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PubMed2001

Have rapid socioeconomic changes influenced awareness of blood pressure in Poland?

The aim of our study was to evaluate changes in awareness of blood pressure during transition into a market economy in Poland. Thus, in 1994, we conducted a cross-sectional survey based on a questionnaire interview on a sample of 2080 men (M) and women (F) aged 18 years and over. The subjects were selected from a Polish population by stratified and cluster random sampling with quotas by the Center for Social Research in Sopot. They were asked if they were aware of blood pressure. The results were analysed according to age, sex, education level, income and place of living. In September 1997 we carried out the same investigation on a new group of 1664 adults. In addition to the questionnaire, the blood pressure (three recordings at home) measurements were completed. The interviewers were well-trained medical students. Awareness of blood pressure has declined (P < 0.001) from 71% in 1994 to 65.5% in 1997. The highest decrease in awareness of blood pressure was observed among less educated people, as well as among people living in smaller cities and villages. The overall prevalence of hypertension was 25.9% by 'older' WHO criteria (BP > or =160/95 mm Hg or taking antihypertensive medication) and 44.5% by JNC VI criteria (BP > or =140/90 mm Hg or taking antihypertensive medication). Forty-six percent of hypertensive subjects classified by JNC VI criteria were previously known to be hypertensives and 54% were newly detected (F: 39%, M: 69%). Low awareness of blood pressure in Poland is the crucial factor of insufficient detectability of hypertension. Decline of awareness of blood pressure being the most significant among people representing lower social status, emphasises the need for urgent preventive measures.

Adolescent↗
PubMed2004

Agreement between the clinical Oxfordshire Community Stroke Project classification and CT findings in Poland.

The Oxfordshire Community Stroke Project (OCSP) classification provides a simple means of classifying the clinical syndromes associated with acute stroke. The validity of the classification can depend on many factors. Accuracy and time of the clinical and radiological examination are very important. It was used in the International Stroke Trial (IST). The study was conducted in 467 hospitals in 34 countries. Our aim was to assess how well the OCSP classification could predict infarct site and size on computed tomography (CT) scan when performed in a trial within 48 h after the onset of stroke and the clinical assessment was carried out by different doctors in different hospitals. We examined data on the patients randomized in the IST by the seven participating hospitals in Poland. Patients admitted to the hospital were examined by the doctor on duty. Eight aspects of the neurological deficit present just before randomization were recorded. The computer system in the randomization centre employed a validated algorithm to assign the patient to one of the four infarct syndromes: lacunar syndrome (LACS), partial anterior circulation syndrome (PACS), total anterior circulation syndrome (TACS) and posterior circulation syndrome (POCS). We assessed the localization and extent of the recent infarction on available CT scans and correlated these with the computer-assigned OCSP category. CT scans were available for 558/759 (74%) of the patients randomized in Poland. In 458 (82%) of cases, CT was carried out in the first 24 h after the onset of stroke. In 444 (80%) scans, a recent infarct was visible. These radiological lesions were appropriate to the clinical classification in 56% of patients with TACS, 73% with PACS, 61% with LACS and 59% with POCS. In Polish centres in IST, amongst the patients with infarction visible on CT, the OCSP subtype predicted the size and site of the infarct in about two-thirds of cases. These data suggest that, provided its limitations are taken into account, the classification can be usefully applied in multicentre clinical trials (or epidemiological studies) and to aspects of the routine clinical care of patients with acute stroke.

Aged↗
PubMed1998

HLA class II allele and haplotype distribution in a population from central Poland.

