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PubMed2002

[Tuberculosis in Poland 2000--at the turn of the century].

UNLABELLED: The aim of this paper was to evaluate incidence, prevalence and mortality from TB in Poland in 2000 and to examine trends of TB incidence. Individual date on tuberculosis cases reported to National TB Register and data of prevalence and mortality from TB were analysed. The paper presents the epidemiological situation of TB in Poland in 2000. The year of 2000 was the seventh consecutive year of decline at TB incidence after previous years (1991-1993) of increase. In 2000 there were 11,477 newly registered TB cases, of which 1428 were relapses. The incidence was 29.7 per 100,000 population, /26.0 were the new cases and 3.7 relapses/. Relapses represented 12.4% of all registered cases. The incidence in 2000 was 5.7% lower than in 1999, but the rate of decline was smaller than in previous year--8.4%. Among the total number of newly registered cases there were 6518 cases--16.9 per 100,000--bacteriologically confirmed, of which 3.713 cases were sputum smear positive. The proportion of bacteriologically confirmed cases was 56.8% and of sputum smear positive--33.9% 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 95.5% of cases the diagnosis was respiratory tuberculosis. Low proportion--4.5%--of extrarespiratory tuberculosis, which have continued for many years, may indicate inadequacies in diagnosis and registration of this form of disease. The incidence of tuberculosis increases with age, from 1.4 in children up to 62.4 among 65 and older. The proportion of cases in the age group 20-44 years is still high (34.7%). The incidence in men (40.9) is two times higher than in women (19.1), and in rural population higher than in urban--30.5 and 29.2 respectively. The prevalence of tuberculosis at the end of 2000 was 38.5 (14,895 cases), of which 55.4% were bacteriologically confirmed cases (8252 cases). In the latter group there were 232 cases bacteriologically positive for longer than one year, and 369 cases resistant to at least 1 drug. The proportion of resistant cases (3.9%) is similar to previous years and does not seem to influence the overall effectiveness of chemotherapy. There were 1.022 (1.024) deaths due to tuberculosis 995 (985)--respiratory tuberculosis and 27 (39) extrarespiratory tuberculosis) reported in 1999 i.e. (2.6) per 100,000. Almost 43% of all deaths were in patients 65 year of age and older. Since many years the TB mortality is the order of 0.3% of total mortality. 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 in Europe is estimated at 25-30 years. Tuberculosis has been and will remain a major public health problem in Poland for many decades.

Adolescent↗
PubMed2002

[Epidemiology of tuberculosis in Silesia Voivodship (Poland) between 1990-2000].

The incidence of tuberculosis in Poland is about 2-3 times higher than average for EU countries. The aim of this study was to evaluate epidemiology of tuberculosis in Silesia Voivodship against the background of the country of Poland. The paper presents actual TB epidemiology situation (incidence, prevalence, morbidity and mortality from TB in Silesia and in Poland) as well as its trends observed between 1990-2000. The regional incidence in 2000 was 15% lower than in 1990, but 35.4 per 100,000 population is still higher than 29.7 per 100,000 observed in Poland. The incidence of tuberculosis increases with age, 1.2 in children aged 0-14 years up to 58.1 among 65 and older. In 2000 incidence in the age groups 20-44 and 45-64 years (36.7 and 57.4, respectively) was much higher than average observed in Poland (28.0 and 47.2, respectively), as well the proportion of new cases in this age groups (38.8 and 40.2%, respectively). The TB incidence in men (51.8) is 2.6 times higher than in women (20.0). Between 1998-2000 in Silesia Voivodship prevalence was growing and in 2000 it was 56.9 per 100,000. In 2000 TB mortality was almost two times higher in Silesia (5.1) than average in Poland (2.7) and opposite to trends observed in the country, it was 11% higher than in 1990. Epidemiological situation of tuberculosis in Silesia Voivodsip is bad. To correct this situation it is necessary to improve the process of fast diagnosis and effective therapy.

Adolescent↗
PubMed2002

[Evaluation of the epidemiology of neoplasms in the Pomerania Voivodship in 1999 in comparison with the situation in Poland].

