AIMS: Present society is constantly ageing and elderly frequently suffer from conditions that are difficult and/or costly to treat if detected late. Effective screening of the elderly is therefore needed so that those requiring detailed clinical work-up are identified early. We present a prospective validation of a screening strategy based on a Polyscore of seven predominantly autonomic, non-invasive risk markers. METHODS AND RESULTS: Within a population-based survey in Germany (INVADE study), participants aged ≥60 years were enrolled between August 2013 and February 2015. Seven prospectively defined Polyscore components were obtained during 30-min continuous recordings of electrocardiogram, blood pressure, and respiration. Out of 1956 subjects, 168 were excluded due to atrial fibrillation, implanted pacemaker, or unsuitable recordings. All-cause mortality over a median 4-year follow-up was prospectively defined as the primary endpoint. The Polyscore divided the investigated population (n = 1788, median age: 72 years, females: 58%) into three predefined groups with low (n = 1405, 78.6%), intermediate (n = 326, 18.2%), and high risk (n = 57, 3.2%). During the follow-up, 82 (4.6%) participants died. Mortality in the Polyscore-defined risk groups was 3.4%, 7.4%, and 17.5%, respectively (P < 0.0001). The Polyscore-based mortality prediction was independent of Framingham score, diabetes, chronic kidney disease, and major stroke and/or myocardial infarction history. It was particularly effective in those aged <75 years (n = 1145). CONCLUSION: The Polyscore-based mortality risk assessment from short-term non-invasive recordings is effective in the elderly general population, especially those aged 60-74 years. Implementation of a comprehensive Polyscore screening of this age group is proposed to advance preventive medical care.

• Klíčová slova
• Autonomic markers, Elderly general population, Polyscore, Prospective validation, Risk assessment,
• MeSH
• autonomní nervový systém MeSH
• cévní mozková příhoda * MeSH
• hodnocení rizik MeSH
• infarkt myokardu * MeSH
• lidé MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: Increased aortic stiffness may be one of the mechanisms by which obesity increases cardiovascular risk independently of traditional risk factors. While body mass index (BMI) is generally used to define excess adiposity, several studies have suggested that measures of central obesity may be better predictors of cardiovascular risk. However, data comparing the association between several measures of central and general obesity with aortic stiffness in the general population are inconclusive. METHODS: In 1031 individuals (age 53 ± 13 years, 45% men) without manifest cardiovascular disease randomly selected from population, we tested the association between parameters of central obesity (waist circumference - WC, waist-to-hip-ratio - WHR, waist-to-height ratio - WHtR) and general obesity (BMI) with carotid-femoral pulse wave velocity (cfPWV). RESULTS: In univariate analysis, WC and WHtR were more strongly associated with cfPWV than BMI in both genders, while WHR showed a stronger association with cfPWV only in women. WHtR was more closely associated with cfPVW than WHR. This difference between obesity measures remained after multivariate adjustment. When the fully adjusted hierarchical regression was used, among central obesity measures, WHtR had the largest additive value on top of BMI, while there was no additive value of BMI on top of WHtR. CONCLUSION: Central obesity parameters are more closely associated with aortic stiffness than BMI. Of central adiposity measures, WHtR has the strongest association with aortic stiffness beyond body mass index and cardiovascular risk factors. Our results suggest that WHtR may be the best anthropometric measure of excess adiposity in the general population.

• Klíčová slova
• Aortic stiffness, Body mass index, Obesity, Pulse wave velocity, Waist circumference, Waist-to-height ratio, Waist-to-hip ratio,
• MeSH
• abdominální obezita * MeSH
• adipozita * MeSH
• analýza pulzové vlny MeSH
• aorta patofyziologie   MeSH
• dospělí MeSH
• index tělesné hmotnosti MeSH
• kardiovaskulární nemoci epidemiologie   etiologie   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita komplikace   MeSH
• obvod pasu MeSH
• poměr pasu a boků MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• tělesná výška MeSH
• tuhost cévní stěny * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

PURPOSE: Stigma among health care professionals is detrimental to the life of those with mental health problems. In the region of post-communist Europe, the level of stigma among health care providers remains understudied. We aimed to compare attitudes towards people with mental illness between Czech medical doctors and the general population. METHODS: The Community Attitudes towards Mentally Ill (CAMI) scale was used to measure stigmatizing attitudes among a nationally representative sample of (1) adults residing in the Czech Republic (n = 1810) and (2) Czech medical doctors (n = 1200). Descriptive statistics and multivariable linear regression were used to assess differences between both samples. RESULTS: Compared to the general adult population in the Czech Republic, Czech medical doctors demonstrated less stigmatizing attitudes toward people with mental illness in 26 of the 27 CAMI items as well as in the total CAMI score. Medical doctors, however, were more likely to consider mental hospitals as an up-to-date method of treating people with mental illness. CONCLUSIONS: Our findings demonstrate more favourable attitudes towards people with mental illness among Czech medical doctors when compared to the Czech general population. Stigma, however, is high among both these groups.

