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PubMed2004

[Treatment of croup syndrome in children in Poland: results of the prospective multi-center observation].

UNLABELLED: The aim of the study was to estimate treatment practice in hospital management of croup syndrome (laryngitis subglottica) in children in Poland. MATERIAL AND METHODS: During the period of 12 months, we have prospectively observed 482 children with croup syndrome admitted to 15 pediatric departments in Lower Silesia (south-west region of Poland). Data concerning epidemiology, clinical course and treatment were collected from uniform observation cards. There were 326 boys and 156 girls aged between 2 and 174 months in our study. RESULTS: Among 482 observed children, received glucocorticoids 424 (88%) mainly parenteral, L-epinephrine--211 (43.8%), mist therapy--241 (50%), antihistamines--308 (63.9%), antibiotics--280 (58.1%). Children treated with antibiotics were younger (p=0.0316), their temperature, amount of leukocytes and value of C-reactive protein was higher when compared with those not treated (p=0.0002; p=0.0081, p=0.0172 respectively). CONCLUSIONS: Children in Lower Silesia with croup syndrome were treated in agreement with recent standards with glucocorticoids and/or epinephrine. There was an excessive usage of antihistamines which have no established treatment role. It seems that in many cases antibiotic treatment could have been avoided.

Adolescent↗
PubMedDate not supplied

[Intensification of post-traumatic stress disorder of Siberian deportees from the North-East region of Poland].

AIM: Presentation of Post-Traumatic Stress Disorder based on the approach of various authors concentrating, upon the concept of the American classification: DSM III (1980) and DSM IV (1994). We acknowledged the necessity of displaying empirical results of intensification of PTSD among the Siberian deportees population in the region of North-East part of Poland. METHOD: In our analysis, we stressed the importance of the distant in time, psychological consequences of dwelling in extremely difficult living conditions that often threatened the life of those who had been deported to Siberia between 1939 and 1956. 40 "Siberian deportees" (20 men and 20 women) were examined. The method of PTSD-Interview (PTSD-I) was used here in order to obtain, in each individual case, the indicatory number indispensable for the statistical analysis. RESULTS AND CONCLUSION: An average result of PTSD intensification in the case of women reaches a "very significant" level and in the case of men it is even higher. The disparity between the average results of women and of men are statistically significant (p<0.05). This research has confirmed the assumptions that suffering from trauma in the early stage of development (within the age range of 8-15) leaves a permanent mark in the human psyche. Statistical analysis revealed a high level of intensification of PTSD among the population of the "Siberian deportees" from the North-East region of Poland.

Age Factors↗
PubMed2004

Equine herpes virus 2 infection in horse populations in Poland.

The prevalence of Equine herpesvirus 2 (EHV-2) infections in the horse populations in Poland was investigated. Peripheral blood leukocytes (PBLs) of 139 horses were tested. The animals were divided into four groups: clinically healthy horses, horses suffering from respiratory disorders, mares with a recent abortion and horses with diagnosed ataxia. Thirty-four virus isolates were obtained from leukocytes of the tested animals by cocultivation with equine dermal cells and were identified as EHV-2 by PCR using primers for the gB gene of EHV-2 and/or primers for the sequence located upstream of the gene homologous to the equine interleukin 10 (IL-10) gene. These results indicate that EHV-2 is prevalent in horse populations in Poland. As the virus was most frequently isolated from horses with respiratory disorders its etiological importance may be considered.

Animals↗
PubMed2004

[Occupational diseases in Poland, 2003].

BACKGROUND: Data on occupational diseases constitute an important element of the bulk of information on the health of workers as well as on the sanitary conditions prevailing in their work environment. Yearly records of the incidence of occupational diseases, and the annual analyses of the incidence data render it possible to identify high-risk groups, so that preventive measures can be taken to reduce the risk of the resultant pathologies. METHODS AND MATERIALS: This work is based on the information included in the "Occupational Disease Reporting Forms" received by the Central Register of Occupational Diseases in 2003. The forms specified the diagnosed disease, patient's age and gender, period of occupational exposure to agents responsible for the disease development, branch of the national economy and the region of the country. The incidence was specified in terms of indices per 100 000 paid employees. RESULTS: A total of 4365 cases of occupational diseases were diagnosed in Poland in 2003. The incidence rate was 46.6 cases per 100 000. The highest rates were recorded for chronic vocal organ diseases (11.7), pneumoconiosis (8.6), bilateral permanent hearing loss (7.9), contagious or parasitic diseases (5.9) and skin diseases (2.3). In 60.7% of patients with diagnosed occupational disease, the period of exposure to a relevant harmful agent was over 20 years. The highest incidence of occupational diseases was recorded in the mining industry in general (372.5 cases per 100 000) and in the coal mining industry in particular (439.4 cases per 100 000 paid employees). CONCLUSIONS: In 2003, the incidence of occupational diseases continued to decrease in Poland. This downward tendency has been observed since 1999. A lower number of cases of hearing loss, contagious or parasitic diseases, chronic voice disorders and of skin diseases mostly contributed to the general decrease in the incidence of occupational diseases.

