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PubMed2001

The large increase in incidence of Type I diabetes mellitus in Poland.

AIMS/HYPOTHESIS: A rising incidence of Type I (insulin-dependent) diabetes mellitus in different countries in Europe during the last decade has been recently reported. However, in the early 1990s, Poland was reported to have a stable low incidence of this disease. This study aimed to estimate the annual incidence of Type I diabetes in a north-eastern region of Poland (Białystok region) and investigate if it is associated with age, sex, urban rural differences and the season of disease onset. METHODS: A register of patients with Type I diabetes using two independent sets of data sources was established in 1994 as part of the EURODIAB TIGER programme. The primary data sources were paediatric and internal medicine divisions of the hospitals in the Białystok province and the secondary were outpatient diabetic clinics in the region. The degree of ascertainment was 98.5 % for the combinated data sources. RESULTS: We found a significant rising trend in the incidence of Type I diabetes in children under 15 years of age (in 1998 the incidence was approximately twice as high as in 1994). Increasing incidence rates were observed in the rural areas but not in urban populations. Seasonal variation in the incidence was also found, with a peak in winter and nadir in summer. CONCLUSIONS/INTERPRETATION: These results show that the north-eastern region of Poland is an area with a moderate rather than a low risk of Type I diabetes. Our observations confirm the important role of environmental and socio-economic factors or both in the pathogenesis of Type I diabetes.

Adolescent↗
PubMedDate not supplied

Poland's syndrome: different clinical presentations and surgical reconstructions in 18 cases.

BACKGROUND: The literature reports many variations of Poland's syndrome. This article describes 18 cases of Poland's syndrome in different stages of treatment, with variable clinical presentations and reconstructive techniques. METHODS: This study evaluated 15 females and 3 males, ages 2 to 43 years, for breast deformity, nipple-areolar complex position, pectoralis muscle malformation, thoracic deformities, and the presence of brachysyndactyly. Surgical treatment was performed for 14 patients, individualized for each case. RESULTS: For the women, the hypoplastic breast was treated with a latissimus dorsi muscular flap associated with silicone gel implant in five cases. Two other patients still are receiving tissue expansion for a future muscular and prosthetic reconstruction. Prosthetic implants alone were used on the affected side in four cases. The nipple-areolar complex was reconstructed for two patients. Seven women underwent contralateral breast surgery: reduction mammoplasty in three cases, mastopexy in two cases, and prosthetic implants in two cases. The only man who underwent surgery was treated with endoscopic rotation of the latissimus dorsi muscle flap. CONCLUSIONS: This study demonstrated several breast reconstruction options for patients with Poland's syndrome, reinforcing the importance of an individualized treatment to achieve complete and adequate rehabilitation.

Adolescent↗
PubMed1999

Preliminary report on pathology of colorectal cancer in Poland in 1995 and 1975: is it still the same disease?

Over past three decades in Poland we have seen a steady increase in the incidence of colorectal cancer. It is unclear whether this phenomenon is associated with changes in biology of the disease. In the present study we compared basic clinical data and pathological features of colorectal carcinomas submitted as resection specimens to a single institution in 1975 (n=76) and 1995 (n=106). We found a significant increase in sigmoid tumors (15.8% in 1975, 34.9% in 1995, P=0.0028), a decline in the frequency of mucinous carcinomas (22.4% in 1975, 7.5% in 1995, P=0.0041), and reversed distribution of low- and high-grade tumors (more high-grade than low-grade carcinomas in 1975, the opposite in 1995). We observed trends toward more pronounced peritumoral desmoplastic response, less prominent chronic peritumoral inflammatory infiltrate, and more frequent perineural invasion. The 1995 patients were on average significantly older at surgery (59 years in 1975, 64 years in 1995, P=0.02) and had smaller tumors (max. diameter=5.49 cm in 1975, 4.27 cm in 1995, P=0.0018). There were no differences in distribution of tumor stage, patient's sex, type of infiltrating margin formed by carcinomas, relative amount formed by the solid tumor component, invasion of veins and lymphatics, or presence of an adenoma contiguous with a carcinoma. Differences between 1975 and 1995 cases observed in our material probably reflect the changing biology of colorectal carcinoma in Poland. Mucinous, high-grade, proximal tumors, surrounded by prominent chronic inflammatory infiltrate, diagnosed in relatively younger subjects are associated with familial and sporadic cancers due to widespread genomic instability (replication error positive or RER(+) phenotype). We conclude that in Poland the APC/K-ras/p-53 carcinogenesis pathway is becoming even more important than the carcinogenesis characterized by RER(+) tumors. This study is a starting point for further investigations aimed at confirming this hypothesis.