• Klíčová slova
• Attitudes, CAMI, General population, Medical doctors, Mental illness, Stigma,
• MeSH
• dospělí MeSH
• duševně nemocní MeSH
• duševní poruchy * MeSH
• lékaři primární péče * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• postoj ke zdraví * MeSH
• postoj zdravotnického personálu * MeSH
• průzkumy a dotazníky MeSH
• společenské stigma MeSH
• stereotypizace MeSH
• ústavy pro duševně nemocné MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH

Homelessness is a growing problem in the Czech Republic where homeless people represent a specific minority group beset by many problems linked to their divergent lifestyle. It was therefore expected that the homeless population would be at greater risk of exposure to environmental pollutants than the general population. The aim of our study was to compare blood lead (B-Pb) and blood cadmium (B-Cd) levels in the homeless population (HP) with those obtained from the Human Biomonitoring Project (CZ-HBM), which used blood donors considered representative of the general population (GP). We present data obtained between 2004 and 2006 for B-Pb and B-Cd in 257 Prague homeless adults and compare them to B-Pb and B-Cd levels in 104 Prague adult blood donors from the CZ-HBM project in 2005. The mean (geometric) B-Pb levels in men were 36.5 (HP) and 35.4microg/l (GP), which is not significantly different. However, statistically significant differences were observed between men and women in the GP (P<0.001), but not in HP; B-Pb levels in women (34.8microg/l) did not differ from those of HP men (36.5microg/l), but were significantly (P<0.001) higher than those of GP women (25.8microg/l). B-Pb levels were not influenced by smoking. B-Cd levels in the homeless nonsmokers (geometric means 1.06 and 1.18microg/l in men and women, respectively) were more than 2.5 times higher than in the nonsmoking GP (0.36 and 0.38microg/l for men and women, respectively). B-Cd levels were significantly (P<0.001) influenced by smoking in both groups, but, surprisingly, the values in GP smokers (men=0.96microg/l, women=0.93microg/l) were lower than those in HP nonsmokers (men=1.06microg/l, women=1.18microg/l). A positive correlation was found between cadmium and lead in both men (P<0.05) and women (P<0.01). Our results indicate that the homeless population under study might be exposed to lead and cadmium more extensively than the general population of Prague and that homeless women represent a particularly vulnerable population group.

• MeSH
• dárci krve MeSH
• dospělí MeSH
• kadmium krev   MeSH
• kouření krev   MeSH
• látky znečišťující životní prostředí krev   MeSH
• lidé bez domova * MeSH
• lidé středního věku MeSH
• lidé MeSH
• městské obyvatelstvo MeSH
• monitorování životního prostředí * MeSH
• olovo krev   MeSH
• rozložení podle pohlaví MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• kadmium MeSH
• látky znečišťující životní prostředí MeSH
• olovo MeSH

Total homocysteine (tHcy) level was identified as a strong and independent predictor of cardiovascular events. We investigated the association between tHcy and mechanical properties of large arteries in a random, general population-based sample of 251 subjects (mean age 48 years). Large artery properties, such as aortic and peripheral (lower-limb) pulse wave velocity (PWV), and augmentation index of radial artery were measured using semi-automatic Sphygmocor device. Aortic PWV (APWV) positively correlated with tHcy (r = 0.28, P<0.0001), and a significant increasing trend of APWV was found by tHcy quartiles (P = 0.0003 by ANOVA). This association remained significant after adjustment for conventional cardiovascular risk factors (age, gender, smoking, overweight, hypertension, dyslipidaemia and impaired glucose metabolism) and for usual homocysteine confounders (folate, B12, renal function). Subjects with mild hyperhomocysteinaemia (i.e. with tHcy > or = 15 micromol/l) had 2.74 times higher risk of having their APWV over 8.42 m/s (i.e. in the top quartile). No such association was found either for PWV measured at lower extremity or for radial augmentation index. In conclusion, in our series of subjects from general population, we found a strong and independent relationship between homocysteine concentration and APWV, a parameter of stiffness of central arteries.