Humans↗
PubMed2004

Predicted and observed thyroid cancer incidence in Poland after year 1986.

Chmielarczyk et al. analyzed thyroid cancer incidence in Poland between the years 1986 and 1994. Both for males and for females they found exponential increase of the directly standardized total incidence rates. The exponential growth could also be concluded for several age-specific rates in both sexes. Following the suggestion by Chmielarczyk et al., in this paper an attempt to verify their conclusions is undertaken. To this aim thyroid cancer incidence rates observed in Poland in 1995-2000 are compared with the predictions obtained from the models used by Chmielarczyk et al. to analyze the 1986-1994 data. The results of the comparison indicate that the predictions for the exponential growth model are consistent with the data observed in 1995-2000 for females. For males, however, an alternative possibility of a linear increase of incidence rates might also be applicable. To reach a more definite conclusion in this case, further follow up is needed.

Adult↗
PubMed2004

Emergency medical service in Poland--current state and a need of reform.

The article focuses on the question of reorganisation of Emergency Medical Service in Poland. First part of the paper contains a short description of a project of the Integrated Rescue System, which have been included in the National Emergency Medical Service Act enacted by Parliament in 2001. Considering to the fact, that implementation of this reform has been stopped after general elections in autumn 2001, in the second part of the paper some arguments supporting the postulate of urgent realisation of this project are discussed. The arguments refer to five spheres: epidemiological, social, political, legal and economical. The conclusions of the discussion are, that in every of those spheres negative consequences of blocking the reform may be observed. The final conclusion is, that reorganisation of ineffective Emergency Medical Service in Poland is still a challenge, which public authorities have to manage.

Emergency Medical Services↗
PubMed2004

The impact of income, education and health on lifestyle in a large urban population of Poland (Cindi programme).

OBJECTIVES: The objective of our study was to examine the impact of income, education chronic diseases and self-rated health on health behavior (smoking, alcohol consumption, physical activity, diet) in a large urban population of Poland. MATERIALS AND METHODS: The data were collected in Lódź, a large industrial city of Poland, between 2001 and 2002, as a part of the Countrywide Integrated Noncommunicable Diseases Intervention Programme. The surveys were directed at random samples of the adult population (1837 men and women, aged 18-64 years). A questionnaire completed during a doctor's visit was used for data collection. RESULTS: Smoking was more prevalent in men then in women, and its prevalence was lower among the better-educated people. The older men drank the most. Strong alcohol consumption was more prevalent in women with a higher education and the highest income. The presence of any of the studied chronic illness decreased daily smoking and the frequency of alcohol consumption among men. Use of vegetable oil in food preparation was less prevalent among older men. Married men in the "medium" education group and widows used vegetable oil most frequently. Healthy physical activity was most prevalent among men in the higher income group; lower rates were observed among persons with skilled education and in men with chronic illnesses. CONCLUSIONS: Based on our findings, we may conclude that education has a strong impact on our lifestyles. It is also evidenced that people who suffer from chronic illness show stronger motivation for healthy behavior. However, we found no relationship between health status and food habits.

Adult↗
PubMed2005

Evaluation of tickborne encephalitis case classification in Poland.

Central European tickborne encephalitis (TBE) is a viral disease of the central nervous system. Despite a surveillance system for TBE existing in Poland since 1970, there are no standardised case definitions and different diagnostic tests are used in various regions. The purpose of this study was to summarise four years of surveillance data using standardised case definitions. From 1999 to 2002, 607 cases of TBE were reported to Poland's national surveillance system: 386 (63.6%) were males, 331 (54.5%) lived in rural areas, and 186 (30.6%) were between 30 and 50 years old. Of 606 diagnosed cases, 453 (74.7%) had aseptic meningitis, 109 (18.0%) had meningoencephalitis, and 44 (7.3%) had meningoencephalomyelitis. Of the 607 reported cases, 602 (99.2%) could be classified: 153 (25.4%) as confirmed, 343 (57.0%) as probable, and 106 (17.6%) as possible cases. There was a significant difference in classified cases by gender: 28.6% of male cases were classified as confirmed, compared with 19.7% of female cases (chi2= 10.48, p=0.0053). There was a significant difference in case classification by clinical diagnosis: 32.4% of cases with meningoencephalitis were classified as confirmed cases, compared with 24.7% of cases with aseptic meningitis (chi2=11.79, p=0.019). There were also significant differences in the distribution by case definition group across geographical regions. For appropriate monitoring of TBE, a uniform and valid case definition should be used in European countries. With only 25% of reported cases meeting the definition for confirmed cases, there is a need for more complete follow-up and standardised testing of suspect cases.

