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Copyright of General Practitioner / Praktický Lékař is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Idiopathic clitoromegaly is a relatively rare disease. A case of isolated idiopathic clitoromegaly is presented. It concerns a 31-year-old woman, in whom the clitoris has showed a tendency for progressive enlargement in the last 3-4 years. The patient had no gynecological and systemic diseases and disorders. Karyotype and hormone levels were normal. No cystic changes in the ovaries and other changes in the abdominal organs were detected during ultrasound. Computerized axial tomographic (CAT) scan of the adrenal glands was performed and showed normal appearance. Method of selection in such cases is operative treatment – clitoroplasty with storage of neurovascular bundle of the clitoris.

Term postoperative cognitive disorder stands for deterioration of cognitive function after surgery in postoperative period. Evaluation and diagnostics of cognitive disorders in perioperative period were highlighted by the increasing number of geriatric patients undergoing a surgery with general anaesthesia, with the goal of fast recovery and preservation of the quality of life. Deterioration in cognitive function after surgery was originally called postoperative cognitive dysfunction. The definitions of postoperative cognitive dysfunction varied. In order to unite them, in 2018 there were published new recommendations during which the postoperative cognitive dysfunction was replaced by the term perioperative neurocognitive disorder. This was divided based on different time frames of onset to pre-existing neurocognitive disorder, postoperative delirium, delayed neurocognitive disorder and (postoperative) neurocognitive disorder. Main goals of this advanced narrative review were description of terminology, identification of risk factors, prevention, and therapy of perioperative neurocognitive disorder. [ABSTRACT FROM AUTHOR]

Evidence-based public health integrates the best available evidence with the knowledge and judgment of experts and other stakeholders to improve health and protect the population from infectious and environmental risks. Good public health best practices should always identify and take into account the quality of the evidence-making process (such as the design and quality of the study performed), the transparency of the methods and processes used to obtain evidence, and whether the strength of supporting evidence has been assessed. The basic tools for obtaining evidence for public health include systematic review (SR), risk assessment, economic analysis (cost-effectiveness studies), surveillance and expert panels or consensus conferences. SRs represent the most important and most valuable types of studies. They summarize all the research published so far, assess its quality and determine the strength of the recommendations, thus providing decision-making powers to public health professionals and policy makers. This article aims to describe the basic focus of practice guidelines in public health and presents a brief proposal of an algorithm for the development, adaptation, implementation and evaluation of evidence-based guidelines in the field of public health. [ABSTRACT FROM AUTHOR]

The organization of public health (PH) interventions usually does not concern the doctor himself, but whole groups of experts, professional societies up to political decisions. Evidence-based public health (EBPH) also affects population health policy. In this context, „evidence-based policy" is sometimes referred to, where evidence of the effectiveness and efficiency of the intended intervention is also required in policy making. The most pressing problem of PH is usually not enough evidence that „something" is to be done, but the lack of evidence for „what" or „how" to be done. In the broad field of EBPH, there is still a lack of conceptual frameworks setting out „how much" and „how good" evidence is needed, or at least sufficient, for policy decisions on public health interventions and programs. The need to harmonize and standardize the development of guidelines, including the evaluation of their quality and regular re-evaluation, are among the most fundamental requirements. Knowledge of the epidemiological situation in a particular country or region, and over given period of time, as well as modeling of further possible developments, are essential for making relevant recommendations. For example, the outputs of surveillance systems, risk assessments, cost-effectiveness analyzes, or consensual „evidence" also serve as evidence for public health. The process of guidelines development consists of the phases of planning, realization, publication, implementation, evaluation, and revision. Proven standardized methods are to be used in each of these phases. This article aims to summarize methods of creating, adapting, implementing, and evaluating evidence-based best practices in public health. [ABSTRACT FROM AUTHOR]

The major part of the radiation dose that humans receive from natural radioactive sources is due to inhalation of radon and its decay products. The study focuses on radon concentration (CRn) investigation in kindergartens and nurseries in the district of Montana. The influence of building characteristics on CRn was evaluated. The measurement of the CRn was performed using passive detectors. The survey was carried out between December 2019 and May 2020 with a total number of 602 detectors. The average value of CRn in the premises of the studied kindergartens and nurseries in this district is 125 Bq·m−3, and the geometric mean (GM) value is 88 Bq·m−3. The buildings that have built ventilation and sewerage systems have lower CRn. The effective doses of the children and workers were evaluated in order to assess the radon exposure.

