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PubMed2000

Changing mortality patterns in East and West Germany and Poland. II: short-term trends during transition and in the 1990s.

OBJECTIVES: To examine trends in life expectancy at birth and age and cause specific patterns of mortality in the former German Democratic Republic (GDR) and Poland during political transition and throughout the 1990s in both parts of Germany and in Poland. METHODS: Decomposition of life expectancy by age and cause of death. Changes in life expectancy during transition by cause of death were examined using data for 1988/89 and 1990/91 for the former GDR and Poland; examination of life expectancy changes after transition were based on 1992-97 data for Germany and 1991-96 data for Poland. RESULTS: In both the former GDR and Poland male life expectancy at birth declined by almost one year during transition, mainly attributable to rising death rates from external causes and circulatory diseases. Female life expectancy in Poland deteriorated by 0.3 years, largely attributable to increasing circulatory mortality among the old, while in East German female rising death rates in children and young adults were nearly outbalanced by declining circulatory mortality among those over 70. Between 1991/92 and 1996/97, male life expectancy at birth increased by 2.4 years in the former GDR, 1.2 years in old Federal Republic, and 2.0 years in Poland (women: 2.3, 0.9, and 1.2 years). In East Germany and Poland, the overall improvement was largely attributable to falling mortality among men aged 40-64, while those over 65 contributed the largest proportion to life expectancy gains in women. The change in deaths among men aged 15-39 accounted for 0.4 of a year to life expectancy at birth in East Germany and Poland, attributable largely to greater decreases from external causes. Among those over 40, absolute contributions to changing life expectancy were greater in the former GDR than in the other two entities in both sexes, largely attributable to circulatory diseases. A persisting East-west life expectancy gap in Germany of 2.1 years in men in 1997 was largely attributable to external causes, diseases of the digestive system and circulatory diseases. Higher death rates from circulatory diseases among the elderly largely explain the female life expectancy gap of approximately one year. CONCLUSIONS: This study provides further insights into the health effects of political transition. Post-transition improvements in life expectancy and mortality have been much steeper in East Germany compared with Poland. Changes in dietary pattern and, in Germany, medical care may have been important factors in shaping post-transition mortality trends.

Adolescent↗
PubMed2005

[Poland'syndrome and hand's malformations: about a clinic series of 37 patients].

INTRODUCTION: Poland's syndrome is a rare malformation which associates thoracic anomalies and anomalies of homolateral upper end. We wish to know the frequency of hand's malformations in this syndrome in our clinical experience. MATERIAL AND METHODS: We have revised 37 patients who were seen initially for a thoracomammary anomaly. This clinical series from plastic surgery service of Toulouse has been revised to know the importance of hand's malformations. RESULTS: Hand's malformations in Poland's syndrome are rare in your study, they touch only 12% patients. We find only 4 malformations in 33 patients, four were lost. They were only females, we find three brachymesophalangies and a major form. DISCUSSION: Hand's malformations in Poland's syndrome are less frequent than classically. There is no parallelism between gravity of thoracic malformation and that one of upper end. In this series, we find only one case with syndactyly; originally, Poland's syndrome was named << Poland's syndactyly >>. Finally, we think that we can talk about Poland's syndrome without anomaly of homolateral upper end, the major element is musculary agenesia of sternocostal pectoralis major. The search of homolateral upper end has to be systematic in front of suspicious of Poland's syndrome.

Adolescent↗
PubMed1999

Epidemiology of syphilis and gonorrhoea in eastern Poland in the years 1988-1997.

