BACKGROUND: In Slovakia, a mandatory national universal pediatric total cholesterol (TC) screening program is in place to identify cases of familial hypercholesterolemia (FH). However, the program\'s effectiveness has not been systematically assessed.
OBJECTIVE: This study aimed to estimate the prevalence of FH among parents of children that had elevated TC levels identified during screening.
METHODS: This prospective, non-interventional, observational study enrolled parents of 11-year-old children who underwent TC screening in 23 selected pediatric outpatient clinics between 2017 and 2018. FH was diagnosed using the Dutch Lipid Clinic Network (DLCN) criteria and targeted next-generation sequencing. The primary objective was to estimate the proportion of children with a TC level of >188 mg/dL (>4.85 mmol/L) who had a parent with a confirmed diagnosis of FH.
RESULTS: A total of 112 parents of 56 children with an elevated TC level were enrolled. Five children (8.9%) had a parent in whom FH was genetically confirmed. Without genetic analysis, all five parents would only be diagnosed with \"possible FH\" by DLCN criteria. Of parents, 83.9% (n = 94/112) had an LDL-C level of >116 mg/dL (>3 mmol/L), but only 5.3% (n = 5/94) received lipid-lowering therapy. Among the five parents with genetically confirmed FH, all had an LDL-C level >116 mg/dL (>3 mmol/L), with a mean (±SD) of 191 (±24) mg/dL (4.94 [±0.61] mmol/L). Only two of these parents received lipid-lowering therapy.
CONCLUSIONS: The present study demonstrates the significance of mandatory universal pediatric TC screening in identifying families with FH and other at-risk families in need of lipid-lowering therapy.

Attention on work-related musculoskeletal disorders (WMSDs) involves statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development has led to new tools and methods for the assessment of physical load at work. These methods are mostly based on the direct sensing of appropriate parameters, which allows more precise quantification. The aim of this paper is to compare several commonly used methods in Slovakia for the assessment of ergonomic risk reflecting current EU and Slovak legislative regulations. A Captiv wireless sensory system was used at a car headlight quality control assembly workplace for sensing, data acquisition and data processing. During the evaluation of postures and movements at work, we discovered differences in the applicable standards: Decree 542/2007 Coll. (Slovak Legislation), the STN EN 1005-4+A1, and the French standards default in the Captiv system. Standards define the thresholds for hazardous postures with significant differences in several evaluated body segments, which affects the final evaluation of the measurements. Our experience from applying improved risk assessment methodology may have an impact on Slovak industrial workplaces. It was confirmed that there is a need to create uniform standards for the ergonomic risk assessment of body posture, including a detailed description of the threshold values for individual body segments.

BACKGROUND: Recent years have seen a growing interest in the use of digital tools for delivering person-centred mental health care. Experience Sampling Methodology (ESM), a structured diary technique for capturing moment-to-moment variation in experience and behaviour in service users\' daily life, reflects a particularly promising avenue for implementing a person-centred approach. While there is evidence on the effectiveness of ESM-based monitoring, uptake in routine mental health care remains limited. The overarching aim of this hybrid effectiveness-implementation study is to investigate, in detail, reach, effectiveness, adoption, implementation, and maintenance as well as contextual factors, processes, and costs of implementing ESM-based monitoring, reporting, and feedback into routine mental health care in four European countries (i.e., Belgium, Germany, Scotland, Slovakia).
METHODS: In this hybrid effectiveness-implementation study, a parallel-group, assessor-blind, multi-centre cluster randomized controlled trial (cRCT) will be conducted, combined with a process and economic evaluation. In the cRCT, 24 clinical units (as the cluster and unit of randomization) at eight sites in four European countries will be randomly allocated using an unbalanced 2:1 ratio to one of two conditions: (a) the experimental condition, in which participants receive a Digital Mobile Mental Health intervention (DMMH) and other implementation strategies in addition to treatment as usual (TAU) or (b) the control condition, in which service users are provided with TAU. Outcome data in service users and clinicians will be collected at four time points: at baseline (t0), 2-month post-baseline (t1), 6-month post-baseline (t2), and 12-month post-baseline (t3). The primary outcome will be patient-reported service engagement assessed with the service attachment questionnaire at 2-month post-baseline. The process and economic evaluation will provide in-depth insights into in-vivo context-mechanism-outcome configurations and economic costs of the DMMH and other implementation strategies in routine care, respectively.
CONCLUSIONS: If this trial provides evidence on reach, effectiveness, adoption, implementation and maintenance of implementing ESM-based monitoring, reporting, and feedback, it will form the basis for establishing its public health impact and has significant potential to bridge the research-to-practice gap and contribute to swifter ecological translation of digital innovations to real-world delivery in routine mental health care.
BACKGROUND: ISRCTN15109760 (ISRCTN registry, date: 03/08/2022).

