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PubMed2005

High genetic diversity of ciprofloxacin-nonsusceptible isolates of Streptococcus pneumoniae in Poland.

We have analyzed the susceptibility to ciprofloxacin of 697 pneumococcal isolates collected in 1998-2002 in Poland from patients with respiratory tract diseases. Thirty-one ciprofloxacin-nonsusceptible isolates (MICs, > or =4 microg/ml) were identified, of which two were resistant to levofloxacin (MIC, 8 microg/ml). Serotyping, pulsed-field gel electrophoresis, multilocus sequence typing, and the analysis of resistance determinants showed their great genetic diversity.

Anti-Infective Agents↗

PubMed1999

Multidrug-resistant Streptococcus pneumoniae in Poland: identification of emerging clones.

Penicillin resistance among Streptococcus pneumoniae isolates has rapidly emerged in Poland during the last decade and has reached prevalence levels of up to 14.4% in 1997. In order to investigate the nature of this increase, a molecular epidemiological analysis of non-penicillin-susceptible multidrug-resistant pneumococci isolated in 1995 and 1996 was conducted. Thirty-seven patients who suffered mainly from upper respiratory tract infections and pneumococcal pneumonia were enrolled in this study. The medical centers to which the patients were admitted were located in 16 Polish towns across the country. Eight distinct BOX PCR types were observed, representing 14 subtypes. Restriction fragment end labeling (RFEL) analysis divided the pneumococcal strains into 16 distinct types. By combining the BOX PCR and RFEL data, four genetically distinct clusters of strains were identified. Two clusters represented the genetic clones 23F and 9V, which have recently emerged all over the world. The two other genetic clusters, which represented serotypes 23F and 6B, clearly predominated in the analyzed collection of Polish non-penicillin-susceptible pneumococcal strains. Since the latter clusters did not match any of the 133 RFEL types of non-penicillin-susceptible pneumococci collected in 15 other countries, their Polish clonal origin is most likely.

Adolescent↗

PubMed2001

Outbreak of vancomycin-resistant Enterococcus faecium of the phenotype VanB in a hospital in Warsaw, Poland: probable transmission of the resistance determinants into an endemic vancomycin-susceptible strain.

The first outbreak caused by vancomycin-resistant enterococci of the VanB phenotype in Poland was analyzed. It occurred in a single ward of a Warsaw hospital which is a specialized center for the treatment of hematological disorders. Between July 1999 and February 2000, 11 patients in the ward were found to be infected and/or colonized by Enterococcus faecium that was resistant in vitro to vancomycin and susceptible to teicoplanin. PCR analysis confirmed that the vancomycin-resistant E. faecium (VREM) isolates carried the vanB gene, which is responsible for the VanB phenotype. Pulsed-field gel electrophoresis (PFGE) typing revealed that the isolates belonged to four distinct PFGE types and that one of these was clearly predominant, including isolates collected from seven different patients. The isolates contained one or more copies of the vanB gene cluster of the identical, unique DraI/PagI (BspHI) restriction fragment length polymorphism type, which resided in either the same or different plasmid molecules or chromosomal regions. All this data suggested that the outbreak was due to both clonal spread of a single strain and horizontal transfer of resistance genes among nonrelated strains, which could be mediated by plasmids and/or by vanB gene cluster-containing transposons. The comparative analysis of vancomycin-susceptible E. faecium (VSEM) isolates collected from infections in the same ward at the time of the VREM outbreak has led to identification of a widespread VSEM strain that was possibly related to the major VREM clone. It is very likely that this endemic VSEM strain has acquired vancomycin-resistance determinants and that the acquisition occurred more than once during the outbreak.

Anti-Bacterial Agents↗

PubMed2006

Genotyping of Toxoplasma gondii by multiplex PCR and peptide-based serological testing of samples from infants in Poland diagnosed with congenital toxoplasmosis.

Toxoplasma gondii has a clonal population genetic structure with three (I, II, and III) lineages that predominate in North America and Europe. Type II strains cause most cases of symptomatic human infections in France and the United States, although few other regions have been adequately sampled. Here we determined the parasite genotype in amniotic fluid and cerebrospinal fluid samples from congenital toxoplasmosis cases in Poland. Nineteen confirmed congenital cases of toxoplasmosis were analyzed, including both severe and asymptomatic cases. The genotype of parasite strains causing congenital infection was determined by direct PCR amplification and restriction fragment length polymorphism analysis. Nested multiplex PCR analysis was used to type four independent polymorphic markers. The sensitivity of multiplex nested PCR was >/=25 parasites/ml in amniotic fluid and cerebral spinal fluid samples. Parasite DNA was successfully amplified in 9 of 19 samples (eight severely affected and one asymptomatic fetus). Only genotype II parasites were identified as the source of T. gondii infection based on restriction fragment length polymorphism analysis. Strains causing congenital infections were also typed indirectly based on detection of antibodies to strain-specific peptides. Serotyping indicated that 12 of 15 cases tested were caused by type II strains and these positives included both symptomatic and asymptomatic infections. Overall, the combined analysis indicated that 14 of the cases were caused by type II strains. Our results are consistent with the hypothesis that parasite burden is associated with severity of congenital toxoplasmosis and indicate that serological testing provides a promising method for genotypic analysis of toxoplasmosis.