We have studied the distribution of HLA DRB1, DQA1, DQB1 alleles and haplotypes in a sample of 103 unrelated healthy individuals from the region of Lodz in central Poland by the polymerase chain reaction and hybridization with allele-specific oligonucleotide probes (PCR-SSO). DRB1*0101, DRB1*07, DRB1*1501, DRB1*03 and DRB1*11 were the most frequent alleles at the DRB1 locus. The DRB1*04 group was observed at a high frequency, but only five out of the 19 DR4 subtypes tested were observed. The most frequent was DRB1*0401, followed by DRB1*0403, DRB1*0402, DRB1*0407 and DRB1*0417. Eight DQA1 alleles were found in this Polish population, among which DQA1*0501, DQA1*0101 and DQA1*0102 were the most frequent. At the DQB1 locus 13 alleles were found. Among them, four were present with frequencies above 10%: DQB1*0201, DQB1*0301, DQB1*0501 and DQB1*0602. Our results underline significant differences between the population of central Poland and populations of neighbouring countries such as Germany, Ukraine and the Czech Republic. This study will serve as a reference for further anthropological studies, as well as studies of associations between HLA and disease.

Alleles↗
PubMed2002

External and iatrogenic trauma of the urinary bladder: a survey in Poland.

OBJECTIVE: To assess incidence of urinary bladder injuries (frequently associated with pelvic trauma and often iatrogenic) in Poland. MATERIALS AND METHODS: The records and details of urinary bladder injuries treated between 1995 and 1999 were analysed for 61 urological departments in Poland. RESULTS: During the 5-year period 512 patients had urinary bladder injuries; in 210 (41%) the injury was caused by a road traffic accident, in eight (2%) by compression (crushing injury) within the limits of the pelvic bones, in 40 (8%) by a fall from a height, in three by a gunshot wound and in the remaining 251 (49%) the injury was iatrogenic. Among the 261 bladder injuries that were not iatrogenic, 41 (16%) were associated with pelvic bone trauma. In 36 patients there was simultaneous injury of the urinary bladder and posterior urethra, constituting 14% of such injuries and 7% of all trauma cases. The iatrogenic injuries were in 98 patients (39%) in urological departments, in 130 (52%) women in gynaecological departments and in 23 (9%) on surgical wards. The injury was open in 102 patients (20%) and closed in 372 (73%); there was bladder contusion in 38 patients (7%). The injuries were intraperitoneal in 225 patients (44%) and extraperitoneal in 287 (56%). For diagnosis, abdominal ultrasonography was used in 455 (89%) patients, intravenous pyelography in 266 (52%), cystography in 388 (76%) and computed tomography in 15 (3%). The delay between trauma and diagnosis was 0.5-124 h. Surgical treatment of the injury comprised a monolayer suture of the bladder wall in 51 patients (10%), a two-layered suture in 461 (90%), perivesical drainage in 468 (91%) and inspection of the peritoneal cavity in 232 (45%). The mean (range) interval between diagnosis and treatment was 14 (7-70) days. Seven patients died after the treatment failed. CONCLUSIONS: Almost half the patients had iatrogenic injuries, of which over half occurred in gynaecological and maternity wards. Thus it is important teach the basic range of urological operations to trainee doctors. The commonest diagnostic method was not ascending cystography but ultrasonography; we recommend ascending cystography be used with at least two views after filling the urinary bladder with approximately 300 mL of contrast medium, with an additional film after emptying the contrast medium. In patients with pelvic bone trauma it is reasonable to use spiral computed tomography with virtual analysis before surgery. A two-layered suture of the bladder wall with perivesical drainage should be used.

Accidental Falls↗
PubMed2002

Renal and ureteric trauma: diagnosis and management in Poland.