Because of the sexually transmitted diseases (STDs) epidemic in the former Soviet Union and the possibility of a rise in early syphilis and gonorrhoea in the eastern region of Poland it seemed important to calculate the incidence rates for early syphilis and gonorrhoea for 3 border regions (east, west and south) and the central part of the country in the last 10 years. In addition, data were analysed on patients and their sexual partners (from Poland and abroad), and the country where the contact took place obtained from 14 Provincial Skin-VD Out-Patients' Clinics of eastern Poland. The results from 1988/89 and 1996/97 were compared. It was shown that early syphilis morbidity significantly decreased in western and southern Poland, fell in the central part and rose in the east slightly. Gonorrhoea morbidity significantly decreased in all regions. However, the number of provinces with early syphilis and gonorrhoea incidence rates in the 1990s of the same value or higher than in the 1980s, or of the whole of Poland clearly increased in eastern and central regions. The early syphilis and gonorrhoea morbidity in east Poland in the 1990s in relation to 1980s was marked by significant increase in the percentage of the foreigners treated (12.2 vs 1.8, P<0.001 for early syphilis, and 10.0 vs 2.3, P<0.001 for gonorrhoea) and in sexual contacts with foreigners reported by Polish patients (23.7 vs 0.8, P<0.01 for early syphilis and 17.7 vs 4.3, P<0.01 for gonorrhoea). Of the foreign contacts reported in 1996/97 by early syphilis and gonorrhoea patients, 60.4% and 82.2%, respectively, were casual. Contact with foreigners took place, mainly, in the former Soviet Union. The study illustrates that there may be a danger of an increase in the incidence of syphilis and gonorrhoea in Poland due to the epidemics in the neighbouring countries.

Emigration and Immigration↗
PubMed1998

[The Dominican Nicholas of Poland as a mediaeval poet, philosopher and doctor].

The person of Nicholas of Poland, living on the turn of the 13th century, has a documentary evidence in the so called Thraska chronicle, the preserved opuscules and in the document of some dukes of Poland from the years between 1271 to 1316. Nicholas was a friar of the order of Dominicans and achieved his education in Montepellier. In his poem entitled Antipocras, Nicholas of Poland for the first time expressed the point of view, that successful therapy may be possible, despite our ignorance about the real cause of illness. Nicholas expressed himself against Hipokrates and Galenus and also throwed off the standard urinoscopy. Nicholas payed attention to the fact, that not only precious medicines, but simple remedies may be effecacious in therapy. The opuscule Experimenta consists in a collection of prescriptions for preparation and application of different medicines. Nicholas of Poland was an advocate of remedies produced from snakes and amphibians. The surgical opuscule entitled Cyrurgia is the first writing and manual on surgery of Poland. It contents very interesting observations, especially about fistulas and cancer. This opuscule links to the so called snake therapy too. The Dominican Nicholas is the first in historical sources mentioned surgeon of Poland, who achieved high school education. The connections between Nicholas of Poland and the person and the court of the Duke Lestco Niger are documentary well foundated.

History, Medieval↗
PubMed2005

[Incidence of tuberculosis in Poland 2004 and its trends].

UNLABELLED: Tuberculosis has been a major public health problem in Poland for many decades. The aim of this investigation was to evaluate incidence of TB in Poland in 2004 and to examine trends of TB incidence in last decade. In 2004. decrease of tuberculosis notification rates in Poland has continued. In this year 9.493 new tuberculosis cases notified in Poland. Incidence rate was 24.9 per 100.000 population with the large differences in notification rates between voivodships/geographic region/ from 14.5 (The West) to 36.0/100.000 The East). Between 1994-2004 notification rates decreased by 42%. New cases represented 87.8% of all TB cases. Pulmonary cases represented 91.6% of all cases of which 59% were bacteriologically confirmed (smear and/or culture positive). 37% of all TB pulmonary cases were sputum smear positive, which is rather low but similar to previous years. Low proportion--8.4% of extrapulmonary cases which is observed for many years may indicate inadequacies in diagnosis and registration of this TB form. Pediatric TB cases--incidence 1.9--represented 1.3% of all cases notified in Poland. The incidence of tuberculosis increases with age from 1.9 in children up to 51.7 among 65 and older patients. Median age of TB patients is between 50-54 years. The incidence of men 34.1 is two times higher than in woman (16.2) and in rural population it is near the same: 25.5 and in urban 24.5. Among of all the TB pulmonary cases there were 395 cases with resistance to at least one drug. In these cases was about 100 MDR cases. Registered 260 TB cases among prisoners--2.7% of overall cases, and 16 TB cases were among foreigners. CONCLUSIONS: In last decade decrease of TB has continued. The incidence of tuberculosis in Poland was about two times higher than mean incidence for Enlarge European Union. The distance between Poland and EU countries with lowest incidence is estimated for 20-25 years.

Adolescent↗
PubMed1998

Active surveillance of meningococcal meningitis in Poland.

