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Non-persistence with secondary preventive measures, including medications such as statins, adversely affects the prospects of successful outcomes. This study was aimed at evaluating non-persistence with statin therapy in cohorts of young and elderly patients after a transient ischaemic attack (TIA) and identifying patient-associated characteristics that influence the risk for non-persistence. The study cohorts included 797 adult patients who were initiated on statin therapy following a TIA diagnosis between 1 January 2010 and 31 December 2010. Patients were followed up for 3 years and those with a treatment gap of at least a 6-month period were considered ‘non-persistent’. In order to identify any age-related differences, all analyses were conducted in the entire study cohort (n = 797) as well as separately in the ‘younger’ (aged

Many toxic substances in the workplace can modify human health and quality of life and there is still insufficient data on respiratory outcomes in adults exposed to phthalates. The aim of this work was to assess in waste management workers from the Nitra region of Slovakia (n = 30) the extent of exposure to phthalates and health-related outcomes. Four urinary phthalate metabolites mono(2-ethylhexyl) phthalate (MEHP), monobutyl phthalate (MnBP), monoethyl phthalate (MEP) and monoisononyl phthalate (MiNP) were determined by high-performance liquid chromatography with mass spectrometry (HPLC-MS/MS). Urinary concentration of MEHP was positively associated with ratio of forced expiratory volume in 1 s to forced vital capacity % (FEV1/FVC) (r = 0.431; p = 0.018) and MiNP with fat free mass index (FFMI) (r = 0.439; p = 0.015). The strongest predictor of pulmonary function was the pack/year index as smoking history that predicted a decrease of pulmonary parameters, the FEV1/FVC, % of predicted values of peak expiratory flow (PEF % of PV) and FEV1 % of PV. Unexpectedly, urinary MEHP and MINP were positively associated with pulmonary function expressed as PEF % of PV and FEV1/FVC. We hypothesize that occupational exposure to phthalates estimated from urinary metabolites (MEHP, MiNP) can modify pulmonary function on top of lifestyle factors.

Antiplatelet therapy following a transient ischemic attack (TIA) constitutes an important secondary prevention measure. The study was aimed at evaluating the development of non-persistence with antiplatelet therapy in elderly patients after a TIA and identifying patient-related characteristics associated with the probability of non-persistence during the follow-up period. The study cohort (n = 854) was selected from the database of the largest health insurance provider of the Slovak Republic. It included patients aged ≥65 years, in whom antiplatelet medication was initiated following a TIA diagnosis during the period between 1 January 2010 and 31 December 2010. Each patient was followed for a period of 3 years from the date of the first antiplatelet medication prescription associated with TIA diagnosis. Patients in whom there was a treatment gap of at least 6 months without antiplatelet medication prescription were defined as “non-persistent”. The factors predicting non-persistence were identified in the Cox proportional hazards model. At the end of the follow-up period, 345 (40.4%) patients were non-persistent with antiplatelet medication. Protective factors decreasing a patient´s likelihood of becoming non-persistent were age ≥75 years [hazard ratio (HR) = 0.75], polypharmacy (concurrent use of ≥6 drugs) (HR = 0.79), arterial hypertension (HR = 0.68), diabetes mellitus (HR = 0.74), hypercholesterolemia (HR = 0.75), and antiplatelet medication switching during the follow-up period (HR = 0.73). It is concluded that following a TIA, elderly patients aged

Background: Epidemiological studies have demonstrated the ototoxic effects of exposure to polychlorinated biphenyls (PCBs). In a previous study, this effect was attributed to the PCB postnatal seru...

