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[Complete and dissociated forms of Poland's syndrome (5 cases)].

The authors report 5 cases of aplasia of pectoralis major including 2 associated with a malformation of the hand falling within the context of Poland syndrome, which is a relatively common congenital malformation consisting of an association in varying degrees of hypoplasia of pectoralis major and a complex malformation of the homolateral hand. The pathogenesis of this malformation is gradually emerging and while familial cases have been reported, the majority of Poland syndromes are sporadic. The hypothesis involving interruption of the embryonic blood supply of the subclavian arteries during a critical period of embryonic development at about the 46th day is the most attractive. This hypothesis also enables extension of the manifestations seen to other congenital malformation syndromes. However, it could be disproved in one of our cases and the notion of early embryonic damage was more plausible.

Adolescent↗

[The evolution of epidemiology and clinical characteristics of laryngeal and hypopharyngeal carcinoma in Poland from 1991 to 2001].

On the base of retrospective analysis of 12,888 cases of carcinoma of larynx and hypopharynx, diagnosed in 19 ENT Departments in Poland from 1991 to 2001, the assessment of basic epidemiological data, including the localization of tumor and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 11 years the trends to change of the mentioned above parameters has been examined. The significant increase of female patients in this period was observed, with average proportion M:F = 8:1. The glottis localization of carcinoma dominated (47.6%), followed by supraglottis (40.8%) and pyriform fossa (7.8%), with significant increase of pyriform fossa tumors in the analyzed period of 11 years. In the majority of cases the carcinoma of larynx and hypopharynx was diagnosed in the advanced stage (T3 + T4) of local disease, with the highest percentage in localization within the pyriform fossa (81.0%), and the lowest percentage in glottis tumors (45.6%). The regional lymph nodes metastases has been diagnosed in 46.7% of the analyzed group, with the highest percentage in tumors localized in pyriform fossa (82.9%), and the lowest percentage in tumors of glottis localization (33.1%). In the 11 years time the significant drop down of N0 cases and tendency to increase of N2 and N3 in the supraglottis localization of tumor. The distant metastases in the analyzed group at the time of diagnosis has been registered in 2.0%, with the highest percentage in posterior pharyngeal wall (7.6%) and pyriform fossa (7.4%). The authors postulate the renewal of prospective study on epidemiology, clinical characteristics and treatment results of larynx and hypopharynx carcinoma in Poland.

Adenocarcinoma↗

[Mumps in Poland in 2003].

In 2003, 87,336 cases of mumps were reported in Poland. The incidence (228,7 per 100,000) was higher then in 2002(104.6), which corresponds to a periodical increase of mumps incidence. According to the natural periodicity the peak incidence would be expected to take place in 2002. The increase of mumps incidence in 2003, still lower however then the previous peaks, can be attributed to the prolongation of the epidemics cycle usually occurring with growing vaccine coverage. Even though the mumps vaccine was not included into the national immunization program, the coverage in 3-year old children in 2003 reached 39.6%. Approximately 4.6% of cases were hospitalized (4,056) and no mumps deaths were reported. Children 5-9 year old constituted the most affected age group (incidence 2,133.1 per 100,000). In Poland the MMR vaccine was recommended on voluntary basis in place of measles vaccine for children in their 2nd and 7th year of age. Immunization of 2-years old children is mandatory beginning in 2004.

Adolescent↗

[Influenza in Poland in 2003].

Following two years of low influenza incidence in Poland, the activity of this disease markedly increased in 2003. In total 1,216,285 cases of influenza like illness were registered (incidence 3,184.4 per 100,000). Regionally the incidence ranged from 1,195.7 in Zachodniopomorskie to 5,719.7 per 100,000 in Mazowieckie. Children and adolescents under 15 years of age accounted for 41.7% of all cases (507,102 cases, age specific incidence 7,579.0 per 100,000). In this age group the incidence varied regionally from 2,718.1 in Podlaskie to 14,087.6 per 100,000 in Mazowieckie. 3,128 patients (0.26% of all cases) required hospital admission. There were 141 deaths due to influenza (mortality 0.12%) in 2003, in 78.7% these were persons over 70 years of age. Nineteen strains of influenza virus were isolated in 2003 in Poland, including 15 strains of subtype A(H3), 3 strains of subtype A(H1) and one strain of type B. Besides, in other 10 cases influenza A infection was confirmed by direct immunofluorescence test. All isolated influenza strains were antigenically similar to the vaccine strains recommended for the epidemic season 2002/03 and 2003/04.

