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The Poland-Möbius syndrome is a combination of two rare congenital syndromes with an estimated prevalence of 1:500,000. It is characterized by a nonprogressive bilateral facial paralysis, the inability of the eyes to abduct beyond the midline, orofacial anomalies, limb deficiencies, and an absence or hypoplasia of the pectoral muscles.
Use of a three-dimensional CT scan as an adjunct for planning chest-wall and breast reconstruction in Poland's syndrome is presented with follow-up MRI with three-dimensional reformation to demonstrate the results of the implant reconstruction. The imaging techniques are capable of accurately portraying the three-dimensional tissue deficit and asymmetry. This imaging may assist in the choice of muscle transposition flaps and reconstructive technique.
We tested a total of 735 men and women, who either had clinical symptoms of lower urogenital tract infection or were considered for epidemiological reasons to be at high risk for sexually transmitted diseases, for Chlamydia trachomatis infection. Microbiologic examinations were performed by tissue culture with cycloheximide-treated McCoy cells. C. trachomatis infection was diagnosed in approximately 50% of men with nongonococcal urethritis, 23.5% of men with gonococcal urethritis, 69% of men with postgonococcal urethritis, and in 45% of male partners of C. trachomatis-positive women. Among men under 35 years of age with epididymitis, C. trachomatis was isolated from 42%, whereas Neisseria gonorrhoeae was found in only 21 men. C. trachomatis was isolated from 59% of women with nongonococcal cervicitis, 46% of those with gonococcal cervicitis, and 74% of those with postgonococcal cervicitis. Among female partners of men with nongonococcal urethritis, 68% were C. trachomatis-positive, as were 73.5% of the female contacts of C. trachomatis-positive men. In the groups of men and women without clinical or epidemiologic evidence of sexually transmitted infection, C. trachomatis-positive cultures were obtained from 3.8% and 3.6%, respectively. These studies revealed that the prevalence of C. trachomatis infection in northeastern Poland is high and is similar to that reported in Western countries.
The Poland-Möbius syndrome is the combination of two rare congenital disorders and has been reported previously in only 13 patients. We report two additional cases with an evaluation of the findings and possible pathogenesis, and discuss the role of computerized tomography in evaluating the brain, pons, orbits, and facial nerve.
An epidemiological study of the total population of patients with leukaemia in Poland during the period 1963-90 was performed with special emphasis on time trends. The material stemmed from the Polish National Cancer Registry and was believed to be virtually complete. Of the 38,200 patients, 50% had acute leukaemia, 25% had chronic lymphatic leukaemia, 15% had chronic myeloid leukaemia, and 10% of the patients had undefined lymphatic and myeloid leukaemia. Over the 28-year period, the incidence of leukaemia increased threefold in the age group 70-80+ years, and the increase in the age group 50-69 years was suspected. In the final 11 years of the study acute leukaemia increased in total age groups, mainly among those aged 70-80+ years, whereas the incidence of chronic myeloid leukaemia remained unchanged. The incidence of chronic lymphatic leukaemia increased only in the age group 70-80+ years.
In a population-based case-control study of stomach cancer conducted in Warsaw, Poland, 464 cases and 480 controls were interviewed to evaluate the role of family history and other risk factors. A greater than threefold increase in risk was associated with a history of stomach cancer in a first degree relative (OR = 3.5; 95% Cl = 2.0-6.2), but no excess risk was seen with other forms of cancer. The risk associated with familial occurrence was not significantly modified by gender, age or ABO blood type, and did not vary with Laurén histologic classification. Our findings add to evidence for a familial predisposition to both diffuse and intestinal types of gastric cancer. Further studies are needed to identify the susceptibility genes and environmental exposures that may account for the familial tendency to stomach cancer.
The CYP and GST genetic polymorphisms, controlling metabolism of xenobiotics, are considered to influence an individual's susceptibility to environmental and occupational carcinogens and predisposition to cancer. In the study, the effect of the GSTM1, GSTP1, CYP1A1 and CYP2D6 polymorphisms was investigated in relation to PAH-DNA adduct levels in non-tumourous lung tissue from non-small cell lung cancer (NSCLC) patients living in the industrialized region of Upper Silesia, Poland. The level of adducts among smokers was significantly elevated when compared to non-smokers (P = 0.0005). Adduct levels correlated inversely with age of patients (P = 0.00001). The GSTP1 and CYP2D6 polymorphisms had no influence on DNA adduct levels. There was a significant relationship between high adduct levels and the combined GSTM1 (null)/CYP1A1-Ile/Val genotype in the squamous cell carcinoma group (P = 0.028). An elevated number of adducts was found in patients with the GSTM1 (null)/CYP1Al-Ile/Val genotype compared to the GSTM1 (null)/CYP1A1-Ile/Ile carriers (P = 0.043). A higher frequency of the CYP1A1-Ile/Val and GSTM1 (null)/CYP1A1-Ile/Val genotypes was observed in patients with high adduct levels (P = 0.05 and P = 0.009, respectively). A significant prevalence of the GSTM1(null)/CYP1A1-Ile/Val carriers in the adenocarcinoma group was found (P = 0.003). Thus, our findings imply that the GSTMI and CYP1A1 exon 7 polymorphisms may influence PAH-DNA adduct levels in target tissue from NSCLC patients, especially in the squamous cell carcinoma group. Moreover, individuals carrying the GSTM1(null)/CYP1A1-Ile/Val genotype might exhibit a greater predisposition to a peripheral type of lung cancer.
The purpose of the study was to assess the importance of physical activity performed both in occupational settings and in leisure time on the risk of colorectal cancer, considering the possible confounding effects of dietary habits. The hospital-based case-control study was carried out in Poland. In total, 180 incident cases of colorectal cancer were recruited. An equal number of controls, individually matched by gender and age, were chosen from patients with no history of cancer. A food frequency questionnaire combined with quantity of foods eaten was used to assess the usual dietary pattern for 148 food items. The average physical load of the interviewed patients before the occurrence of disease was ascertained by self-assessment. The degree to which patients' recreational time was sedentary was measured by the number of hours spent watching TV. The adjusted risk of colorectal cancer was reduced by half in those active in leisure time (OR 0.45, 95% CI 0.24-0.84). The effect of occupational physical activity was of about the same order of magnitude in terms of risk reduction (OR 0.61, 95% CI 0.29-1.29) and both activities combined acted as independent protective factors. The protective effect of healthy nutrition appeared to be independent from that attributed to physical effort.
Glutathione S-transferases are important in the detoxification of a wide range of human carcinogens. Previous studies have shown inconsistent associations between the GSTT1 and GSTM1 null genotypes and stomach cancer risk. We investigated the relationship between these and related genotypes and stomach cancer risk in a population-based case-control study in Warsaw, Poland, where stomach cancer incidence and mortality rates are among the highest in Europe. DNA from blood samples was available for 304 stomach cancer patients and 427 control subjects. We observed a 1.48-fold increased risk for stomach cancer (95% confidence interval 0.97-2.25) in patients with the GSTT1 null genotype but no evidence of increased risk associated with the GSTM1, GSTM3 or GSTP1 genotypes. Furthermore, the stomach cancer risk associated with the GSTT1 null genotype varied by age at diagnosis, with odds ratios of 3.85, 1.91, 1.78 and 0.59 for those diagnosed at ages less than 50, 50-59, 60-69 and 70 years or older, respectively (P trend = 0.01). This was due to a shift in the GSTT1 genotype distribution across age groups among stomach cancer patients only. These results suggest that the GSTT1 null genotype may be associated with increased risk of stomach cancer.
We report a 13-year-old boy with an apparently previously undescribed combination of findings including facial features of frontonasal dysplasia, Poland anomaly, and contralateral hypoplasia of the lower limb. Clinical correlations among these features are discussed.
Four hundred and twenty-seven Escherichia coli isolates from 427 cases of infantile diarrhoea in Poland, belonging to serogroups O18, O26, O44, O86, O126 and O127 and 150 E. coli isolates from 52 healthy children were examined for selected virulence properties. The presence of the plasmid pAA, a plasmid encoding enterohaemolysin, the genes encoding intimin (eae), bundle-forming pili (bfp), Shiga toxins I and II (stxI, stxII) and cytotoxic necrotising factor types 1 and 2 (cnfl, cnf2) was investigated by PCR. Adhesion to HEp-2 cell monolayers was also tested and selected strains were investigated for the presence of P-fimbriae and haemolytic activity. Typical enteropathogenic E. coli isolates (typical EPEC, strains possessing eae and bfp, but not stx) were not found. The particular classes of E. coli among 427 isolates from ill children were: atypical EPEC (eae+ bfp, stx-), 21.3%; Shiga toxin-producing E. coli (STEC), 0.7%; diffusely adherent E. coli (DAEC), 4%; enteroaggregative E. coli (EAEC), 16.9%; necrotoxic E. coli type 1 (NTEC1), 0.2%; and cell-detaching E. coli (CDEC), 29%. With the exception of STEC, all the above classes of E. coli were found among the isolates from healthy children which comprised: atypical EPEC 8.0%, DAEC 6.7%, EAEC 17.3%, NTEC1 14.0% and CDEC 40.0%. Cell detachment (CD) was significantly associated with 3-h haemolytic activity. There was also strong correlation between haemolytic activity (Hly) and the presence of P-fimbriae. No correlation was found between the presence of the cnf1 gene and CD, Hly or P-fimbriae.
Spiroplasma sp. strain SMA(T), isolated in Poland from white satin moth larvae, Leucoma salicis L. (Lepidoptera: Lymantriidae), was serologically distinct from other Spiroplasma species, groups or subgroups. Dark-field microscopy of the cells revealed the classical helical shape and subsequent transmission electron microscopy revealed cells surrounded by only a single cell membrane (lacking a cell wall). Growth of strain SMA(T) occurred in M1D medium at 30 degrees C. Strain SMA(T) catabolized both glucose and arginine, but did not hydrolyse urea. The G+C content of the DNA was 24+/-1 mol% as determined by melting temperature analysis. Serological analysis revealed a very weak cross-reactivity (positive reaction only up to a 1 : 80 dilution) with two Spiroplasma strains, 277F (Spiroplasma sp. group I-4) and LB-12 (Spiroplasma sp. group I-5). Strain SMA(T) (=ATCC BAA-521T=NBRC 100392T) is designated the type strain of a novel species, Spiroplasma leucomae sp. nov. (class Mollicutes: order Entomoplasmatales: family Spiroplasmataceae).
This paper describes observations and experiences gathered whilst conducting group therapy with trainees in analytical psychology in Poland. The challenges and conflicts around language and translation reflect challenges common to analysis everywhere: accuracy of interpretation, agreements on permission to interpret and the acceptability of interpretation. The way in which archetypal patterns developed and matured suggests this approach to work with trainees may have wider application.
Investigation of two cases of invasive meningococcal disease within a single family revealed the presence of isolates of Neisseria meningitidis phenotype C:2b:P1.2,P1.5 belonging to sequence type (ST) 66. The ST66 clone is a single-locus variant of the widely distributed ST8 complex, which has been observed previously in Spain, Belgium, Australia and New Zealand. This hypervariable meningococcal lineage has been responsible for local epidemics worldwide. This is the first report of ST66 meningococcal isolates of this phenotype from Poland.
This paper analyses the interplay between alcohol policy and research in Poland during the last two decades. It was a period of profound political and economic changes that strongly influenced the alcohol scene. In the 1970s alcohol was treated as a secret issue. Despite a rapid growth of alcohol consumption neither the authorities nor media expressed any concern about the growing wave of related problems. Funding allocated to research was very low and only a few devoted individuals continued their studies, albeit on a reduced scale. The beginning of the 1980s saw a sudden politicization of the alcohol issue. The government was blamed for pushing alcohol. In response to this challenge, alcohol controls were tightened. A huge programme of alcohol research was initiated to accumulate knowledge and evidence for further alcohol policy, as well as to symbolize a high priority of the alcohol issue. In following years, however, the political significance of alcohol decreased. The system established for its control was eroded, and finally collapsed in the late 1980s and early 1990s. The huge research evidence that was accumulated during the 1980s is not being applied to alcohol policy, which itself has virtually ceased to exist.