Introduction: In the medical field, nanoparticles (NP) Fe3O4 are currently considered to be a relatively inert carrier for therapeutic and diagnostic pharmaceuticals, and they are also presumed for intravenous (i.v.) administration. Because they have nano dimensions, they probably can penetrate through various membranes and pass from the bloodstream to other organs in the body (Borm P, Muller-Schulte D. Nanoparticles in medicine, 2007, Chapter 21, pp. 387–413, Particle Toxicology, ed. Donaldson K, Borm P, Taylor & Francis Group, USA, 434 p., ISBN 0-8493-5092-1). Therefore, in our experiment, we have examined the impact of a NP Fe3O4 instilled i.v. (to a tail vein of an animal) on the select parameters of bronchoalveolar lavage (BAL). The aim of our study was to determine whether the NP investigated by us, pass through the vascular system to the respiratory tract, and if so, how they affect the selected inflammatory and cytotoxic parameters of BAL. Materials and methods: Wistar rats were intravenously given a suspension of Fe3O4 and after time intervals of 1, 7, 14 and 28 days, the animals were sacrificed, BAL was performed and selected inflammatory and cytotoxic BAL parameters were examined. Conclusion: Based on the results obtained by us, Fe3O4 NP exposure, compared to the control, induced inflammatory response, the cytotoxic damage and respiratory toxicity. The results further show that Fe3O4 NP, 28 days after i.v. instillation, were eliminated from the respiratory tract by defense mechanisms.

The objective of this cross-sectional epidemiological study was to assess if long-term exposure to polychlorinated biphenyls (PCBs) is associated with hearing impairment. Four hundred and thirty-three children aged 8-9 years residing in an area polluted by PCBs in Eastern Slovakia were examined otoscopically, tympanometrically and by pure tone audiometry. PCB levels in their serum were determined by gas chromatography. Transient otoacoustic emissions (TEOAE) were measured in a subgroup of 161 children. The mean of the sum of PCB concentrations in serum was 528.2ng/g serum lipids (median 321ng/g serum lipids). Serum PCB concentrations were associated with an increase of hearing threshold at low frequencies and a negative correlation between serum PCBs and the amplitude of TEOAE response was observed in the uppermost tertile of children grouped with regard to serum PCBs, not related to thyroid hormone levels. It was concluded that long-term environmental exposure to PCBs is associated with subclinical but diagnosable hearing deficits.

We have confirmed the ototoxic effect of polychlorinated biphenyls (PCBs) in human adolescents already observed in rats by measuring amplitudes of distortion product otoacoustic emissions (DPOAEs) ...

Changes in some lung cytotoxic parameters after exposure to refractory ceramic fibres (RCF) or to cigarette smoke (S) and after combined exposure to RCF+S were studied in male Wistar rats in order to evaluate their potential adverse health effects. Four groups of rats were treated as follows : 1) intratracheally instilled by saline solution (0.4 ml); 2) intratracheally instilled by 4 mg of RCF; 3) exposed only to S (85 mg of total particulate matter/m(3) air ) for two hours daily; 4) exposed to RCF+S. After 6 months the animals were exsanguinated and the bronchoalveolar lavage (BAL) was perfomed. Viability and phagocytic activity of alveolar macrophages (AM), activity of lactate dehydrogenase (LDH) in cell-free BAL fluid (cf-BALF), acid phosphatase (ACP) and cathepsin D (CATD) in cfBALF, in BALF cells and in the lung tissue were estimated. Viability of AM was depressed by every type of exposure with RCF+S effect being at least additive. Phagocytic activity of AM increased in the presence of RCF. No significant changes in LDH activity were found. Activities of lysosomal enzymes measured in the lung tissue homogenates were not significantly changed, but those in the cfBALF increased especially after exposure to S with most expressive increase in BALF cells after exposure to S and RCF+S. In the case of CATD the effect of RCF+S was more than additive. The results point out to the persistence of the RCF exposure cytotoxic effects and their amplification by cigarette smoke.

Background In bird cohort studies have been observed that low levels of polychlorinated biphenyls (PCBs) have a negative effects on early cognitive development in children. More recent studies supp...

Background Human milk is an important carrier of PCBs and lactational transfer represents the primary route of PCB exposure to developing mammals. A measure of exposure of infants is the amount tak...

