Jana Janoutová

CD36 gene polymorphism is associated with Alzheimer's disease.

CD36 gene encodes a membrane glycoprotein (type B scavenger receptor) present on the surface of many types of cells and having multiple cellular functions ranging from angiogenesis to gustatory perception of fatty acids. Using a case control genetic association approach we have analyzed selected single nucleotide polymorphisms (SNPs) in a total of 859 patients with Alzheimers disease (AD) and controls and have identified the allele A in rs3211892 polymorphism of CD36 gene as significantly increasing the risk of AD. Additionally we have investigated, in the same sample of control subjects and patients, SNPs in ApoE gene and confirmed that the previously identified AD-associated SNPs indeed increased the risk and decreased the age of onset of AD as reported by others earlier. Based on the current knowledge of CD36 biochemistry we propose that the AD risk-imparting variants of CD36 alter cholesterol homeostasis, oxidation stress or induce pathological inflammatory cascades. The SNP rs3211892 has previously been associated with heart disease and other conditions but the present study is the first to identify a significant association between variations in CD36 gene and the risk of Alzheimers disease.

Hearing Loss in Persons Exposed and not Exposed to Occupational Noise.

OBJECTIVE This study aimed to compare hearing loss in individuals at risk and those not at risk for occupational noise and to compare working loss by gender. MATERIALS AND METHODS The analysis used data from a current Czech Ministry of Health grant project called Epidemiological and Genetic Study of the Frequency of Hearing Loss (2011 to 2015; NT12246-5/2011). The analyzed sample comprised 4988 participants. Hearing was tested using pure-tone threshold audiometry, tympanometry, and measurement of the stapedius reflex. RESULTS Females at risk and those not at risk for occupational noise who were younger than 44 years and older than 75 years were found to have no statistically significant differences at any pure-tone threshold audiometry frequency. In females aged 45 to 74 years, statistically significant differences were found. In males, hearing loss was observed as early as 18 years of age. When comparing males and females at no risk for occupational noise, there were no statistically significant differences at any of the frequencies in those younger than 29 years. In females aged 30 years or older, statistically significant differences were observed at various frequencies in all age groups. When comparing males and females at risk for occupational noise, statistically significant differences were more frequent than in employees not exposed to noise. CONCLUSION Hearing loss in females does not significantly vary depending on occupational exposure. The opposite is true for males. However, the maximum differences in mean levels did not exceed 10 dB. It is therefore clear that noise is a preventable factor, and the use of personal protective equipment is warranted.

How serious are health impacts in one of the most polluted regions of Central Europe

Abstract Background: The long-term exposure to pollutants in ambient air is associated with higher mortality and occurrence of respiratory and cardiopulmonary diseases. The longitudinal cross-section study focuses on the associations between long-term exposures to carcinogenic and non-carcinogenic pollutants and the prevalence and incidence of such specific diseases including immunodeficiencies. Methods: The data on health status from industrial and non-industrial regions were obtained from health documentation for a 5-year period from 2007 to 2011 and represent the whole population living in polluted (1,249,323 inhabitants) and unpolluted (631,387 inhabitants) regions. The data on concentrations of PM10, PM2,5, NO2, SO2, benzene and benzo[a]pyrene were collected. The concentrations of pollutants were estimated from measured data by using dispersion models. The average population-weighted concentration of pollutants, which is representative for a defined geographic area and time period from 2007 to 2011, was calculated from the obtained data. The logistic regression and the Mantel-Haenszel χ2 test were used to determine the odds ratios (OR) and p-values for a linear trend. Moreover, the relative risks of mortality and morbidity to specific diseases were calculated according to theoretical dose-response association published by World Health Organization (WHO). Results: The probability of incidence of chronic obstructive pulmonary disease and bronchial asthma is statistically significantly higher in the population living in the polluted region compared to the population living in the unpolluted region. The association between long-term exposure to pollutants and the prevalence of immunodeficiency with predominantly antibody defects (D80) was confirmed. The strongest association was found for exposures to particulate matter (PM2,5). The prevalence of immunodeficiency with predominantly antibody defects was also observed in both regions depending on the age of the population and statistically significant difference was only found in the group of adults (20 and over). Conclusion: These associations encourage the hypothesis, that the long-term exposure to PM2.5 might cause the activation of cellular immune response. Further research is needed to explore the correlative immunoregulatory mechanism linking PM2.5 (or other pollutants – SO2) and immune cells. Nowadays, it is also believed that these associations are important in the increase of incidence of immune inflammatory response which is proven risk factor for cardiovascular disease (atherosclerotic disease, coronary heart disease and sudden cardiac death). Positive association between long-term exposure and prevalence of bronchial asthma and chronic obstructive pulmonary disease might be skewed due to important socio-economic factors (especially smoking).

