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PubMed2004

Poland's syndrome and premature ovarian failure.

A 19-year-old female with Poland's Syndrome with associated left amastia, scoliosis, and left Sprengel deformity developed secondary amenorrhea from premature ovarian failure. Her menarche was at 13 years of age, and periods were regular and monthly until 15 years of age when her periods suddenly stopped. Her hormonal evaluation was significant for elevated FSH (46.5 mIU/ml) and LH (28.5 mIU/ml), and low estradiol (23 pg/ml). Anti-ovarian antibody level was less than 2 units (normal < 4 units). Her chromosomes were 46XX, by both standard karyotype and by fluorescence in situ hybridization. On transabdominal and transvaginal ultrasonography, ovaries were not visualized, the uterus was of normal size and anteverted and both kidneys were normal. The patient began hormone replacement therapy with conjugated estrogen (Premarin) 0.625 mg po daily and progestin (Provera) 5 mg on days 20 to 25. Because of menopausal symptoms, she was switched to a combination oral contraceptive (OC) with 20 mcg ethinyl estradiol that was eventually increased to 30 mcg. Her menopausal symptoms (hot flashes and sweating) improved on the continuous 30 mcg ethinyl estradiol combination OC. Following a comprehensive review of the literature, this is the first reported case of Poland's Syndrome associated with premature ovarian failure; however, this association may be coincidental.

Adult↗
PubMed2005

A checklist of parasites recorded on sticklebacks (Actinopterygii: Gasterosteidae) from Poland.

Parasites of the three-spined stickleback, Gasterosteus aculeatus (L.), and the nine-spined stickleback, Pungitius pungitius (L.), from brackish and freshwater habitats in Poland are listed. The following list was compiled from published records and own long-term studies. Parasites are listed alphabetically in meaningful groups of parasites with notes about their location on the host and distribution in Poland with references. A total of 51 species (taxa) of parasites were recorded on G. aculeatus (3 Apicomplexa, 1 Microsporidia, 3 Peritrichia, 1 Myxozoa, 7 Digenea, 2 Monogenea, 10 Cestoda, 10 Nematoda, 7 Acanthocephala, 3 Copepoda, 1 Branchiura, 2 Hirudinea, 1 Bivalvia) and 16 parasites on P. pungitius (1 Apicomplexa, 1 Microsporidia, 2 Peritrichia, 4 Digenea, 1 Monogenea, 2 Cestoda, 2 Nematoda, 1 Copepoda, 1 Branchiura, 1 Bivalvia).

Animals↗
PubMed2005

Poland-Möbius syndrome and cocaine abuse: a relook at vascular etiology.

This report presents a severe case of Poland-Möbius syndrome with central apnea at birth, ventilator-dependent, and with brainstem calcifications. The newborn had unilateral defect of the right pectoralis muscle, breast, and limb. He manifested bilateral paralysis of the cranial nerves resulting in shallow respiration, apnea, and dysphagia. He finally required tracheostomy and gastrostomy. Maternal history revealed multiple uses of cocaine during the first 3 months of pregnancy. The patient supports the Poland-Möbius combination and the possibility of vascular disruption sequence.

Brain Stem↗
PubMedDate not supplied

Is retrieval of bone material from multiorgan donors effective enough to cover demand for biostatic bone tissue grafts in Poland?

In Poland there is growing demand for biostatic allogeneic bone transplantation mostly for traumatologic operations and orthopedic reconstructions. The bone material is primarily harvested during postmortem examinations in forensic and pathology laboratories. Nevertheless, the collected amounts are not sufficient, so that material needs to be acquired from alternative sources, such as multiorgan donors. Between 1998 and 2003, 2331 potential donors were registered by the Transplantation Coordinating Center in Warsaw, which was adjusted to 1794 donors who would have been accepted as donors of the bone tissue. Unfortunately, due to denials from family members and public prosecutors, the sample was only 1416 donors, which would cover about 40% of the clinical orthopedic demand in Poland.