SUMMARY The occurence of lung diseases (obstructive, malignant) resulting from smoking has an increasing tendency. The lung is the primary organ at risk from the effects of inhaled cigarette smoke and smoking has been implicated as a contributing factor to the causation of various respiratory diseases. The aim of presented work was to find out the subchronic effect of the 6-month exposure to cigarette smoke on the selected inflamma tory and cytotoxic parameters of bronchoalveolar lavage in W rats and thus to contribute to understanding of the mechanism of action of tobacco smoke and/or path mechanism of lung injury developed after cigarette smoking. In special chamber, the animals smoked 8 standard research 1R1 type of cigarettes per day, except Saturdays and Sundays, during 6 months. The daily concentration of total particulate matter (TPM)/m 3 air for two hours per exposure requiring to burn eight cigarettes was 85 mg. Animals were sacrificed after the 6-month exposure and bronchoalveolar lavage (BAL) was performed and selected inflammatory and cytotoxic BAL parameters were examined and compared with the control group. Following BAL parameters were investigated: the total cell and alveolar macrophages (AM) count in BAL, the differential cell count (% of AM, % of polymorphonuclears − PMN, % of lymphocytes − Ly), proportion of immature AM, proportion of bi-nucleated cells − BNC, viability, the phagocytic activity of AM, cytokines TNF-α (tumor necrosis factor alpha) and IL-1s (interleukin−1beta). Conclusion: A) The 6-month smoking of eight cigarettes daily significantly changed prevailing number of examined BAL parameters; B) The presence of inflammatory and cytotoxic responses in lung tissue can probably signalize beginning or developing of disease process.

Mineral fibers and particles are finding growing applications in industry and thus entering into the human environment. The utility of using such products for various purposes is promising but detailed information related to immune safety is needed. Immunotoxic effects may be displayed as immunosuppression, immunostimulation, hypersensitivity and autoimmunity. Humans may be exposed to fibers and particles from a variety of sources, including occupational settings, ambient air, consumer products, drinking water and food. This chapter is dedicated to the effect of inhalation exposure to asbestos, rock wool, glass wool, ceramic fibers and nickel oxide particles on the immune system.

Background and aims: The mammalian auditory system forming a part of CNS, with its complex development, is a typical target of neurodevelopmental toxicity. Polychlorinated biphenyls (PCBs), a membe...

We measured organochlorine concentrations of 15 polychlorinated biphenyl congeners and six organochlorine pesticides (PCB28, 52, 101, 123(+149), 118, 114, 153, 105, 138(+163), 167, 156(+171), 157, 180, 170, 189, alpha-, beta-, gamma-HCH, HCB, p,p'-DDT and p,p'-DDE) in 2047 subjects from contaminated and background areas of eastern Slovakia. Data were collected in 2001 and analyzed by high-resolution gas chromatography with electron capture detection in 2002-2003. Elevated levels persist in subjects from Michalovce district, site of former production facility, after almost 20-years since the end of the PCB manufacturing. Sum of 15 PCB congeners was 3105 ng/g of lipid in the Michalovce district versus 871 ng/g of lipid for subjects from the background districts of Svidnik and Stropkov. Relatively high concentration in children from the Michalovce district, sum PCB = 766 ng/g of lipid versus 372 ng/g of lipid in children from background area suggest ongoing exposure from environmental reservoirs and contaminated food. Consistent differences between genders in both contaminated and background areas are reported here. Levels in males are about 20% higher in both districts. Levels of organochlorine pesticides, particularly of DDT metabolite DDE and hexachlorobenzene are also elevated in the Michalovce district, reflecting intensive use of pesticides in agriculture in the past. About 30% decrease in serum organochlorine levels was observed in comparison with our earlier samples collected in 1998. These results suggest that contamination with PCBs still remains a source of relatively high environmental exposure for subjects in the Michalovce district.