Starting from 1970, the notification of N. meningitidis cases in Poland was compulsory and separated from other cases of meningitis purulenta. Based on the experience of European Monitoring Group on Meningococci, the active surveillance of meningococcal meningitis in Poland was initiated in April 1995. It was the first time that such study was conducted to recognise the actual situation of meningococcal meningitis infections in our country. Ninety seven N. meningitidis strains were isolated (31 in 1995 and 66 in 1996) from cerebrospinal fluid (CSF) of meningitis patients hospitalized in 54 hospitals located in 33 out of 49 provinces of Poland. Most patients were below 2 years of age and 43% belonged to infant group. Meningococcal strains were phenotypically characterized as follow: identification of N. meningitidis was performed by Gram staining, oxidase and catalase tests as well as latex or diagnostic sera agglutination assays. Meningococcal serotypes and subtypes were determined by whole-cell ELISA with monoclonal antibodies. The predominant meningococcal serogroup during 1995 and 1996 was B (80% of all isolates tested), the serogroup C (12.6%) and W-135 (3.5%). Only two non-groupable and two serogroup A strains were isolated in Poland. Active surveillance allowed to determine B:22:P1.14 to be the most prevalent N. meningitidis phenotype in Poland. Two isolates of N. meningitidis phenotype C:2a:P1.2,5, which caused emergency situation in Czech Republic since 1993, were isolated from CSF of patients in October 1996 in southern Poland. All strains were susceptible to cefotaxime, chloramphenicol, ciprofloxacin, rifampin and tetracycline; some strains were resistant to sulphonamides (60.6% - MIC = 32 mg/l and 14.8% - MIC = 128 mg/l). Only one of the tested strains in two years surveillance study in Poland was resistant to penicillin (MIC = 2 mg/l).

Adolescent↗
PubMedDate not supplied

Comparison of drug utilization of most commonly used drugs in Poland and Czech Republic.

Utilization of drugs from the following groups: antibacterial, cardiovascular, gastrointestinal and respiratory tract diseases in Poland and Czech Republic was analyzed. The most commonly sold drugs were among antibacterial drugs, viz., doxycycline (4.5DDD/1000 inh./day in Poland; 3.3 in Czech Republic), co-trimoxazole (Poland-2.9; Czech Republic 2.5), ampicilline and amoxicilline; among gastrointestinal drugs, ascorbic acid (Poland 42.2; Czech Republic 59.3), among respiratory drugs, sodium cromoglicate in Poland and bromhexine in Czech Republic, and among cardiovascular drugs, enalapril in Poland and diuretics with potasium sparing drug in Czech Republic. In general, the leading drugs in Poland and Czech Republic, were the same. All drugs with highest utilization were on the Essential Drug List. Some differences in drug utilization between these two countries could result from the prevalence of particular diseases in each population and physician's prescribing patterns.

Czech Republic↗
PubMed1993

Detecting ozone and demonstrating its phytotoxicity in forested areas of Poland: a pilot study.

Ambient concentrations of ozone (O(3)) were measured and O(3) phytotoxicity to tobacco (Nicotiana tabacum L.) was demonstrated in several forest locations in Poland during a pilot study from July-October, 1991. At southern and central locations in Poland, the 24-hour average O(3) concentrations measured with a UV absorption photometer were in the range of 32-55 ppb, and the corresponding 1-hour maxima in the range of 39-83 ppb. At these locations longer period (four to fifteen days) average concentrations were determined using O(3) passive samplers (DGA, Inc.) and were reaching 60 ppb, while at Bialowieza in eastern Poland O(3) concentrations averaged less than 40 ppb. In Szarow, near the Niepolomice Forest in southern Poland, 1-hour O(3) maxima estimated from the data obtained using passive samplers were about 105 ppb in early September. At several locations in southern and central Poland, extensive O(3) injury was determined on O(3)-sensitive Bel W-3 tobacco plants; such injury did not occur in the Bialowieza Forest of eastern Poland. The results of this pilot study indicate that O(3) is present at phytotoxic levels in southern and central Poland.

Journal Article↗
PubMed2002

The contribution of medical care to changing life expectancy in Germany and Poland.