The article by Ceppi and colleagues, Genotoxic Effects of Occupational Exposure to, Glass Fibres - A Human Biomonitoring Study, published in Mutation Research -Genetic Toxicology and Environmental Mutagenesis in 2023 was reviewed with great interest. The authors undertook a novel approach to conducting a biomonitoring study of genotoxicity markers among a population of glass fibre manufacturing workers in Slovakia. On the surface, the Ceppi et al. (2023) study provides an interesting application of genotoxicity markers among a human population of workers to explore potential markers of effect (DNA strand breaks) and potential risk of susceptibility (e.g., genetic damage, disease, death). However, limited data for exposure reconstruction, uncertain influences from smoking history, and lack of consideration of decades of human epidemiology research showing no increased risk of malignant or non-malignant respiratory disease and mortality among glass fibre manufacturing workers, reveals that the conclusions of the authors are overreaching and inconsistent with the existing science. The limitations of this study preclude the ability to draw causal inferences or conclusions about DNA strand breaks as a marker of exposure, effect, or susceptibility within this population of Slovakian glass fibre workers. Further longitudinal research is required (e.g., more robust temporal assessment of occupational exposures - fibres and other compounds - and smoking history) to support the study conclusions.

Park greenery represents an oasis for urban residents; however, during the flowering period of trees that produce allergenic pollen grains, these areas threaten individuals suffering from seasonal allergic respiratory diseases. In this study, we evaluated the temporal distribution of the allergenic potential of three most important urban parks in Bratislava over the vegetation period, using a modification of the Urban Green Zone Allergenicity Index (IUGZA) and Individual-Specific Allergenic Potential Index (IISA) designed as a running index - rIUGZA and rIISA. We found that rIUGZA gives better information for park management and revitalization, since it considers the potential size of woody plants, while rIISA, considering the actual size of the vegetation, provides more relevant information for pollen-allergy sufferers. Based on rIISA, the allergenic potential was highest in May for the Grassalkovich Garden (formal baroque garden) and Janko Kráľ Park (English landscape park) and in April for the Medic Garden (repurposed baroque garden). We also found differences in the duration of the period of increased allergenic potential in these parks, ranging from 1 to 3 months. Based on the total annual sums of rIISA, we found the highest allergenic potential in the Medic Garden and lowest in the Janko Kráľ Park. This variance is caused mainly by the different density of trees and percentage of allergenic species. The biggest contributors to the allergenic potential were Platanus, Acer and Tilia. Based on the information on temporal variation of the allergenic potential during the vegetation period provided by the running indices, it is possible to improve the planning of park revitalization based on the flowering period of allergenic species and provide better information to the pollen-allergy sufferers for minimizing the allergenic effect of urban green areas on their health during a particular month.