Amniotic Fluid↗

PubMed1998

Ecological study of reasons for sharp decline in mortality from ischaemic heart disease in Poland since 1991.

OBJECTIVE: To investigate the reasons for the decline in deaths attributed to ischaemic heart disease in Poland since 1991 after two decades of rising rates. DESIGN: Recent changes in mortality were measured as percentage deviations in 1994 from rates predicted by extrapolation of sex and age specific death rates for 1980-91 for diseases of the circulatory system and selected other categories. Available data on national and household food availability, alcohol consumption, cigarette smoking, socioeconomic indices, and medical services over time were reviewed. MAIN OUTCOME MEASURES: Age specific and age standardised rates of death attributed to ischaemic heart disease and related causes. RESULTS: The change in trend in mortality attributed to diseases of the circulatory system was similar in men and women and most marked (> 20%) in early middle age. For ages 45 to 64 the decrease was greatest for deaths attributed to ischaemic heart disease and atherosclerosis (around 25%) and less for stroke (< 10%). For most of the potentially explanatory variables considered, there were no corresponding changes in trend. However, between 1986-90 and 1994 there was a marked switch from animal fats (estimated availability down 23%) to vegetable fats (up 48%) and increased imports of fruit. CONCLUSION: Reporting biases are unlikely to have exaggerated the true fall in ischaemic heart disease; neither is it likely to be mainly due to changes in smoking, drinking, stress, or medical care. Changes in type of dietary fat and increased supplies of fresh fruit and vegetables seem to be the best candidates.

Adult↗

PubMed1990

A case-control study of lung cancer with special reference to the effect of air pollution in Poland.

STUDY OBJECTIVE: The aim of the study was to assess the affect of inhaled pollutants on lung cancer risk. DESIGN: The study was a retrospective case-control survey of lung cancer deaths over a six year period (1980-1985). Information on occupation, smoking habits, and residency was collected from next of kin. Classification of exposure to community air pollution was based on measured levels of total suspended particular matter and sulphur dioxide. SETTING: Cases and controls had been resident in the city of Cracow, Poland. PARTICIPANTS: Cases were male (n = 901, questionnaire response rate 70.7%) and female (n = 198, response rate 65.1%) lung cancer deaths; controls were deaths from other causes, excluding other respiratory diseases, and frequency matched by age and sex (males n = 875, response rate 73.5%; females n = 198, response rate 64.0%). MAIN RESULTS: Lung cancer risk was found to depend strongly on total cigarette consumption, on age at starting to smoke, and on time since stopping smoking. Relative risk estimates for occupational exposure in iron and steel foundries or in other industries were significantly increased in males. Relative risk in men for highest air pollution level was 1.48 (95% confidence interval 1.08-2.01), while in women the increase was not significant. The joint action of the risk facts of smoking, occupational exposure, and air pollution was found to fit almost perfectly into a multiplicative model. CONCLUSIONS: Under conditions found in Cracow, air pollution may increase lung cancer risk, acting multiplicatively with known risk factors such as smoking and industrial exposure.

Adolescent↗

PubMed2003

Comparative analysis of nutrition data from national, household, and individual levels: results from a WHO-CINDI collaborative project in Canada, Finland, Poland, and Spain.

STUDY OBJECTIVE: This project determined to what extent data on diet and nutrition, which were collected in a non-uniform manner, could be harmonised and pooled for international and national comparison. DESIGN: Direct comparisons of dietary data between studies were made using food balance sheets (FBS), household budget surveys (HBS), and individual dietary data (IDS); comparisons were also made within countries. Differences in study design and methodological approaches were taken into consideration. Data from research projects from the following four World Health Organisation (WHO) Countrywide Integrated Noncommunicable Disease Intervention (CINDI) countries were included-Canada, Finland, Poland, and Spain. MAIN RESULTS: FBS overestimated food consumption and nutrient intake compared to IDS. Results between HBS and IDS were quite similar, except for fish, meat, pulses and vegetables, which were underestimated by HBS, and sugar and honey and cereals, which were overestimated. Percentages of energy from fat, carbohydrates and proteins were higher when estimated from FBS, HBS, and IDS respectively. CONCLUSIONS: Results suggest that estimations from these three sources of dietary data are difficult to compare because they are measuring different levels of dietary information. The understanding of their relations may be important in formulating and evaluating a nutrition policy.