Age Distribution↗
PubMed2002

Financing occupational health services in Poland.

OBJECTIVES: Financing occupational health services (OHS) at the regional and basic level is an important issue in view of the transformation process going on in OHS in Poland. The Occupational Health Services Act from 1997, The Public Finance Act from 1999 and The Labour Code Act with amendment have been regulated by the new principles of financing. The organizational structures and the financial system have been changed since 1 January 1998. The process is still being continued. The gaps between information systems of past and present financial data enforced the examination of the current situation in regard to the structure of financing and internal allocation of financial means. MATERIAL AND METHOD: The studies of OHS funding were carried out by the Nofer Institute of Occupational Medicine in Lodz. The data were collected and analysed for the period 1998-2000. They included full accessible statistics on OHS funding in Poland. The information on the financing system was collected by a questionnaire mailed to directors of OHS centres, and was supplemented by direct contact with directors. RESULTS AND CONCLUSIONS: Sources of OHS financing in Poland are as follows: local government, state budget, companies, social health insurance institutions (since 1 January 1999 a social health insurance system has been implemented), OHS providers (as primary units), other sources. Analyses of their structures in a given period were conducted. The role of companies and social health insurance institutions in financing Regional Occupational Health Services Centres (ROHSCs) was considered in relation to the existing law regulation.

Data Collection↗
PubMed1997

The present state of occupational medicine in Poland.

Occupational medicine in Poland has a long tradition, dating back to the establishment of the first health-care institutions for industrial workers at an early stage of Poland's industrialization. Legal foundations of the industrial health-care system, based on the Soviet model, were enacted in 1953. During its most dynamic period of development (1970s and 1980s) the industrial health-care system provided medical services to about 6 million workers. The process of the political and economic transition in Poland began in 1989, and since 1991 there have been numerous transformations in the structure and function of industrial health services. The present article describes the main stages of the transformation process, occupational health training, research, advisory bodies, and the system for setting of hygienic standards.

Education, Medical↗
PubMed2002

Poland syndrome associated with renal agenesis.

Poland syndrome is characterized by unilateral aplasia or hypoplasia of the sternocostal portion of the pectoralis major muscle and ipsilateral syndactyly. In some cases other associated anomalies, including renal malformations, dextrocardia, and vertebral abnormalities, have been reported. We report a 7-month-old girl with Poland syndrome who also presented with ipsilateral renal agenesis. This report suggests that renal structural anomaly may be an integral part of this syndrome. We recommend renal imaging studies be performed on all children with Poland syndrome.

Female↗
PubMed2006

Genetic variability of hepatitis B virus isolates in Poland.

There is very limited knowledge about the genetic variability of HBV strains circulating in the population of Polish chronically infected HBV patients. The aim of this study was to analyse the phylogenetic relatedness and polymorphism in some functional domains of HBV genome among chronically infected patients from northern Poland. Fifty-one serum samples were included to analysis of HBV genomes due to the viral load sufficient for DNA preparation and sequencing. The sequences of the rt polymerase/S and preC/BCP regions of those isolates were analysed, compared to genome sequences of different variants of HBV from GenBank database and genetic relatedness of Polish genotypes to known reference strains was estimated. A phylogenetic tree of 41 analysed genotype A isolates as well as 8 genotype D strains was constructed showing relationship to know reference strains. Two isolates, initially classified as genotype F turned to be related to genotype H, newly described genotype deriving from genotype F, a very rare genotype in Europe. HBV genotypes' distribution pattern in Poland and phylogenetic relatedness seems to be different from our Eastern neighbours. Due to the fact that Poland is still ethnically uniform country, it is interesting to explore molecular epidemiology of HBV infections in our population.