Incidence and risk factors for delirium development in ICU patients - a prospective observational study

BACKGROUND AND AIMS Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period. We evaluated the incidence of delirium and its predisposing and precipitating risk factors. All patients were assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU). RESULTS AND CONCLUSIONS Of the total of 332 patients with a median APACHE II (the Acute Physiology and Chronic Health Evaluation) score of 12, who were evaluated for delirium, 48 could not be assessed using CAM-ICU (47 due to prolonged coma, 1 due to language barriers). The incidence of delirium was 26.1%, with trauma and medical patients being more likely to develop delirium than surgical patients. Risk of delirium was significantly associated with age ≥ 65 years, and alcohol abuse in their anamnesis, with APACHE II score on admission, and with the use of sedatives and/or vasopressors. Delirious patients who remained in the ICU for a prolonged period showed a greater need for ventilator support and had a greater ICU-mortality.

Pacienti užívající nová perorální antikoagulancia - výsledky epidemiologické studie

Background: New oral anticoagulants are undoubtedly a big step forward. Their use is safer than warfarin, and there is no need for monitoring, which provides a great deal of relief especially for less-moving patients. In spite of their great advantages, especially for the optimization of treatment, the group of patients and their basics should be monitored. Aim: The aim of the study was to find out the basic characteristics of patients, including comorbidities and other important parameters. Methods: The data was obtained from the Benedor cardiac database in Ostrava. The selection criterion was the use of DOACs (Direct Oral Anticoagulants), i.e. the use of dabigatran, rivaroxaban or apixaban. The EpiData program was used for data processing. Data was also exported and processed in Excel, Stata and OpenEpi. The total number of respondents was 334 patients. Results: The most prominent feature of patients was overweight and obese 55.8%. Normal weight was maintained by only 11.3% of patients. Most patients suffered from three other diseases (most often hypertension and ischemic heart disease). Conclusion: In general, a group of patients may be characterized as polymorbid, overweight or obese. It would be appropriate to lead patients to a healthy lifestyle and thus improve their health.

The importance of nutritional counseling for obese patients undergoing endoscopic procedures

Souhrn: Účel: Cílem práce bylo vyhodnocení změn stravovacích návyků u pa cientů po endoskopické sleeve gastroplastice, kterým bylo poskytováno komplexní nutriční poradenství. Metody: Vyhodnocení dotazníků stravovacích zvyklostí u 20 obézních pa cientů (16 žen, 4 muži), kteří s cílem redukovat nadměrnou tělesnou hmotnost a tělesný tuk podstoupili v roce 2016 endoskopickou terapii metodou endoskopické sleeve gastroplastiky. Pa cientům bylo v 1., 3. a 6. měsíci po endoskopickém zákroku poskytnuto nutriční poradenství, zúčastnili se edukačního kurzu vaření a zároveň před zákrokem a 6 měsíců po zákroku vyplnili totožný dotazník stravovacích zvyklostí. Vyhodnocení dotazníků mělo za cíl ověřit, zda opakovaně předávaná nutriční doporučení povedou ke změnám ve stravování. Výsledky: Stravovací zvyklosti zaznamenaly signifikantní změny v konzumaci ryb (p = 0,044), jejich zařazování do jídelníčku se zvýšilo. K pravidelnější den ní konzumaci došlo také u mléka a sýrů (p = 0,032), byla navýšena konzumace jogurtů a jiných zakysaných mléčných výrobků (p = 0,021). Byla omezena konzumace bílého pečiva (p = 0,038), moučníků a sladkostí (p = 0,002). Pa cienti se stravovali pravidelněji (p = 0,013) a více věnovali pozornost složení stravy (p = 0,015). Závěr: Výsledky ukazují, že pravidelné nutriční konzultace, které byly u pa cientů prováděny 1., 3. a 6. měsíc po endoskopickém zákroku, ovlivnily pozitivně jejich stravovací návyky.

