Drahoslava Hrubá

Pre- and postnatal parental smoking and wheeze in infancy: cross cultural differences

In longitudinal cohort studies, the relationships between prenatal and postnatal tobacco smoke exposure and infant wheezing illnesses were compared in two geographically defined populations in Avon, UK and Brno and Znojmo in the South Moravian Region of the Czech Republic. Pregnant females living in defined regions and with expected dates of delivery between defined dates were recruited. Females completed self-report questionnaires during pregnancy and when their infant was 6 months old. For this analysis, responses to questions about smoking during pregnancy, environmental tobacco smoke (ETS) exposure and reported wheezing illnesses of infants at 6 months after birth were used. Odds ratios for wheeze in relation to the smoking variables were calculated with adjustment for potential confounding effects. The prevalence of smoking during pregnancy was higher in Avon (17.5%) than the Czech Republic (7.1%). Exposure of infants to ETS during the first 6 months after birth was also reported to be higher in Avon (35.5%) than the Czech Republic (9.7%). The prevalence of reported wheezing by 6 months of age was 21.4% in Avon and 10.3% in Brno and Znojmo. In Avon, there was a significant relationship between infant wheeze and maternal smoking during pregnancy (odds ratio (95% confidence interval) 1.30 (1.09-1.56), p=0.004) but not with environmental exposure after birth (1.11 (0.98-1.25)). In contrast, in Brno and Znojmo in the Czech Republic, there was a significant relationship between infant wheeze and ETS exposure (1.66 (1.17-2.36), p=0.04) but not with maternal smoking during pregnancy (0.99 (0.64-1.55)). This study demonstrated an apparent difference in the associations between prenatal and postnatal tobacco smoke exposure and infant wheezing illnesses in two populations with different smoking prevalence. The relationships were independent of a number of potential confounding variables that have been associated with infant wheezing. Possible explanations of these observations include dose-related effects of prenatal and postnatal tobacco smoke exposure of infants.

The atherogenic index of plasma is increased by hormonal contraception

Abstract Background/Aims. Oral contraceptives are known to induce secondary dyslipidemia. The aim of this study was to determine if hormonal contraceptives affect the new atherogenic index of plasma (AIP) = log[triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C)] together with the total cholesterol/HDL-C (TC/HDL-C) and the apolipoprotein B/apolipoprotein A1 (apoB/apoA1) ratios. Design and methods. This study included 43 healthy women. Blood lipids, apoA1, apoB and the high-sensitivity C-reactive protein (hsCRP) concentration were examined before the start of hormonal contraception and after 3, 6 and 9 months of its regular use. AIP, the apoB/apoA1 ratio and the TC/HDL-C ratio were calculated. Results. After 9 months of continued hormonal contraception, we found significantly increased levels of TC, HDL-C, low-density lipoprotein cholesterol (LDL-C), TG, apoA1 and apoB (p < 0.05 for all analytes). The TC/HDL-C and apoB/apoA1 ratios remained unchanged; however, the AIP and the hsCRP concentration increased significantly (p < 0.005 and p < 0.006). LDL-C increased slightly over the first three examinations (0, 3, 6 months), and the rest of the indices increased over the first two examinations (0, 3 months) and maintained stable values through the fourth examination (9 months). Conclusions. The increased AIP and hs-CRP concentration after 9 months of hormonal contraception demonstrate that contraceptive-induced dyslipidemia has a proatherogenic nature, even when the TC/HDL-C and the apoB/apoA1 ratios are unchanged.

Key Determinants Influencing the Health Literacy of Pregnant Women in the Czech Republic / Ključne Determinante, Ki Vplivajo na Zdravstveno Pismenost Nosečnic na Češkem