Adult↗
PubMed2005

Medicine and pharmacy--facts and myths about the development of an innovative pharmaceutical industry in Poland.

Innovation is fundamental to the pharmaceutical industry and a key to improvements in healthcare. Its effectiveness depends on huge, constant investments in research. This innovative industry directly affects the course of studies in healthcare and medicine. Its efforts translate directly into the length and quality of our lives. For several years now, the progress underway in pharmaceutical industry has produced measurable benefits. Doctors have new pharmaceuticals at their disposal, including many types of antibiotics and anti-viral drugs, vaccines and a wide range of drugs which save lives or make them more comfortable. In the near future, ever more efficient cures for neoplastic, rheumatic, neurological, psychic, metabolic, circulatory or respiratory diseases can be expected. Innovation is necessary. The human population is ageing, and the task of an innovative pharmaceutical industry is to keep it in a good condition. The use of innovative drugs can translate directly into lowering the costs of illness. A continuous reduction in spending on healthcare has been observed. The costs of inventing an innovative drug are enormous though (US dollar 800 million), and studies on a new drug last between 10 and 13 years. An essential element in recovering the incurred costs and ensuring funds needed for new research is protection by patent. Innovative pharmaceutical companies in Poland are committed to increasing the competitiveness and sustaining the development of not only the market, but also the entire pharmaceutical sector. It is a group of companies of crucial importance to the Polish healthcare system, as it influences improvement in the quality of medical services. Through their investments and spending on research and development, innovative companies accelerate economic growth. In Poland, the innovative pharmaceutical industry is represented by the Association of Pharmaceutical Companies Representatives in Poland (SPFFwP).

Chemistry, Pharmaceutical↗
PubMed2006

Opportunistic infections and other AIDS-defining illnesses in Poland in 2000-2002.

BACKGROUND: The introduction of highly active antiretroviral therapy (HAART) led to a decreased incidence of the most severe opportunistic infections (OIs) in HIV-infected patients. In Poland, HAART became widely used in 1998. MATERIALS AND METHODS: This study was based on data from medical records data collected in the years 2000-2002 from medical centers for HIV-infected patients in Poland. The aim of the study was to determine the incidence of opportunistic infections (OIs) and other AIDS defining illnesses (ADIs). The chi(2) test was used to determine any significant trends. RESULTS: The incidence of ADIs was 6.8, 6.5 and 4.8/100 persons/year in 2000-2002, respectively. The most common diagnosed OIs were: fungal infections, tuberculosis, recurrent pneumonia, PCP and toxoplasmosis. In patients receiving HAART (HAART+) the incidence of ADIs was significantly lower than in non-ARV-treated as well as in all HIV+ (p < 0.02, p < 0.001, p < 0.001, respectively). A significant decrease in the incidence of ADIs in HAART+ patients between 2000 and 2002 (p < 0.0001) was observed. From 25% to 30% of ADIs among HAART+ patients were diagnosed within the first 3 months of antiretroviral therapy. In HAART+ patients the most common ADIs were fungal infections and tuberculosis. The diagnosis of ADIs resulted in the recognition of HIV status in 8.7-8.9% of patients. CONCLUSIONS: Five years after the introduction of HAART the incidence of ADIs had declined. Fungal infections and tuberculosis were the most common OIs in HIV+ patients in Poland.

AIDS-Related Opportunistic Infections↗
PubMed1989

Real-time echo-Doppler Duplex Scanner in the evaluation of patients with Poland sequence.

In two neonates with partial Poland sequence, an infant with complete Poland sequence and his mother subclavian artery diameter and its flow velocity waveforms were determined by real-time echo-Doppler Duplex Scanner. These measurements were significantly lower than on the normal side in the same patient. Subclavian hypoplasia appears as a local vascular defect which, in addition to thoracic muscle defects and bone defects of the hand, may be one of the main components of the Poland sequence.

Echocardiography, Doppler↗
PubMed1990

Health inequalities in Poland.

This text is a second paper on relations between social inequalities and health in Poland. Our first paper was included in a collective report from a conference on social inequalities in health and health services utilization in 24 European countries (The Health Burden of Social Inequalities: Poland, pp. 157-170. WHO EURO, Copenhagen, 1986). It contains a description of social inequalities in health occurring in Poland, based on existing statistical data and information from scientific research. This text is an expansion of the previous one; here we present more updated information; we also try to identify some reasons for existing inequalities in health.