Bone Transplantation↗
PubMedDate not supplied

Questionnaire regarding the knowledge of the rules of organ procurement from cadaveric donors for transplantation directed to the directors of medical institutions in Poland.

We assessed the level of knowledge of organ procurement regulations among the directors of medical institutions in Poland. We also sought to promote the objection form, and the activity of the Central Register of Objections. A questionnaire consisting of 10 questions was sent to 381 random medical health care institution directors countrywide. In 89% of surveyed institutions, the written text of the organ procurement regulations was available and 94% of directors knew the forms of objection, but in 26% of institutions the form was not available and in 14% it was never obtainable. In the medical institutions directors' opinions, the estimated number of objections is 13% of the population in Poland. Organ transplantation is a form of treatment most medical institutions are familiar with, but the matter of donation is not as well known as transplantation, as observed in 48% of questioned institutions.

Cadaver↗
PubMedDate not supplied

Geography of the referred potential liver recipients and donors in Poland in 2004.

Our aim was to assess the accessibility of potential liver recipients to cadaveric organs and the ability of transplant teams to realize recipients needs in Poland in 2004. Our calculations revealed that in Poland the number of cadaveric liver transplants was two to three times lower than in other countries and is insufficient to meet the needs, also the number of referred potential liver recipients is two to three times lower than expected.

Geography↗
PubMed2004

The prevalence of anti-rubella antibodies in women of childbearing age in Poland.

Congenital rubella is a clinically serious problem, which is due to maternal infection with rubella virus during the first trimester of pregnancy. It may result in spontaneous abortion or in fetal infection leading to fetal birth defect. Maternal anti-rubella antibodies have a protective effect and they may prevent congenital rubella. Vaccination of 13-year-old girls in Poland was introduced in 1989. Vaccination coverage is above 95%. The presence of anti-rubella antibodies in maternal blood >15 IU/ml is indicative for immunity to rubella. Thus, the aim of the study was the evaluation of anti-rubella antibody levels in women 15-30 years old. Samples of that sera were collected from six provinces in Poland. We have observed the decrease of anti-rubella antibody titer together with increasing age of tested women. Among 1289 investigated women 135 [10.5%] did not have protective levels of anti-rubella antibodies. We have noticed large decline in protective anti-rubella antibodies in young women (19-22 years of age), who are just entering their prime childbearing years.

Adolescent↗
PubMed1999

Comparison of medical care and survival of hospitalized patients with acute myocardial infarction in Poland and the United States.

Few studies have evaluated between-country differences in medical care and survival after acute myocardial infarction, and none have compared the US with countries from Eastern Europe. Comparable data from the US (Atherosclerosis Risk in Communities Study [US-ARIC]) and Poland (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease project [Pol-MONICA]) were developed. From 1987 through 1993, a total of 3,694 patients were hospitalized with acute myocardial infarction events in the 2 Pol-MONICA communities and 4,801 in the 4 US-ARIC communities. Patients in the US-ARIC were 1.7 times more likely to be treated in a coronary care unit and received cardiac procedures, calcium channel blockers, and thrombolytic agents significantly more often than patients in the Pol-MONICA. The use of antiplatelet agents, nitrates, angiotensin-converting enzyme inhibitors, and beta blockade agents was similar in both countries. Case fatality (28-day) rates after hospitalized acute myocardial infarction were nearly identical (men, 7% in Pol-MONICA vs 6% in US-ARIC; women, 9% in Pol-MONICA vs 8% in US-ARIC). However, when fatal coronary heart disease events not associated with a hospitalized myocardial infarction were included, the US-ARIC rates were less than half than those seen in Pol-MONICA. Substantial differences in treatment of hospitalized acute myocardial infarction between countries did not translate into a survival advantage for patients reaching clinical attention. Differences in case severity, arising from the high out-of-hospital coronary death rate in Poland may play an important role in this finding.