The aim of the research was the analysis of epidemiological situation of neoplasm in Pomerania Voivodship in 1999 compared with situation in Poland. Neoplasms are the second cause of deaths in Poland. Only cardiac and circular system diseases are more frequent cause of deaths. The situation of cardiac and circular system mortality has positively changed and the number of circular deaths has decreased. On the contrary, the number of neoplasms deaths has increased. Especially, as far as neoplasm are concerned, Pomerania Voivodship's situation is not good. Main trends in epidemiological situation of cancers in Pomerania Voivodship are similar to the situation in Poland, however standardized mortality and incidence rates are higher than average in Poland. In Pomerania Voivodship standardized mortality rates are very high, for females the highest in Poland, for males the second in row of Polish voivodships. In the structure of registered new cases of cancer in Pomerania Voivodship we observe high percentage of multi-sites neoplasms in comparison with data for Poland. The reason of this is undoubtedly connected with the coding system used in Pomerania Voivodship. The presented results indicate the need searching for the factors causing the situation and create programs to eliminate them. The programs must concentrate on early diagnosis of cancers as well as heath promotion and natural environment preservation.

Adolescent↗
PubMedDate not supplied

KAMEDO Report No. 76: Floods in Poland in 1997 and in Sweden in 2000.

Extensive flooding occurred in Poland in 1997 and in Sweden in 2000. These events and their management are reviewed in this Report. The floods in Poland were more extensive than in Sweden as they covered some 10% of Poland's landmass. An estimated 55 persons died as a direct result of the floods in Poland and none were reported due to the flood in Sweden. No epidemics were encountered in either country, presumably related to the extensive use of bottled water and radio instructions to boil all water before its use. The water supply was interrupted and untreated water was taken into the water distribution systems. Chlorination of the water supplies was added in Sweden. Sewage and refuse management was problematic. The heathcare system was impacted profoundly in Poland both by direct damage to hospitals and/or loss of essential services such as electricity and water supplies. Government responses are described with the needs in Poland being extensive including the need for outside assistance. Some pathways used for obtaining aid were outside of government coordination. Comprehensive conclusions and recommendations derived from the observations are provided.

Disasters↗
PubMed2005

[Changes in smoking frequency in Poland in the years 1923-2003].

INTRODUCTION: Smoking is a commonly recognized risk factor of civilization diseases. The number of damaging compounds, including carcinogenic, inhaled by a smoker and exhaled, is directly proportional to a number of smoked cigarettes. Health promotion and prevention are bases of fighting strategy with health risk connected with smoking. The aim of the study was to contrast the number of sold cigarettes in one year in Poland, calculated per capita in selected years of 20th century and at the beginning of current century. The details, which are analysed in the study considering a total number of cigarettes sold in Poland, come from The Statistical Yearbooks and The Demographical Yearbooks of the Central Statistical Office. The analysis showed that in the year 2003 the number of cigarettes sold in Poland, calculated per capita were 4.3 times larger in comparison to the number of cigarettes sold in Poland, calculated per capita in the year 1923. In fact, the difference of the number of sold cigarettes is more unfavorable because the details which concerned cigarettes disposal do not include significant illegal cigarettes import. The highest number of cigarettes sold in Poland, calculated per capita in the analysed period of time, was noticed in the years: 1979--2741 cigarettes, 1980--2679 cigarettes and in 1987--2671 cigarettes, and the lowest was at the beginning of the analysed period: in 1923--450 cigarettes, in 1938--600 cigarettes and in 1949--893 cigarettes. Smoking spread in Poland at the beginning of current century which is measured by the number of sold cigarettes and noticed changes in statistics, calculated per capita, although downward trend is still on the high level.

Humans↗
PubMed2006

[Tuberculosis epidemiology in Silesia Voivodship (Poland) between 1994-2004].

