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PubMed2003

[Alexander Project--5 years in Poland].

The aim of the Alexander Project is to monitor resistance and its trends among the most common bacterial pathogens responsible for community-acquired lower respiratory tract infections and to compare the results obtained between different countries. In Poland, from 1996 to 2000 the percentage of Streptococcus pneumoniae isolates non-susceptible to penicillin was 14.1%. Most often decreased susceptibility to penicillin co-existed with resistance to other classes of antibiotics (multi-drug resistance). The biggest number of pneumococci were resistant to co-trimoxazole (35.2%) and doxycycline (33.6%). Of Haemophilus influenzae isolates, 5.3% produced beta-lactamases. All H. influenzae isolates were susceptible to amoxicillin/clavulanic acid and 3rd-generation cephalosporins. Many isolates of this species were resistant to co-trimoxazole (19.1%). The results of the Alexander Project provide crucial data for guiding national recommendations for empirical treatment of respiratory tract infections.

Anti-Bacterial Agents↗
PubMed2003

Prevalence of goiter in schoolchildren--a study on the influence of adequate iodine prophylaxis in Poland.

Poland has been known as an area with iodine deficiency. Surveys carried out in 1992/1993 and 1994 revealed that the voluntary model of iodine prophylaxis introduced in 1986 was ineffective. In 1997 a new model of iodine prophylaxis based on obligatory household salt iodization has been implemented. In order to assess its effectiveness new studies were undertaken in 1999-2001. The study involved 1471 school-children aged 6-15 years from 12 sites. In every subject thyroid volume by means of ultrasound and urinary iodine concentration were assessed. The results were compared with data obtained from the same schools in the 1992/1993 survey. Between 1992/93 and 1999/2001 goiter prevalence decreased from 14.5% to 5.2% (p<0.05) and median urinary iodine concentration increased from 56 microg/l to 103 microg/l (p<0.05). A decrease in goiter prevalence was observed in 6 sites with moderate goiter endemia, whereas the changes in goiter prevalence were statistically insignificant in other 6 sites. Three sites were characterized by goiter prevalence close to 5% before and after implementing the obligatory model of iodine prophylaxis. Goiter prevalence in the remaining three sites remained within the same limit of 7-10%, in spite of observed ioduria increase. The Authors conclude that the Polish model of obligatory iodine prophylaxis ensures efficient iodine supplementation and this is confirmed by a significant increment in ioduria. The effect of this model on thyroid volume is evident in moderate goiter endemia areas. Slight changes in goiter prevalence in mild goiter endemia regions need further monitoring and considering other factors affecting thyroid volume.

Adolescent↗
PubMed2003

Iodine deficiency disorders incidence in neonates based on the experience with mass screening for congenital hypothyroidism in southeast Poland in the years 1985-2000.

Thyroid hormones are very important for the child mental and physical development. In southeast Poland screening for congenital hypothyroidism detection was established in 1985; this region was defined as an iodine deficient area. The results provided the first signal pointing to insufficient iodine prophylaxis in the region. In the years 1985-2000, a total of 634,179 newborns were tested. TSH levels in blood spots on filter paper were determined using three consecutive methods: RIA, fluoroimmunometry (FIA) and luminoimmunemetry (LIA). In the first five years of the program, the incidence of permanent hypothyroidism was 1:4,000, while the incidence of iodine deficiency disorders (IDD) was 1:272. These findings led to the recognition of the fact that iodine prophylaxis had been discontinued in 1981 and reintroduced in 1992 and from that time on the incidence of IDD in neonates has been evidently lower. In the period between 1991 and 2000, we observed a 0.14% incidence rate of IDD, while until 1991 it had been 0.5%. In the years 1998-2000, the respective value was 1:5,420. The incidence of transient hypothyroidism also dropped from 1:3,920 to 1:48,474. Therefore we conclude that, based on screening studies carried out since 1985, the analysis of TSH levels may be regarded as a tool for iodine deficiency monitoring in neonates. Between 1985-2000, a drop in the incidence of IDD in newborns is clearly seen. Moreover, investigations carried out in particular years show that even low-grade iodine supplementation leads to TSH level decrease in newborns.