Objective: The aim of the report is to determine the risk factors of mothers whose infant died of suffocation before reaching the 1st year of age. Methods: The research method of choice was a retrospective content analysis of autopsy reports from medical and forensic autopsies of infants under 1 year of age. Each autopsy report was conceived as a case study. The research sample included the autopsy reports of children where the immediate cause and mechanism of death was suffocation – both of internal and external reasons (n=11). The social risk factors of mothers were identified based on the mechanism and circumstances of their infant's death. The only case where the expert opinion allowed for SIDS became the verifying unit of the analysis of other cases in the case study series. Results: The qualitative analysis of the whole series showed that the cases may be sorted in two basic categories. The first one included the cases where the infant's death had a direct cause (n=6); in these cases, the clearly violent death was directly connected – with respect to the cause and time – with the hostile actions of another person. The other category included cases of neglect and other types of conduct (n=5). These cases were further divided into actions under the influence of drugs and insufficient care. Conclusion: The results confirmed the importance of social risks of mothers (SES, accommodation, social exclusion, family relations, health literacy of the mothers). The analysis of the autopsy reports revealed the social feature of the cases of infant death by suffocation, which is the cumulative effect of the difficult life situation of the mothers combined with their low level of health literacy. [ABSTRACT FROM AUTHOR]

Copyright of General Practitioner / Praktický Lékař is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Hippocratic oath is a most famous, commented and hotly discussed medical ethical text in the Western world. It has become an important ever-present ethical message for medicine, showing remarkable permeability through centuries and various cultures. In modern days its principles are being re-formulated to meet the requirements of medical graduation pledges thus getting symbolically incorporated into the medical status. The medical pledges used in the Czech Republic are always a part of the statute of the respective medical faculty. In total there are 3 versions of the medical pledges. All of them include such principles as respect for teachers, protection and transfer of knowledge, patient protection from harm, maintenance of purity of thought and obligations for patients irrespective of race, nationality, political and/or social attitudes. On the contrary, some of the original issues are absent in all the pledges, namely collegiality among doctors, free education, healthy lifestyle for patients, non-implementation of surgical procedures, avoidance of abortion drugs and sexual contacts with patients. The Hippocratic oath represents an historical text in numerous versions, but still it is all the time relevant. It focuses attention of the society on fundamental, evergreen questions of the medical ethics and confirms significance of the medical pledges as well as public declarations of commitments for doctors' integrity in full awareness of their responsibility to the patients. [ABSTRACT FROM AUTHOR]

This article sheds light on some features of ghrelin (GHR)- and tryptase (Try)-positive mast cells (MCs) distribution in human lung of preterm newborns with respiratory distress syndrome (RDS). GHR possessed anti-inflammatory activity and reliable therapeutic properties in some lung diseases. So far, GHR expression has been defined predominantly in neuroendocrine cells of bronchial mucosa in fetal and infant lungs. Lung tissue from 8 dead newborns with RDS were investigated immunohistochemically with anti-GHR and anti-Try antibodies. The number of GHR+ and Try+ MCs was determined in three locations –bronchi, bronchiole and in alveolar septa. MCs were more numerous around main bronchi with diminishing numbers around bronchiole and in alveolar septa. The number of MCs in the latter was increased in newborns with pneumonia. The number of GHR+ MCs in alveolar septa was lower in newborns with RDS as compared to newborns with RDS combined with pneumonia (2.83 ± 1.13 vs 4.81 ± 2.6, p < 0.001). The amount of Try+ MCs along bronchial wall was significantly more than GHR+ MCs in RDS newborns (6.97 ± 4.53 vs 3.85 ± 4.30, p = 0.001). It could be supposed that pulmonary MCs increased in newborn lungs in inflammatory process. MCs in human lung contained GHR peptide that had immunomodulatory function and participated in hormone regulation of inflammation.

