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PubMed2006

Eligibility of stroke units in Poland for administration of intravenous thrombolysis.

Systemic thrombolysis treatment was approved in Poland in 2003 and should be performed in specialist stroke units (SU). We performed a survey to determine stroke service preparedness for thrombolysis treatment in Poland. We sent a questionnaire evaluating the neurological departments in Poland, where stroke patients are treated. We divided them into four categories: (i) class A SU (fulfilling criteria of the National Program for Stroke Prevention and Therapy and European Stroke Initiative guidelines), (ii) class B (conditionally fulfilling criteria), (iii) class C (not fulfilling criteria), and (iv) departments without SU. Only class A units are eligible for implementing thrombolysis. We obtained response from 194 of 222 (87.4%) departments; 90 (46.4%) declared having an SU. According to criteria, 20 class A, 56 class B, 14 class C. During one year, 71 208 patients were admitted to hospitals; 69,982 (98.2%) to neurological departments. A total of 10,959 (15.4%) were treated in class A SU, 23,650 (33.2%) in class B, 5153 (7.2%) in class C, whereas 30,220 (42.4%) in neurological departments without SU. Our survey showed that only 15.4% stroke patients in Poland are admitted to high-quality SU, where thrombolysis may potentially be administered. Improvement of SU quality in Poland is necessary for wide implementation of new methods of stroke therapy.

Disability Evaluation↗
PubMed2004

Poland-Moebius syndrome: a case with oral anomalies.

The combination of Moebius and Poland anomalies is rarely described in the literature. While some authors believe this association is an independent syndrome, others think that Poland, Moebius and Poland-Moebius syndromes are variations of the same condition. We report a case of Poland-Moebius syndrome in a 6-year-old girl who presented with bilateral convergent strabismus, the inability to abduct her eyes beyond the midline and brachydactyly of her right hand. Oral manifestations included incompetent lips and an abnormal tongue. Other facial features included hypoplasia of her mandible and her left ear at a slightly lower level than her right ear. Panoramic and lateral skull radiographs confirmed the absence of certain teeth and the hypoplastic mandible. The diagnosis of Poland-Moebius syndrome was made on the basis of cranial nerve involvement and oro-facial manifestations.

Anodontia↗
PubMed1994

A prospective community-based study of stroke in Warsaw, Poland.

BACKGROUND AND PURPOSE: Poland is a country with high morbidity and mortality rates from cardiovascular diseases. No recent studies have evaluated the contribution of cerebrovascular diseases to this morbidity and mortality. Our aim was to accurately determine stroke incidence rates in Warsaw, Poland. METHODS: A 2-year prospective and population-based stroke registry was maintained for health care units 2 and 3 in Warsaw, Poland (population, 182,285). Case subjects were ascertained by surveying hospital admissions, outpatient visits, and death certificates. RESULTS: During the 2 years of the study (1991 to 1992), 633 cases of first-event strokes were registered, 462 of which were first ever in a lifetime. Computed tomography or necropsy was performed in 72% of first-ever stroke cases. The crude annual incidence rate for first-ever stroke was 127/100,000 (95% confidence intervals, 111 to 145); the rate standardized to the European population was 111 (95% confidence intervals, 96 to 128). Our incidence rates for first-event strokes were found to be in the middle of the range among other first-event studies. When comparing our first-ever stroke incidence rates with those of comparable studies performed throughout Europe, they were found to be similar for groups aged younger than 65 years but lower in the older age groups. The distribution of ischemic and hemorrhagic stroke subtypes was similar to that of other countries. CONCLUSIONS: This first population-based prospective stroke registry in Poland showed that incidence rates were not high compared with other studies throughout Europe and the world. These stroke incidence rates are not a large contributing factor to high cardiovascular morbidity rates in Poland.

Adult↗
PubMed1998

Opposing national stroke mortality trends in Poland and for African Americans and whites in the United States, 1968 to 1994.