This paper assesses the impact of medical care on changes in mortality in east Germany and Poland before and after the political transition, with west Germany included for comparison. Building upon Rutstein's concept of unnecessary untimely deaths, we calculated the contribution of conditions considered responsive to medical care or health policy to changes in life expectancy between birth and age 75 [e(0-75)] for the periods 1980/1983-1988 and 1991/1992-1996/1997. Temporary life expectancy, between birth and age 75, has been consistently higher in west Germany, intermediate in east Germany and lowest in Poland. Although improving in all three regions between the early 1980s and the late 1990s, the pace of change differed between countries, resulting in a temporary widening of an initial east-west gap by the late 1980s and early 1990s. In the 1980s, in east Germany, 50-60% of the improvement was attributable to declining mortality from conditions responsive to medical care (west Germany: 30-40%). A net positive effect was also observed in Poland, although counterbalanced by deterioration in ischaemic heart disease mortality.In the former communist countries, improvements attributable to medical care in the 1980s were due, largely, to declining infant mortality. In the 1990s, they benefited also adults, specifically those aged 35+ in Poland and 55+ in Germany. A persisting east-west gap in temporary life expectancy in Germany was due, largely, to higher mortality from avoidable conditions in the east, with causes responsive to health policy contributing about half, and medical care 16% (men) to 24% (women) to the differential in 1997. The findings indicate that changes in the health care system related to the political transition were associated with improvements in life expectancy in east Germany and, to a lesser extent, in Poland. Also, differences in the quality of medical care as assessed by the concept of "unnecessary untimely deaths" appear to contribute to a persisting east-west health gap. Especially in Poland and the former German Democratic Republic there remains potential for further progress that would narrow the health gap with the west.

Adolescent↗
PubMed2005

Molecular epidemiology of chronic hepatitis B virus infection in northern Poland.

Hepatitis B virus (HBV) infection is a global health problem, with more than 350 million people chronically infected worldwide. The chronic HBV infection in Poland is also an essential medical and social problem. Starting from 1993, a steady decline of the incidence of HBV has been observed, reaching the estimated rate of 4.5 per 100 000 in 2004. Nothing is known about the genetic variability of HBV in Poland, the occurrence and spreading of genetic variants and mutants of hepatitis B virus in the population of Polish patients during the course of the disease and in relation to antiviral treatment. It is very interesting to study the molecular epidemiology of the Polish population regarding hepatitis B virus infection as Poland is still ethnically a uniform country, with no more than 3-4% of ethnic minorities. The first results regarding distribution of HBV genotypes and serotypes in northern Poland have been published by our group in 2003 and 2004. This work was part of a scientific project supported by the Fifth Framework Programme initiative of the European Union, entitled "Emerging variants of hepatitis B virus: new tools for epidemiological survey, diagnosis of infection, and monitoring of drug resistance". In the course of the project more than 200 hepatitis B infected patients from the northern part of Poland have been enrolled, diagnosed and - if the viral load of HBV was suitable for analysis - genotyped by sequencing of the HBV pol/S gene fragment. This review presents the main characteristics and some interesting aspects of the studied cohort of chronically infected patients from northern Poland as well as the molecular epidemiology.

Female↗
PubMed2005

Arm circumference in adults in Poland as an important factor influencing the accuracy of blood pressure readings.

AIMS: The aim of this study was to assess the distribution of right arm circumference (RAC) in adults in Poland and to establish how often other than standard cuffs should be used in everyday practice. We also wanted to examine whether large cuffs are available in the market in Poland and whether the cuffs comply with WHO and JNC VII recommendations. MATERIAL AND METHODS: In 2002, we conducted a cross-sectional representative survey NATPOL PLUS to examine prevalence and control of cardiovascular risk factors in Poland. The survey included a questionnaire interview, blood pressure (BP) and anthropometric measurements, as well as laboratory tests. The examined representative sample of adults in Poland consisted of 3051 men and women aged 18-94 years. The measurements of RAC were performed in all respondents. Arterial hypertension (AH) diagnosis was based on three separate visits (BP > or =140/90 mmHg or treatment). Subjects with body mass index (BMI) > or =25 kg/m were included to overweight/obese group. RESULTS: The prevalence of AH was 29% and of overweight or obesity, 52%. In 24% of all adults RAC was > or = 32 cm, and in 6% was < 24 cm. In hypertensives, the respective figures were 36 and 3%; and in overweight/obese subjects 40 and 0.6%. Mean RAC was 29.2+/-3.8 cm (males 30.2+/-3.5 cm; females 28.3+/-3.9 cm, P<0.001). Mean RAC was significantly greater (P<0.01) in patients with AH (30.4+/-3.9 cm; males 30.7+/-3.5 cm; females 30.2+/-3.8 cm) than in normotensive subjects (28.4+/-3.7 cm; males 29.9+/-3.4 cm; females 27.3+/-3.5 cm). However, these differences were not statistically significant when the results were adjusted for age and BMI. Additional analysis of sphygmomanometers available in Poland showed that parameters of standard cuffs fulfilled recommendations of JNC VII and WHO/ISH guidelines. However, the sets with large cuffs were usually much more expensive and only one manufacturer made them available as a special order. CONCLUSIONS: One-third of adults in Poland have an arm circumference, which requires use of a 'non-standard' sized cuff. Moreover, in patients with AH or overweight/obese subjects, wider or narrower cuffs should be used in approximately 40% of subjects.