COMPREHENSIVE GROUP THERAPY OF OBESITY AND ITS IMPACT ON SELECTED ANTHROPOMETRIC AND POSTURAL PARAMETERS

OBJECTIVE Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. METHODS The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroComs SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. RESULTS There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). CONCLUSION The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions).

Lung Cancer and HPV Infections

Clanek podava souhrnne informace o nejnovějsich vědeckých poznatcich týkajicich se karcinomu plic a možneho vlivu lidskeho papilomaviru jako rizikoveho faktoru na vznik tohoto onemocněni. Výsledky jednotlivých studii jsou stale rozporuplne a IARC dosud nevydala zasadni prohlaseni o zařazeni HPV jako prokazaneho lidskeho karcinogenu v uloze tohoto onemocněni.

A Summary of Environmental Health Studies in the City of Ostrava and the Surrounding Region in the Czech Republic

AIM This study is concerned with environmental health studies conducted in Ostrava (Czech Republic) and the surrounding region since the early nineties. METHODS Various databases, journals and reports, including internal or unpublished reports, were reviewed to assess the individual publications. A brief description of the studies and main results were collated. RESULTS The city of Ostrava and the surrounding region is an important industrial centre in the Czech Republic with a long-term heavy environmental and occupational disease burden. In spite of the theoretically assessed decline of health risks related to decreasing concentrations of compounds in the environment in recent years, it still poses a disproportionally high risk for the city residents. There are a number of studies suggesting supportive evidence, but they are highly variable in their approach to this topic resulting in a high uncertainty of observed associations and consistency of results. Most of the studies were focused on specific contexts, without any relation to environmental factors. CONCLUSIONS A more systematic approach is needed to assess environmental health burden of diseases especially in relation to air pollution, based on the prospective cohort study, that would lead to sufficient new evidence for accurate and updated description of the environmental health burden in Ostrava.

Bioaerosols in the Suburbs of Ostrava during a One Year Period

AIM The aim of this paper is to provide information about the concentrations of airborne bioaerosols (airborne bacteria, fungi and endotoxins) in outdoor suburban environments in Ostrava, Moravian-Silesian region, Czech Republic. METHODS The methods were based on systematic bioaerosol monitoring during one calendar year, subsequent analysis of the samples and statistical processing. The regression, correlation analysis and analysis of variance for one factor and pairwise comparisons were performed on bioaerosol data to determine their dependence on season, daytime, temperature, humidity and dew point. RESULTS The results show higher fungi concentrations especially in summer (corrected mean 365 colony forming units - CFU per m3) compared to other seasons (75-209 CFU/m3) and higher concentrations of bacteria in the evening (380 CFU/m3) compared to other parts of the day and seasons (in summer 206-252 CFU/m3 and in winter 81-87 CFU/m3). Concentrations of endotoxins were relatively low throughout the year, on average 0,056 endotoxin units (EU) per m3. CONCLUSIONS The concentration of bioaerosol (bacteria, fungi and endotoxins) were found in ambient air at substantially lower levels than in an indoor environment. Although the concentrations of this bioaerosol greatly fluctuate with temperature, dew point, season and daytime, they do not represent increased health risks.