Cross-Cultural Comparison↗
PubMed1995

The prevalence and abundance of internal parasites in working horses autopsied in Poland.

The digestive tracts of 50 working horses from private farms in Poland were examined. Thirty-seven nematode species, two tapeworm species and one species of botfly were recovered. The most prevalent small strongyle species were Cyathostomum catinatum, Cylicocyclus nassatus, Cylicostephanus goldi, Cylicostephanus longibursatus, Cyathostomum coronatum, Cylicostephanus calicatus, Cylicocyclus leptostomus and Cylicostephanus minutus. Thirteen cyathostome species showed a site preference in the ventral colon, five in the dorsal colon and three in the caecum. One species, Cylicocyclus triramosus, was new for Poland. Delafondia vulgaris was the most common large strongyle, with 74% prevalence, but low abundance. Parascaris equorum (26%) and Oxyuris equi (36%) were common. Strongyloides westeri (4%), Habronema majus (16%) and Habronema muscae (8%) were less prevalent. Both Habronema species were new for Poland. Tapeworm infection were not prevalent (Anoplocephala magna (4%) and Anoplocephala perfoliata (4%)). Botfly larvae were found in 40% of the horses examined. It was stated that no anthelmintics had been used on the farms.

Animals↗
PubMed2005

Estimation of fluoride distribution in the mandible and teeth of the red deer (Cervus elaphus L.) from industrially polluted areas in Poland.

MINI SUMMARY: Animals from areas contaminated by industrial emissions containing fluoride may accumulate it predominantly in hard tissues. Therefore, an analysis was performed for the determination of fluoride content in mandibles and teeth of deer living at large in different areas in Western Pomerania (Poland). Samples of hard tissues obtained with a dental drill, were dissolved in perchloric acid and analyzed for fluoride content with an ion-selective electrode. Using the Generalized Regression Neural Network (GRNN), it was possible to arrange definite variables according to their order of importance concerning the fluoride mean content in investigated bone material. Parametric analysis revealed in which sites of mandibles and teeth the fluoride accumulation was the highest. In our calculation, the traditional statistic as well as artificial neural network was applied. OBJECTIVE: One of the interesting properties of fluoride is its balancing accumulation in the hard and soft tissues. In this paper, we decided estimate how the changeable doses of fluoride in natural environment influence on fluoride distribution and accumulation in the examined sites of mandible and teeth. MATERIAL AND METHOD: The material consist of 103 mandibles of red deer (Cervus elaphus L.) from five forestry districts of Western Pomerania in Poland, which are located near or far away from two major industrial plants: Police Chemical Work and the Dolna Odra Coal Power Plant. Samples (10 mg of powdered bone or tooth) were dissolved in perchloric acid and the fluoride content was determined with an ion-selective electrode. Comparisons were done with the Statistica 5.5 and Statistica Neural Networks. RESULTS: Animals living in Western Pomerania (Poland) have high fluoride contents in their bones. Fluoride accumulation in mandibles and teeth is irregular. The higher content of fluoride show incisal area, but coronoid process of the mandible was not sensitive to different exposure of environmental fluoride at all. Parametric analysis revealed that the accumulation pattern of fluorine was different in the two groups of deer. CONCLUSIONS: Many biological and environmental factors may influence on incessant fluoride accumulation in osseous tissue of ruminants living at large. The use of artificial neural networks enables a more accurate insight into the process of fluorine accumulation in the mandible and teeth and helps in the ranking of factors influencing this process.

Animals↗
PubMed2006

Etiology of tick-borne febrile illnesses in adult residents of North-Eastern Poland: report from a prospective clinical study.