Adult↗
PubMed1996

Poland's syndrome and vascular malformations.

Unilateral hypoplasia of the breast and the pectoralis muscle with a missing anterior axillary fold as part of Poland's syndrome are of major concern, especially for women. The latissimus dorsi is one of the most suitable flaps for breast and anterior thorax reconstructions but it may be hypoplastic or absent. If so, a free tissue transfer of the contralateral latissimus dorsi muscle is the next possible option for reconstruction. As Poland's syndrome is additionally associated with vascular malformations of the diseased hemithorax such as hypoplastic or missing vessels, a preoperative angiography is mandatory for planned microvascular tissue transfer.

Abnormalities, Multiple↗
PubMed1994

Poland anomaly after in vitro fertilization.

OBJECTIVES: To describe an extremely rare anomaly in an infant born after IVF-ET, and to assess its possible relationship to the artificial reproductive technology. DESIGN: Case report. SETTING: Infertility and IVF Unit, in a tertiary academic medical center. PATIENT: A 31-year-old healthy patient with a 9-year history of secondary, unexplained infertility. INTERVENTION: Standard IVF-ET treatment cycle, using GnRH-a (short protocol) and hMG for controlled ovarian hyperstimulation. RESULTS: Poland anomaly (asymmetric thorax with absence of the right pectoralis major muscle, low set rudimentary right nipple, and very mild hypoplasia of the right upper limb) is described for the first time in an infant who is one of a trizygotic triplet after IVF treatment. CONCLUSIONS: In view of the currently held hypothesis concerning the pathogenesis of Poland anomaly, the possibility of a teratogen or an event related to the reproductive procedure as the cause of this anomaly seems unlikely.

Adult↗
PubMedDate not supplied

Poland-Moebius syndrome: a case report.

BACKGROUND: The primary site of pathology in Moebius syndrome is still unknown, although several studies have variably localized the lesion in the extraocular muscles, cranial nerves, or central nervous system. CASE: A 24-year-old man with Poland-Moebius syndrome and acquired progressive bilateral paralytic lower eyelid ectropion is described. OBSERVATIONS: In this patient, magnetic resonance imaging studies revealed a barely detectable pontine hypoplasia and normal recti muscles. Nerve conduction studies of the facial nerves showed a severe demyelinating or dysmyelinating type of neuropathy. Bilateral lower eyelid ectropium of the patient was successfully corrected by canthal tightening procedures. CONCLUSION: Contrary to many reported cases, this patient serves as a rare example of a progressive type of Poland-Moebius syndrome presumably resulting from a combination of a brainstem abnormality and a peripheral neural degenerative process.

Adult↗
PubMed1984

Early reconstruction of Poland's syndrome using autologous rib grafts combined with a latissimus muscle flap.

The complex chest wall deformity of Poland's Syndrome may require intervention in early childhood for missing ribs and paradoxical movement of the involved anterior chest with lung herniation. To stabilize the chest wall, we have used autologous rib grafts and prosthetic fabric to replace absent endothoracic fascia. While physiologically sound, this method does nothing for the cosmetic defect which consists of absence of the pectoralis minor and one half to two thirds of the pectoralis major muscles. Silastic implants are not satisfactory in childhood and have complications from recurrent trauma and mobility in young adults. We have had recent experience in three patients (ages 10, 14, and 16 years) with an original technique which results in chest wall stabilization and immediate cosmetic reconstruction without prostheses. The operation utilizes simultaneous rib grafts and a rotational latissimus muscle flap. The muscle not only produces a near-normal contour, but also maintains sensation and contractile function. We propose this technique as a method of choice for the correction of Poland's Syndrome and suggest that it may have wider application in children and teenagers who need soft tissue and muscle replacement of the chest wall for other reasons.

Adolescent↗
PubMed1989

Surgical treatment of thoracic deformity in Poland's syndrome.