Abstract Background. Health literacy is a critical determinant of women’s and children’s health and therefore has immense consequences for the health of society as well. Evidence from epidemiological, clinical and experimental studies indicates that unhealthy lifestyles and risky behavioural habits of parents before conception and during pregnancy influence the etiology of various health defects. Decreasing primary risk factors, practicing physical wellness, monitoring physiological markers and preparing for labour, breastfeeding and newborn care should be the main parental responsibilities during the prenatal period. Methods. Our study focused on specifying the main determinants of health literacy among 360 pregnant Czech women by using an anonymous questionnaire and selected anthropometric data of mothers. The criteria for study participation produced a sample representing 1.41% of Czech women in labour during a given 2012 reference period. Results. Despite quite adequate knowledge of both risks and supporting factors for pregnancy and foetal development, the lifestyles of a majority of the women surveyed were far from optimum: only 30% reported good dietary and physical activity habits, 24% were active or passive smokers and one third of the women occasionally drank alcohol, more often among those who were university educated. Conclusion. Our results have confirmed previously published data noting that health literacy and a healthier lifestyle of pregnant women are associated with a higher level of education (except for alcohol drinking) and with contact with a midwife (in some examined parameters) in prenatal courses IZVLEČEK Uvod. Zdravstvena pismenost je ključna determinanta zdravja žensk in otrok, ki ima ogromne posledice tudi na zdravje družbe. Dokazi iz epidemioloških, kliničnih in eksperimentalnih študij kažejo, da nezdravi življenjski slogi ter tvegano vedenje staršev pred zanositvijo in med nosečnostjo vplivajo na etiologijo različnih zdravstvenih okvar. Zmanjševanje dejavnikov tveganja, skrb za fizično dobro počutje, spremljanje fizioloških markerjev ter priprava na porod, dojenje in nego novorojenčka bi morali biti glavna odgovornost staršev v predporodnem obdobju. Metode. Naša študija je bila namenjena določitvi glavnih determinant zdravstvene pismenosti med 360 češkimi nosečnicami s pomočjo anonimnega vprašalnika in izbranih antropometričnih podatkov o materah. Na podlagi meril za sodelovanje v študiji je bil izbran vzorec, ki je predstavljal 1,41 % nosečih žensk na Češkem v zadevnem obdobju leta 2012. Rezultati. Kljub dokaj dobremu poznavanju tveganj in podpornih dejavnikov za nosečnost in razvoj zarodka so se življenjski slogi večine žensk, vključenih v raziskavo, močno razlikovali od optimalnih: samo 30 % jih je poročalo o dobrih prehranskih navadah in telesni aktivnosti, 24 % je bilo aktivnih ali pasivnih kadilk, ena tretjina žensk je občasno pila alkohol, pogosteje univerzitetno izobražene. Zaključki. Naši rezultati so potrdili predhodno objavljene podatke, ki kažejo, da sta zdravstvena pismenost in bolj zdrav življenjski slog nosečnic povezana z višjo stopnjo izobrazbe (razen pitja alkohola) in stikom z babico (pri nekaterih proučenih parametrih) na predporodnih tečajih

Analysis of male and female smoking in women pregnant after IVF/ET

Former smokers had significantly lower effects of their infertility treatment using the IVF methods. Treatment of current smokers was compleetely unsuccessful.

Cardiovascular Diseases among Women

Podle mnoha epidemiologických studii jsou ženy vnimavějsi k ucinkům kardiovaskularnich rizikových faktorů. Kromě toho maji ženy dalsi přidatne rizikove faktory, specificke pro jejich pohlavi: uživani hormonalnich oralnich kontraceptiv a nahradni hormonalni terapie, porody, toxicke komplikace těhotenstvi. Tato publikace popisuje dřivějsi i novějsi výsledky významných studii, zaměřených na genderove rozdily v nemocnosti a umrtnosti na nemoci srdce a cev.

Nekuřácké domovy - názory studentů 5. ročníku všeobecného lékařství na prevenci pasivního kouření

Názory a postoje studentů 5. ročníku všeobecného lékařství aktivně zapojených do projektu Nekuřácké domovy ukazují na důležitost komplexního přístupu k prevenci kouření. Účast studentů na projektu otevírá nový pohled na možnosti preventivního působení. Budoucí lékaři tak mohou lépe porozumět postojům kuřáků a nekuřáků a tyto zkušenosti pak mohou uplatňovat ve svém vlastním přístupu k prevenci kouření. Klíčová slova: kouření pasivní, programy prevence kouření, studenti

Persistence of conduct disorders and their relation to early initiation of smoking and alcohol drinking in a prospective ELSPAC Study

The important risk factors of early initiation of smoking and alcohol drinking are: prosmoking family and peers, conduct disorders and delinquency, poor academic performance. The data obtained by physicians, teachers and children were collected at the age of 11 years. Children were divided into group A (without symptoms), Group B (with one or more symptoms). For statistic analysis, the programme EPI INFO was used.During the period between 7 and 11 years, new children with problematic behaviour (178=3.9%) were diagnosed in Group A, while substantial decreasing of children previously included in Group B was seen (by 59.1%). Together 7.05% of 11 years old children visited specialists (psychologists) due to their conduct disorders: 6.8% from Group A and 12.3% from Group B. Children more often than their teachers reported the frequent occurrence of conduct disorder. About 20% of children smoked, and more than 40% had tasted alcohol. However, the differences between Groups A and B were not significant. Our prospective study has demonstrated the possibility of misinterpretation of behavioural outputs. Children with previous behavioural problems had not a higher risk for early smoking and alcohol use.

MS71 CRP, LIPIDS AND LIPOPROTEINS AFTER HORMONAL CONTRACEPTION

The aim of this study was to evaluate the effect of oral hormonal contraception (OHC) on hs-CRP, blood lipids and lipoproteins in young women. Conclusion: 3 month usage of oral hormonal contraception has unfavourable effect on hs-CRP level as a markers of cardiovascular risk. On the other hand changes of blood lipids and lipoproteins had no atherogenic character.

Smoking is associated with other types of risk behaviour

At the Department of Preventive Medicine, we have developed several educational anti-smoking programmes for various groups of the population and have used them in intervention studies with the participation of co-workers at regional offices for hygiene and preventive medicine.