• MeSH
• biologické markery krev   MeSH
• cévní rezistence fyziologie   MeSH
• dospělí MeSH
• homocystein krev   MeSH
• hyperhomocysteinemie krev   komplikace   diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci aorty krev   etiologie   patofyziologie   MeSH
• pulzatilní průtok fyziologie   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• surveillance populace * MeSH
• ultrasonografie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• biologické markery MeSH
• homocystein MeSH

The main unresolved issues concerning environmental exposure to chrysotile asbestos of the general population are discussed. A review of the results of the measurement of airborne chrysotile fibres in buildings is presented showing that the results have been consistently low with the exception of buildings with damaged friable asbestos-containing material. Quantitative risk assessments are presented indicating that the lifetime risk is small compared to many other environmental risks. Possible adverse health effects of paraoccupational exposures in the case of high domestic airborne asbestos levels cannot be excluded. Both on the basis of electron microscopy analyses of asbestos exposures at locations with heavy traffic, and the very shallow slopes in the exposure-response relationships for increased lung cancer risk, the conclusion is drawn that exposure to airborne asbestos-containing friction materials has not been proven to pose a significant health risk to the general population. Reviewing animal ingestion studies published and all the available epidemiological studies related to asbestos in drinking water, the conclusion is drawn that the carcinogenic risk in the general population is low even in the case of drinking water containing elevated concentrations of chrysotile asbestos.

• MeSH
• chrysotilový azbest škodlivé účinky   MeSH
• konstrukční materiály analýza   MeSH
• lidé MeSH
• nádory epidemiologie   etiologie   MeSH
• pracovní expozice analýza   MeSH
• rizikové faktory MeSH
• výfukové emise vozidel analýza   MeSH
• vystavení vlivu životního prostředí škodlivé účinky   MeSH
• zásobování vodou analýza   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• chrysotilový azbest MeSH
• výfukové emise vozidel MeSH

BACKGROUND: Alcohol use is one of the leading public health concerns in the Czech Republic. Drinking motives play a vital role in both initiation and subsequent alcohol use. A revised version of the self-report Drinking Motives Questionnaire (DMQ-R) has been proposed to assess these motives. The present study aims to validate the DMQ-R in the Czech general population. METHODS: A total sample of 1,784 Czech participants completed a national survey. For the analysis, only a sub-sample of the past 12 months alcohol users was used: N = 1,123; 52.8% male; mean (SD) age = 40.2 (13.3). Drinking motives were assessed by the adopted Czech version of the DMQ-R. Both confirmatory (CFA) and exploratory factor analysis (EFA) were conducted to examine the factorial structure of the instrument. The age of the participant was additionally considered in the analysis (15-24 years as opposed to 25-64 years). RESULTS: The CFA supported the four-factor model in the 25-64 age group. The analysis supported the construct validity of the Social, Conformity, and Coping factors. The Enhancement factor retained only two items and was found to refer more to a domain of 'Pleasant Feeling'. For the 15-24 age group, the hypothesised four-factor structure was not corroborated. CONCLUSIONS: The Czech version of the DMQ-R was found to be a reliable measurement tool of the Social, Conformity, and Coping motives. Future research should investigate the dimensionality of the instrument items presumed to correspond to the Enhancement motives. This should be conducted particularly among adolescents and young adults aged 15-24 years, where administering the DMQ-R with a large enough sample is also needed.

• Klíčová slova
• Alcohol use, Czech Republic, Drinking motives, Factor analysis, General population,
• MeSH
• adaptace psychologická MeSH
• dospělí MeSH
• faktorová analýza statistická MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• motivace * MeSH
• pití alkoholu * psychologie   epidemiologie   MeSH
• průzkumy a dotazníky normy   MeSH
• psychometrie MeSH
• reprodukovatelnost výsledků MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH
• Geografické názvy
• Česká republika MeSH

