Lung cancer (LC) represents a major healthcare issue worldwide. It is the leading cause of cancer-related mortality in Slovakia and European Union. Data from multiple randomized controlled trials have shown significant evidence of a mortality benefit in LC using screening with low-dose computed tomography of the chest (LDCT). Therefore, European healthcare authorities, relevant expert societies, and professional organizations recommend implementing national LC screening (LCS) programs in their member countries. This article outlines the basic methodology, guidelines, and practical aspects of LCS implementation strategies in Slovakia. We describe fundamental principles to identify asymptomatic high-risk patients reduce false positive and false negative results, decrease benign resection rates, and avoid unnecessary invasive procedures. The efficacious utilization of public resources to secure the highest possible quality standards of LDCT plays a crucial role in successfully implementing a nationwide LCS program (Tab. 1, Fig. 4, Ref. 31). Text in PDF www.elis.sk Keywords: lung cancer, screening, early detection, smoking cessation.

UNASSIGNED: The aim of the study is to assess the degree of adherence of medical laboratories to Kidney Disease Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD) in laboratory practice in Czechia and Slovakia.
UNASSIGNED: An electronic questionnaire on adherence to KDIGO 2012 guideline was designed by an external quality assessment (EQA) provider SEKK spol. s.r.o. The questionnaire was placed and distributed through website to all medical biochemistry laboratories in Czechia and Slovakia (N = 396).
UNASSIGNED: A total of 212 out of 396 laboratories responded to the questions, though some laboratories only answered some questions, those applicable to their practice. A total of 48 out of 212 laboratories adopted the KDIGO 2012 guideline in full extent. The metrological traceability of creatinine measurement to standard reference material of SRM 967 was declared by 180 out of 210 laboratories (two of the responding laboratories did not measure creatinine). Thirty laboratories are not well educated on traceability of creatinine measurement and seven laboratories do not calculate estimated glomerular filtration rate (eGFR). Both urinary albumin concentration and albumin to creatinine ratio are reported by 144 out of 175 laboratories (37 of the responding laboratories did not measure urinary albumin).
UNASSIGNED: Majority of laboratories in Czechia and Slovakia adopted some parts of the KDIGO 2012 guideline in their practice, but only 23% of the laboratories apply them completely. Thus, further education and action should be conducted to improve its implementation.

Authors have proposed a concept of guidelines for applying the ambulatory complex cardiovascular rehabilitation (ACCVR) into the clinical practice in Slovakia. As a background they have used an actual cardiovascular mortality and morbidity data from home country and abroad as well. They emphasize the non-optimal situation in this aspect which may not be solved by the increasing supporting the invasive revascularization methods and by the intensifying pharmacotherapy only, because the favourable effects of these procedures is timely missing if it is not accompanied by the therapeutic lifestyle changes. In this proposal the ACCVR is considered not as a regular, controlled physical training only, but there is included patient´s education, relaxation, stress management, behavioral changes and possible social support too. At the end of one 3 months lasting cycle of ACCVR there is subsumed a final test oriented on patient´s education and physical fitness levels and the continuing long-term contacts with him during following home-based training. Main parts of the concept are the concrete conditions which should by fulfilled as for as a personal, space and device equipment needed for accreditation so called cardiology stationary for ACCVR activities (in connection with cardiology department for out patients). Moreover, there are also included practical guidelines how to do patient´s stratification, how to send the patients to stationary, indications and contraindications, establishing of the training heart rate and training load, the composition of one cycle 3 months lasting, application of the progressive aerobic and resistance training and how to continue in home-based training. At the end the authors have proposed conditions which are needed to fulfil for a successful implementation of ACCVR into the health care system.Key words: cardiovascular rehabilitation for out patients - exercise training - home based training with telemonitoring control - progressive resistance training - relaxation and stress management.