In 1841, Poland described congenital deficiency of the pectoralis major and minor muscles associated with syndactyly. This syndrome is a spectrum, often involving chest wall and breast deformity as well. Identification of the various musculoskeletal components involved permits optimal thoracic reconstruction in the small proportion of patients who will require it. From 1955 to 1988, 75 patients (40 males and 35 females) with Poland's syndrome were treated or evaluated. Patients with isolated deficiencies of the pectoral muscles, breast, or hand deformity were excluded. The complex was right-sided in 44 patients, left-sided in 30, and bilateral in one. The pectoralis minor and the costal portion of the pectoralis major muscle were absent in all patients. Hand anomalies were present in 50 patients. Athelia and/or amastia were noted in 37 patients. In ten patients, the rib cage deformity required reconstruction, and in three cases, rib or cartilage grafts were needed for complete repair. Often unappreciated in these cases is the significant rotation of the sternum toward the involved side and contralateral carinate deformity. Correction is achieved by bilateral subperichondrial costal cartilage resection and sternal osteotomy (seven of ten patients), thus allowing anterior displacement and orthorotation of the sternum. Chest wall reconstruction must be tailored to the requirements of each patient. No intraoperative or postoperative complications occurred in these ten patients. In males without rib cage deformity, generally no treatment is required to replace the absent pectoral muscles, although in two cases rotation of the latissimus dorsi muscle was performed. In all females, reconstruction of the ipsilateral breast is required at full development.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormalities, Multiple↗
PubMed1998

Contents and relationship of elements in human hair for a non-industrialised population in Poland.

The concentrations of 11 elements: Pb, Mn, Fe, Cd, Cu, Ni, Cr, Zn, Na, K and Ca in hair were determined by AAS. Hair samples (n = 266) were collected between 1990 and 1994 from inhabitants of the Silesian Beskid in the south of Poland (non-industrialised region). The effects of age (1-30 years old, 31-80 years old), sex (male, female) and colour of hair on the heavy metal levels were determined. Using statistical methods of cluster analysis, multiple regression analysis and factor analysis we obtained information concerning relations among metals in the hair. The strongest relations between metals in the hair are as follows: Fe-Mn, Cr-K and Cd-Pb in the first cluster and Zn-Ni in the second cluster. For our population (n = 266, non-industrialised region in Poland) we obtained a factor loading > 0.7. Factor 1 was contributed by Na and K; Factor 2 by Pb, Cd, Mn and Fe; Factor 3 by Ca (a negative correlation); Factor 4 by Ni; Factor 5 by Cu; Factor 6 by Co, Cd and K; and Factor 7 by Cr, Pb, Mn, Fe and K. These seven factors explain 77.7% variance. We obtained linear multiple dependence (P < 0.05) as follows: Mn = f (Cd, Fe, Ca); Na = f (Zn, K, -Ca); K = f (-Zn, Cr, Na); Pb = f (Cd, Zn, Cr, Fe); Zn = f (Ni, Na, -Cr, -K); Fe = f (Pb, Mn); Cr = f (Pb, K, -Zn); Co = f (Cd, Cr); and Ca = f (Mn, -Zn, -Na). These relations can be useful to explain relationships among the metals in man.

Adolescent↗
PubMed2002

Polynuclear aromatic hydrocarbons, phenols, and trace metals in selected soil profiles and plant bioindicators in the Holy Cross Mountains, south-central Poland.

