-Linked Immunosorbent Assay, Female, Humans, Lipids:blood, Lipoproteins:blood, Male, Prostaglandins:blood, Reference Values, Risk Assessment, Risk Factors, Thrombosis:blood, Yo.   

OBJECTIVE: The identification of an atherogenic and a non-atherogenic lipoprotein profile, athero phenotype B vs. non-athero phenotype A, in a group of healthy normolipidemic subjects reveals a new clinical phenomenon in lipoprotein profiles, an atherogenic normolipidemia. Individuals with atherogenic normolipidemia are at increased risk to develop premature atherothrombosis and experience a sudden cardiovascular event.

METHODS: A quantitative analysis of non-atherogenic and atherogenic lipoproteins in plasma in a group of healthy normolipidemic volunteers who had no clinical signs of cardiovascular system impairment was performed. An innovative electrophoresis method on polyacrylamide gel (PAG) (Lipoprint LDL System, USA) was used for the analysis of plasma lipoproteins. With regard to lipids, total cholesterol and triglycerides in plasma were analyzed with an enzymatic method, CHOD PAP (Roche Diagnostics, FRG). Prostacyclin and thromboxane A2 were analyzed with an ELISA analysis (DRG USA). A new parameter, the score for anti-atherogenic risk (SAAR), was calculated as the ratio between non-atherogenic to atherogenic plasma lipoproteins in examined subjects.

RESULTS: There was a high concentration of LDL3-7 subfraction (p<0.0001) and a slowly increasing triglyceride concentration (p<0.05) in the atherogenic subgroup. The non-atherogenic subgroup of healthy subjects was characterized by high SAAR scores, as well as a low concentration of LDL3-7 subfractions (p<0.0001). Other statistically significant differences between the atherogenic and non-atherogenic subgroup, including total cholesterol, prostanoid parameters (prostacyklin, thromboxane A2), and lipoproteins values, were not confirmed.

CONCLUSIONS: The advantages of this new method include: (i) identification of an atherogenic and a nonatherogenic lipoprotein profile in an individual's plasma (ii) identification of an atherogenic normolipidemic lipoprotein profile in plasma (iii) introduction of a new risk measure, the score for anti-atherogenic risk (SAAR), for an estimation of a patient's atherogenic risk of atherothrombosis development. (iv) the presence of small dense LDL in plasma is decisive for declaration of an atherogenic lipoprotein profile. It is valid for hyperlipidemia and for normolipidemia as well....

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Journal Article 2011; 32(3): 308-312 PubMed PMID: 21712783 Citation  Keywords:  Adult, Culture Media, Female, Humans, Leukocyte Count, Microbial Sensitivity Tests, Neutrophils:physiology, Pregnancy, Rectum:microbiology, Risk, Risk Factors, Streptococcal Infections:diagnosis, Streptococcus agalactiae, Vagina:microbiology,.   

OBJECTIVES: The aims of the study were: 1) to evaluate the prevalence of recto-vaginal group B streptococci (GBS) colonisation using Todd Hewitt Broth - recommended by the Centers for Disease Control (CDC) - and Granada medium; 2) to establish the sensitivity and specificity of Granada medium for the detection of GBS colonisation; 3) to evaluate each vaginal Gram stained swab for bacterial vaginosis (BV) using Nugent criteria and for determining the amount of polymorphonuclear (PMN) leucocytes.

METHODS: Eighty pregnant women between 35 and 40 gestation weeks hospitalised in the Department of Gynecology and Obstetrics, Medical University of Silesia, Poland, were included in the study. Two specimens were collected from each patient: one from the posterior vaginal fornix (Gram stain) and one from both vagina and anus to detect GBS colonisation. Each vaginal Gram stained swab was evaluated for BV using Nugent criteria as well as for PMN leucocyte count. To detect GBS colonisation, the liquid Todd Hewitt Broth, subsequently subcultured to blood agar and direct inoculation onto Granada medium, were used. Isolated GBS were identified by morphological features and by serological (Slidex Strepto-Kit, bioMerieux) and biochemical (rapid ID 32 Strep, bioMerieux) testing.