Adolescent↗

[Pertussis in Poland in 2003].

Since reemergence of pertussis in Poland since 1997/1998 shift of incidence toward older groups of age was observed. Possible explanations include decreased effectiveness of used whole cell pertussis vaccine and lack of booster vaccinations in the age older than two. At least this last possibility was eliminated by introduction of additional dose of DTaP at the age of 6. Though effects of this change may be observed within several oncoming years. 2034 cases were reported in 2003, a slight increase from the previous year (1788 in 2002) More cases occurred among females (1159 cases, 5.9/100,000) than among males (875 cases, 4.7/100,000) and in urban areas (6.8/100,000) than in the rural ones (2.9/100,000). Big differences in numbers of cases reported between different districts and between urban and rural areas bring strong possibility of insufficient sensitivity of the surveillance in many regions of Poland.

Adolescent↗

[Hepatitis A in Poland in 2003].

Epidemiological situation of hepatitis A in Poland since 1997 was evaluated as low endemicity and since 2002 as very low endemicity. High percentage of cases were noted among adult persons, especially in the age 25-29 years. The course of disease was more serious, than before 1997. In 2004 only 95 cases of hepatitis A were noted in Poland (Incidence rate 0.25/100 000). The number and percentage of unimmunized persons, especially among children, adolescents and young adults increases very rapidly. In such situation vaccination against hepatitis A of persons from risk groups is necessary.

Disease Outbreaks↗

[Hepatitis C in Poland in 2003].

HCV surveillance in Poland is based on registration of newly detected both acute and chronic cases. The data from 1999 - 2003 demonstrate a slight upward trend with an increase in incidence of 0.1 per 100,000 annually. In 2003 there were 2,255 registered cases (incidence 5.9 per 100,000), including 5.2% mixed HCV/HBV infections. The incidence in the urban areas (7.6 per 100,000) was two times higher then the incidence in rural areas (3.1) and the incidence in men (7.0) was 42% higher then in women (4.9). In men the highest incidence was noted in the age group 20 to 24 years (10.8 per 100,000) and in women in the age group 60 - 64 years (9.4). Geographically, the incidence varied from 0.8 per 100,000 in Podlaskie to 16.6 per 100,000 in Swietokrzyskie voyvodship. In total 80.8% of the cases were hospitalised. In several voyvodships the percentage of hospitalised cases was higher, reaching even 100%. This suggests low surveillance sensitivity to less severe cases in these areas. There were 116 deaths from hepatitis C in Poland in 2003. Deaths attributed to HCV infection accounted for 4.2% of all infectious disease deaths in 2003.

Adolescent↗

[Tetanus in Poland in 2003].

In last decade gradual decrease in numbers of reported cases of tetanus was observed. In 2003, 30 cases of tetanus (14 women and 16 men) were reported in Poland. All those cases were among people of age 20 or more. In 2003 relatively high number of 14 deaths were recorded. All cases were unvaccinated or vaccination status was unknown. The data show effectiveness of vaccination program in younger age groups, but they also show need for promotion of post exposure prophylaxis, especially among older people both in rural and in urban areas. No case of neonatal tetanus was noted in Poland since 1984.

Adolescent↗

[Cestode infections in Poland in 2003].

In 2003, 218 intestinal cestode infections were registered in Poland. Among them 157 were caused by Taenia saginata, 4 by T. solium, 32 by Taenia sp., 1 by Diphyllobothrium latum,. Moreover, 34 cases of cystic echinococcosis were also registered. The obtained results confirmed decreasing frequency of intestinal cestodes in Poland.

Adolescent↗

[Malaria in Poland in 2003].