The incidence of tuberculosis in Poland is about 2-3 times higher than average for E.U. countries. The aim of this study was to evaluate tuberculosis epidemiology in Silesia Voivodship (region where 12% of Polish citizens live) against the background of the country (Poland). The paper presents actual TB epidemiology situation (incidence, prevalence, morbidity and mortality from TB in Silesia and in Poland) as well as its trends observed between 1994-2004. The regional incidence in 2004 was 36% lower than in 1994, but 28 per 100,000 population is still higher than 24.9 per 100,000 observed in Poland. The incidence of tuberculosis increases with age, 0.8 in children aged 0-14 years, up to 48.0 among 65 and older. In 2004 incidence in the age groups 20-44 and 45-64 years (23.7 and 46.9 respectively) was much higher than average observed in Poland (20.3 and 39.5 respectively), as well the proportion of new cases in this age groups. The TB incidence in men (41.7) is 2.6 times higher than in women (15.2). Between 1998-2004 in Silesia Voivodship morbidity was growing and in 2004 was 60.6 per 100,000. In the year 2000 TB mortality was almost two times higher in Silesia (4.4) than the average in Poland (2.4). Epidemiological situation of tuberculosis in Silesia Voivodship between 1994-2004 improved but is still bad. To correct this situation it is necessary to improve the process of fast diagnosis and effective therapy.

Adolescent↗
PubMed2006

[Epidemiology of tick-borne diseases in Poland].

The paper summarizes state of art knowledge on tick-borne diseases epidemiology in Poland. The most prevalent diseases are Lyme borreliosis (LB) and tick-borne encephalitis (TBE). Although there is growing number of data published on anaplasmosis and babesiosis prevalence in ticks and humans, there is no national data on these diseases and their epidemiological features remain unclear. All tick-borne agents have a common vector tick--the sheep tick Ixodes ricinus. LB and TBE are mandatory reportable diseases. In 2005 case definitions were implemented in Poland to allow a better comparability of data within the country and with other European countries. LB is widespread in Poland. Studies of prevalence of infected ticks indicate that from 6 to 15% of I. ricinus ticks in different sites are infected with the spirochete. Data from seroepidemiologic studies and from routine surveillance (started in 1996) confirm that the disease is widespread in Poland, and its incidence is increasing. It has increased from 2.31 per 100,000 in 1999 to 11.55 in 2005. One reason of this increase is the improvement in diagnosis of the disease. There is a need to promote personal protection during outdoor activities and knowledge on LB symptoms, especially among populations at risk--forestry workers, farmers. TBE incidence is limited to two main foci--one in the Northeast of Poland bordering Baltic states endemic region, and the second on the South of Poland, neighbouring the Czech and Slovak republics. Seroepidemiologic data, supported by surveillance data, indicate that there are areas of particularly high TBEV activity. The mostly affected occupational groups are: unemployed, retired, students, and farmers. This is a reason to promote personal protection and prophylactic vaccination of both inhabitants of endemic regions and tourists visiting endemic regions.

Adolescent↗
PubMedDate not supplied

[Evaluation of needs in early post-stroke rehabilitation in Poland].

BACKGROUND AND PURPOSE: According to European Stroke Initiative (EUSI) recommendations every stroke patient should undergo rehabilitation. We aimed to evaluate the needs of comprehensive stroke in-patient rehabilitation in Poland. MATERIALS AND METHODS: We designed and distributed a questionnaire evaluating rehabilitation departments in Poland, where stroke patients undergo early rehabilitation. Comprehensive rehabilitation was defined as: kinesitherapy (minimum 60 minutes/day), speech therapy (minimum 30 minutes 5 days a week), rehabilitation of other cognitive impairments and group kinesitherapy. We separated rehabilitation departments where comprehensive post-stroke rehabilitation is conducted, and calculated the number of beds in these departments only for stroke patients. We estimated the number of acute stroke patients in Poland. We evaluated the number of patients requiring in-patient rehabilitation based on results from the 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, where all stroke patients who need in-patient rehabilitation have such a possibility. We estimated the number of beds required in rehabilitation departments for stroke patients in Poland. RESULTS: We obtained responses from 115 out of 172 (66.9%) rehabilitation departments. Comprehensive post-stroke rehabilitation is conducted in 11 departments. 159 beds in these departments are for stroke patients. From 64,896 acute stroke patients 9,927 will need in-patient rehabilitation. We need 604 more beds in rehabilitation departments for stroke patients in Poland. CONCLUSION: Only 10% of rehabilitation departments could provide comprehensive stroke rehabilitation in Poland. At present, the number of beds in rehabilitation departments for stroke patients covers about 20.8% of actual needs. An increased number of rehabilitation beds for stroke patients could result in a decreased number of disabled post-stroke patients.