Adolescent↗
PubMed2004

[Risk of alveococcosis for humans in Poland].

The paper presents data on occurrence, diagnosis and treatment of alveolar echinococcosis in humans as well as possible methods of its prevention. Studies done in 2001-2003 in Poland have shown the high prevalence of the tapeworm in red foxes in the north-east (34.5%) and south-east (39.3%) of Poland with foci of infection in some counties (up to 70% foxes infected). It makes the high potential risk for human infection in these areas.

Animals↗
PubMed2004

[Survival of cervical cancer patients in selected regions of Poland in 1990-1996, in relation to some prognostic factors].

To evaluate whether cervical cancer patients in selected regions of Poland show similar 5-year survival rates and if they are different from European average and, also, to evaluate the effect of selected prognostic factors. The analysis based on a cohort of 1386 cervical cancer cases identified by population-based Cancer Registries collecting data from Kieleckie and Opolskie voivodships and from the City of Warsaw in 1990-96. These data become complete by adding information from medical records. The 5-year relative survival rates were calculated using the life tables method, and, a multivariant regression analysis was applied for evaluation of prognostic factors. The regions differed significantly in stage distribution (p<0.001), however, they were similar in age groups and histological diagnosis. The age-standardized relative 5-year overall survival rate was 52.2%, and was among lowest rates in Europe. The rate in Kieleckie was 60.7%; in Opolskie--43.3%, and in Warsaw--51.9%. The rates for Stage I in those regions were comparable at over 80%, but were different for Stage II and higher stages. The multivariant analysis showed a significant risk increase related to stage advancement (p<0.0001) as well as to the place of living in Opolskie (p=0.02) and to the adenocarcinoma diagnosis (p=0.05). However, the analysis did not confirm the effect of age of diagnosis as a prognostic factor. The overall, age-standardised 5-year relative survival rates of cervical cancer patients are one of the lowest in Europe, though diversified in the regions. They are almost satisfactory and close to European average in Kieleckie where prevention was effective, but poor in the other regions. The low survivals overall are basically due to the unsatisfactory proportion of the early stage of disease. The uneven survivals of patients with Stage II and higher stages of cancer in the selected regions of Poland suggest different standards of treatment.

Adenocarcinoma↗
PubMed2004

[The advertising of medicinal products to the public in Poland--legislative, ethical, health and social concerns].

Regulations regarding the advertising of medicinal products to the public in Poland, EC directive and WHO ethical criteria for medicinal drug promotion were compared. Current Polish regulations varied considerably with Community's and WHO point of view. The article covers the potential health and social effects of the recent situation in the area of medicines advertising in Poland.

Advertising↗
PubMedDate not supplied

[Historical outline of forensic medicine in Poland and its connections with forensic medicine in German-speaking countries].

The author briefly presented development of forensic medicine as a separate branch of medical sciences in Poland from the end of the Middle Ages to date. He comments on conditions in which forensic medicine developed after partitions of Poland and its restoration of independence. He emphasized the merits of Prof. Wachholz and his pupils, as well as the great publishing effort of forensic scientists during the interwar period and after World War II. He did not fail to highlight links between Polish and German forensic medicine and quotes numerous examples of very close contacts between both communities in this field.

Autopsy↗
PubMed2004

[Retrospective overview of medically treated non-fatal injuries in pupils aged 11-15 years in Poland (1994-2002)].