This report presents the results of PAH, phenol, and selected trace element (Cd, Cu, Hg, Pb, S, and Zn) determinations on detailed soil profiles and associated plant bioindicators (including lichen Hypogymnia physodes, moss Hylocomium splendens, pine Pinus sylvetris) from the three most representative habitats in the Holy Cross Mts, south-central Poland. This study is only part of a larger ongoing environmental study that includes complex sulfur isotope and element determinations in three national parks in N, central and S parts of Poland. The highest concentrations of PAHs (1887 ppb) and numerous trace elements are found in the organic horizon-O and humic horizon-A of each soil type. Different plant species and their individual tissues reveal considerable variability in the concentration of PAHs, phenols and elements examined. Most of the H. physodes thalli also reveal higher concentrations of individual hydrocarbons and some elements (including S and Zn) than their host bark. The highest concentration levels of phenols (1217 ppb) are noted in the 1-year pine needles. Most of the PAHs and elements examined seem to be of anthropogenic origin. The only exception is the distribution pattern of elements in southwestern part of the study area, which is linked to the local bedrock geochemical anomaly. The results of this study indicate that the content of PAHs, Cd, Cu, Hg, Pb, S and Zn in the soils and plant bioindicators examined has not changed considerably since 1998.

Altitude↗
PubMed1980

An integrated approach to health services and manpower development: the experience of Poland.

After World War II, a new socio-economic policy stimulated development of industry and the socio-economic reconstruction of Poland. One of the main objectives of the new social policy was to develop the national health service so that it was available to the whole population. The most important decisions made for the health services and health manpower development in Poland were the following: 1945 -- Ministry of Health appointed as superior body responsible for organization and administration of national health services; 1951 -- Medical and Pharmaceutical Faculties become Medical Academies under the administration of the Minister of Health. Medical schools for nurses, midwives, sanitary instructors, and allied health personnel placed under supervision of the Ministry of Health; 1954 -- Sanitary epidemiological services organized and State Sanitary Inspection Act passed; 1956 -- Industrial health service organized; 1960 -- Minister of Health and Social Welfare appointed and charged with the administration of social welfare as well as rehabilitation and employment of invalids; 1971 -- Medical care and medical aid made available free of charge for the entire population, including the rural population previously not covered by health insurance system. In the years 1946--1960, a tendency towards vertical centralization prevailed in the organization and administration of the health services. Subsequently, decentralization has dominated, with a tendency to integrate health services with the social services, especially at the provincial and county levels and, more recently, in the form of the Integrated Health Service Institutions at the local level.

Allied Health Personnel↗
PubMed2001

Health care under transformation in Poland.

The general health insurance introduced in Poland in 1999 is essentially a social insurance. In this article, the main features of the present health care system are discussed, i.e. the sources and principles of financing, ownership relations, structures, entitlements to obtain medical services and the rules of access to services. Emphasis has been put on the operations of various entities operating within the health care sector, including opportunistic conduct of the providers of services financed from public sources, cost dumping, establishing provider alliances, methods of cost control, and the fact that some patients leave the publicly financed system. In Poland, a parallel private system has been developing for many years. Systemic transformations have not changed that direction, but increased considerably the significance of household income and education as the factors that differentiate patient in equality. This article is concluded with the note on the opportunities for the development of supplementary private insurance.

Financing, Government↗
PubMed2001

The anti-smoking climate in EU countries and Poland.

BACKGROUND: In the fall of 1998, 9095 smokers above 18 years, were interviewed about their smoking behaviour and knowledge and attitudes relating to the smoking. The survey (S) was conducted for the Cancer Commission of the EU and sponsored by SmithKline Beecham. An anti-smoking thermometer that is intended to assess the anti-smoking climate (ASC) in each EU country plus Poland was created. In doing so country owners of the S were asked to choose and rank the five questions in the S they thought best reflected the ASC. The five questions chosen were--smoking is a major cause of death and disease, want to stop smoking, governments should do more, ever made a serious quit attempt and smoke free areas should be provided. METHOD: The smokers comprised a representative sample of smoking cigarette per day, vis-a-vis age, sex and rural or urban area. Face to face interviews were conducted using a semi-structured questionnaire. RESULTS: Poland had the most developed ASC, 368 points, followed closely by Sweden 358. In the bottom were Germany 266 and Austria 258. Large differences were noted on willingness to quit; from the 85% in Sweden to Italy 37%. CONCLUSION: The ASC varies considerably within EU and measures to reduce the death and disease from smoking should be tailored to the situation in each country.

Adolescent↗