Adolescent↗

PubMed1986

Poland syndrome associated with 'morning glory' syndrome (coloboma of the optic disc).

A 12 year old girl with the Poland syndrome and the 'morning glory' syndrome is described. The patient presented with absence of the left pectoralis major muscle, hypoplasia of the left arm, symbrachydactyly, and ipsilateral coloboma of the optic disc. This is the first report of the association of these two congenital anomalies.

Abnormalities, Multiple↗

PubMed1993

Poland anomaly with contralateral ulnar ray defect.

We report an atypical case of the Poland anomaly. Unreported features are that the hand abnormality is on the contralateral side to the chest wall defect, there is an ulnar ray predominance, and lack of syndactyly.

Fingers↗

PubMed1997

Molecular basis of mild hyperphenylalaninaemia in Poland.

The major cause of the different forms of hyperphenylalaninaemia (HPA) is mutations in the gene encoding phenylalanine hydroxylase (PAH). The aim of this study was to determine the mutations responsible for mild forms of HPA and to relate different clinical phenotypes of HPA patients to their PAH genotypes. Four "mild" mutations, including the most frequent A403V and R297H mutations, occurred exclusively in mild hyperphenylalaninaemia (MHP). Mutations A104D, R243Q, R241H, and Y414C were detected in patients with mild phenylketonuria (mild PKU) only. These results may be useful in establishing a molecular differential diagnosis for PAH deficiency in Poland.

Humans↗

PubMed1979

Critical evaluation of the venereal disease control campaign in Poland 1970-76.

A comprehensive campaign to control venereal diseases was undertaken in Poland in 1970. During the eight-year period of the campaign a significant decrease in the morbidity rate of gonorrhoea and syphilis was achieved. The number of cases of primary and secondary syphilis decreased by 85% and the number of cases of gonorrhoea by 30%. This paper presents the main guidelines of the campaign and a critical evaluation of the various epidemiological methods applied, such as mass screening for syphilis and gonorrhoea, epidemiological treatment, contact-tracing, improvement of treatment methods, improvement of methods of health education, and training of physicians and laboratory staff in venereology.

Female↗

PubMed2005

DNA damage from polycyclic aromatic hydrocarbons measured by benzo[a]pyrene-DNA adducts in mothers and newborns from Northern Manhattan, the World Trade Center Area, Poland, and China.

Polycyclic aromatic hydrocarbons (PAH), of which benzo[a]pyrene is a representative member, are combustion-related environmental pollutants and include known carcinogens. Laboratory animal studies indicate that the dose of PAHs to the fetus is on the order of a 10th that to the mother and that there is heightened susceptibility to PAH-induced carcinogenesis during the fetal and infancy periods. Carcinogen-DNA adducts, a measure of procarcinogenic genetic damage, are considered a biomarker of increased cancer risk. Here we compare the levels of benzo[a]pyrene-DNA adducts as a proxy for PAH-DNA damage measured in maternal blood and newborn cord blood obtained at delivery in four different populations of mothers (total of 867) and newborns (total of 822), representing a 30-fold range of exposure to ambient PAHs. The populations include residents in Northern Manhattan, participants in a study of the effects of the World Trade Center disaster, residents in Krakow, Poland, and residents in Tongliang, China. Mean adduct concentrations in both maternal and cord blood and the proportion of samples with detectable adducts, increased across the populations [Northern Manhattan < World Trade Center (WTC) < Krakow < Tongliang], consistent with the trend in estimated ambient exposure to PAHs (P < 0.001). For mothers, the means in the respective populations were Northern Manhattan (0.21 adducts per 10(8) nucleotides), WTC (0.23 adducts per 10(8) nucleotides), Krakow (0.28 adducts per 10(8) nucleotides), Tongliang (0.31 adducts per 10(8) nucleotides); the corresponding means in the newborns were Northern Manhattan (0.23), WTC (0.24), Krakow (0.29), Tongliang (0.31). The percentage of mothers with detectable levels of adducts in the respective populations were Northern Manhattan (36.8%), WTC (57.5%), Krakow (72.9%), Tongliang (73.4%); the corresponding percentages among the newborns were Northern Manhattan (42.4%), WTC (60.6%), Krakow (71.1%), Tongliang (79.5%). Despite the estimated 10-fold lower PAH dose to the fetus based on laboratory animal experiments, the adduct levels in the newborns were similar to or higher than in the mothers. This study suggests that the fetus may be 10-fold more susceptible to DNA damage than the mother and that in utero exposure to polycyclic aromatic hydrocarbons may disproportionately increase carcinogenic risk. The data support preventive policies to limit PAH exposure to pregnant women and children.

Adult↗

PubMed2000

Prevalence of arylsulfatase A pseudodeficiency allele in metachromatic leukodystrophy patients from Poland.