BACKGROUND: The war in Ukraine has led to significant migration to neighboring countries, raising public health concerns. Notable tuberculosis (TB) incidence rates in Ukraine emphasize the immediate requirement to prioritize approaches that interrupt the spread and prevent new infections.
METHODS: We conducted a prospective genomic surveillance study to assess migration\'s impact on TB epidemiology in the Czech Republic and Slovakia. Mycobacterium tuberculosis isolates from Ukrainian war refugees and migrants, collected from September 2021 to December 2022 were analyzed alongside 1574 isolates obtained from Ukraine, the Czech Republic, and Slovakia.
RESULTS: Our study revealed alarming results, with historically the highest number of Ukrainian tuberculosis patients detected in the host countries. The increasing number of cases of multidrug-resistant TB, significantly linked with Beijing lineage 2.2.1 (p < 0.0001), also presents substantial obstacles to control endeavors. The genomic analysis identified the three highly related genomic clusters, indicating the recent TB transmission among migrant populations. The largest clusters comprised war refugees diagnosed in the Czech Republic, TB patients from various regions of Ukraine, and incarcerated individuals diagnosed with pulmonary TB specialized facility in the Kharkiv region, Ukraine, pointing to a national transmission sequence that has persisted for over 14 years.
CONCLUSIONS: The data showed that most infections were likely the result of reactivation of latent disease or exposure to TB before migration rather than recent transmission occurring within the host country. However, close monitoring, appropriate treatment, careful surveillance, and social support are crucial in mitigating future risks, though there is currently no evidence of local transmission in EU countries.

Suicidal behavior is multifaceted and encompasses various factors. Among these, alcohol dependence and acute alcohol intoxication stand out as significant risk factors for suicide. The retrospective study aimed to record the development of suicide, also in connection with alcohol consumption, in the catchment area of the Department of Forensic Medicine and Pathological Anatomy of the Health Care Surveillance Authority in Martin, Slovak Republic, in the years 2009-2019.

BACKGROUND: To the present day, the prevalence and incidence of cervical cancer remains very significant. For disadvantaged groups such as the Roma, screening for the disease should be given increased attention, as members of this minority have lower access to health care and lower average health literacy.
OBJECTIVE: The aim of our study was to assess the prevalence of cytological screening for cervical cancer among Hungarian-speaking Roma and non-Roma populations in Hungary, Romania and Slovakia, in relation to the possible influencing factors. We also investigated respondents\' perceptions of the importance of cervical cancer screening and HPV vaccination. In this paper, we focus on presenting the data from Hungary in relation to the results from the other two countries. The study sample size was 1366.
METHODS: Data were presented as mean ± SD and proportion. To compare Roma and non-Roma samples, the independent samples t-test was used. Cross tabulation with Pearson\'s chi-square test with calculating phi/Cramér\'s V effect size (p<0.05) was used to reveal association between ethnicity and studied variables.
RESULTS: In Hungary, a higher proportion of Roma women (p = 0.004) did not attend cytological screening for cervical cancer compared to non-Roma women, a difference confirmed in the other two countries. Non-Roma women attached greater importance to attendance at cervical cancer screening (p = 0.022). The Roma population aged 18-65 years had lower rates of annual cytological screening for cervical cancer compared to non-Roma in all age groups, while the annual screening rate decreased with age, regardless of ethnicity.
CONCLUSIONS: Further health promotion to prevent cervical cancer in the Roma and non-Roma population would be necessary, regardless of national borders, specifically to address risk factors in all age groups, with a focus on young people, who are less aware of the risk, and older age groups, who mostly believe that the disease does not affect them due to their age. Orv Hetil. 2023; 164(36): 1416-1425.
Bevezetés: A méhnyakrák prevalenciája és incidenciája mind a mai napig igen jelentős mértékű. Az olyan hátrányos helyzetű csoportok esetében, mint a romák, a betegség szűrésére fokozott figyelmet kell fordítani, ennek a kisebbségnek a tagjai ugyanis nehezebben veszik igénybe az egészségügyi ellátást, és az átlagos egészségműveltségük is alacsonyabb. Célkitűzés: Kutatásunk célja az volt, hogy felmérjük magyar ajkú, magyarországi, romániai és szlovákiai roma és nem roma lakosság nőgyógyászati szűrővizsgálaton való részvételi gyakoriságát, összefüggésben az ezt befolyásoló lehetséges tényezőkkel. Emellett vizsgáltuk, hogy a válaszadók hogyan vélekedtek a méhnyakrákszűrés, valamint a HPV elleni védőoltás fontosságáról. Jelen közleményben a magyarországi adatok bemutatására helyeztük a hangsúlyt, összefüggésben a másik két ország eredményeivel. A vizsgálati minta elemszáma 1366 fő volt. Módszer: Az adatokat gyakorisági eloszlással, átlag ± SD számítással, arányszámokkal vizsgáltuk, a roma és nem roma minták összehasonlításához független mintás t-próbát, az etnikai hovatartozás és a vizsgált változók közötti összefüggés feltárására kereszttábla-elemzést, Pearson-féle khi-négyzet-statisztikát, phi/Cramér-féle V-hatásnagyságot használtunk (p<0,05). Eredmények: Magyarországon az etnikai hovatartozás és a méhnyakrák citológiai szűrővizsgálatokon való részvétel szignifikáns összefüggést mutatott (p = 0,004), a roma nők a nem romákhoz képest nagyobb arányban nem vettek részt szűrővizsgálaton, a különbség igazolódott a másik két országban is. A nem roma nők nagyobb jelentőséget tulajdonítottak a méhnyakrákszűrésen való részvételnek (p = 0,022). A 18–65 év közötti roma lakosság az évenkénti szűrővizsgálat tekintetében minden korcsoportban kisebb arányban vett részt szűrővizsgálaton a nem romákhoz képest, miközben az etnikai hovatartozástól függetlenül az életkor előrehaladtával csökkent az évenkénti szűrési gyakoriság. Következtetés: A roma és a nem roma lakosság körében a méhnyakrák megelőzése érdekében – országhatároktól függetlenül – elkerülhetetlen az egészségfejlesztés, ezen belül is kifejezetten a rizikófaktorok ismertetése minden korosztályban, de kiemelve a fiatalokat, akik kevésbé érzékelik a kockázatot, és az idős korosztályt, amelynek tagjai többnyire úgy gondolják, hogy a betegség az életkorukból adódóan már nem érinti őket. Orv Hetil. 2023; 164(36): 1416–1425.