BACKGROUND AND PURPOSE: The United States (US) has experienced declines in stroke mortality in contrast to the increases reported for Poland. As part of the Poland and US Agreement on Cardiovascular and Cardiopulmonary Research, stroke mortality trends in Polish and US subpopulations were compared in the context of cross-population differences in competing causes of death and determinants of stroke. METHODS: Age-adjusted annual stroke, cardiovascular disease (CVD), non-CVD, and all-cause mortality rates were determined for men and women aged 35 to 64 and 65 to 74 years from 1968 to 1994 for African Americans and US whites and in Poland. Mean annual percent changes of mortality rates were estimated during 1968 to 1980 and 1981 to 1994 with the use of piecewise log-linear regression. RESULTS: US stroke mortality rates declined 3.7% to 4.8% annually during 1968 to 1980 and 2.0% to 3.1% during 1981 to 1994, with similar declines in each ethnic, gender, and age group. Polish rates increased 3.3% to 5.5% annually for all age-gender groups in Poland during 1968 to 1980. Polish men aged 35 to 64 experienced increasing rates during 1981 to 1994 (1.6% annually), while Polish women and older men experienced slight declines or little change. Only Polish men aged 35 to 64 years exhibited increases in stroke, CVD, and non-CVD mortality rates during both time intervals. CONCLUSIONS: Poland and the US experienced opposing stroke mortality rate trends between 1968 and 1994. These national and ethnic trends occurring in just one generation suggest major effects of lifestyle, socioenvironmental, and/or medical care determinants.

Adult↗
PubMed2006

Privatisation of hospitals in Poland--barriers and opportunities.

The paper discusses the question of privatisation of the in-patient care sector in Poland. The references to the general reforming processes are made, as well as the legal context of ownership changes is presented. First part of the article describes the forms of privatisation applied in Poland, such as privatisation of the management, partial privatisation, functional privatisation and total privatisation. The basic data concerning legal regulations currently being in force is also included. Legal status is an important obstacle for the process of privatisation, since the regulations are incoherent and ambiguous. The project of Commercialisation and Privatisation of Independent Public Health Care Facilities Law was presented in 2001, but the political situation was unfavourable for such a regulation. The paper discusses also the potential profits that may be gathered during the privatisation, which may be proved by the experiences in the field of out-patient care, as well as the examples of other countries. It is stated that success of privatisation depends on changes in the structure of sources of financing health care system. The last part of the article describes the previous course of privatisation processes of in-patient sector. Presently about 18% of hospitals in Poland are private facilities, but their role in the system is marginal. The case of hospital in Wiecbork, which was the first bankrupt private hospital in Poland, is presented as the example of dangers caused by the invalid law. The final conclusion is that there is an urgent need in Poland to create clear and coherent legal frames for the privatisation of hospitals, as well as harmonisation of the changes with general reforms of the health care system.

Delivery of Health Care↗
PubMed2000

[Poland's syndrome].

Poland's syndrome consists of the variable clinical features, but always includes unilateral aplasia of the chest wall muscles and ipsilateral anomalies of upper extremity. The incidence of Poland's syndrome, reported by different authors ranges from 1:10,000 to 1:100,000 and is observed more frequently in males than in females with the right side of the body affected more often than the left. The etiology of this syndrome is still discussed. However most of described cases were sporadic, rare familial incidence of Poland's syndrome were also presented. Therefore different etiologic factors of the Poland's syndrome are taken into account: genetic, vascular compromise during early stages of embriogenesis but also teratogenic effect of environmental xenobiotics (e.g. cigarette smoking by pregnant women). The authors present also the case of 20-years old man with inherited bilateral syndactyly with the right side aplasia of major pectoralis muscle and face asymmetry. The familial history was negative in respect to the features, associated with Poland's syndrome.

Adult↗
PubMed2003

Infertility in Poland--present status, reasons and prognosis as a reflection of Central and Eastern Europe problems with reproduction.