OBJECTIVE: To analyse retrospectively kidney and ureteric injuries (the former often associated with multiple-organ trauma) and thus optimize diagnostic and treatment methods. PATIENTS AND METHODS: The records and details of kidney and ureteric injures treated between 1995 and 1999 in 61 urological departments in Poland were analysed. RESULTS: In all, 887 kidney injuries were analysed; blunt trauma comprised 97%, with most injuries classified as renal contusion and minor parenchymal damage (687 cases). Intravenous urography was used in 80% of the patients and computed tomography in only 20%. In all, 234 patients (26%) underwent surgery; nephrectomy was the most common surgical treatment, in 170 patients (73% of those undergoing surgery). Complications occurred in 9% of patients after conservative treatment and in 5% after surgery. Of the 452 ureteric injuries, 340 (75%) were iatrogenic, 81 (18%) blunt injuries and 31 (7%) open injuries. Of the iatrogenic injuries 73% occurred during gynaecological procedures, 14% in general surgery and 14% in urological procedures. The most frequent diagnostic method was intravenous urography (244 cases), with retrograde pyelography (98) and ureteric catheterization in 125. The diagnosis was established immediately during surgery in 104 patients. The most frequent surgical treatment was uretero-neocystostomy (213, 47%), the others being a Boari flap (113, 25%), end-to-end anastomosis (92, 20%), reconstruction with an ileal loop (30, 7%) and autotransplantation (four, 1%). CONCLUSION: In Poland, patients with blunt kidney injuries often undergo surgery, with nephrectomy the most frequent procedure. Computed tomography with the intravenous administration of contrast medium should be considered the diagnostic method of choice for kidney injures. Catheterization of the ureters before surgery and an indigocarmine intravenous infusion (to stain the urine) when a ureteric injury is suspected may reduce the rate of iatrogenic injury and improve the rate of intraoperative diagnosis. We suggest catheterizing the ureters in any doubtful case to avoid injury, because prevention is better than treatment.

Humans↗
PubMedDate not supplied

The cost-effectiveness of alternative therapeutic strategies for the management of chronic hepatitis B in Poland.

OBJECTIVE: The aim of the study was to estimate the cost-effectiveness of alternative therapeutic strategies for the management of chronic hepatitis B (CHB) in Poland. METHODS: The model for the Polish health-care context was based on clinical data from the literature and local data on health-care resource utilization and unit costs. Costs and effects of a population of CHB patients were modeled using four scenarios, which attempt to reflect real-life practice in which patients may receive any of the treatment options available and in which a proportion of patients may still receive no treatment because therapy is not suitable. Strategies A and B assumed the availability of both treatment options: the first choice of treatment is in A, lamivudine, and in B, interferon alpha (IFN-alpha). In strategy C, the only approved treatment is IFN-alpha, and in strategy D, the patients receive no antiviral treatment. The outcome measures were HBeAg seroconversion and nonprogression to cirrhosis-the surrogate marker with predictive value for improved survival. Only direct medical costs were analyzed. The payer's perspective and time horizon of 1 year were adopted. One-way sensitivity analysis and extreme scenario analysis were performed. RESULTS: The best results in terms of seroconversion and nonprogression to cirrhosis were achieved for strategy A, costs were lowest for strategy D, and strategies B and C were dominated by strategy A. The incremental cost/effectiveness ratio (ICER) comparing strategy A with strategy D was 57,855 Polish new zloty (PLN) per extra seroconversion and 79,550 PLN per cirrhosis case avoided. CONCLUSIONS: Cirrhosis reduces estimated life expectancy by 37.76 years and by 20 years among 30- and 50-year-olds, respectively. The ICER for strategies A and D was 2105 PLN and 3978 PLN per life-years gained for the population at ages 30 and 50, respectively, and was below the suggested threshold for cost-effectiveness, based on treatment costs for 1 year of hemodialysis in Poland (62,400 PLN). Changing the value of key drivers for sensitivity analysis did not have a significant effect on the ICER.

Antiviral Agents↗
PubMed2001

Epidemiological studies on Trichinellosis among swine, wild boars and humans in Poland.

The introduction of the digestion method (the magnetic stirrer type) resulted directly in the reduction of Trichinella sp. infection among people in Poland. Pork and its products are still the main cause of human trichinellosis in Poland. However, epidemics caused by eating wild boar meat suggested that this way of the transmission of Trichinella sp. larvae to humans might be of considerable importance.

Animals↗
PubMed2002

Hepatic exstrophy complicating Poland's anomaly.

Poland's anomaly is comprised of a constellation of anomalies. To be included in the syndrome, a child must have a deficiency of the pectoralis major and minor muscles and an associated anomaly of either the ipsilateral breast or hand. Associated defects may include syndactyly osseous and cartilagenous costal aplasia and adactyly. A case of hepatic exstrophy through a full-thickness chest wall defect in an infant with Poland's anomaly is reported.