Analysis of life-threatening maternal morbidities, the condition of which required subsequent treatment in Intensive Care Units (ICU) in the Slovak Republic in the years 2012-2020.
Retrospective analysis of 655 identified cases of mothers admitted to the intensive care units out of 436,136 births. The reasons for the transport were divided into nine categories: peripartum bleeding, hypertensive diseases, thromboembolism, cardiovascular diseases, sepsis/severe infections, metabolic diseases, complications of anaesthesiology, gastroenterological problems and others.
The total incidence of admission to the intensive care units in the observed period was 1.5 per 1,000 births, but for mothers of Roma nationality it was 8.8 per 1,000 births. The average age of mothers was 30.7 years, while 29.7% were over 35 years old. Overweight and obesity was present by 70.4% of mothers. The most common reason for transport to the ICU (49.3%) was severe postpartum hemorrhage. The second most common cause (26.0%) was hypertensive diseases (preeclampsia, eclampsia and HELLP syndrome). The third most common cause (4.9%) was sepsis and severe maternal infections. The mortality rate of mothers admitted to the ICU was 2.3% and infant mortality of these mothers was 8.7%.
The incidence of admission of mothers to the ICU in the monitored years was 1.5 per 1,000 births, which in international comparison ranks Slovakia among countries with a lower incidence.

OBJECTIVE: To assess the incidence of peripartum hysterectomy (PH) in Slovakia. Additionally, we wanted to describe reasons for the procedure, associated clinical circumstances, and complications.
METHODS: This was a descriptive, population-based study among women who underwent PH in Slovakia between January 2012 and December 2020. Peripartum hysterectomy was defined as surgical removal of the uterus from the peripartum period up to 42 days postpartum. Data were obtained retrospectively from the standardized questionnaires that are completed in Slovakia for any case of PH. The background population consisted of all other women who delivered during the study period.
RESULTS: Of the 436 136 births, there were 397 cases of PH, giving an incidence of 0.91 per 1000 births. It was higher with advanced maternal age, multiparity, multiple pregnancies, and cesarean deliveries. The main reasons for the procedure were placental pathologies and uterine atony in 52.9% and 33.0%, respectively. A total of 150 (37.8%) women required admission to an intensive care unit. The mortality rate was 1.5%.
CONCLUSIONS: The incidence of PH is relatively high in Slovakia when compared with other European countries, highlighting the need to improve prenatal diagnosis of morbidly adherent placenta and the management of peripartum hemorrhage.