The aim of the study was to analyse: annual occurrence of injuries in pupils aged 11, 13 and 15 years in Poland, common location of injury occurrence and type of activity, as well as the type of body harm. The results of the survey were compared with similar studies in 1994 and 1998 and series of trends were drawn. The survey was carried out in Poland within the Health Behaviour in School-aged Children. A WHO Collaborative Cross-national Study (HBSC). The representative sample (N = 6383) was selected by two-stage, cluster drawing with stratification by place of residence. As the survey instrument the international questionnaire was used, translated and adapted for national purposes. Selected determinants of injuries were examined by crude odds (OR) with 95 per cent confidence interval (CI) calculated from contingency tables with the use of EPI INFO 6.04d software. Results of the study indicated the linear increase of non-fatal injuries among 11, 13, 15 years old pupils in 1994-2002 (from 17.6% to 28.4%) and even more evident increase of repeated injuries in the same time (from 2.1% to 8.6%, respectively). School and home were the most common location of injuries occurrence, while training for sport was the most common type of activity. Boys, living in urban areas were at highest risk of injuries in total, and by selected injuries outcomes. An increase of awareness that injuries are preventable and implementation of well know in the world prevention strategies are needed to stop disadvantageous trends in non-fatal medically treated injuries among school-aged children.

Adolescent↗
PubMed2005

Body mass index and risk of death in middle-aged men and women in Poland. Results of POL-MONICA cohort study.

BACKGROUND: Overweight and obesity have been considered to be the causes of serious health consequences. So far, there have been no studies in Poland to analyse the relationship between Body Mass Index (BMI) and mortality. AIM: To determine the relationship between BMI and the mortality risk due to all causes and due to cardiovascular diseases (CVD) in the middle-aged population of Poland. METHODS: The study group consisted of men and women aged 35-64, residents of two districts of Warsaw (Praga Północ and Praga Południe) and the former Tarnobrzeg Voivodship who were selected at random for POL-MONICA Project cross-sectional studies in 1983-1994. Risk assessment of death due to all causes and due to CVD was performed using the Cox proportional hazards method. Persons with BMI of 22-23.9 were adopted as reference group. RESULTS: Sample size consisted of 5,281 men and 5,691 women. Prospective observation was carried out from 5 to 15 years, mean duration 10.7 years. Overall, the observation comprised 117,839 person-years. During the study, 914 men died (including 448 due to CVD) as well as 430 women (including 160 due to CVD). After adjusting for age, place of residence (Warsaw vs. the Tarnobrzeg Voivodship), risk factors (hypercholesterolemia, arterial hypertension and smoking) and self-assessment of health, increased risk of all cause death was found in men with BMI lower than 20 kg/m(2) (relative risk 2.27), with BMI of 32-34.9 kg/m(2) (relative risk 1.41), with BMI > or =35 kg/m(2) (relative risk 1.73), and in women whose BMI was lower than 20 kg/m(2) (relative risk 1.66). Increased risk of CVD death was found in men with BMI lower than 20 kg/m(2) (relative risk 1.97), with BMI of 32-34.9 kg/m(2) (relative risk 1.66), with BMI > or =35 kg/m(2) (relative risk 2.06), and in women with BMI > or =35.0 kg/m(2) (relative risk 2.02). CONCLUSIONS: The POL-MONICA study carried out in the middle-aged Polish population did not confirm a relationship between overweight (BMI from 25 to 29.9 kg/m(2)) and risk of death due to all causes or due to CVD.

Adult↗
PubMed2000

Cribra orbitalia in early medieval population from Ostrów Lednicki (Poland).

Cribra orbitalia is mostly diagnosed as being of nutritional origin, especially iron deficiency anaemia, and as the effect of infectious diseases and parasitic infestations. That lesion of the orbital roof is the good indicator of the biological state of the prehistoric populations. The frequency of occurrence of the cribra orbitalia was examined in the early medieval (12th-14th century) human population from Ostrów Lednicki (an island on the Lednica Lake--Wielkopolska Province, Poland). The intensity of the cribra orbitalia was estimated on the basis of Hengen's scale, and author's scale (3 degrees of intensity). 494 adult skulls, 259 females (52.4%), 234 males (47.4%) and one indeterminate individual (0.2%) were analysed. Cribra orbitalia were present in 149 (30.2%) individuals of this population. Frequency of occurrence of this lesion was higher in females (17.4%) than in males (12.8%), and its distribution in different age categories was: adultus 15.8% (78 individuals), maturus 12.6% (62 individuals), senilis 1.8% (9 individuals). Cribra orbitalia were more frequent in the left orbit. Occurrence and intensity of this pathology of the orbital roof was compared with the various osteometric features: measurements of the skull, calculated body height and massivity of the postcranial skeleton. There was lack of the correlation among those features and cribra orbitalia. Results of this study were compared with other medieval skeletal series from Poland.

Ethmoid Bone↗
PubMed2004

[Prevalence of risk factors for atherosclerosis in participants of the Southern Poland Epidemiological Survey (SPES) with normal blood pressure].