Echocardiography↗
PubMed2001

Molecular characterisation of Shiga toxin-producing Escherichia coli O157 strains isolated in Poland.

Ten Escherichia coli O157 strains isolated from cattle and children in Poland were investigated by the use of molecular biological methods. All strains possessed the intimin and enterohaemolysin genes and harboured the genetic determinants for Stx2 toxin (five isolates), Stx1 toxin (two strains) or both (three isolates). The genetic relatedness of the strains was examined by restriction fragment length polymorphism (RFLP) of chromosomal DNA digested with Xbal and Notl. Nine closely related RFLP patterns were observed. Comparison of bovine and human E coli O157 isolates based on the analysis of Xbal and Notl digested profiles showed that all strains belonged to one genetic cluster. These results indicate that cattle must be considered as a possible source of human E coli O157 infection in Poland.

Adhesins, Bacterial↗
PubMed2004

[Differential diagnosis of Poland-syndrome versus unilateral accentuated thelarche].

AIM: The syndrome was first described by Poland in 1841. It classically consists of unilateral muscular and osseous anomalies of the thorax and upper limb with defects of the ipsilateral breast and nipple. We report the value of panoramic-sonography in the diagnosis of this rare condition in three patients. METHOD: The three girls, all born in 1990, were independently introduced to our unit of children and adolescent gynaecology because of unilateral "developmental defects" of the breasts at the beginning of puberty. To discriminate a Poland-Syndrome from unilateral accentuation of thelarche standardized clinical and sonographical examinations were performed. RESULTS: In 2 cases we found unilateral aplasia of the glandular tissue of the breast with different distinction of mamilla and pectoralis muscle. The 3 (rd) case showed a hypoplastic breast development with osseous defects of the chest wall, aplasia of the pectoralis muscle and brachydaktylia. CONCLUSION: The standardized panoramic sonography allowed an immediate and safe diagnosis without hazardous radiation exposure.

Adolescent↗
PubMed1995

Intrafamilial phenotypic heterogeneity of the Poland complex: a case report.

Three cases of familial unilateral gluteal hypoplasia are reported. The index case in addition to having gluteal hypoplasia also has unilateral pectoral muscle hypoplasia. Another relative has unilateral symbrachydactyly of the distal phalanges of one foot. All four affected individuals in our pedigree were female. We propose that our cases are best classified as part of the Poland complex of anomalies. Our cases emphasize that intrafamilial phenotypic heterogeneity is possible within the Poland complex.

Buttocks↗
PubMed2002

Is acute hepatitis B still a nosocomially-acquired infection in Poland? A case-controlled study of transmission routes in a hospital sample.

The aim of this study was to evaluate the role of medically linked risk factors for acute HBV infection in the Podlasie region of North-Eastern Poland. The records of 107 adult patients and 214 age- and sex-matched controls hospitalized in the Department of Infectious Diseases, Białystok, Podlasie Region during the period 1997-2000 with the diagnosis of acute hepatitis B were reviewed. On multivariate analysis, household contact with hepatitis B [odds ratio (OR) = 18.0, 95% confidence interval (CI) 2.0-165.5] and a history of injections (OR = 2.7, 95% CI 1.5-4.7) in the preceding 6 months were independently associated with acute HBV infection. In conclusion, our data indicate that despite a significant decline in the incidence of hepatitis B, injections are still involved in the spread of HBV in Poland.

Adolescent↗
PubMed2002

Tick-borne encephalitis in north-eastern Poland in 1997-2001: a retrospective study.