Poland has been considered a representative country for the population of Central and Eastern Europe as it has genetically homogenous population and reveals profound similarities in economical and historical processes common for all countries of the region. According to our observations there is approximately 20% of infertile couples in Poland (lack of concentration after at least 12 month of unprotected intercourse) and 40-60% of them are infertile because of the male factor. However, studies of infertility in Poland that have been conducted so far need to be verified. The changes connected with the style of life and new tendencies observed during the tedious political changes had considerable influence on childbearing rate in Poland. Additional factors diminishing the fertility rate are: the change of the status of women in a society, raising amount of everyday stress, the high rate (17%) of unemployment and the low average income. Furthermore, in Poland, the diagnostics and treatment (assisted reproductive technology) are entirely financed from the private funds of a patient. Summing up, the problem of childlessness in Central and Eastern Europe is a complex one and very alarming therefore it is necessary to work out and to implement research, preventative and therapeutic programmes strengthened through the international cooperation of specialized centers of excellence.

Adolescent↗
PubMed2002

[Legionellosis--a new infection in Poland].

Legionellosis became a notifiable disease in Poland in January 1st 2002; however, research on Legionella infection started earlier. Our study of laboratory methods for investigation Legionella infecting humans and waters brought some knowledge on Legionella infections in Poland. The aim of the publication is to present up-to-date findings concerning epidemiology and laboratory methods for surveillance of Legionella infections in European countries and of our own laboratory experience on surveillance of Legionella infections in Poland as well as some retrospective data on the research on Legionella. For the first time Legionella was described in Poland as amoebic pathogen in 1954. In the present investigation the level of water contamination by Legionella in buildings of different institutions was examined. The strains of Legionella pneumophila sg 2-14 were found in 30-100% of water samples collected from hotels, banks, factories and inhabited houses. The level of antibodies to antigens of L. pneumophila sg 1 measured in over 500 serum samples of healthy persons by microagglutination test indicated that titre 256 found in the serum of patient confirm legionellosis. The serological tests were also used for epidemiological studies in an outbreak of legionellosis in Poland. Altogether 403 specimens from hospitalised patients send by hospitals all over the country were diagnosed and 19 were found positive for Legionella infection. The further research on legionellosis is needed.

Antigens, Bacterial↗
PubMed2004

[The effect of air pollution on pulmonary function in young men from different regions of Poland].

UNLABELLED: The aim of study was to evaluate possible influence of air pollution on pulmonary function in the population of 1278 healthy non-smoking young men (18-23 years old) from different parts of Poland. Poland was divided into three regions depending on different concentration of SO2, NO2 and airborne particulate matter (PM10) in the air: region 1 comprised North Poland--agricultural areas with the lowest concentrations of pollution, region 2 comprised Central Poland--big agglomerations with moderate air pollution, region 3 comprised South Poland--big agglomerations and industrial centres with the highest pollution level. Subjects were divided further according to a study place (North Group--subjects from region 1, Central Group--subjects from region 2 and South Group--subjects from region 3). Spirometry and bodypletysmography were performed at rest by using of mobile lab PNEUMOBIL (Jaeger). The results of the study were statistically analysed with the use computer packet Statistica. RESULTS OF THE STUDY: Significant decrease of medium values of pulmonary function test (PFT) was observed in the non-smokers from the region of increased air pollution (South Group) in comparison to the non-smokers from the region of low pollution level (North Group).

Adult↗
PubMed2003

Lack of significant differences in immunity against diphtheria between populations of Eastern and Western regions of Poland.

Incidents of diphtheria in countries which were formerly part of the Soviet Union (Ukraine, Russia and Belorus) resulted in the need to evaluate thoroughly the effectiveness of preventive vaccination in Poland, especially in the border regions of the country where the biggest migration of population can be observed. The aim of this work was a comparison of the immunity to diphtheria in two geographically different regions of Poland--eastern (Lublin) and western (Zielona Gora) ones. It showed immunoprophylaxis to diphtheria that was implemented on these areas. Diphtheria antitoxin level (IgG) was determined with application of the ELISA method in 1236 (529/707) people. No significant differences were found in the level of antibodies in the groups < 2 years of age and > 19 years of age in people below the protective titre (0.1 IU/ml). The difference occurring in the interval between 2nd and 18th year of life (in western Poland 7.6% and in eastern Poland 16%) may result from different implementation of the vaccination program in these regions (booster doses). Recommendations for vaccination to diphtheria in people over 25 years of age should be implemented especially in the frontier regions of Poland adjoining countries threatened with diphtheria occurrence.