Malignant tumors of the heart are rare. Even rarer, however, are metastases to the heart from cancers originating from the gastrointestinal tract. This case report involves a 63-year-old patient who presented into the clinic with a gastric ulcer and subsequent haemorrhage, and who died after sudden cardiac arrest. Autopsy revealed a metastatic involvement of the heart muscle from low-grade carcinoma of the stomach, as well as many other organ metastases.

Background and Purpose: Regular reporting on Corporate Social Responsibility (hereinafter referred to as CSR) should make it easier for enterprises to identify the sustainability risks and lead to an increased investors and consumers’ confidence. The aim of the paper is to find out how the indices which evaluate the socially responsible behaviour of enterprises are constructed.

Brewers’ spent grains (BSG) are the main waste product of the brewing industry, accounting for about 85% of the total waste materials. Their composition is different (due to various brewing technologies) but includes high levels of dietary fiber, proteins, essential amino acids, polyphenols, antioxidants, vitamins and fats. The aim of the present study was to investigate the phenolic content and antioxidant activity (the radical scavenging assay (DPPH) and ferric reducing antioxidant power (FRAP)) of 19 different malt types and their BSG. The highest phenolic content was demonstrated by the BSG of Caraaroma malt, whereas the BSG of Carafa Special type 1 had the highest DPPH radical scavenging activity and ferric reducing antioxidant power. Based on the results obtained, malts with the highest biological value were selected for inclusion in the composition of functional foods.

The Hippocratic Oath is the foundation for the moral ideals and goals of Western medicine. We aimed to develop a research tool to determine the perception among diverse groups of physicians and to determine the current perception of the Hippocratic Oath.

Obesity is a global epidemic of modern times and has serious health consequences, as it is a major risk factor for the development of chronic diseases such as hypertension, type 2 diabetes, dyslipidemia, atherosclerosis and its complications. The study of risk factors, pathogenetic mechanisms, as well as the search for new methods of treatment and prevention of this pathology is an important task of modern medicine. Today it is known that the composition and function of the intestinal microbiota play a certain role in the development of obesity and a number of metabolic disorders. One of the areas of prevention of early onset and development of these diseases may be the maintenance of a normal composition and correction of disorders of the intestinal ecosystem. In this review, the currently known interrelationships of changes in the composition of the intestinal microbiota and obesity are reviewed, and studies have been analyzed to assess the composition of the adult intestinal microbiota in obesity. The presently available data on the correction of overweight and obesity by exposing the composition of the intestinal microbiota are presented.

Objective: The aim of this repeated investigation in work satisfaction in general nurses was to determine key factors of working environment, which are responsible for the staff turnover of nurses. The survey of factors of working environment was composed according to motivation theory of F. Herzberg. The first extensive investigation was executed in 2006, and the second representative one was performed in 2011. The basic principle of the research design was double evaluation of factors of working environment. At first the nurses classified the factors according to their own value preferences, subsequently according to the degree of their fulfillment from the employer side. The paper presents the results from the year 2011 and the statistical evaluation was based on the Euclidean distance model test. Methods and cohort: The method of data collection used the structure interview, the interviewer sheet being the research tool. The general nurses, who work in the hospitals in the Czech Republic, represented the target group, in a total of 1992 nurses. A statistical test based on the determination of their order and distances was used for processing of individual factors. The relation between work satisfaction and tendency for staff turnover was determined by the Spearman correlation coefficient. Results: Key factors of the work environment (the order is always according to importance) follow the personal preference of general nurses: wage, care of patients and assurance of the position. The distance among the factors revealed absolute priority of the first two factors (wage, care of the patients). Factors which were proved to represent the highest difference between personal preferences and their fulfillment from the side of the employers are: wage, assurance of the position and working climate and evaluation according to distance revealed wage as the most significant unfulfilled factor. Most nurses (91.6%) demonstrate working satisfaction. In contrast, when a suitable situation comes, 35% of them is prepared to leave the job certainly or rather than not. A significant correlation was also found between work satisfaction and the intention to leave the employer (r = -0.510). Conclusion: The research presents the possibility to determine the factors of work satisfaction simultaneously with the evaluation of the employer. The advantage lays in the possibility to determine divergence between personal preferences of the general nurses and their felt saturation from the side of the employer. The selected statistical test makes it possible to determine the order of priorities as well as emotional distance between individual priorities. These results give transparent and effective outcome for the management of human resources in hospitals. [ABSTRACT FROM AUTHOR]