Adult↗
PubMed2006

Poland's syndrome and gastric cancer: report of a case.

Poland's syndrome, a rare congenital anomaly characterized by pectoralis muscle defect and ipsilateral hand abnormalities, has been reported in association with various malignancies. Gastric cancer associated with Poland's syndrome has not been described previously. To our knowledge, the case of the 21-year-old man we describe herein represents the first report of Poland's syndrome associated with gastric cancer. Although previously there was no certain evidence that linked Poland's syndrome and cancer, elucidating the molecular mechanisms that cause this syndrome may further clarify the relationship between Poland's syndrome and malignancies. At least, these associations confirm the relationship between Poland's syndrome and malignancies, and require oncologic awareness.

Adult↗
PubMed1993

Genetic background of clinical homogeneity of phenylketonuria in Poland.

In order to elucidate the clinical homogeneity and severity of the hyperphenylalaninaemias in Poland, a total of 71 children with typical phenylketonuria (PKU) originating from western and northern Poland were screened for 13 mutations in the phenylalanine hydroxylase (PAH) gene. Eighty percent of all PKU alleles tested were found to carry an identified mutation. One mutation, namely the R408W mutation, accounted for more than 63% of mutant PAH alleles in Poland, the other 27% being accounted for by six mutations: IVS12nt1 (5%), IVSnt546 (5%), Y414C (4%), R252W (1.5%), R261Q (< 1%), and G272ter (< 1%). The predominance of the R408W mutation resulted in a high rate of homozygotes (35.2%) and compound heterozygotes for this mutation in children from western and northern Poland. The frequency and deleterious nature of this mutation probably accounts for the clinical homogeneity and severity of the hyperphenylalaninaemias in Poland. In addition, the high rate of the R408W mutation and its association with mutant haplotype 2 at the PAH locus in Poland give additional support to the Balto-Slavic origin of this mutant gene.

Base Sequence↗
PubMed2004

Skin reactivity to histamine and codeine in unselected 9-year-old children from Italy, Poland and Libya.

BACKGROUND: Previous studies have shown that histamine skin reactivity (the dimensions of a skin wheal elicited by a prick with histamine 10 mg/ml) in unselected school children has increased in Italy during the past two decades and is higher in Italy than in Poland. Hence this variable can probably be influenced by a changing or different lifestyle. The aim of this study was to compare skin reactivity to histamine and codeine (a marker of histamine releasability from mast cells) in schoolchildren from countries with different lifestyles. METHODS: Six previously unstudied unselected populations of 9-year-old schoolchildren (two each from Poland, Italy, and Libya; n = 863 subjects; 49.0% males) were pricked with two concentrations of histamine (10 and 1 mg/ml) and codeine (90 and 9 mg/ml). RESULTS: The higher concentrations of both pharmacologic agents tested yielded significantly different wheal areas in the three countries: Poland < Italy < Libya (histamine, 11.8, 16.1 and 20.7 mm2; codeine, 9.2, 13.2 and 16.2 mm2; p < 0.001 for all comparisons). The lower concentrations elicited almost matching results. Histamine wheal areas correlated closely with areas elicited by codeine in the same individual: angular coefficients of the histamine to codeine regression lines were 0.535, Italy; 0.551, Libya; 0.612, Poland; and 0.581 for the whole population. More histamine was needed to produce a wheal in Poland than in Libya: a 20-mm2 wheal required an injected histamine concentration of about 8.8 mg/ml in Libya, 29.5 mg/ml in Italy and 102.1 mg/ml in Poland. CONCLUSION: More studies are necessary to explain the observed international differences in skin histamine reactivity and their effect on the prevalence of positive allergen skin tests.

Child↗
PubMed2005

Measurements of vibrotactile perception thresholds at the fingertips in Poland.