Purpose Heart transplant candidates are a selected group of patients with advanced heart failure (HF). Prognosis estimation is the key determinant of optimal patient management. The aim of the study was to analyze the descriptive characteristics, long-term survival, and mortality predictors in pts with advanced HF hospitalized at a single centre. Methods and Materials Consecutive patients with HF considered for heart transplantation and hospitalized at the National Cardiovascular Institute Bratislava from January 1, 1998, to January 1, 2010, were retrospectively analyzed. Kaplan-Meier survival analysis was performed. Independent mortality predictors were established using logistic regression analysis. Results One thousand and two pts were eligible for the analysis. The mean age of pts was 49 years, 86.8% were males, NYHA class was 2.6±0.7, and left ventricular ejection fraction was 24.3±7.7%. The etiology of HF consisted predominantly of dilated cardiomyopathy (57%), coronary artery disease (27.5%), and arterial hypertension (7.1%). The most important comorbidities included arterial hypertension (43%), atrial fibrillation (24.6%), diabetes mellitus (25.1%), and anemia (17.2%). Cumulative survival was as follows: 1-year survival 83%, 3-year 63%, 5-year 50%, 7-year 39% and 10-year 23%. HF progression was the cause of death in 55.7% of pts and sudden death in 37.5% of pts. Presence of coronary artery disease, left ventricular diastolic diameter of >79 mm, plasma sodium 2297 pg/mL, intravenous treatment, and furosemide dose at discharge >240 mg/day were independent predictors of 1-year mortality. Conclusions We present a long-term follow-up of a large and selected cohort of pts from a single centre that reflects the course of HF with severe left ventricular systolic dysfunction, barely modified by comorbidities. Mortality of pts with advanced HF still remains high, with 50% of pts surviving 5 years. This cohort represents the pool of potential assist device implant candidates.

Background. The goal of our interest is to bring attention to standardisation of the aspirin effectiveness examination in patients profiting from (life)long antithrombotic terapy. Optical platelet aggregation tests have been most widely used. Examination with endogenous inductors of platelet aggregation - thrombin, colagen, arachidonic acid, adenosine diphosphate (ADP) has a low specificity and reproducibility. Aim. To compare a newer inductor of platelets aggregation cationic propyl gallate (CPG) with ADP for the examination of aspirin (ASA) efffectivity with optical aggregometry. Methods. We prospectively enrolled 116 consecutive patiens with a stable cardiovascular disease on ASA 100mg/day for ≥ 1 month. The controll group was formed from 62 healthy volunteers, without antithrombotic treatment. Analysis. We investigated platelet aggregation by optical aggregometry (aggregometer LASER 4x, BIOART). CPG and ADP were added as aggregating agents. The measured parameter were: CPG-slope (this parameter expresses steepness of the aggregation curve and also the speed of aggregation (%/minutes)) and ADP-max (the maximum percent change in light transmittance from baseline). Results. Definition. First, we determined the CPG-slope cut-off value for the definition of ASA-non-effective treated patient. We established it on the ground of CPG-slope values in the control group. The values from controll group followed a normal distribution (test Shapiro - Wilk). We calculated the cut-off value using the 95% - confidence interval. The CPG-slope cut-off value was 79 %/min for ASA-effective treated patient. We marked the patients as ASA-non efffective treated when the CPG-slope was ≥ 79%/min. The same way we used to define the cut-off value for ADP-max. We identified the aspirin treatment as uneffective when the value of ADP-max had been > 62%. Comparison. The values of CPG-slope and ADP-max were in a close correlation in the group of patients treated with aspirin. The correlation index (r = 0,671) was highly significant. By CPG-induced optical aggregation were 33,6% ASA-non-effective treated patients. While using both inductors (CPG, ADP) were the proportion of ASA-non-effective treated patients 25%. By both tests (CPG, ADP) were equally divided 71,6% patients. ASA-non-effective treated patients were more commonly obese (46,2%) with hypertension (94,9%) and hypercholesterolemia (73,7%) and were less commonly treated with statins (30,8%) as the aspirin effective treated patients (42,%, 88,2%, 59,2% resp.42,1%). Conclusion. Meassurement of a platelet aggregation by CPG is reproducible with high sensitivity and specificity. The study has also brought attention to the importance of control the cardiovascular risk factors. Figure. Statistical parameters Figure. Statistical parameters