The aim of this study was to characterize the epidemiology and clinical features of tick-borne encephalitis in north-eastern Poland. Clinical and epidemiological data were analysed of patients hospitalized with the diagnosis in the Department of the Infectious Diseases and Neuroinfections of the Medical University in Bialystok in 1997-2001. Tick-borne encephalitis was diagnosed in 152 patients: 51 (34%) presented with meningitis, 89 (59%) with meningoencephalitis and 12 (8%) with meningoencephalomyelitis. Headache (84%) and fever (81%) were the most common symptoms. Meningeal signs were present in 137 patients (90%). Most common neurological abnormalities were: Oppenheim and Babinski signs (74 patients, 49%), ataxia (37, 24%), impaired consciousness (37, 24%) and pareses (16, 10%). Of patients examined, 146 (96%) had raised pleiocytosis, frequently accompanied by high cerebrospinal fluid protein concentration (90%), raised erythrocyte sedimentation rate (65%), peripheral blood leucocytosis (26%) and increased aminotransferase activity (16%). There was only 1 forest worker among the patients. Tick-borne encephalitis remains common in north-eastern Poland but, possibly because of effective vaccination, it has virtually disappeared among forest employees. The diagnosis appears difficult in some cases, as meningeal signs may not be present and laboratory findings may not be suggestive of a viral infection.

Adolescent↗
PubMed2004

The effectiveness of vaccination with whole-cell pertussis vaccine by age group in Poland 1996-2001.

Recurrence of pertussis in highly vaccinated populations has been observed in many countries. Two mechanisms have been proposed to explain it: a shift in incidence towards older age groups in which the protective effect of vaccination is diminished; and vaccine-induced changes in genomic and immunological characteristics of circulating strains of Bordetella pertussis, which become different from vaccine strains, thereby reducing vaccine efficacy. Marked increase in the incidence of pertussis has been observed in Poland since 1997, following a decade of stability at a low level. As previously shown, the immunization calendar in Poland does not ensure sufficient protection among children older than 9 y. The decrease in the protective effect becomes noticeable after the age of 5. In this paper we examine changes in the effectiveness of pertussis vaccination in 4 age groups during 1996-2001, using surveillance data. We find that over that period a decrease occurred in the reported effectiveness (in children aged 2 to 5 y, from 97.3% in 1996 to 73.5% in 2001 and in 6 to 9 y-olds, from 84.3%, to 68.8%). We also discuss an alternative hypothesis that the above findings are due to selection or measurement bias resulting from incomplete reporting or imperfect diagnostic procedures.

Adolescent↗
PubMed2003

Content and bioconcentration of mercury in mushrooms from northern Poland.

Mercury (Hg) was quantified using cold vapour-atomic absorption spectrometry (CV-AAS) in the fruiting bodies of nine edible and five inedible mushrooms and in underlying soil substrate samples. In total, 404 samples comprising caps and stalks and 202 samples of soil substrate (0-10 cm layer) were collected in 1996 from Trójmiejski Landscape Park, northern Poland. Mean Hg concentrations in the soil substrate for different species varied between 10 +/- 3 and 780 +/- 500 ng x g(-1) dry wt (range 2.3-1700). Among edible mushroom species, Horse Mushroom (Agaricus arvensis), Brown Birch Scaber Stalk (Leccinum scabrum), Parasol Mushroom (Macrolepiota procera), King Bolete (Boletus edulis) and Yellow-cracking Bolete (Xerocomus subtomentosus) contained elevated concentrations of Hg ranging from 1600 +/- 930 to 6800 +/- 4000 ng x g(-1) dry wt in the caps. Concentrations of Hg in the stalks were 2.6 +/- 1.1 to 1.7 +/- 1.0 times lower than those in the caps. Some mushroom species investigated had high Hg levels when compared with specimens collected from the background reference sites elsewhere (located far away from the big cities) in northern Poland. Bioconcentration factors of Hg in the caps of Horse Mushroom, Parasol Mushroom and Brown Birch Scaber Stalk were between 150 +/- 58 and 230 +/- 150 ng x g(-1) dry wt, respectively, and for inedible Pestle-shaged Puffball (Claviata excipulformis) was 960 +/- 300 ng x g(-1) dry wt. Linear regression coefficients between Hg in caps and in stalks and Hg soil concentrations showed a positive relationship for A. arvensis and Horse mushroom (p < 0.05) and a negative correlation for the caps of Death Caps (Amanita phalloides) and Woolly Milk Cap (Lactarius torminosus) (p < 0.05), while for other species no clear trend was found.