Febrile tick-borne diseases can be caused by different pathogens. The study objective was to prospectively determine the etiology of infection among adults exposed to tick bite and to detect acute human granulocytic anaplasmosis (HGA), a recently emerging infection, in north-eastern Poland. We evaluated 68 patients (34 males and 34 females, mean age 44.2+/-15 years) who had fever within 4 weeks after a tick bite. Paired sera were tested for antibodies against tick-borne encephalitis virus, Borrelia burgdorferi and Anaplasma phagocytophilum. Microscopic examination of EDTA whole blood and nested PCR targeting A. phagocytophilum 16S rDNA gene fragment were carried out at enrolment. Tick-borne infections were diagnosed in 57 individuals (84%). Sixty-four patients were hospitalised. Tick-borne encephalitis (TBE) was revealed in 49 cases; in 39 patients as a single infection, in three patients concurrent with erythema migrans or other Lyme borreliosis symptoms, in five patients concurrent with probable or possible Lyme borreliosis, and in two patients concurrent with A. phagocytophilum infection. Diagnosis of HGA was confirmed in one patient by PCR and in another one by seroconversion. In two further individuals, A. phagocytophilum infection was confirmed by immunofluorescence (antibody titers > or = 1:128), which, however, does not fulfil the ESCAR (European Society of Clinical Microbiology and Infectious Diseases Study Group on Coxiella, Anaplasma, Rickettsia, and Bartonella) criteria for HGA case definition. Lyme borreliosis was diagnosed in 16 patients; in six of them as a single infection. Both confirmed HGA cases and seropositive individuals had A. phagocytophilum infection concurrent either with Lyme borreliosis (two cases) or with TBE (two cases). The clinical course was severe in three and moderate to mild in the remaining TBE cases, as well as in all Lyme borreliosis and HGA cases. TBE was found the most prevalent disease among adults with febrile illnesses occurring after a tick bite in north-eastern Poland. Concurrent tick-borne infections were frequent with multiple pathogens involved. Two confirmed acute HGA cases (fulfilling the European case definition criteria defined by ESCAR) were detected for the first time in a prospective manner in Poland.

Adolescent↗
PubMed2006

Babesia microti: prevalence in wild rodents and Ixodes ricinus ticks from the Mazury Lakes District of North-Eastern Poland.

Infections of Babesia microti (Apicomplexa, Piroplasmida), a common erythroparasitic protozoon of Holarctic rodents, are not widely acknowledged in Poland. The presence of this parasite in various species of wild rodents has been well documented throughout the northern temperate zone of North America, Europe, and Eurasia. However, human babesiosis attributable to infection with B. microti has been reported only from the north-eastern and upper midwestern United States and Japan. We recently carried out an epizootiological survey investigating the prevalence of B. microti both in the tick Ixodes ricinus and in wild rodents in North-Eastern Poland. Blood samples were collected from a total of 483 animals comprising three species: Apodemus flavicollis, Microtus arvalis, and Microtus oeconomus trapped at Urwitałt near Mikołajki in the Mazury Lakes District. Questing adult I. ricinus ticks were collected in the study sites by blanket dragging of vegetation in heterogeneous, deciduous woodland, and, in addition, rodents were carefully examined for feeding larvae and nymphs. Altogether, B. microti was detected in 9 out of 1513 I. ricinus ticks (0.6%) examined by PCR. This included 163 adults (92 females and 71 males), 50 nymphs, and 1300 larvae 3%, 8%, and 0% of which were PCR-positive, respectively. Of 85 A. flavicollis, 374 M. arvalis and 24 M. oeconomus, 1%, 12.8%, and 42% were parasitaemic, respectively, as determined by microscopic examination of blood smears stained with Giemsa. B. microti DNA, extracted from 53 M. arvalis and 5 M. oeconomus and examined by nested PCR, targeting a piroplasm-specific portion of the 18S ribosomal DNA, revealed 72% and 40%, respectively, to be PCR positive. Sequence analysis showed that all PCR-positive samples had rDNA sequences identical (100% homology) to that of the Munich B. microti strain isolated from Mus musculus. The results of this study indicate that the B. microti commonly encountered among Microtus spp. rodents is probably not a zoonotic strain and, therefore, that it is most unlikely to represent a risk to public health in the Mazury Lakes District of North-Eastern Poland.

Animals↗
PubMed2004

Antibodies to Neospora caninum in the blood of European bison (Bison bonasus bonasus L.) living in Poland.