RESULTS: GBS colonisation was observed in 22 (27.8%) patients in both used media. Only in one case were GBS detected in Todd Hewitt Broth and not detected in Granada medium. The sensitivity and specificity of Granada medium were established as: 95.65% and 100%, respectively, compared with Todd Hewitt Broth recommended by CDC. Nugent criteria demonstrated 6.25% of cases of BV; in one case both BV and GBS colonisation were detected.

CONCLUSIONS: The selective Granada medium may be used concurrently with liquid Todd Hewitt Broth as a screening tool for prenatal group B streptococcal colonisation in pregnant women....

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Journal Article 2010; 31(1): 1-3 PubMed PMID: 20150863 Citation  Keywords:  Biological Clocks:physiology, Biomedical Research:standards, Causality, Chronobiology Disorders:complications, Humans, Models, Theoretical, Neoplasms:epidemiology, Risk Factors,.   

: A cascade of investigations into the validity of the chronodisruption-cancer theory (CD-CT), proposed 2008 in Neuroendocrinology Letters as a synthesis of abundant experimental and tantalizing - but still limited - epidemiological data, can be expected in coming years. In view of the possible public health relevance of the suggested links between chronodisruption, defined as the disruption of the temporal organization or order of biological rhythmicity over days and seasons, and the development of disease, including cancer, we provide practical aspects which should be considered for the planning, conduct and the very interpretation of such studies. The interrelated considerations address two facets: first, the critical necessity of causal clarification can be evinced appropriately by Poole's earlier contribution to the Journal. Researchers into the validity of the CD-CT should certainly consider Poole's 2002 illustration via causal graphs for shift work, light at night and breast cancer of the subtleties that can arise in the use of exposure surrogates of different kinds. Second, we emphasize the importance of considering the Zeitgeber multiplicity to avoid causal reductionism in epidemiologic - but also other - chronodisruption research....

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Journal Article 2009; 30(6): 739-748 PubMed PMID: 20038934 Citation  Keywords:  Adult, Birth Rate:trends, Contraception:utilization, Czech Republic:epidemiology, Europe:epidemiology, Female, Humans, Infertility, Female:epidemiology, Maternal Age, Pregnancy, Registries, Reproductive Techniques, Assisted:utilization, Risk Factors, Trip.   

OBJECTIVE: The aim of the study was to evaluate the importance of increased use of assisted reproduction technologies (ART) for the fertility trends in the Czech Republic.

DATA AND METHODS: Comparative analysis based on demographic and ART data was used. Demographic data have been published by EUROSTAT and the Czech Statistical Office. ART data have collected by ESHRE.

FINDINGS: In the 1990s a trend towards later childbearing contributed greatly to the decline in total fertility rate (TFR) in the Czech Republic. Recently, recuperation of delayed births has resulted in the increase of TFR to 1.5 children per woman which is considered to be a critical minimum level. The highest increase in fertility rates occurred in the age group of 35-39, in which the contribution of ART treatments usually is greatest. Moreover, a substantial increase of multiple births has been registered. In 2005 the estimated share of children born after ART in the Czech Republic (3%) was close to countries with the highest share (Nordic countries, Belgium or Slovenia). However, the Czech Republic registered only half the number of ART cycles per million inhabitants than in those countries. Contrary to Nordic countries the Czech Republic faced an extremely low TFR of 1.28 children per woman. As the estimation of average number of cycles suggests, the need for fertility treatment has not been met in the Czech Republic yet. Moreover, due to the continuous postponement of childbearing to higher women s age, demand for ART treatment will be even higher in the near future and will probably result in the need of more than 2 500 cycles per million inhabitants in the Czech Republic.

CONCLUSIONS: Spreading of ART is particularly relevant in the countries caught in the low fertility trap as higher impact on fertility trends could be expected. In the Czech Republic there is a chance to get over the critical level of TFR if comprehensive population policy including the improved access to ART based on well-considered strategy with explicit aim to optimize the quality of health care was accepted. However, from the demographic perspective the risk of further delay of childbearing encouraged by ART treatment should be taken into account while making these decisions....

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