Agaricales↗
PubMed2005

Concentrations of heavy metals in the tissues of red deer (Cervus elaphus) from the region of Warmia and Mazury, Poland.

Cadmium, lead, copper and zinc were quantified using a validated ICP/MS method in the tissues and organs of 82 specimens of red deer of different sexes and ages, which had been hunted at the Great Lakes Land region in the north-eastern of Poland in 2000-01. Copper and zinc occurred in liver, kidney and muscle tissue of red deer at concentrations of 6.4-29, 3.3-7.2 and 1.9-6.4, and of 19-43, 17-41 and 19-64 mg kg(-1), respectively, which are considered typical for the species, age and gender compared with values noted for some other wild and domestic ruminant species elsewhere. For cadmium and lead, the concentrations decreased in the order kidney > liver > muscle tissue, with overall means of 2.2, 0.19, and 0.10, 0.31, and 0.26, 0.22 mg kg(-1) wet weight, respectively. The cadmium content of the kidney of a proportion of red deer sampled exceeded the legal tolerance limits set in Poland. The means (but not individual animal data) obtained for cadmium in kidney and liver correlated (0.99) with the age of red deer. Also, the lead content of the muscle meat of red deer for many carcasses exceeded the legal limit, which was probably due to contamination from the fine dust particle remains from the lead bullets used.

Animals↗
PubMedDate not supplied

Manganese, copper, zinc, iron, cadmium, mercury and lead in muscle meat, liver and kidneys of poultry, rabbit and sheep slaughtered in the northern part of Poland, 1987.

Manganese, copper, zinc, iron, cadmium, mercury and lead concentrations have been determined in muscle meat, livers and kidneys of ducks, geese, chickens, hens, rabbits and sheep slaughtered in the northern part of Poland in 1987. The mean values obtained related to wet weight for muscle meat, livers and kidneys of animals were: 0.11-0.27, 0.73-3.3 and 0.90-1.9 mg/kg Mn; 0.52-7.3, 3.8-88 and 2.8-15 mg/kg Cu; 5.7-40, 20-45 and 21-30 mg/kg Zn; 10-35, 27-83 and 50-180 mg/kg Fe; less than 5-5, 16-140 and 250-5100 micrograms/kg Cd; less than 1-3, 2-10 and 5-12 micrograms/kg Hg; and less than 10-20, 100-210 and 120-1300 micrograms/kg Pb, respectively. Substantial differences have been found in the mean copper concentration in muscle meat, livers and kidneys, zinc and iron in muscle meat, and cadmium in kidneys, between some of the species examined. The mean and maximum concentrations of mercury and lead found in muscle meat and organs of animals in the present study were low, and only in the case of cadmium were somewhat higher values found in kidneys of rabbit and hen. The results obtained are compared with the literature data on the concentrations of the metals examined in muscle meat, livers and kidneys of poultry, rabbit and sheep in Poland or elsewhere.

Animals↗
PubMedDate not supplied

Changes in body adiposity in girls and boys from the rural areas of East Poland over a time span of 20 years.

INTRODUCTION: Excess adiposity is one of the major causes of a number of developing civilization diseases, hence increasing adiposity levels in populations of various countries over years have raised considerable attention worldwide. OBJECTIVE: The study aimed to evaluate the character, dynamics and tendencies in adiposity changes in the population of children and youths from the rural areas of East Poland over the last 20 years. MATERIAL AND METHODS: Body adiposity was evaluated using BMI values, fatty tissue content (in % and kg), and measurements of three skinfolds. The results obtained in the years 1999-2000 were compared with those reported for rural children and youths from that area in 1980. RESULTS: Total body adiposity as well as adiposity of individual body parts were observed to increase considerably in the years 1980-2000. The highest adiposity gains were reported in the puberty period. CONCLUSIONS: The maintenance of the secular trend in body adiposity of children and youths from the rural areas of East Poland was observed in the experiment. The extent of those changes appeared to be differentiated depending on the adiposity measure applied, as well as sex and stage of ontogenetic development of subjects.

Adiposity↗