Humans↗
PubMed1993

Changes in the incidence and survivals of ovarian cancer in Poland.

The incidence and mortality trends, as well as survivals, are presented according to the Warsaw Cancer Registry data concerning 4,112 ovarian cancer cases registered in the years 1963-1988, in two populations, the urban of Warsaw City and the rural of the Warsaw Rural Areas (WRA). The standardized incidence rate in Warsaw in 1988 was 13.44/100,000 and it has not changed significantly in relation to the 1963 figure, but statistical significance characterized the increase of incidence in WRA population and the general population of Poland. The standardized incidence rates were as follows: WRA 1963 6.8, 1988 11.7; in Poland as a whole respectively, 6.5 in 1960 and 11.7 in 1988. The most rapid increase of incidence occurred in the 1960s, then the trend stabilized, and another increase began in 1984. The incidence growth was accompanied by similar trends in mortality. The mortality rates in 1988 were: 8.3 in Warsaw; 6.9 in Poland, and 6.9 in WRA. The mortality increase was statistically significant in WRA and in the total population of Poland. The analysis of mortality and incidence trends in Warsaw City and in Poland as a whole justifies the identification of Warsaw as a high-risk population, while Poland appears to be a population of rapidly growing ovarian cancer risk. Despite a statistically insignificant growth of ovarian cancer incidence and mortality in Warsaw, the risk keeps increasing as can be seen in the permanent increase of incidence and mortality rates which began in 1973, in increasingly age-specific incidence and mortality rates in almost all age groups, and in a shift of top incidence and mortality rates towards younger age groups. The risk of this cancer is higher in Warsaw City than in rural areas, but the urban/rural ratio was declining from 2.5 to 1.3 during the study period. The relative 5 years survival rates in Warsaw are similar to those observed world wide, and they are 37.3% against 38.5% in WRA. Compared with the previous period between the years 1963 and 1968, there has been an improvement in the 5-year survival rates in both populations and in all age groups, except the oldest, resident in Warsaw.

Adolescent↗
PubMed1993

[Paths of food hygiene in Poland].

Varying economic conditions and management systems in different countries have determined the foundation of legal regulations for sanitary food control. The legal system in Poland in the years 1795-1928 was subject to the laws of three partitioning powers: Prussia, Russia and the Austro-Hungarian Empire. On March 28, 1928, the President of Poland passed three decrees equivalent to acts which had a significant impact on sanitary food control. The decrees took into account the following issues: animal protection, food products inspection and evaluation of slaughter animals and meat. For the people of Poland, who in the first half of the 20th century lived within the boundaries drawn by the partitioners, it was important that the legal systems had been based on German law, regarded the best possible at that time. Although the decrees were based on Prussian and Austrian regulations, the infrastructure of food production, of food trade and hygiene in Poland until 1945 was built on the Russian administrative foundation (2/3 of Polish territory) (Fig. 1). After World War II, the economic system established in Poland was subordinate to Soviet rules. This included food manufacturing plants as well as the system of food control. In 1989 Poland came through deep political and economic changes, but the legal system has remained the same. However, there are disputes about the scope between the National Hygiene Inspectors (PIS) operating under the Ministry of Health and Veterinary Hygiene Inspectors (WIS) subject to Woivod's Office.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1998

Excess mortality in working age males in Poland: general patterns.

Since the second World War, excess mortality of males has been steadily growing in Poland. The aim of this paper was to analyze the basic relationships between excess male mortality and some social and economic factors, with special reference to both age and place of residence. Data published in Demographic Yearbooks and included in reports produced by the Government Population Council were used in the analysis. The excess male mortality is expressed in terms of male/female mortality ratio, and also in terms of the difference between the average female and male life expectancy. In the early 1990s the general male mortality rate in Poland was by 23% higher than the general female mortality rate, whereas in males at younger working age (20-44 years) mortality was three times higher, and in the older age (45-64 years) groups 2.7 times higher than the female mortality. Compared with the majority of European countries, Poland is characterised by high rates of excess male mortality, which points to a deteriorated health status of the population. At present, excess mortality of the working age males is much higher than in the 1960s and 1970s. Our analysis of the 1960-1994 trends revealed that the highest excess male mortality occurs in the 20-24 age group. Although recently a falling trend has been observed in the infant, juvenile and post working age groups, a continuous increase is noted in the working age population of Poland. Causes of death were also included in our analysis. Among circulatory diseases, the highest excess mortality was due to acute myocardial infarction (the risk of death from this disease was 8 times higher for males than for females). Accidents, injuries and poisoning constitute another leading group of causes responsible for excess mortality (6/1 male/female death risk ratio). The excess male mortality rates are higher in the rural than in the urban areas. The excess male mortality was also reflected in the indices of average life expectancy. In 1995, the average life expectancy was 67.6 years for males and 76.4 years for females. Thus, in Poland males live 8.6 years shorter than females on average. Increased excess mortality among the working age males, a considerable difference between male and female average life expectancy, disturbed demographic male/female balance, these are at least some of the reasons why further in depth studies of excess male mortality in Poland should continue.