Arylsulfatase A (ASA) pseudodeficiency (PD) allele was searched for in 22 patients originating from Poland and suffering from different types of metachromatic leukodystrophy (MLD). Four of them carried the PD allele in a heterozygous state. The prevalence of the PD allele among investigated MLD patients was revealed to be 9%, while the frequency of the PD allele in healthy controls was estimated at 6-7%. One of the examined MLD patients was additionally a carrier of an isolated mutation leading to the loss of the N-glycosylation site. The question arises whether and how MLD mutations create a convenient milieu for PD mutations to occur (or inversely).

Alleles↗

PubMed2002

Drugs in the postsocialist transitions of Estonia, Latvia, Lithuania and Poland.

The article discusses problems related to illicit drugs in Poland, Lithuania, Latvia and Estonia against the background of the postsocialist transitions of the 1990s. Besides the drug problem, the political and market reforms of the 1990s were accompanied by a surfacing of a variety of social problems, some of which had already been present during the authoritarian socialist regimes. Gaining reliable and comparable statistics on drug-related harm has become very difficult due to changes in treatment system and health statistics. Nevertheless, all available evidence suggests that the use of illicit drugs has grown rapidly in all four countries, it now being close to the Western European level. As a result of international impulses rather than domestic interest, strictly restrictive drug policies have been adopted. Drug problems are aggravated by a marginalisation of a large part of the populations. Accordingly, their reduction may require a more general revision of the four countries' economic and social policies.

Estonia↗

PubMed2004

Marketing of alcohol to young people: a comparison of the UK and Poland.

This paper takes an international perspective on the marketing of alcohol to young people by examining case studies of the marketing of alcohol in the UK and Poland. It is suggested that marketing is a powerful mechanism for attracting young consumers. The alcohol industry is an innovative industry able to use a wide variety of marketing tools to achieve success in the market-place. It is important to recognise that the marketing activities of the industry are becoming increasingly transnational and that policy response has to be equally transnational.

Adolescent↗

PubMed2003

Acquired perforating dermatosis in a patient with Poland syndrome.

Acquired perforating dermatosis (APD) is characterized by umbilicated 1- to 10-mm-measuring papulonodules with a central adherent oystershell-like keratotic plug, typically on the dorsa of the hands, forearms and over the knees. APD is associated with systemic diseases, especially diabetes mellitus and/or renal failure. Histologically the lesions show transepidermal elimination of altered dermal components into a cup-shaped epidermal depression. We present a 69-year-old man with coexisting APD and Poland syndrome (PS), an association not yet described. PS (OMIM 173800) is a rare congenital anomaly consisting of unilateral partial or total absence of the greater pectoralis muscle and ipsilateral symbrachydactyly. Most cases of PS are sporadic as it was in our case. Our patient had, in addition, an untreated diabetic condition, hyperuricaemia, dilated cardiomyopathy and a very recent pulmonary embolism. He responded to therapy with allopurinol.

Aged↗

PubMed2006

Predictors of poststroke dementia: results of a hospital-based study in poland.

Dementia affects up to 30% of stroke survivors 3 months after stroke. The goal of this study was to determine the risk factors of poststroke dementia (PSD) in a cohort of consecutive stroke patients in Poland. A standard stroke evaluation was conducted on admission in 220 consecutive patients with ischemic/hemorrhagic stroke after excluding 30 (12%) patients with prestroke dementia. After 3 months, the survivors completed a comprehensive neuropsychological examination. The DSM-IV definition was used for diagnosis of dementia. Dementia was diagnosed in 44 (22.6%) patients 3 months after stroke. In logistic regression analysis, age (OR 1.08, 95% CI 1.04-1.14, p < 0.001), diabetes mellitus (OR 2.67, 95% CI 1.06-6.57, p = 0.03) and neurological deficit on admission (OR 0.92, 95% CI 0.89-0.96, p < 0.001) were independently associated with PSD in the Polish hospital-based population.

Aged↗

PubMed1985

On the fine structure of the distribution of primary nervous system neoplasms in Western Poland.

The incidence rates of primary nervous system neoplasms in 5 districts (large administrative units) of Western Poland with a relatively homogeneous health care system but some contrasts in economic activity, as well as in 224 communes (smallest administrative units) located within these 5 districts, with a total population of 3,097,000 were estimated on the appointed day (31.12.79). Testing the hypothesis, assuming a homogeneous distribution of nervous system neoplasms over the region under investigation, that the incidence rates were distributed as a Poisson variable has revealed a focal distribution of these tumours; in 15 communes the frequency was higher than 9.0 and deviated from the remainder in the 5% right tail of the distribution. The main conclusion from the presented results was that tumours of the nervous system, of which 90% were intracranially located, may occur in clusters or foci, and this could prove to be of clinical as well as statistical import.

Adolescent↗