Thyroid diseases may adversely affect the conception, maintain pregnancy. They increase the risk of complications in pregnancy and may have a negative effect on the fetus. Therefore it is necessary to capture thyroid diseases in the population of pregnant women, in the early stage of pregnancy. In Slovakia, since 2009, the Expert Guideline of the Ministry of Health of the Slovak Republic for the diagnosis and treatment of autoimmune thyroid diseases in women during pregnancy has been in force. In our patient cohort, we monitored 666 pregnant patients, the timeliness of screening, thyroid parameters, the number of pregnancies and their complications, the need for levothyroxine treatment. We found that screening was shifted to an earlier period of pregnancy (11.4 gestational week 2015/2016 vs 8.2 gestational week 2016/2017), the most sent patients were in the first trimester of pregnancy (72 %), 81 % of patients had positive thyreoperoxidase antibodies, 10 % had overt hypothyroidism, 90 % had subclinical hypothyroidism, pathology in the pregnancy had 13 % patients. The treatment was needed in 70 % of patients. Obviously, the number of screened patients in the 1st trimester has increased (83 % 2016/2017) from the time since the introduction of screening. We can also see the high number of patients with positive autoantibodies. These are patients who need to be monitored and also treated if TSH increase more than upper limit for an actual trimester to minimize the risk of pregnancy complications.Key words: hypothyroidism - pregnancy - screening - thyroxin.

The aim of the study was to identify fungal spores, in particular plant pathogenic fungi, occurring in the air in selected mountain ranges. The results revealed not only the array of fungal species migrating with air currents from the Czech Republic and Slovakia but also how the season of the year affects the distribution of spores. Such studies may lay a foundation for future aeromycological monitoring, in accordance with the requirements for integrated plant protection. Aeromycological research was carried out between 2013 and 2016 at 3-month intervals in mountainous areas along the southern borders of Poland: the Bieszczady, the Pieniny, the Giant Mountains (Karkonosze) and the Babia Góra Massif. The research relied on impact method employing Air Ideal 3P sampler, which, by drawing in atmospheric air, also collects fungal spores. Regardless of altitudinal zonation, the changing weather conditions appeared to be the main reason for the variations in the number of the fungal spores under study in those years.

European Consensus Guidelines (ECG) on the management of respiratory distress syndrome (RDS) have been developed and updated twice since 2007 reflecting changes in practice as new evidence emerges. The aim of this study was to evaluate the progress in clinical outcome of babies after the implementation of the updated ECG in 2010. Forty-eight neonates born in 2002-2003 (Group 02/03; n = 15) and in 2012-2013 (Group 12/13; n = 33) at gestational age of 26.2 ± 1.7 weeks were included into this retrospective study. Resuscitation procedures, ventilation support, and postnatal administration of surfactant were assessed. In Group 12/13, compared with Group 02/03, there was a higher rate of maternal corticosteroid prophylactic treatment (33 % vs. 0 %, p < 0.001), more children received primary nasal continuous positive airway pressure (nCPAP) (54.5 % vs. 20 %, p < 0.01) and repeated doses of surfactant (33 % vs. 0 %, p < 0.001), and had a reduced rate of mortality, bronchopulmonary dysplasia, and necrotizing enterocolitis. We conclude that the management of extremely preterm newborns improved considerably over the decade resulting in a significant reduction of mortality and morbidity.

Organovascular arterial ischemic diseases (cardiovascular, cerebrovascular, extremitovascular, renovascular, genitovascular, pulmovascular, mesenterovascular, dermovascular, oculovascular, otovascular, stomatovascular etc.) are an important manifestations of systemic atherosclerosis and other arterial diseases of vascular system (arteriolosclerosis/arteriolonecrosis; diabetic macroangiopathy; diabetic microangiopathy; Mönckeberg´s mediosclerosis/mediocalcinosis; arteritis - vasculitis; syndromes of arterial compression; fibromuscular dysplasia; cystic adventitial degeneration; arterial thrombosis; arterial embolism/thromboembolism; traumatic and posttraumatic arteriopathies; physical arteriopathies; chemical and toxic arteriopathies; iatrogenic arterial occlusions; dissection of aorta and of arteries; coiling; kinking; complicated arterial aneurysms; arteriovenous fistula, rare vascular diseases). Key clinical-etiology-anatomy-pathophysiology (CEAP) aspects of the mesenteriovascular arterial ischemic diseases are discussed in this article (project Vessels).