Adult↗
PubMed1999

Breast Cancer in Two Patients with Poland's Syndrome.

Poland fs syndrome is characterized by a congenital defect of the pectoralis major associated with various types of anomalies of the ipsilateral upper extremity. Furthermore, there have been reports of Poland fs syndrome associated with malignancies such as leukemia, malignant lymphoma, and leiomyosarcoma. We describe two cases of Poland fs syndrome associated with breast cancer. The first patient developed right breast cancer associated with ipsilateral breast hypoplasia, defects of the pectoralis major and minor, and syndactyly. She underwent mastectomy and dissection of the axillary nodes. The second patient had left breast cancer associated with ipsilateral breast hypoplasia, defects of the pectoralis major and minor, and syndactyly. She underwent breast-conserving surgery and dissection of the axillary nodes without irradiation of the breast. Both patients are currently alive and free of disease. Although previously there has been no evidence that links Poland fs syndrome and breast cancer, elucidating the molecularmechanism that causes Poland fs syndrome may further clarify the relationship between Poland fs syndrome and malignancies.

Journal Article↗
PubMed2000

Founder BRCA1 mutations and two novel germline BRCA2 mutations in breast and/or ovarian cancer families from North-Eastern Poland.

Germline mutations in the BRCA1 and BRCA2 genes account for the majority of high-risk breast/ovarian cancer families, depending on the population studied. Previously, BRCA1 mutations were described in women from Western Poland. To further characterize the spectrum of BRCA1 mutations and the impact of BRCA2 mutations in Poland, we have analyzed 25 high-risk breast and/or ovarian cancer families from North-Eastern Poland for mutations in all coding exons of the BRCA1 and BRCA2 genes, using combined heteroduplex analysis/SSCP followed by direct DNA sequence analysis. Out of 25 probands a total of five (20%) carried three recurrent BRCA1 mutations (300T>G, 3819del5, 5382insC). The 300T>G mutation accounted for 60% (3/5) of BRCA1 mutations and allelotyping suggested a common founder of this mutation. No unique mutations were found. In addition, we identified three BRCA2 (12%) mutations, one recurrent 4075delGT, and two novel frameshift mutations, 7327ins/dupl19 and 9068delA. We conclude that 30% of high-risk families from North-Eastern Poland may be due to recurrent BRCA1 and unique BRCA2 mutations. Intriguingly, the BRCA1 mutation spectrum seems to be different within subregions of Poland.

Adult↗
PubMed2006

Examining Ambrosia pollen episodes at Poznań (Poland) using back-trajectory analysis.

The pollen grains of Ambrosia spp. are considered to be important aeroallergens in parts of southern and central Europe. Back-trajectories have been analysed with the aim of finding the likely sources of Ambrosia pollen grains that arrived at Poznań (Poland). Temporal variations in Ambrosia pollen at Poznań from 1995-2005 were examined in order to identify Ambrosia pollen episodes suitable for further investigation using back-trajectory analysis. The trajectories were calculated using the transport model within the Lagrangian air pollution model, ACDEP (Atmospheric Chemistry and Deposition). Analysis identified two separate populations in Ambrosia pollen episodes, those that peaked in the early morning between 4 a.m. and 8 a.m., and those that peaked in the afternoon between 2 p.m. and 6 p.m.. Six Ambrosia pollen episodes between 2001 and 2005 were examined using back-trajectory analysis. The results showed that Ambrosia pollen episodes that peaked in the early morning usually arrived at Poznań from a southerly direction after passing over southern Poland, the Czech Republic, Slovakia and Hungary, whereas air masses that brought Ambrosia pollen to Poznań during the afternoon arrived from a more easterly direction and predominantly stayed within the borders of Poland. Back-trajectory analysis has shown that there is a possibility that long-range transport brings Ambrosia pollen to Poznań from southern Poland, the Czech Republic, Slovakia and Hungary. There is also a likelihood that Ambrosia is present in Poland, as shown by the arrival of pollen during the afternoon that originated primarily from within the country.