Seventeen cases of malaria were reported in Poland in 2003. All of them were imported: 13 from Africa, 2 from Asia and 1 from Indonesia. In 8 cases P. falciparum etiology was confirmed. Among the cases 14 were men and 3 were women. The youngest patient was 10 and the oldest 63, 11 of the patients were in the age group 21 to 40 years. Most commonly the reasons for travel were tourism or family visits (6 cases), professional (4 cases) and missionary (4 cases) travel. One death from falciparum malaria was reported in Poland in 2003. In 4 cases some kind of chemoprophylaxis was documented. In other prophylaxis was not used or not documented.

Adolescent↗

[Tuberculosis in Poland in 2003].

In 2003 year decrease of tuberculosis notification rates in Poland has continued. In this year 10 125 tuberculosis cases (TB) were notified in Poland--incidence rate--26.5 per 100 000 population, with the large differences in notification rates between voivodeships (from 16.9 to 39.8/100 000). Between 1994-2003 notification rates decreased by 3.9% yearly overall. 87.8% of the TB cases notified were new cases. Pulmonary cases represented 90.9% of TB cases. Male to female sex ratio--2.1. Age specific rates were much lower in children--1.5/100 000 (100 cases)--1% of all TB cases and highest in person over 65 years--57.6/100 000 (27.9% all TB cases). Sixty percent of all pulmonary cases were confirmed by culture and 38% were sputum smear positive. Among all the pulmonary TB cases treated there were 292 cases with resistance to at least one drug. They represented 3.4% of bacteriologically positive pulmonary cases treated and from many years remains relatively low. There 892 death due tuberculosis reported in 2002 y.i.e. 2.3/100 000. Mortality among males--3.7 and 1.1/100 000 among females. Since many years the TB mortality is of the order 0.2% of total mortality and almost 40% mortality from infectious diseases. In 2003 year--93.5% new born babies were vaccinated BCG; 82% of all TB pulmonary cases were detect by symptoms and 4% by contact examination. Success rates (cured or completed) of treatment were reported in 83.3%; failed 1.0%; deaths during treatment were reported in 6.2% (2.4% from TB) treatment default in 7.8% treated cases.

Adolescent↗

Current determinants of early retirement among blue collar workers in Poland.

BACKGROUND: The current demographic trend in Poland indicates a progressive ageing process, which will result in a decreased number of persons at the age of work capability. Thus it is essential to find out the reasons for the diminished occupational activity of elderly workers. The aim of the project was to identify the factors that significantly contribute to early retirement during the period of socioeconomic transformation in Poland. MATERIALS AND METHODS: The analysis concerned 637 workers, aged over 45 years, but before reaching the age of retirement (60 years for women and 65 years for men) who were employed in selected industrial enterprises at technological or production-related departments. The study group was recruited from the population of former workers who quit their employment between 1996 and 2000, before they reached the age of retirement. The reference population, matched for age (+/- 3 years) and gender, comprised workers at similar workposts. RESULTS: The following groups of variables were found to be significant risk factors for early retirement: variables describing the conditions of work (piecework system, OR = 7.00, 95% CI: 2.01-24.37; heavy lifting at work OR = 2.24, 95% CI: 1.20-4.17) and variables related to the household characteristics (shortage of leisure time, OR = 1.87, 95% CI: 1.16-4.67), health condition (disability, OR = 1.87, 95%CI: 1.09-3.21; increased rate of sickness absence, OR = 2.20, 95% CI: 1.52-3.17), and alcohol abuse (OR = 3.19, 95% CI: 1.33-7.64). CONCLUSIONS: The data analysis revealed a spectrum of factors that either contribute to or decrease the risk for early retirement. These may be used as a reference in taking on activities aimed at preventing this adverse trend and stimulating occupational activity of elderly workers.

Age Factors↗

Current status of lung transplantation in Poland: experience of the Silesian Center for Heart Diseases.

Until the year 2001, lung transplantation was not available in Poland, as the only one among other kinds of solid organs transplantation. In 2001, in the Silesian Center for Heart Diseases the first successful combined heart-lung-one-block transplantation was performed. In 2003 and 2004, a successful single lung transplantation in Poland was performed in our center. Here the authors presented their experience with lung transplantation including the indications for specific types of transplantation, the immunosuppressive regimen, the management of early and late stages after lung transplantation, the infection complications, and the current problems with lung transplantation progress.