Purpose: Primary aldosteronism (PA) is considered the most common form of secondary hypertension, however, its prevalence, particularly in a general population, is still a matter of debate. The aim of our study was to evaluate the prevalence of PA in a randomly selected general population sample.Materials and methods: A total of 1940 individuals (1% population random sample) aged 25-64 years were screened for major cardiovascular risk factors in six districts of the Czech Republic. Hypertension was defined as a mean of two blood pressure readings ≥140/90 mmHg at one visit or taking antihypertensive medication. Within this population, 740 individuals were labelled as hypertensives and 650 of them sampled for the analysis of direct plasma renin and serum aldosterone. The diagnosis of PA was based on elevated serum aldosterone, low plasma renin and high aldosterone/renin (ARR) ratio and was also verified by a confirmatory test with saline infusion.Results: Positive ARR was found in 52 (8%) individuals (64% women, 36% men, however, due to substatntial proportion of reluctatnt participants to undergo a further work-up (27%), we could confirm the diagnosis of PA only in 13 of them (2%). Aldosterone-producing adenoma was found in one case only, seven patients had idiopathic type and five individuals refused potential surgical treatment therefore, adrenal venous sampling was not performed.Conclusion: Elevated serum aldosterone together with low renin and high ARR were found in 52 (8%) of hypertensives selected from a general population sample, however, the diagnosis of PA was confirmed only in 13 of them (2%). This study based on a general population survey highlighted the difficulty of conducting epidemiological studies on primary aldosteronism in a relatively healthy cohort part of whom did not provide the level of collaboration that is necessary to assess the true prevalence of this condition.

• Klíčová slova
• Primary aldosteronism, confirmatory tests, direct plasma renin, population screening, prevalence, secondary hypertension, serum aldosterone,
• MeSH
• aldosteron krev   MeSH
• antihypertenziva terapeutické užití   MeSH
• biologické markery krev   MeSH
• dospělí MeSH
• hyperaldosteronismus krev   diagnóza   epidemiologie   MeSH
• hypertenze diagnóza   farmakoterapie   epidemiologie   patofyziologie   MeSH
• krevní tlak účinky léků   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• průřezové studie MeSH
• renin krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• aldosteron MeSH
• antihypertenziva MeSH
• biologické markery MeSH
• renin MeSH

The relationship is shown between a concentration of urinary iodine and serum thyroglobulin in population studies carried out on a general population that was randomly selected from the registry of the General Health Insurance Company (individuals aged 6-98 years, 1751 males, 2420 females). The individuals were divided into subgroups with a urinary iodine concentration of <50, 50-99, 100-199, 200-299 and >/=300 microg/l. The mean and median of thyroglobulin were calculated in these subgroups. Tg concentrations were dependent on gender (males

• MeSH
• aplikace orální MeSH
• dítě MeSH
• dospělí MeSH
• jod aplikace a dávkování   nedostatek   moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pohlavní dimorfismus MeSH
• registrace * MeSH
• reprodukovatelnost výsledků MeSH
• rozložení podle pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• stárnutí krev   MeSH
• thyreoglobulin krev   MeSH
• věkové rozložení MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• jod MeSH
• thyreoglobulin MeSH

BACKGROUND: The prevalence of complementary and alternative medicine (CAM) ranges between 0.3% and 86% in most highly developed countries. In the Czech Republic, CAM is used by 76% of the general population. Our aim was to examine patterns in CAM use among a representative sample of the general population in the Czech Republic, for 2011 and 2014. MATERIAL AND METHODS: A cross-sectional survey was conducted. A sex-, age- and region-stratified sample of citizens aged 15 years and older was randomly selected from the 2014 voter registration lists (n = 8,395,132). A comparative analysis of data collected in 2011 and 2014 was performed. RESULTS: Overall, 76.0% (N = 1,365) versus 87.0% (N = 1,565) of the respondents reported use of 1 or more CAM modalities during the past 30 days, in 2011 and 2014, respectively (p < 0.001). In both years, the top 4 CAM modalities used were vitamins/minerals, herbal teas, massage, and relaxation. Yoga replaced dietary supplements excluding vitamins/minerals in the 5th position. Nevertheless, only herbal teas (48.0% vs. 53.0%, p = 0.002), massage (20.0% vs. 26.0%, p < 0.001), relaxation (10.0% vs. 19.0%, p < 0.001), and yoga (3.7% vs. 7.1%, p < 0.001) showed a significant increase in use. CONCLUSIONS: The prevalence of CAM use in the Czech Republic is increasing, especially among people who use biological, body- and mind-based CAM therapies. There is a great need to educate students and health care professionals about the efficacy and safety of CAM in order to meet the patients' demands on CAM.

• Klíčová slova
• Complementary therapies, Czech Republic, Follow-up, Pattern, Population, Reasons of use, Utilization,
• MeSH
• demografie MeSH
• dospělí MeSH
• komplementární terapie statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• následné studie MeSH
• průřezové studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH