Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “POLAND”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,117 records · Page 62Linked to original sources
PubMed2002

Primary care reform: a pilot study to test the evaluative potential of the Patient Enablement Instrument in Poland.

BACKGROUND: Primary health care reform is underpinned by a move towards patient-centred holistic care. This pilot study uses the Patient Enablement Instrument (PEI) to assess outcome at a fundamental level: that of the patient and their doctor at consultation. OBJECTIVES: Our aim was to assess the evaluative potential of the PEI in relation to a reform programme in Poland by (i) comparing the outcomes of consultations (using the PEI) carried out by nine doctors (three diploma GPs who had participated in the training programme, three GPs who had not participated in the training programme and three polyclinic internists); and (ii) relating PEI scores to a proxy quality process measure (consultation length). METHODS: A cross-sectional quantitative questionnaire survey was carried out using the PEI. The subjects were patients consulting with nine doctors distributed within a single region around Gdansk. RESULTS: The overall results with the PEI and consultation length reflected UK experience. In addition, there were significant differences between groups in this pilot study. Patients seen by diploma GPs achieved higher patient enablement scores (mean 4.33, 95% confidence interval 4.09-4.58) relative to GPs (mean 3.44, 3.21-3.67) and polyclinic doctors (mean 3.23, 2.99-3.47). However, there is evidence of appreciable between-doctor variation in PEI scores within groups. The difference in patient enablement between groups was not affected by patient case mix, in contrast to the duration of consultation, which was. Holistically trained diploma GPs spent longer with patients with psychological problems. Patients seen by diploma GPs received longer consultations (mean 12.65 min, 95% confidence interval 12.18-13.13) relative to their colleagues (the GPs' mean was 10.11, 9.82-10.41 min; that of the polyclinic internists was 10.16, 9.81-10.50 min). The duration of consultation was positively correlated with patient enablement. CONCLUSION: The results of such training courses should be examined from the perspective of both the patient and their doctor. Significant differences were found in both patient enablement and consultation length between patients attending groups of doctors delivering primary care, but working from different paradigms. This pilot shows promising results which, if repeated in a larger study, would provide an objective means of evaluating such reform programmes.

Analysis of Variance↗
PubMed2001

Impact of health education on knowledge and prevention behavior for congenital toxoplasmosis: the experience in Poznań, Poland.

In 1991-1997 educational activities were undertaken in the Poznań region of Poland to promote health education for the prevention of toxoplasmosis. The effect of education was measured in 2710 pregnant women by a questionnaire survey. Knowledge of toxoplasmosis and its prevention was almost doubled within 4 years. Similarly, the proportion of women having antenatal serological tests for toxoplasmosis significantly increased. In the examined population the knowledge of how Toxoplasma gondii is transmitted/acquired was better than the knowledge of individual risk factors for congenital toxoplasmosis. Correct hygienic behaviors in pregnancy were often practised by women who lacked good knowledge of toxoplasmosis. The experience from this study suggests the possible effectiveness of including prevention of toxoplasmosis into the whole package of preventing infectious diseases in pregnancy and into healthy lifestyle promotion. Health educational activities need to be realized by modern promotional technologies in addition to making available traditional written educational texts. There is a considerable role of medical services in promotion of a hygienic behavior in pregnant women preventing congenital toxoplasmosis in their offspring. Health education should be especially tailored to the population of pregnant women below the age of 21.

Adult↗
PubMed1993

Vodka consumption, tobacco smoking and risk of gastric cancer in Poland.

A multicentre hospital-based incident case-control study with 520 male gastric cancer cases aged < 75 years and an equal number of age- and sex-matched controls without cancer has been carried out in Poland to assess potential risks due to smoking and alcohol consumption. It was shown that after adjusting for socio-demographic and dietary confounders and vodka drinking, smoking cigarettes had no significant effect on risk. The estimated relative risk (RR) increased to 2.27 (95% confidence interval [CI] : 0.97-5.28) for intestinal cardia cancer for those who smoked cigarettes without filters. The RR for stomach cancer grew as the frequency and amount of vodka drunk increased. People drinking vodka at least once a week had about a threefold higher risk compared to non-drinkers (RR = 3.06, 95% CI : 1.90-4.95). The effect of vodka drinking on risk was particularly strong for non-cardia cancers of the intestinal type. Those who usually drank vodka before breakfast had an elevated risk (RR = 2.98, 95% CI : 1.60-5.53) which was also present in all the subgroups investigated. Cardia and non-cardia cancer showed differences with respect to the interaction between tobacco smoking and vodka drinking. For cancers of the cardia region the risk was low for non-smokers or those who drank small amounts of vodka. The risk for cardia cancer increased considerably for smokers of cigarettes without filters and vodka drinkers who consumed large amounts (RR = 3.70, 95% CI : 1.13-12.06). For the non-cardia region a uniform increase could be observed for vodka drinking regardless of cigarette smoking status.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1999

Using patient surveys to measure the quality of outpatient care in Kraków, Poland.

OBJECTIVE: To test the feasibility of using patient reported information to create indicators of quality (access, patient experience--including satisfaction, and clinical quality) with the goal of providing Kraków city clinic managers (and potentially other audiences) with information about the quality of outpatient care in selected clinics. Setting and methods. Almost 2,000 patients from 19 outpatient clinics in Kraków, Poland were surveyed in November and December 1997 and January 1998. We prepared a self-completed questionnaire to capture data about the patient's experience with access to services, interactions with registration staff, communication with the doctor, information received from the doctor, and receipt of preventive services. RESULTS: Access varied across clinics. For example, 84% of patients waited less than 10 minutes at registration, whereas only 53% of patients waited less than 30 minutes to see the doctor. Among those who tried to register by telephone, only 72% were successful. Satisfaction was highest with the doctor visit (satisfaction=79, on a scale of 1-100) and lowest with telephone registration (satisfaction = 59). Preventive health care screening was generally disappointing, particularly for Papanicolaou smear and clinical breast examination, although frequent users of a clinic (with more opportunities for screening) generally had higher rates of screening. CONCLUSION: We demonstrated the feasibility of constructing indicators of multiple dimensions of the quality of outpatient care using patient-reported information. Quality dimensions captured by survey included access, patient experience and clinical quality. Results were successfully summarized in easy to read and understand formats for clinic managers and city health department officials.

Adolescent↗
PubMed2001

Antibiotic susceptibility of bacterial strains isolated from urinary tract infections in Poland.

Worldwide data show that there is increasing resistance among urinary tract pathogens to conventional drugs. The aim of this study was to obtain data on susceptibility patterns of pathogens responsible for urinary tract infections (UTIs) in Poland to currently used antimicrobial agents. A multicentre study of 141 pathogens from hospital-acquired infections and 460 pathogens from community-acquired infections was carried out between July 1998 and May 1999. The most prevalent aetiological agent was Escherichia coli (73.0%), followed by Proteus spp. (8.9%) and other species of Enterobacteriaceae (9.6%). Few community infections were caused by Gram-positive bacteria (2.2%). Gram-positive cocci were isolated more frequently from a hospital setting (14.1%) and the most common were Enterococcus spp. (8.5%). Pseudomonas aeruginosa was found only among hospital isolates and was responsible for 10.7% of infections. E. coli isolates from both community and hospital infections were highly susceptible to many antimicrobial agents with the exception of those isolates producing extended-spectrum beta-lactamases (ESBLs). Of all Enterobacteriaceae tested, 38 strains (6.9%) were capable of producing ESBLs.

Anti-Bacterial Agents↗
PubMed2002

Ceftazidime-hydrolysing CTX-M-15 extended-spectrum beta-lactamase (ESBL) in Poland.

The CTX-M-15 extended-spectrum beta-lactamase (ESBL) was recently identified in Enterobacteriaceae isolates in India, and demonstrated significant hydrolytic activity against ceftazidime, in contrast to the majority of CTX-M enzymes. CTX-M-15 differs from CTX-M-3, which is one of the most prevalent ESBLs in Poland, by only a single amino acid change (Asp-240-->Gly). Three cefotaxime- and ceftazidime-resistant Enterobacteriaceae isolates, recovered during 1998-2000 in two Polish hospitals, were found to produce CTX-M-15. Similar to those from India, the isolates contained the ISEcp1 insertion sequence located upstream of the bla(CTX-M-15) gene, which has been recently demonstrated to mobilize 3'-adjacent genes to transfer between DNA replicons. However, its different position with respect to the beta-lactamase gene indicated the independent selection of the ESBL gene in the two countries.

Anti-Bacterial Agents↗
PubMed2004

Pseudomonas aeruginosa strains harbouring an unusual blaVIM-4 gene cassette isolated from hospitalized children in Poland (1998-2001).

OBJECTIVES: During 1997-2001, 151 isolates of imipenem-resistant Pseudomonas aeruginosa were obtained from clinical specimens taken from children hospitalized in Warsaw, Poland. These strains were investigated further to determine the mechanism of resistance. METHODS: The strains were analysed by a combination of genotyping and PCR-based strategies. RESULTS: Eleven of these strains were found to contain the metallo-beta-lactamase (M beta L) gene bla(VIM-4). The first strain appeared in 1998, and P. aeruginosa strains harbouring this M beta L have become endemic in this hospital since then. All P. aeruginosa strains belonged to serotype O:6, and PFGE analysis revealed four different patterns and three sub-types. All 11 M beta L-producing strains contained an identical class 1 integron with the usual 5' and 3' conserved sequences. The integron included two resistance cassettes, aacA4 in the first position and the bla(VIM-4) cassette in the second position. The bla(VIM-4) gene included an unusual direct repeat of 169 bp of the 3' portion of the bla(VIM-4) gene. CONCLUSIONS: An unusual bla(VIM-4) M beta L has become endemic in P. aeruginosa isolates infecting Polish children hospitalized on surgical wards. The formation of this unusual bla(VIM-4) gene cassette could be explained by a mechanism involving deletion of a segment of an ancestral tandem repeat of bla(VIM-4) via slipped strand replication, mediated by a combination of polymerase and integrase.

Child↗
PubMed2005

Borrelia burgdorferi sensu stricto in yellow-necked mice and feeding Ixodes ricinus ticks in a forest habitat of west central Poland.

Wild rodents and the subadult Ixodes ricinus (L.) ticks infesting them were examined for the presence of Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt & Brenner s.l. in a sylvatic habitat in west central Poland during May-September 2002. In total, 818 feeding ticks were recovered from 73 infested yellow-necked mice, Apodemus flavicollis Melchior; in addition, bank voles, Clethrionomys glareolus Schreber, were rarely captured and proved to be weakly parasitized. Only 2.7% of A. flavicollis and 2.2% of 320 engorging larvae were polymerase chain reaction (PCR) positive for the bacterium. All spirochete-PCR-positive samples yielded exclusively B. burgdorferi s.s. This genospecies was also the most prevalent in questing nymphs and accounted for 87.5% of the total number of Borrelia infections in nymphal ticks collected during May and June 2 yr later. The presence of the same genospecies both in naturally engorged larvae and blood-positive animals as well as the high predominance of B. burgdorferi s.s. in questing nymphs strongly differs from most study sites investigated in Europe. This unique pattern of Borrelia-diversity in both rodents and ticks seems to be determined by highly site-specific host vertebrate cenosis, and yellow-necked mice are involved in the maintenance of B. burgdorferi s.s. in the forest habitat. However, the transmission efficiency of this spirochete from the mice to the I. ricinus vector seems to be very low. The research provides additional information on the complexity of B. burgdorferi s.l. ecology in Europe, pointing to the importance of the local host community.

Animals↗
PubMed2000

Occupational ceramic fibres dermatitis in Poland.

Recently, the use of asbestos has been considerably limited in Poland, with the simultaneous increase in the manufacture, processing and application of man-made mineral fibres, which includes ceramic fibres. The aims of this study were (1) to assess the type and frequency of dermal changes caused by the irritant activity of ceramic fibres among workers at the plants that manufacture packing and insulation products; and (2) to compare the irritant activity of Polish-made L-2 and L-3 ceramic fibres with that of the Thermowool ceramic fibres made in England. Workers (n = 226) who were exposed to ceramic fibres underwent dermatological examination. Patch tests with the standard allergen set, together with samples of the fibres L-2, L-3, and Thermowool fibres, were applied to all the workers. It has been shown that the Polish-made L-2 and L-3 fibres differed from Thermowool fibres in that the L-2 and L-3 fibres contained zirconium and were coarser. The proportion of filaments with diameters above 3 microns was 11.1% in the L-3 fibre and 6.3% in the L-2 fibre samples. The Thermowool fibre did not contain filaments thicker than 3 microns. Evident dermal changes, resulting from strong irritant activity of the fibres, were detected in 109 (48.2%) of the workers examined. Irritant contact dermatitis acuta (maculae, sometimes papulae and small crusts on the upper extremities, trunk, and lower extremities), disappearing after 2-3 days, was found in 50 (22.1%) workers. Irritant contact dermatitis chronica (diffuse permanent erythema with numerous telangiectasiae on the lateral portions of the face and neck, on the trunk, behind the auricles) was detected in 40 (17.7%) workers. The remaining 19 (8.4%) workers had both types of dermal change. All examined workers complained of very strong itching. The results of the patch tests confirmed the irritant activity of the ceramic fibres. Erythema without oedema, persisting for up to 96 h, appeared at the places where the fibres had been applied to the skin in 44 (19.5%) workers. In addition, the irritant activity of the fibres has been shown to be correlated with their thickness. The Thermowool fibre was the weakest irritant, because it did not contain filaments above 3 microns in diameter; the L-2 fibre containing 6.3% filaments above 3 microns caused somewhat stronger skin irritation; while the L-3 fibre, which contained 11.1% filaments thicker than 3 microns, was the strongest irritant. A few cases of allergy to nickel, chromium and colophony (rosin) were also detected.

Adult↗
PubMed1998

Recent developments in molecular epidemiology: A study of the effects of environmental polycyclic aromatic hydrocarbons on birth outcomes in Poland.

The authors briefly review the current potential and limitations of molecular epidemiology. This approach uses biomarkers to measure the internal and bioeffective dose of toxicants, early biologic effects likely to be predictive of cancer, and variations in individual susceptibility. The most frequent application of biomarkers has been in assessment of exposure/dose and susceptibility due to genetic and nongenetic factors. More research is needed to establish the predictive significance of biomarkers in terms of disease risk. To illustrate that molecular epidemiology has potential in identifying etiologic factors in disease, this article presents data from a recent study of the developmental effects of fetal exposure to polycyclic aromatic hydrocarbons (PAH) via ambient pollution. The study was carried out in an industrialized area of Poland with relatively high levels of PAH pollution from coal burning. PAH-DNA adducts in leukocytes and plasma cotinine were measured in umbilical cord blood as dosimeters of transplacental PAH and cigarette smoke, respectively. The study subjects were 70 newborns from the industrialized city of Krakow and 90 newborns from Limanowa, a rural town with far greater use of coal for home heating. Newborns whose levels of PAH-DNA adducts were above the median (3.85/10[8] nucleotides) had a significantly decreased birth length, weight, and head circumference. Cotinine was significantly inversely associated with birth weight and length. Although preliminary, these results provide a new molecular link between PAH exposure and developmental effects, generating initial data and hypotheses for further study.

Adult↗
PubMed1989

Poisson regression modeling of temporal variation in incidence of childhood insulin-dependent diabetes mellitus in Allegheny County, Pennsylvania, and Wielkopolska, Poland, 1970-1985.

Contradictory observations have accumulated regarding a secular trend and/or an epidemic pattern in the incidence of insulin-dependent diabetes mellitus. In this study, insulin-dependent diabetes mellitus incidence below age 15 years was examined in Allegheny County, Pennsylvania, and in Wielkopolska, Poland, two areas diverse in terms of their geography and average risk for this disease. Numerator data were extracted from individual patient records, and annual denominator data were available for the years 1970-1985. Poisson regression models were used to disentangle the contributions of country, race, sex, age, period, and cohort effects to the observed variation in incidence. Poles and Allegheny County nonwhites were at greatly and moderately reduced risk, respectively, relative to Allegheny County whites. An increase in risk with age was significant and proportional in all three groups. There was significant time variability in Wielkopolska, where an epidemic began in 1982 and continued through 1985. This was a period rather than a cohort phenomenon and was a result of a recent outbreak of the disease rather than a long-term trend. In Allegheny County, changes in risk over the 16-year period were insignificant, although incidence doubled among whites aged 0-9 years during 1982-1983. The Poisson regression modeling provided a quantification and formal comparison of determinants of the incidence of insulin-dependent diabetes mellitus.

Adolescent↗
PubMed2001

Occupational exposure to external ionising radiation in Poland, 1999.

In 1999 about 6208 radiation workers from 389 departments were monitored by CLOR in Poland. The distribution of annual personal doses shows that 85% of controlled workers received doses below the MDL (0.4 mSv) and about 97% controlled workers received doses below 5 mSv. Doses higher than 50 mSv were received by three operators of industrial radiography units. The radiation workers under control are divided into four main work sectors: nuclear industry, research and education, medicine, and general industry. The average annual dose for all workers in each particular sector was 0.22 mSv, 0.22 mSv, 0.30 mSv and 0.80 mSv, respectively. The average annual dose for the entire monitored population was 0.47 mSv. The average annual dose in each particular sector for number of workers receiving E > 0, i.e. Hp(10) > or = 0.4 mSv, amounted to 1.78 mSv, 2.03 mSv, 1.88 mSv and 4.85 mSv, respectively. The average annual dose for the full number of workers receiving E > 0 was 3.21 mSv. This paper contains the detailed analysis of occupational exposure. The distributions of annual occupational exposure in different work sectors are also given.

European Union↗
PubMed2004

Uranium isotopes in public drinking water and dose assessment for man in Poland.

238U, 234U and 235U were determined in tap water from municipal water pipes that drew their supply from surface water or ground water in various locations in Poland. Average activity concentrations of 238U, 234U and 235U in tap water from surface water were 9.6 +/- 7.1, 12.8 +/- 9.7 and 0.41 +/- 0.31 Bq m(-3), respectively, whereas from ground water they were 4.5 +/- 6.0, 5.7 +/- 6.9 and 0.19 +/- 0.27 Bq m(-3), respectively. Activity concentrations of 234U were higher than 238U. Ratios of 234U/238U ranged from 1.07 to 2.60, indicating the lack of equilibrium between these isotopes. The average 235U/238U ratio was 0.043 +/- 0.008, being close to 0.046 for natural uranium. Average annual intake with water and food was 7.6 +/- 5.1 Bq for 238U and 9.5 +/- 6.6 Bq for 234U. Annual committed effective doses calculated from these intakes for adults were 0.34 +/- 0.23 and 0.47 +/- 0.32 microSv, respectively; 235U contributed to the total dose from the uranium isotopes by about 2%.

Environmental Exposure↗
PubMed1989

Familial Poland's syndrome.

Absence of the right pectoralis major muscle and hypoplasia of the ipsilateral breast was observed in 3 females and hypoplasia or agenesis of the right pectoralis major muscle in 2 males of the same family. One member of this family, a 17-year-old girl, underwent a right latissimus dorsi muscle flap, placement of silicone-gel breast implant, and a right infraclavicular natural Y prosthesis. Although none of our 5 patients from this family had congenital upper limb abnormalities, we believe that they still qualify as having Poland's syndrome. This would distinguish them as being the fourteenth known family reported in the world literature with this diagnosis. A brief review of the history as well as hypotheses of etiological mechanisms are presented.

Adolescent↗
PubMed1980

Natural radiation in Poland and its disturbance in an urban environment.

Natural gamma radiation was investigated in both a rural and an urban environment in a two-part program. In the first part, outdoor doses were monitored for 2 yr at 300 locations throughout the country, mainly rural regions. The second series of measurements was performed in and around a medium-sized town. For 1 yr, the dose rates were measured in the open air and inside residential buildings. Surveys were carried out by means of TL dosimetric cards that were evaluated automatically and by a pressure ionization chamber. We found that in Poland the natural radionuclides from the upper layer of the earth produce outdoor dose rates ranging from 1.5 to 9 mu rad hr-1 absorbed in air and the terrestrial radiation contributes 20-70% of the total outdoor radiation. Significant variations were observed during different seasons of year. The population-weighted outdoor average found for the whole country amounted to 3.73 mu rad hr-1, i.e. 20% lower than the estimated world average. The natural outdoor radiation field is significantly altered in towns because of different ground beddings. Low-activity coverings made of asphalt or concrete reduce the dose rates above them by about 15%, while those made of certain kinds of stone increase the dose rates by 50-100%. Dose rates inside buildings are higher than those outdoors by 20-80%, depending on the building material.

Background Radiation↗
PubMed1987

Estimate of lifetime dose in persons exposed occupationally to x rays in Poland.

Estimates are presented of the magnitude of doses incurred over prolonged periods by individuals exposed occupationally to x rays. The results of individual monitoring in Poland from 1966 to 1978 formed the basis of the estimates. Probability distributions of receiving a certain 40-y lifetime x-ray dose were assigned to several subgroups monitored by applying the method of Markov's chains. Independently, by linear extrapolation of the measured increment rate, the mean life doses were estimated for a number of subgroups. The results seem to demonstrate that occupational exposure to x rays in the subgroups studied is slightly diversified, and its current level is of the same order as the exposure due to background radiation.

Faculty↗
PubMed1993

Plutonium in daily diet in Poland after the Chernobyl accident.

The content of 239,240Pu was determined in the daily diet collected in northeastern Poland (Bialystok) from March 1987 to May 1992. The estimated annual intake of plutonium decreased from 774 mBq y-1 in the first year after the Chernobyl accident down to approximately 90 mBq y-1 in the sixth year. Large fluctuations of daily intake in the first 2 y suggested that a large fraction of plutonium in the daily diet originated from the external contamination. Assuming the fractional absorption factor of 10(-5) for externally contaminated foodstuffs and 10(-3) for root uptake, the assimilated 239,240Pu would be in the range from approximately 0.02 mBq up to approximately 2 mBq for the period studied.

Accidents↗
PubMed1994

Radiocesium in diet and humans in northeastern Poland after the Chernobyl accident.

137Cs and 134Cs concentrations were determined in the daily diet and foodstuffs in northeastern Poland in the fourth through sixth years after the Chernobyl accident. Intakes, body burdens, and dose equivalents were evaluated in the consecutive years. The data from this and previous work were used for the calculation of the effective half-time of radiocesium in humans. The effective half-time for 137Cs (1.94 y) was similar to that observed after nuclear weapons tests. The effective half-time for 134Cs was 0.98 y. Taking these half-times into account, the whole-body committed dose equivalent for the adult population was estimated to be 256 microSv; it was about 50% higher than that after the nuclear weapons tests.

Accidents↗