OBJECTIVE: The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber is to address a last European guidelines for the management of dyslipidaemias, as well as results in evidencebased medicine (EBM) in order to assess their contribution to our expanding knowledge on reducing of residual organovascular risk.
CONCLUSIONS: Lipid metabolism can be disturbed in different ways, leading to changes in plasma lipoprotein function and/ or levels. This by itself and through interaction with other vascular risk factors and endothelial dysfunction may affect the development of atherosclerosis and other vascular diseases. Therefore, dyslipidaemias cover a broad spectrum of lipid abnormalities, some of which are of great importance in organovascular prevention. Dyslipidaemias may be related to other diseases (secondary dyslipidaemias) or to the interaction between genetic predisposition and environmental factors. Dyslipidaemias may also have a different meaning in certain subgroups of patients which may relate to genetic predisposition and/ or co morbidities. This requires particular attention complementary to the management of the total CV risk. Optimal LDLcholesterol levels are the primary strateging task in the therapeutical preventive approaches. However, at present increasing attention has focused on the role of inflamation, levels of HDLcholesterol and triglycerides in the process of atherosclerosis. Statins represent basic pillar in dyslipidemia treatment. Despite the intensive management of all conventional vascular risk factors and the intensified treatment with statins, residual organovascular risk remains high. Therefore the interest is focused on finding the place of combined antidyslipidemic treatment and the development of new antidyslipidemics.
CONCLUSIONS: Strategies for preventing of organovascular diseases have emphasized vascular risk factors effective modification using treatment approaches supported by evidencebased medicine (EBM).

BACKGROUND: The efficacy and safety of single-pill amlodipine/atorvastatin for reducing blood pressure (BP), low-density lipoprotein cholesterol (LDLC), and predicted 10-year cardiovascular (CV) risk have been demonstrated in low CV risk countries. The Slovak Trial on Cardiovascular Risk Reduction Following National Guidelines with CaDUET® (amlodipine besylate/atorvastatin calcium; Pfizer, Morrisville, PA, USA; STRONG DUET) study evaluated its clinical utility in Slovakia, one of the highest CV risk regions in Europe.
METHODS: This was a two-phase study involving 100 outpatient cardiologist and internist departments in Slovakia. Phase 1 assessed BP control and CV risk profiles in adults with treated hypertension, and phase 2 was an open-label, multicenter, observational study. In the phase 2 study, patients with treated but uncontrolled hypertension and three or more coronary heart disease risk factors received single-pill amlodipine/atorvastatin (5/10 or 10/10 mg) for 12 weeks. Major outcomes were the percentage of patients achieving target BP (≤140/90 mmHg) and/or LDL-C (≤3 mmol/L) and reductions in predicted 10-year CV risk.
RESULTS: Of the 4,672 phase 1 patients, 80.8% had uncontrolled hypertension and 61.4% had dyslipidemia. Of the 1,406 phase 2 patients, 90.3% of patients achieved target BP at week 12, 66.3% achieved target LDL-C, and 60.7% achieved both. The mean 10-year CV risk was reduced by 49% (P < 0.0001); treatment was well-tolerated and safe.
CONCLUSIONS: Single-pill amlodipine/atorvastatin was associated with significant improvements in BP, LDL-C target attainment, and 10-year CV risk in patients with uncontrolled hypertension in Slovakia. The treatment was well-tolerated and safe. Use of single-pill amlodipine/atorvastatin in high CV-risk countries could lead to significant improvements in CV risk management.

The aim of this study was to investigate the association between volume and frequency of moderate-intensity PA and step-based recommendations and individual body composition variables. Our cohort included 167 healthy ambulatory women (mean age 62.8 ± 4.8 years; body mass index [BMI] 27.3 ± 4.2 kg/m(2)) who carried out daily activities while wearing the ActiGraph GT1M accelerometer over a seven day period. Measurements of BMI, body fat mass index (BFMI), fat-free mass index (FFMI), waist-hip ratio (WHR) and visceral fat area (VFA) were obtained by the InBody 720 multifrequency bioelectrical impedance analysis (MFBIA) device. The significant relationship (r(s)=0.66; p<0.05) was found between moderate PA and steps per day. Moderate PA (r(2)=0.03-0.06) and steps per day (r(2)=0.05-0.20) were significantly associated with observed body composition parameters. Women spending > 300 min/week in moderate PA showed significantly lower values of BFMI (p=0.02) than those who spent 150-300 min/week. Carrying out moderate PA for 30 min 5 days a week was significantly associated with lower BMI (p=0.04; η(2)=0.02), BFMI (p=0.02; η(2)=0.03) and VFA (p=0.03; η(2)=0.03). In addition, higher amounts of daily steps were significantly associated with lower BMI (p=0.00; η(2)=0.16), BFMI (p=0.00; η(2)=0.21), VFA (p=0.00; η(2)=0.20) and WHR (p=0.00; η(2)=0.13). A clear association was found between the generally recommended PA guidelines and body composition variables for the women examined in this study. However, the concept of 10,000 steps/day appears to be the strongest predictor of health-related body composition values.