The prevalence of antibodies to Neospora caninum was examined in European bison (Bison bonasus bonasus L.) living in free and fenced areas in Poland. Sera of 320 European bison, different ages and sexes, from breeding areas in Poland were tested for N. caninum antibodies using ELISA test. Positive antibody responses were found in 23 bison (prevalence 7.3%). Additionally, all positive sera were tested by Western blot to verify the ELISA results. The Western blot results confirmed the presence of antibodies to Neospora tachyzoites antigens in all 23 sera tested. The antibodies were detected against a wide range of NC-1 tachyzoite antigens. The antibody responses were directed against proteins at: 9.5, 17, 21, 27, 31, 36.5, 38, 40, 43, 47, 48.5, 53.5 and 58 kDa. The most heavily stained bands had molecular weights of 9.5, 17, 27 and 58 kDa. The most important is that antibody to N. caninum was detected for the first time in sera from bison cow shot in 1988. It is the year of recognition of this protozoan parasite. Our results indicate strongly the presence of N. caninum in European bison in Poland and suggest that a sylvatic cycle of N. caninum can exist. However, further studies are needed to evaluate the existence of a sylvatic cycle of N. caninum. The study on the effect of the infection on the health status and conservation of European bison should be taken under consideration too.

Animals↗
PubMed1999

Association of lipids and lipoprotein level with total mortality and mortality caused by cardiovascular and cancer diseases (Poland and United States collaborative study on cardiovascular epidemiology).

This study evaluates the relation between total serum cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol, and subsequent total, cardiovascular, and cancer mortality. These data are from 4,946 US and 5,198 Polish men and women aged 35 to 64 years at baseline with mortality follow-up over 13 years. Total cholesterol showed a U-shaped or J-shaped relation to age-adjusted total and cancer mortality across all samples, with significance only in Polish women. The multivariable adjusted relative risk for total and cancer mortality was higher in the lowest cholesterol category only in Poland and significant only for cancer. Cardiovascular mortality was positively related to cholesterol, but only in Polish men and US women was mortality significantly higher in the highest versus the lowest cholesterol category. The multivariable adjusted relative risk of cardiovascular death was greater in the highest versus the lowest cholesterol category, but this trend was significant only in the US. HDL cholesterol was inversely related to total (significant only in US men) and cardiovascular mortality (significant only in US and Polish men). A similar, but not significant, association of HDL cholesterol was found with cancer mortality. The multivariable adjusted relative risk of total mortality was inversely related to HDL cholesterol significant in both the US and Poland. The relative risk of cardiovascular mortality was significantly lower at higher HDL cholesterol levels in all samples. The relative risk of cancer mortality was highest and significant at the lowest HDL cholesterol level in the US and Poland. Elevated triglycerides were associated with increased risk of total and cardiovascular mortality, but this trend was significant only in the US. Cancer mortality was not significantly related to triglycerides. The present study indicates that in geographically and culturally diverse populations, the relation of lipids with cardiovascular mortality is similar. The relation with total and cancer mortality varies by country, gender, and lipids. This suggests that relations of total and cancer mortality with lipids or lipoproteins are weaker than associations with cardiovascular mortality.

Adult↗
PubMed2002

Poland's syndrome revisited.

Poland's syndrome is a rare congenital anomaly characterized by unilateral chest wall hypoplasia and ipsilateral hand abnormalities. Literary data suggest its sporadic nature. The prevailing theory of its cause is hypoplasia of the subclavian artery or its branches, which may lead to a range of developmental changes. The incidence of Poland's syndrome varies between groups (male versus female patients, congenital versus familial cases, and so on) and ranges from 1 in 7,000 to 1 in 100,000 live births. Cases of Poland's syndrome associated with leukemia, carcinoma of the hypoplastic breast, and other conditions, confirm the relationship between developmental defects and tumors, and require oncologic awareness. Various manifestations, age, and gender require different surgical approaches. Our experience, which includes 27 patients (15 male, 12 female), 20 of whom (12 male, 8 female) underwent operation, suggests that the repair should be done in two stages in children and in a single stage in adults. Reconstruction and/or stabilization of the aplastic ribs may be achieved using bone grafts or prosthetic mesh. Muscle flaps and breast implants may be used to correct muscle deficiency and breast hypoplasia and to help achieve a complete cosmetic repair.

Adult↗