Adolescent↗
PubMed2004

[Sexual initiation and use of condoms and other methods of contraception among 15-year-old adolescents in Poland and other countries].

OBJECTIVE PRESENTATION: (1) Frequency of sexual initiation and use of condoms and other methods of contraception among 15-year old adolescents in Poland and other countries in 2001/2002; (2) Trends of change in these sexual behaviours in Poland between 1990-2002. MATERIAL AND METHOD: Representative samples of adolescents in Poland (mean age 15.7 years) in 1990 (N=1548), 1994 (N=1540), 1998 (N=1638) and 2002 (N=2152) and in other 28 countries (mean age 15.2 - 16.1 years) in 2001/2002, were used. The surveys were carried out in the frame of Health Behaviour in School-Aged Children; a WHO Collaborative Cross-National Study (HBSC), according to an international research protocol. An international standard questionnaire (anonymous) was chosen as an instrument for data collection. It contained four questions concerning sexual behaviour. RESULTS: In Poland, 2002, 20.9% of boys and 9.2% of girls reported sexual intercourse with mean ages respectively 14.1 and 14.7 years. The frequency of sexual initiation was higher (in boys) and the mean age was lower among adolescents living in towns by comparison to those living in cities. More matured adolescents had earlier sexual initiations. 27% of sexually active adolescents reported that either they or their partners had used any methods of contraception during their last sexual encounter. This risk sexual behaviour was more frequent in than cities (respectively: in boys 30.2% and 23.9%; in girls 42.9% and 19.7%). The most common method used was a condom. Between 1990-1998, the percentage of adolescents having sex and using some methods of contraception during their encounter last sexual were observed. Between 1998-2002, frequency of sexual initiation decreased, whereas percentage of non-users increased. In comparison to other countries increased Poland's percentage of adolescents with early sexual initiation in 2001/2002 was low, but the percentage of non-users of contraceptives was the highest. CONCLUSIONS: At risk sexual behaviours are relatively common among 15-year-old adolescents, and more frequent among adolescents living in cities. In comparison to other countries, Polish adolescents the risk of unplanned pregnancies and sexually transmitted diseases is higher. Future monitoring of sexual behaviours is necessary for prevention (including school sexual education) of at risk behaviours.

Adolescent↗
PubMed2004

Report of a girl with Klippel-feil syndrome and Poland anomaly.

Report of a girl with Klippel-feil syndrome and Poland anomaly: Klippel-Feil syndrome, consisting of the triad of a short neck, low posterior hairline, and limitation of neck movement, is a congenital anomaly characterized by the fusion of cervical vertebrae, Poland anomaly consists of unilateral aplasia of the chest wall muscles and ipsilateral anomalies of upper extremity. We report a 7-year-old girl with typical findings of Klippel-Feil syndrome and Poland anomaly. To the best of our knowledge a case of Klippel-Feil syndrome and Poland anomaly has not been described before, although a combination of Poland, Klippel-Feil and Moebius anomalies has been reported in the literature.

Bone and Bones↗
PubMedDate not supplied

The history of nephrology in Poland.