AIMS: To show the impact of rapid political and economic transitions on alcohol consumption and associated mortality in different socio-demographic segments of the Polish society, with particular focus on gender differences. Two causes of death associated with drinking (liver diseases and alcohol poisoning) are investigated. DESIGN: Mortality time series 1986-2002 are analysed against consumption estimates and population drinking survey data. SETTING: Poland 1986-2002. PARTICIPANTS: General adult population. MEASUREMENT: Age-standardized annual and 3-year death rates were calculated for age, gender and place of residence subgroups. For education, age-standardized relative frequency of deaths or proportional mortality in four basic educational levels was calculated. FINDINGS: Alcohol-related mortality shows great variability in response to substantial changes in alcohol consumption. Patterns of mortality and their magnitude of change correspond with average alcohol consumption and are therefore different for men and women, for different age and educational groups and in urban and rural areas. Level of education, however, may affect alcohol-related mortality more strongly than overall alcohol intake, particularly with regard to acute consequences of drinking. CONCLUSION: The Polish experience illustrates that the impact of rapid political and economic transitions on alcohol consumption and associated mortality is highly differentiated and specific to gender and social class.
Infection with Helicobacter pylori is the main aetiological factor for erosive gastritis and duodenal or gastric peptic ulcers often complicated with life-threatening bleeding in patients with coagulation disorders. The aim of this prospective study was to evaluate the prevalence of Helicobacter pylori infection in haemophilia patients, and to assess the risk of gastrointestinal bleeding associated with this infection. From 2000 to 2002, 146 patients with haemophilia (129, haemophilia A; 13, haemophilia B), mean age, 39.9 years (+/-7.3), were investigated for H. pylori infection using IgG and IgA latex serological test. The control group included 100 men with no coagulation disorders, mean age, 40.9 years (+/-9.2). For 72 (49.3%) patients with haemophilia and 39 controls (39.0%) serological tests were positive indicating the presence of H. pylori infection (P =0.1112). A history of gastrointestinal bleeding was reported in 46 patients (31.5%) with haemophilia and in two control group patients (2.0%) (P < 0.0001). Gastrointestinal bleeding was significantly more frequent in patients with haemophilia infected with H. pylori (33/46; 71.7%) than in patients with no H. pylori infection (13/46; 28.3%; P = 0.0002). In conclusion, the prevalence of H. pylori infection in haemophilic patients in Poland is comparable with that in patients with no coagulation disorders. Helicobacter pylori infection is a risk factor for duodenal and gastric ulcer bleeding in haemophilia patients. In view of the high frequency of upper gastrointestinal bleeding associated with H. pylori infection, we believe that screening and eradication therapy are appropriate in haemophilia patients.
OBJECTIVE: To evaluate whether organizational changes in the Polish health care system affected patients' opinions about selected aspects of the quality of care provided by family nurses. DESIGN: Two independent surveys conducted in 1998 and 2002 using face-to-face interviews with structured questionnaires. SETTING AND PARTICIPANTS: The study was performed in a small town in Poland, where family physicians were introduced in 1995. The study groups consisted of two samples of patients randomly selected from those registered on the patient list. Altogether 1000 interviews were obtained in survey I (in 1998) and 1000 from another sample in survey II (in 2002). In 1998, family nurses were employed by family physicians, but in 2002 they had established their own practices and held direct contracts with the National Health Fund. RESULTS: The surveys carried out at a 4-year interval showed a significant increase in the percentage of patients reporting home visits by family nurses, both at the request of physicians and on the nurses' own initiative (from 16.3 to 45.8%, P < 0.05). Comparative analysis showed that in survey II the percentage of the respondents who were satisfied with nursing care increased from 35.8 to 53.6% (P < 0.05). CONCLUSION: Care provided by independent nurses was available to a larger group of patients. Patients were more satisfied with the services of family nurses working as independent contractors. The investigations in the present study should be supplemented by a qualitative study.