OBJECTIVES: The measurement of vibrotactile perception thresholds (VPTs) at fingertips in workers belongs in Poland among obligatory methods used to diagnose hand-arm vibration syndrome. The aim of the study was to compare vibrotactile perception threshold (VPT) values for healthy subjects using two different types of measuring equipment, i.e. a system designed according to the requirements of the ISO 13091-1 standard and a system that had so far been in use in Poland. MATERIALS AND METHODS: 59 men and 22 women aged on average 40.4 years old participated in the study. The VPT measurements were carried out using a new pallesthesiometer P8 (EMSON-MAT, Poland), developed according to the ISO 13091-1 standard and a vibrotactile meter MCW 2K that had so far been used in Poland. Measurements were taken for the index, middle and ring fingers of both hands using the frequencies of 4, 25, 31.5, 63, 125, 250, 400 and 500 Hz for the ISO method and 63, 125, 250, 400 and 500 Hz for the Polish method. RESULTS: The mean vibrotactile perception threshold values determined with the ISO 13091-1 method were significantly higher in comparison with the values obtained when the method used in Poland was employed. The differences between vibrotactile threshold levels were almost the same at the compared frequencies. CONCLUSIONS: The results of the VPT measurements obtained employing the standard method adopted in Poland may be used in further diagnostic examinations carried out with the ISO 13091-1 method only if an appropriate correction value is calculated in order to determine the difference in the VPT levels at a selected frequency.

Adult↗
PubMed2000

[Tuberculosis in Poland and the world at the beginning of the third millennium].

BACKGROUND: Tuberculosis has been a major public health problem in Poland for many decades. OBJECTIVE: The aim of this investigation was to evaluated incidence, prevalence and mortality from TB in Poland in 1998 and to examine trends of TB incidence. METHODS: Individual date on tuberculosis cases reported to National TB Register and date of prevalence and mortality from TB were analysed. RESULTS: The paper presents the epidemiological situation of TB in Poland in 1998. The year of 1998 was the fifth consecutive year of decline at TB incidence after previous years (1991-1993) of increase. In 1998 there were 13,302 newly registered TB cases, of which 1,476 were relapses. The incidence was 34.4 per 100,000 population, (30.6 were the new cases and 3.8 relapses). Relapses represented 11.1% of all new registered cases. The incidence in 1998 was 4.7% lower than in 1997, but the rate of decline was smaller than in previous year (9.3%). Among the total number of newly registered cases there were 7,501 cases (19.4 per 100,000) bacteriologically confirmed, of which 4,090 cases were sputum smear positive. The proportion of bacteriologically culture positive cases was 56.4% and of sputum smear positive -30.7% which is rather low, but similar to previous years. In view of sufficient network of laboratory services this low proportion of bacteriological confirmation of diagnosis may indicate low quality of bacteriological examinations. In 96.2% of cases the diagnosis was respiratory tuberculosis. Low proportion (3.8%) of non respiratory tuberculosis, which continuous for many years, may indicate inadequacies in diagnosis and registration of this form of disease. The incidence of tuberculosis increases with age, from 1.5 in children up to 67.3 among 65 and older. The proportion of cases in the age group 20-44 years is still high (38.1%). The incidence in men (47.4) is two times higher than in women (22.1), and in rural population higher than in urban--35.6 and 33.7 respectively. The prevalence of tuberculosis at the end of 1998 was 39.5 (15,284 cases), of which 56.2% were bacteriologically confirmed cases (8,593 cases). In the latter group there were 256 cases bacteriologically positive for longer than one year, and 541 cases resistant to at least 1 drug. The proportion of resistant cases (6.3%) is similar to previous years and does not seem to influence the overall effectiveness of chemotherapy. CONCLUSIONS: In recent years incidence of TB in Poland decreased. The incidence of tuberculosis in Poland was about 2 times higher than the average for E.U. countries, but lower than in other Eastern European countries. The distance between Poland and countries with lowest incidence is estimated at 25-30 years.

Adult↗
PubMed2001

[Evaluation of the burden of diabetes in Poland].