Copyright of Occupational Medicine / Pracovní Lékarství is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Older people living in a residential setting have the right to respectful care based on professional ethics. The aim of this study was to describe employees' and clients' lived experiences of elder abuse. A qualitative phenomenological method was used with 26 employees and 20 residents from four homes for elderly people in the town of Ostrava, Czech Republic, and two managers from outside these institutions. All complaints about elder abuse (n 5 11) received by Ostrava Municipal Authority during the period 2003 to 2007 were examined. Two main dimensions of the examined phenomenon were identified: forms of elder abuse and causes of elder abuse. Established forms of elder abuse were summarized as rights violation, financial abuse, psychological abuse, physical abuse and neglect. Causes of elder abuse included institution, employee and client characteristics. It is necessary in residential settings to create preventive policies that will focus on supervision regarding elderly people's rights violation and psychological and physical abuse, as well as on building organizational cultures that will respect ethical principles. [ABSTRACT FROM AUTHOR]

We present a method for the estimation of annual radon concentration based on short-term (three months) measurements. The study involves results from two independent sets of indoor radon concentration measurements performed in 16 cities of the Republic of Macedonia. The first data set contains winter and annual radon concentration obtained during the National survey in 2010 and the second, contains only the radon concentration measured during the winter of 2013. Both data sets pertain to radon concentration from the same cities and have been measured applying the same methodology in ground floor dwellings. The results appeared to be consistent and the dispersion of radon concentration was low. Linear regression analysis of the radon concentration measured in winter of 2010 and of the 2010 annual radon concentration revealed a high coefficient of determination R2 = 0.92, with a relative uncertainty of 3%. Furthermore, this model was used to estimate the annual radon concentration solely from winter-term measurements performed in 2013. The geometrical mean of the estimated annual radon concentration of the 2013: radon concentration (A-2013) =98 Bqm-3 was almost equal to the geometrical mean of the annual radon concentration from the 2010, radon concentration (A-2010) = 99 Bqm-3. Analysis of the influence of building characteristics, such as presence/absence of a basement in the building, or the dominant building material on the estimated annual radon concentration is also reported. Our results show that a low number of relatively short-term radon measurements may produce a reasonable insight into a gross average obtained in a larger survey.

Introduction: Campylobacter spp. are important causative agents of gastrointestinal infections in humans. The most frequently isolated strains of this bacterial genus are Campylobacter jejuni and Campylobacter coli. To date, genetic methods for bacterial identification have not been used in Bulgaria. We optimized the multiplex PSR assay to identify Campylobacter spp. and differentiate C. jejuni from C. coli in clinical isolates. We also compared this method with the routinely used biochemical methods.

In Russia, different quail breeds are widely grown and bred at specialized poultry farms and private farmsteads. In the Amur Region, only private farmsteads engage in this type of aviculture. The most common breeds are Pharaoh quail, Japanese quail, and Estonian quail. 100 eggs of the Estonian quail have been prepared for hatching in a specialized room at a private enterprise. The incubation has been carried out in the Rcom 20 MAX (RMX-20) machine at a temperature of + 37.2–380C and 55–60% humidity over 17–18 days. The egg hatchability amounted to 75%. In Russia, the birds receive balanced complete feeds of the following grades: P-K-5, P-K-2-1, P-K-6, Start, Super Start, RusQuail, Multigain and others. These feeds include different percentage mixtures of corn, oats, wheat, barley, meals and various types of flour (soy, fish, rice, etc.), yeast, chalk, phosphates, sodium chloride and other minerals. In the Amur Region, the balanced feed ration for poultry is produced by local companies “Amuragrocenter” and “Grinodir". These products have been used for feeding the chicks. The study of the Estonian quail bred at a private farmstead using the Amur feeds revealed some changes. According to the literary sources, the average weight of the Estonian breed is 180–200 g. The weight of the quails grown under the specified conditions was significantly higher — up to 200–260 g. In many regions, consumers prefer local products that they trust.