Air↗
PubMed2004

Resolving Chernobyl vs. global fallout contributions in soils from Poland using Plutonium atom ratios measured by inductively coupled plasma mass spectrometry.

Plutonium in Polish forest soils and the Bór za Lasem peat bog is resolved between Chernobyl and global fallout contributions via inductively coupled plasma mass spectrometric measurements of 240Pu/230Pu and 241Pu/239Pu atom ratios in previously prepared NdF3 alpha spectrometric sources. Compared to global fallout, Chernobyl Pu exhibits higher abundances of 240Pu and 241Pu. The ratios 240Pu/230Pu and 241Pu/239Pu co-vary and range from 0.186 to 0.348 and 0.0029 to 0.0412, respectively, in forest soils (241Pu/239Pu = 0.2407 x [240Pu/239Pu] - 0.0413; r2 = 0.9924). Two-component mixing models are developed to apportion 239+240Pu and 241Pu activities; various estimates of the percentage of Chernobyl-derived 239+240Pu activity in forest soils range from < 10% to > 90% for the sample set. The 240Pu/230Pu - 241Pu/239Pu atom ratio mixing line extrapolates to estimate 241Pu/239Pu and the 241Pu/239+240Pu activity ratio for the Chernobyl source term (0.123 +/- 0.0007; 83 +/- 5; 1 May 1986). Sample 241Pu activities, calculated using existing alpha spectrometric 239+240Pu activities, and the 240Pu/230Pu and 241Pu/239Pu atom ratios, agree relatively well with previous liquid scintillation spectrometry measurements. Chernobyl Pu is most evident in locations from northeastern Poland. The 241Pu activities and/or the 241Pu/239Pu atom ratios are more sensitive than 240Pu/239Pu or 238Pu/239+240Pu activity ratios at detecting small Chernobyl 239+240Pu inputs, found in southern Poland. The mass spectrometric data show that the 241Pu activity is 40-62% Chernobyl-derived in southern Poland, and 58-96% Chernobyl in northeastern Poland. The Bór za Lasem peat bog (49.42 degrees N, 19.75 degrees E), located in the Orawsko-Nowotarska valley of southern Poland, consists of global fallout Pu.

Environmental Monitoring↗
PubMed2002

High early case fatality after ischaemic stroke in Poland: exploration of possible explanations in the International Stroke Trial.

PURPOSE: To determine why Polish patients included in the International Stroke Trial (IST) had a higher early case fatality than patients from other countries. METHODS: Of 19,435 patients randomised to IST, 17,370 had CT or autopsy-confirmed ischaemic stroke. We compared the baseline clinical state and 14-day case fatality of patients randomised in Polish centres with those from all other IST countries. We examined: age, gender, presence of atrial fibrillation (AF), conscious level, neurological deficit, cause of death and aspirin use in the 3 days before stroke. RESULTS: In Poland, the 14-day case fatality rate was significantly higher than in other IST countries (13% vs. 9.6%; odds ratio, OR, 1.5, 95% confidence interval, CI, 1.2-1.9). In Poland, a significantly higher proportion of deaths was attributed to coronary heart disease (2.5% vs. 0.7%) and pulmonary embolism (1.0% vs. 0.4%). Polish patients had higher percentage of AF and drowsiness, but were younger. When these factors were adjusted for, Polish patients still had approximately a 57% higher risk of death within 14 days compared with other countries. A logistic regression analysis revealed that an increased risk of death within 14 days in Poland compared to other IST patients was present among patients younger than 75 years (OR 1.7; 95% CI 1.3-2.4), females (OR 1.8; 95% CI 1.3-2.5), patients who were alert at onset (OR 2.4; 95% CI 1.7-3.4), with partial anterior circulation syndrome (PACS) (OR 2.0; 95% CI 1.4-2.8) or lacunar syndrome (LACS) (OR 2.4; 95% CI 1.1-5.0) and without AF (OR 1.8; 95% CI 1.3-2.4). Polish patients were less likely to have been on aspirin before their stroke than other countries (7.6% vs. 20.8%). CONCLUSION: The 14-day case fatality was significantly higher in Poland than in other countries in IST. Part of the increase was due to greater stroke severity in the Polish patients. However, differences persisted even after adjustment for baseline stroke severity. Several factors may have contributed the excess: poor attention to treatment of cardiovascular disease, less attention to treatment of secondary complications of stroke and some other--as yet unidentified--factor specific to Poland.