Modern nephrology developed in Poland mostly from the internal medicine department chaired in Warsaw by the great internist prof. Witold Orłowski (1874-1966). Three of his pupils Tadeusz Orłowski, Jan Roguski and Jakub Penson independently established the foundations of clinical nephrology and renal replacement therapy in different parts of Poland. T. Orłowski and his team worked in Warsaw, where despite developing clinical nephrology and dialysis also performed the first successful renal transplantation in Poland in 1966. Thereafter in 1975 the Institute of Transplantology in Warsaw was established and for several years was the leading research and education center in nephrology and transplantology. J. Penson established a sound clinical nephrology program in Gdańsk, where later physiological and biochemical aspects of the kidney were studied by his successors -- A. Manitius and B. Rutkowski in collaboration with S. Angielski and his biochemical team. They were instrumental in establishing a successful program leading to the development of dialysis in Poland during the last twenty years. J. Roguski in Poznań continued the research on water-electrolyte balance, metabolic and endocrine disturbances in renal patients and immunology of glomerular diseases. The first HD treatment was performed in Poznań in 1958 by the group of J. Roguski and coworkers chaired by K. Baczyk. Subsequently, several strong academic centers were established throughout Poland. F. Kokot in Katowice being himself leader of the Polish nephrology for many years created a very active centre well known for its pioneer publications on water- electrolyte, acid- base and endocrine disorders in different stages of chronic kidney disease. F. Kokot and his successor A. Wiecek are also very active and well recognized on an international scale. In Wrocław a nephrological center was established by Z. Wiktor and later his coworkers Z. Szewczyk and recently M. Klinger. Other valuable academic nephrological centers were created in Kraków (Z. Hanicki, W. Sułowicz), Lublin (Z. Twardowski, A. Ksiazek), Łódź (Z. Orłowski, W. Chrzanowski), Bydgoszcz (A. Nartowicz, J. Manitius) and later Białystok (M. Myśliwiec), and others. Simultaneously strong academic units were formed in the military hospitals-Łódź (K. Trznadel, M. Luciak) and Warsaw (Z. Wańkowicz). The last center was for many years widely known for their studies concerning PD treatment. Pediatric nephrology developed in parallel with adult centers mainly in Warsaw (T. Wyszńska, M. Sieniawska, R. Grenda), Wrocław (Z. Morawska, D. Zwoliska) and Gdańsk (M. Uszycka-Karcz, A Zurowska). Several Polish nephrologists were and still are involved in the activity of European and international nephrological societies.

History, 19th Century↗
PubMed1988

[Hereditary Poland syndrome with megacalycosis of the right kidney].

Poland's syndrome is characterized by congenital aplasia of the sternocostal head of the pectoralis major muscle associated with ipsilateral hand deformities (most often synbrachydactylia). 20% of patients have rib cage abnormalities, some with herniation of the lung. In some cases other associated ipsilateral anomalies (hypoplasia or absence of the nipple and/or the breast, defects of the vertebrae, dextrocardia, renal aplasia of hypoplasia, undescended testes, Möbius syndrome) have been described. We describe a patient with right-sided Poland's syndrome, the first published case associated with megacalycosis of the ipsilateral kidney. It is also the first publication of a familial case with this renal anomaly, since a brother has megacalycosis of the right kidney without Poland's syndrome. The majority of cases of Poland's syndrome are sporadic. The incidence has been estimated at between 1:30,000 and 1:80,000 of live births. The great uncle of our patient had a short forearm and only rudimentary fingers. The etiology of the syndrome is unknown. Toxic effects early in fetal life or effects on primary asymmetrical blood vessels, e.g. the subclavian artery, followed by uneven growth, are discussed as possible causes of Poland's syndrome.

Abnormalities, Multiple↗
PubMed1994

[Concentration of pollen dust in the atmosphere of Poland].

The main allergic disorders of the upper airways are the airborne pollens of various plants. In order to determine the concentration of plant pollens in the atmosphere of Poland in the years 1989-1991 studies were carried out determining pollen counts in 21 locations throughout Poland. Four main periods of pollination were observed: 1) early spring (trees, shrubs); 2) late spring (trees); 3) early summer (grass, hay); 4) summer and early autumn (combined plants). In northern Poland and the mountain regions beginning of pollination is 15-20 days later than in western Poland and is seen approximately 10-15 days later than in central Poland. The Polish pollen counts were compared with the data from Netherlands and Italy.

Air Pollutants↗
PubMed1993

[Evaluation of the epidemiologic situation of tuberculosis in Poland and in the world].