Congenital Hypothyroidism↗
PubMed2003

Molecular evidence of the presence of Borrelia burgdorferi sensu lato in blood samples taken from dogs in Poland.

Our earlier studies on ticks, Ixodes ricinus have demonstrated that the north-western part of Poland is an endemic area for Borrelia burgdorferi sensu lato and therefore sick dogs, at the time of the highest activity of ticks, should be suspected for having borreliosis. We carried out a preliminary PCR survey of the blood of 15 dogs naturally exposed on ticks for the presence of the DNA of B. burgdorferi using primers complementary to the fragment of the gene encoding 16S rRNA of the small ribosome subunit. We found 6 out of 15 dogs were infected, although 2 dogs had a lameness - the attribute of canine borreliosis were PCR-negative. Our findings suggest that the exposure to B. burgdorferi is common in dogs in the region declared an endemic area of borreliosis, and that this disease should be important to local veterinarians.

Animals↗
PubMed2002

Factors influencing low incidence of living donors for renal transplantation in Poland.

PURPOSE OF THE STUDY: To answer the question: "Why are only 3.8% of kidney transplantations in Poland from living donors?" MATERIAL AND METHODS: The research was conducted using data from anonymous polls addressed to family members of dialyzed patients (potential donors). RESULTS: Almost everybody (98%) had heard about the possibility of treating renal insufficiency by kidney transplantation, but only 77% knew about the possibility of giving their own kidney to a related person. Merely 36% had been informed about this treatment method by a doctor. The most common fears within respondents were those of: health worsening after donating a kidney--45%, and the operation itself (taking an organ)--39%.

Adult↗
PubMed2003

[Vaccination against hepatitis B in Poland: importance, effectiveness and future prospects].

Programmes of vaccination against hepatitis B were introduced in Poland for the first time in 1989. The paper presents the influence of these programmes on the decrease of hepatitis B incidence in the last twelve years. We have described the methods of estimating the efficacy of hepatitis B vaccination and presented the causes of weak anti-HBV response depending on the vaccine that was used and the features of the population that was vaccinated. Special vaccination schemes were established to achieve optimal response in chronically ill or immunosuppressed patients. We have cited the latest opinions concerning booster doses in healthy people and in patients at high risk of HBV infection.

Forecasting↗
PubMed2003

[Content of nitrates and nitrites in skim milk powder in different regions of Poland].

The content of nitrates and nitrites in skim milk powder in different regions of Poland was studied. The results obtained depended both on the factory from which the samples originated and on the season of the year. In 82.9% of the samples the level of these compounds was in accordance with the national standards and in 17.1% of the samples slightly over the limit. 97.4% of the samples were in accordance with the foreign standards.

Animals↗
PubMed2003

Thyroid cancer morbidity in Opole province, Poland, after Czernobyl disaster.

The Czernobyl disaster caused an extensive pollution in Europe due to the release into the environment thousands of tons of radioactive isotopes affecting the elevated cancer morbidity in the continent. The authors used the data set on radiation in Opole province, Poland, to model thyroid cancer incidence in the 1994-1998 quinquennium. An increase in thyroid cancer morbidity in females was observed within the 137 + 134Cs elevated concentration areas. The changes of the cancer incidence in males were found not significant for the distinguished radiation levels in the region. The statistical modeling was performed via the BUGS software.

Environmental Exposure↗
PubMed1992

[Selected etiological factors in dental caries among 18-year-old high-school students in Poland in the light of the results of the questionnaire and epidemiological studies].