Bacterial Infections↗

[Poland syndrome (a case report)].

Poland syndrome is characterized with unilateral absence of pectoralis major muscle. Its incidence is one in 30000 live births. A 20 years old case with Poland syndrome is presented together with its clinical and laboratory features in this study. The case had anomaly of shortness of right hand fingers and syndactily between second and third fingers in addition to absence of right pectoralis muscle group. There was not another associated anomaly except aforementioned ones. Strength loss in abduction and adduction of right shoulder was detected with Cybex dynamometer. Furthermore decrease in predicted maximal inspiratory and expiratory pressures was detected.

Adult↗

Bariatric surgery in Poland from 1993 to 2003.

Morbid obesity affects about 300, 000 patients in Poland. The number and type of bariatric procedures performed between 1993 and 2003 has been based on data collected from Polish surgeons active in this field. During the years 1993 - 2003, 1285 primary bariatric procedures were performed in total. Amongst these 79.1% were, commonly done as restrictive ones, including vertical banded gastroplasty-76.3%, laparoscopic adjustable gastric banding-17.7% and silastic ring vertical gastroplasty-5.5% and at last non-adjustable gastric band with 0.5%. Less popular are malabsorptive procedures - 20.9%, with Roux-en-Y gastric bypass - 79.1% and biliopancreatic diversion 20.9%. During last year 2003: malabsorptive procedures represented one third of all primary procedures and the laparoscopic approach was utilised in 18 % of operations. 61 revisions were reported. There are only three centres with experience in treating more than 100 patients (one of them treated over 600). Two centres have experience in carrying out bariatric surgery for longer than five years. During 1993 - 1997 216 operations were performed. Between 1998 - 2002: 724 procedures, and during last year 345. Patients were treated during last year in ten surgical departments. The number of morbidly obese patients treated surgically in Poland is increasing, but it is still inadequate to meet the growing demand.

Anastomosis, Roux-en-Y↗

Rabies surveillance, trends in animal rabies and human post-exposure treatment in Poland, 1990 -2004.

This paper describes recent changes in the epizootical and epidemiological situation of rabies in Poland. Analysis of routine surveillance data on animal cases and human post-exposure treatment was performed in order to examine the impact of introduction of cell culture vaccine for human use and the implementation of the fox immunisation programme. The success of the immunisation programme for wild animals has become evident during the past 3 years, as a 9-fold decrease in animal rabies cases has been observed. To date, however, the downward trend in animal rabies cases has had no effect on the frequency of administration of the post-exposure treatment for humans. Moreover, two cases of locally acquired human rabies have occurred in patients who did not receive post-exposure vaccination. These cases prove that rabies should be still considered a public health concern in Poland.

Animal Diseases↗

Poland syndrome in a neonate: report of one case.

Poland syndrome is an infrequent disease that presents in newborn infants and features an incidence of about one in 7,000 to one in 100,000 live births. The clinical features include an absence of the costosternal portion of the pectoralis major muscle, hypoplasia and/or aplasia of the ipsilateral breast or nipple, hypoplasia of subcutaneous tissue, abnormalities of the rib cage and upper extremity anomalies. We present a male newborn suffering Poland syndrome who featured a depressed left chest wall with respiratory distress. Ultrasonography of the chest revealed the absence of a section of pectoralis major muscle over the left chest wall, although no abnormality was found over the ipsilateral upper extremity. The patient was regularly followed up and showed no limitation to the range of motion of the left upper extremity at the age of four months.

Humans↗

[Stroke mortality in Poland--role of observational studies based on computer databases].

Stroke is a leading cause of death worldwide and remains one of the major public health problems. Most European countries have experienced declines in stroke mortality in contrast to central and eastern European countries including Poland. The World Health Organization Data Bank is an invaluable source of information especially for mortality trends. Stroke mortality in Poland and some problems with accuracy of ICD coding for the identification of patients with acute stroke are discussed. Computerized databases are increasingly being used to identify patients with acute stroke for epidemiological, quality of care, and cost studies. More accurate methods of collecting and analysis of the data should be implemented to gain more information from these bases.

Adult↗