Age Factors↗
PubMed2001

Vaccination against hepatitis viruses in Poland.

At present, two etiologic varieties of viral hepatitis (VH) can be directly vaccine-preventable: VH type A and VH type B. In addition, VH type D can be prevented indirectly through vaccination against VH-B. The first commercially available vaccine against VH-B appeared in 1981 and was human plasma-derived. After several years, it has generally been replaced by a recombinant type of vaccines. The obvious benefits of vaccination against VH-B prompted its introduction into the national immunization program in Poland in 1989. At that time, vaccination was offered free of charge to high-risk groups: newborns of HBsAg-carrier mothers, health-care workers, students: at medical schools, nursing schools, medical technology schools, and caretakers at institutions for mentally retarded persons. However, similarly to the experiences of other countries, observations in Poland indicated that such a targeted strategy fails to induce major epidemiological changes. In 1989 and in 1993, the incidence of VH-B per 100000 was 40.3 and 34.6, respectively. In addition, during these years, the incidence of V-B per 100000 children aged 0-4 years was 20.0 and 38.4, respectively. It has been decided that vaccination against VH-B will be obligatory for all newborns beginning from 1993. Due to financial constraints, it has been introduced in three phases, and since 1996, all newborns in Poland have been vaccinated. Already in 1993, three additional risk groups have been offered vaccination: patients with chronic diseases, patients awaiting planned surgery, and persons coming into close contact with acute VH-B or chronically HBV-infected individuals. In 1999, the incidence of VH-B per 100000 was 9.1/100000, and it may be assumed that vaccination helped to decrease the incidence of VH-B in Poland. The country experience with vaccination against VH-A is still limited. At present, it is recommended for children and adolescents and people dealing with food distribution, as well as for several other groups of people, such as travellers or long-term visitors (soldiers, missionaries, diplomats) to the endemic regions of the world. It has also been recommended in connection with natural disasters such as floods occurring in a large area of Poland in 1997.

Cross Infection↗
PubMed2006

How to improve cooperation with political leaders and other decision-makers to improve prevention of cardiovascular disease: lessons from Poland.

BACKGROUND: Cardiovascular diseases (CVD) are the main health problem in Poland. We decided to use modern social marketing methods to present the current epidemiological situation to political and key opinion leaders in Poland. MATERIALS AND METHODS: The surveys were carried out in the following groups: members of the Polish parliament, members of the executive bodies of the two largest trades unions in Poland, participants at the Polish Hygiene Society Congress, representatives of the health insurance board in the district of Pomerania, and press and radio journalists. The study consisted of a questionnaire, anthropometric measurements, blood pressure measurements, and cholesterol and glucose level tests. The results were presented to examined subjects individually and in the form of an educational conference held on the same day. RESULTS: In the examined groups of political and opinion leaders awareness of one's own blood pressure was declared by 40.6-86% of the subjects, increased blood pressure was found in 36-43.5%, overweight or obesity (body mass index 25 kg/m) in 40.6-67.3%, smoking was declared by 16.5-30%. The results were compared with those obtained in corresponding age groups in the general population. CONCLUSION: The idea of presenting the current epidemiological burden caused by CVD in Poland by means of an assessment of individual and collective CVD risk among political and opinion leaders appeared to be an effective method of education and constructive lobbying for the fight against an epidemic of myocardial infarctions and strokes in Poland.

Cardiovascular Diseases↗