Burden of diabetes in terms of economic costs and life years lost due to premature deaths and disability in Poland is analyzed. This study calculates direct costs of type 1 and type 2 diabetes in Poland in 1998 and burden of diabetes in terms of years of life lost using Disability Adjusted Life Years (DALYs) measure within the Polish Multicenter Study of Diabetes Epidemiology (1998-1999). There is a consequent need to evaluate the burden of diabetes for the society and to develop affordable and cost-effective preventing strategies. The burden of diabetes is examined in terms of resources used by diabetic patients and time lost due to premature deaths and disability caused by diabetes. The profile of "a standard patient" (type 1 and type 2 diabetes) resource utilization is created using patient survey in Krakow. This includes main elements of cost associated with prevention, diagnosis and treatment: ambulatory care (visits); hospital care (bed/days and dialysis sessions); pharmaceuticals (goods consumed) and diagnosis (tests). This study calculates direct costs to the health sector of type 1 and type 2 diabetes in Poland 1998. Burden of diabetes in Poland in terms of time lost in 1998 is expressed in Disability Adjusted Life Years (DALYs) unit of measurement. DALY is a combination of two dimensions: YLL--number of years lost due to premature mortality; YLD--loss of healthy years due to disability caused by diabetes (with and without complications). The incidence approach is applied for the YLD caused by diabetes type 1 calculations by gender and age groups (0-29 years). Incidence rates are obtained from the prospective data collection [1, 2]. Other data as average age of onset, average duration of the disease (with or without complications), severity (age specific disability weight for treated or untreated forms of diabetes--with or without complications) are obtained from the GBD study for the Formerly Socialist Economies of Europe [9]. Discounting and age weighting procedure is applied. The prevalence approach is applied for YLD caused by diabetes type 2 calculations for treated and untreated forms of diabetes (with and without complications) by gender and age groups (35 years and more). Prevalence data are obtained from the Polish Multicenter Study on Diabetes Epidemiology. Age specific disability weights for treated or untreated forms of diabetes (with or without complication) are obtained from the GBD study for the Formerly Socialist Economies. Discounting procedure is not applied (duration of the disease is assumed 1 year). Years of Life Lost are calculated using Polish mortality data and life expectancy at the time of death in 1998. Cost of diabetes study is particularly useful in indicating the magnitude of the costs involved, which tend to be much higher than perceived by the general public. In 1998 the average diabetes type 1 patient's costs were 6.4 times and diabetes type 2 patient's costs 3 times higher than average public direct health care costs. The total costs of diabetes in Poland 1998 accounted for 9.3% of total public health care expenditures. The cost of diabetic patient's estimation indicates the potential benefits of effective medical interventions. Not only mortality rates should be taken into consideration in the creation of health policy and financial planning. Disability of the population is also an important factor, particularly in diseases which do not lead to fatalities. In 1998 112,584 DALYs (46% for males and 54% for females) were lost in Poland due to premature deaths and disability caused by diabetes. 72% of the total was due to disability. Secondary prevention is very important especially for diabetes type 2 patients. 95% of total time lost due to disability is caused by diabetes type 2. National burden of disease evaluation is helpful to develop a justifiable basis for setting priorities in purchasing and investing at central and local levels especially in prevention.

Cost of Illness↗
PubMed2002

[Epidemiological situation of the selected infectious diseases in Poland in 1918-1939].

In Poland, during twenty years between the first and the second world war modern methods and remedies were created and applied to save the society from biological extermination caused by the epidemics of acute infectious diseases that existed in the larger areas of the country and other diseases that could threaten the society when brought from abroad. Poland regained its independence in 1918 as a country completely destroyed by war and encompassed three partitioned sectors that differed in wealth, class consciousness, various infrastructure, legislation, epidemiological situation of infectious diseases and threats spreading from abroad. Infectious diseases such as typhus fever, typhoid fever, cholera, smallpox, dysentery and other diseases spreading by alimentary tracts caused the greatest epidemiological problem. The considerable number of smallpox cases was noted in 1920-1922. In the thirties only individual cases occurred. Since 1934 no fatal cases of smallpox were registered. In 1919, in Poland 219,688 cases and 18,641 typhus fever deaths were registered. Between 1930 and 1939 the annual number of cases ranged from 2000 to 4000. In Poland each year between the first and the second world war typhoid fever was a serious sanitary problem. The largest outbreak of dysentery occurred in Poland in 1920-1921 and comprised 64,000 cases, among them 10,000 deaths. Acute childhood diseases such as scarlet fever and diphtheria were in Poland endemic. Number of registered cases was variable.

Cholera↗