Results of many studies indicate that cardiovascular diseases develop more often in subjects with blood pressure higher than optimal, but lower than the level, at which the diagnosis of arterial hypertension and implementation of therapy is justifiable. The aims of this study were the assessment of prevalence of risk factors for atherosclerosis among people with normal blood pressure in a population of Southern Poland (Southern Poland Epidemiological Survey--SPES), the quantitative evaluation of global risk for coronary events in relation to normal blood pressure classes, as well as the estimation of the size of subpopulation of subjects eligible for lipid-lowering treatment. A subpopulation of 15,484 subjects without known hypertension and coronary heart disease with normal blood pressure measurements were chosen from a total of 50,111 participants of the SPES study. There were 5,304 men and 10,180 women, aged from 18 to 87 years. Optimal blood pressure (< 120/80) was observed in 24%, normal (120-129/80-84) in 40% and high normal (130-139/85-89) in 35% subjects. In both sexes, irrespective of blood pressure classes, the most prevalent risk factors were hypercholesterolemia, overweight/obesity and smoking. The prevalence of hypercholesterolemia (> 200 mg/dl) increased along with blood pressure classes, and the proportion of subjects with cholesterol level > or = 240 was 1.5 times greater in those with high normal (21%), compared to those with optimal blood pressure (13%). The proportion of overweight/obesity was 1.5 times greater in subjects with high normal (50.5%) when compared to those with the optimal blood pressure (32.5%). The global risk for coronary events > 10% was more frequent in subjects with high normal blood pressure. Increase of the proportion of subjects eligible for lipid-lowering therapy from near 0% in women with optimal to approximately 10% in men and 8% in women with high normal blood pressure. A rise of the normal blood pressure class is associated with a clear increase in the prevalence of atherosclerotic risk factors and the global coronary risk. An extended medical care should be considered to all subjects with high normal blood pressure and global risk greater than 10%, including lipid-lowering therapy in approximately 10% of this subpopulation.

Adolescent↗
PubMedDate not supplied

[Legal basis for ontogenetic sex judgment in sex disapproval syndrome in the form of transsexualism. Comparison of the situation in Poland and in some other countries].

Sex disapproval syndrome in the form of transsexualism is characterized by incompatibility of biological and psychically-emotional sex. This incompatibility leads to a discrepancy between one's social role and his or her biological sex. The aim of this paper is to present and compare the legal basis for ontogenetic sex judgment in the sex disapproval syndrome in the form of transsexualism in Poland and in some other countries. Poland, contrary to some other countries, does not have any appropriate legislation for determining the above issue. So far all judgment has been based on exponential activities, in anticipation for the so called transsexual act. This act may be created on the basis of existing legislation in other European countries, which is briefly presented in the work.

Europe↗
PubMed2005

Risk of tick-borne bacterial diseases among workers of Roztocze National Park (south-eastern Poland).

The objective of the present study was to assess the risk of borreliosis and anaplasmosis (ehrlichiosis) among the forestry workers of the Roztocze National Park (south-eastern Poland) by examination of Ixodes ricinus ticks living in park area with PCR method, and by the serological and clinical examination of the workers. In 406 examined ticks, the prevalence of infection with Borrelia burgdorferi sensu lato was 11.5 %. The nested PCR reaction for determining the genospecies showed that the most common was Borrelia burgdorferi sensu stricto (55.3 % of total positive) followed by Borrelia afzelii (38.3 %). As many as 6.1 % out of 115 examined ticks showed the presence of Anaplasma phagocytophilum DNA. The infection rate was high in males and females (14.3 % and 11.1 % respectively) and low in nymphs (1.5 %). In 46 out 113 examined forestry workers (40.7 %) the presence of specific IgG and/or IgM antibodies against Borrelia burgdorferi sensu lato was found in ELISA test, while only 4 out of 56 urban blood donors showed a positive response (p<0.0001). The prevalence of IgG antibodies against Anaplasma phagocytophilum determined with the use of indirect immunofluorescence test (IFA) was 17.7 % in forestry workers compared to 5.4 % in reference group of blood donors (p<0.05). No correlation was found between the presence of antibodies to A. phagocytophilum and to B. burgdorferi s. l. Clinical investigations of 113 forestry workers showed 3 cases of borreliosis (2.7 %) and no cases of anaplasmosis (ehrlichiosis). In conclusion, forestry workers of the Roztocze National Park in south-eastern Poland are often exposed to Ixodes ricinus ticks infected with Borrelia burgdorferi and Anaplasma phagocytophilum, and show a high proportion of asymptomatic borreliosis and anaplasmosis (ehrlichiosis) manifested by a positive serologic response, while the number of clinical cases is relatively low.

Adult↗