Aim: to compare the repair process of DNA double-strand breaks in mammalian cells after acute versus prolonged exposure to X-ray irradiation with different dose rates. Material and methods. Studies were performed on primary human fibroblasts isolated from skin biopsies of healthy volunteers (women, 29 and 30 years). Cells were irradiated using an X-ray machine RUB RUST-M1 (JSC "Ruselectronics", Moscow, Russia) at 37°C temperature with a dose rate of 400 mGy/min (200 kV, 2*2.4 mA, a filter of 1.5mm AI) or 4 mGy/min (50 kV, 2*0.4 mA, a filter of 1.5 mm AI). Immuno-cytochemical protein staining was utilized for yH2AX and Rad51 foci analysis. Results. Phosphorylated histone H2AX (yH2AX) and the key protein of homologous recombination Rad51 foci formation and disappearance kinetics were investigated simultaneously in primary human dermal fibroblasts after acute and prolonged exposure to X-ray radiation at a same dose. It was shown that the relative yield of yH2AX foci per dose reduces with decrease in dose rate, while the relative yield of Rad51 foci conversely increases. Conclusion. Our findings suggest the fundamental differences in the ratio of non-homologous end joining and homologous recombination DNA repair in acute versus prolonged irradiated cells.

According to the Russia’s Innovative Development Strategy until 2020 (Strategy) [1], one of the main goals of innovative growth of the Russian Economy lays in the advanced studies in the fields of renewable energy and low-carbon economy, genome medicine, and implementation of new technologies in agriculture, the fields in which Russia still faces with sufficient technological backlog. In general, the Strategy and following National Science project [2] approved in 2018 is aimed at Russia’s transition from one of the most energy- and carbon-intensive countries to a sustainable low-carbon economy. Russia needs to attract additional resources in human and knowledge capital in order to eliminate or decrease this technological backlog and to join international scientific community’s efforts in the field of green economy. This paper studies how influencing one of two pillars of the Global Innovation Index (GII), knowledge and technology output pillar, by implementing innovations in Russian higher education affects Russian innovative infrastructure and provides technical and resource baseline in reaching main strategic indicators of innovative development in Russia. This paper proposes a framework for attracting and retaining human resources and creating knowledge capital for transition to a sustainable low-carbon economy on the basis of micro and meso level changes.

Abstract Background Health risk appraisal is a promising method for health promotion and prevention in older persons. The Health Risk Appraisal for the Elderly (HRA-E) developed in the U.S. has unique features but has not been tested outside the United States. Methods Based on the original HRA-E, we developed a scientifically updated and regionally adapted multilingual Health Risk Appraisal for Older Persons (HRA-O) instrument consisting of a self-administered questionnaire and software-generated feed-back reports. We evaluated the practicability and performance of the questionnaire in non-disabled community-dwelling older persons in London (U.K.) (N = 1090), Hamburg (Germany) (N = 804), and Solothurn (Switzerland) (N = 748) in a sub-sample of an international randomised controlled study. Results Over eighty percent of invited older persons returned the self-administered HRA-O questionnaire. Fair or poor self-perceived health status and older age were correlated with higher rates of non-return of the questionnaire. Older participants and those with lower educational levels reported more difficulty in completing the HRA-O questionnaire as compared to younger and higher educated persons. However, even among older participants and those with low educational level, more than 80% rated the questionnaire as easy to complete. Prevalence rates of risks for functional decline or problems were between 2% and 91% for the 19 HRA-O domains. Participants' intention to change health behaviour suggested that for some risk factors participants were in a pre-contemplation phase, having no short- or medium-term plans for change. Many participants perceived their health behaviour or preventative care uptake as optimal, despite indications of deficits according to the HRA-O based evaluation. Conclusion The HRA-O questionnaire was highly accepted by a broad range of community-dwelling non-disabled persons. It identified a high number of risks and problems, and provided information on participants' intention to change health behaviour.