The paper describes the current epidemiological situation of tuberculosis in Poland, its trends in the last 2-3 decades and its place on comparison to the global world-wide situation. The incidence of tuberculosis in Poland declined from 182.6 per 100,000 population in 1965 to 43.2 per 100,000 in 1991, but is still at least two times higher than the average for Europe. The rate of decline for the last few decades was about 5.5% annually, but last year an increase has been observed. Among newly detected cases of tuberculosis in Poland in comparison to other European countries there is a higher proportion of young adults, of severe clinical forms, and relatively lower proportion of relapses. The annual risk of tuberculosis infection, the indicator considered as a most reliable one, which ranges from 0.01 to more than 3% worldwide, in Poland as about 0.2%. The highest risk, and prevalence of tuberculosis infection is in African and Asian countries, where there is also the highest prevalence of HIV infection, and consequently an important increase in the incidence of tuberculosis. Such an increase has also been observed in the USA and in some European countries. The increase in the incidence of tuberculosis in Europe however, could not be directly connected with the HIV infection. The current epidemiological situation of tuberculosis and its worldwide perspectives seem to be closely related to: (i) existing geographical differences in the level of the risk and prevalance of tuberculosis (ii) the level and the spread of HIV infection (iii) the difference in the demographic structure of population in different parts of the world which will determine the frequency of dual (HIV/TB) infection, (iv) the effectiveness of tuberculosis control activities, and (v) the level of migratory movements of population, particularly from countries/areas with high prevalence of tuberculosis. The recently observed increase in the incidence of tuberculosis in many parts of the world including Poland indicates clearly the importance and the necessity to constantly monitor all the changes in the epidemiological situation of tuberculosis and of AIDS/HIV infection [corrected].

Adolescent↗
PubMed1993

Epidemiology of breast and gynaecological cancers in Poland.

The epidemiological data on breast cancer and cancer of the female reproductive organs are presented in the light of data provided by the National Cancer Registry and the Warsaw Cancer Registry. Estimates say that cancer of the breast and the reproductive organs attacked 19,764 women in Poland, 1989, of whom 9,436 died. This number represents 41.2% of the total cancer incidence in women. The standardized incidence rates calculated for these cancers per 100,000 and arranged according to localization, were as follows: breast 34.4; cervix 19.5; ovary 12.4; corpus uteri 10.6. Mortality: breast 15.5; cervix 8.0; ovary 6.8; corpus uteri 2.5. Comparing with the average rates in EC countries, the risk in Poland of breast cancer was lower but was higher in cervical and uterine cancers. The risk of ovarian cancer was similar in Poland and the E.C. The relative 5-year survivals estimated for the years 1978-1982 in Poland were as follows: breast 49.3%; cervix 50.7%; and corpus uteri 66.1%, which was lower than in Switzerland, Finland, Australia, and USA (Caucasians); and similar in patients with ovarian cancer (35.1%). Particularly unfavourable 5-year survival rates were given for cancer of the breast and cervix in the rural areas. Unfavourable trends are observed in the control of the breast and cervical cancer in Poland which confirms inadequacy of the existing preventive programmes based on screening. According to estimates, the introduction of preventive measures could reduce cervical cancer mortality by 60% during 10 years and breast cancer mortality by 40% within 7 years, which means saving about 3,000 lives yearly.

Australia↗
PubMed1993

Tobacco, alcohol, and diet in cancer etiology in Poland: a review of Polish epidemiological studies.

A review of the most important case-control studies conducted in Poland and published over the last 30 years, which indicate a role of tobacco, alcohol, and diet in the etiology of cancer, are presented. Very little was done in Poland to publicize these results. The current discussion on causes of the high incidence and mortality from cancer in Poland is now focusing on the extremely high environmental pollution in Poland rather than on such lifestyle hazards as tobacco smoking, alcohol drinking, and poor dietary habits. All studies presented here were performed in the Silesian and Cracow Regions of Poland, which are considered to be the most polluted areas. Awareness of the danger of pollution is very high among the inhabitants and the decision makers; however, awareness of the dangers of one's lifestyle is still relatively low and has been discussed in terms of disbelief rather than in terms of any well-defined facts that should lead to proper priorities for public health action.

Adolescent↗