The performed studies covered 1100 subjects being 18 years old (both girls and boys) representing large and small towns as well as villages situated in 13 provinces. The material and methods were based on the instruction provided by "WHO Basic Methods 1986". Answers given to questionnaire inquiries in the area of nutrition and oral cavity hygiene furnished an image of health consciousness and behaviours of 18-agers in Poland. Dental state and stomatologic treatment requirement jointly with the effects of stomatologic care were evaluated on the basis of the results established by epidemiological studies. The accomplished analysis encompassed the influence of sex, living environment, type of schools and variable content of fluoride in water, exerted on the pattern of the investigated epidemiological parameters. No correlation was recorded between health consciousness and behaviours in 18-year-old youth on the one hand, and the dental state as well as the therapeutic requirements on the other. The questionnaire responses and the epidemiologic studies made it possible to disclose some drawbacks in transmitting and introducing the education-health principles, which was reflected by not the best results concerning the health consciousness and behaviours particularly in male youth and in rural inhabitants. The dental condition is unsatisfactory in the studied population, despite being provided, in most instances, with permanent stomatological care. This indicates that optimization of adequate stomatological service is indispensable. A low percentage of youth with dentition does not predict good prognosis for them to achieve 3-rd health objective set up by WHO for the year 2000. The studies have confirmed the influence of big urban environment, with complete profile of stomatological care and water fluoridation, being exerted on the state of dental therapeutic requirements in 18-year-old youth. Difficult as it appeared was the detection of the sugars consumption role and that of oral cavity hygiene, in the course of one-stage investigation.

Adolescent↗
PubMed2003

[Efficacy and safety assessment program of fusafungin in the treatment of acute upper respiratory tract infections in adults (PROFIL): multicenter study in Poland].

The aim of the study was evaluation of efficacy and safety of new form of fusafungine in the treatment of upper respiratory tract infections in adults. The study comprised 1639 patients treated in 288 centres in Poland. Fusafungine (Bioparox) was administered 4 applications to the pharynx and/or to the nose every 4 hours during the day. The result of treatment were observed after 5 days. Signs and symptoms of infections were observed both by the physician and by the patients. In 1188 patients regression of signs and symptoms was observed after 5 days of treatment both in bacterial and viral infections. Fusafungine in a new (without freon) form is efficacy and safety drugs in the treatment of upper respiratory tract infections in adults.

Acute Disease↗
PubMed2003

[Report of the first case in Poland of pregnancy after intrauterine insemination with semen of a HIV-1 seropositive partner and literature review].

HIV-1 serodiscordant couples are expressing increased interest in childbearing and many are seeking assisted reproduction. In 1992, Semprini et al. published a protocol for processing semen from HIV-1 seropositive men and reported the first births of healthy children after intrauterine insemination of the female partners with a fraction of motile spermatozoa. We described the first case in Poland of the intrauterine insemination of a female partner HIV(-) with the "washed" sperm of a 28-year old man infected with HIV. The woman gave birth to a healthy boy. Both mother and baby were tested for HIV-1 antibodies at the time of birth and 3 months later; both had negative results. Assisted reproduction techniques, although complicated and expensive are offered to serodiscordant couples as a preventive measure against infection that would result from unprotected intercourse.

Adult↗
PubMed2003

[The monitoring of influenza vaccination programs in Poland and European Union].

Every year approximately 100,000 millions of cases of influenza are registered all over the world. In the United States of America from 20,000 to 40,000 people die due to influenza and its complications every year. Vaccination is the best way of protection against this disease and its serious complications. The clinical efficacy and economic benefits of influenza vaccination is well proved and substantiated. Each year the Advisory Committee on Immunization Practices (ACIP), WHO, Atlanta, USA publishes recommendations for influenza vaccinations indicating which groups of people and patients should be vaccinated for clinical reasons and which of them--for epidemiological reasons. Depending on the country, vaccination policies for influenza vaccinations are different. In Poland vaccination against influenza is recommended for all groups mentioned in ACIP document. Nevertheless, there is no reimbursement system for influenza vaccinations in our country, even only for high-risk groups. Desite this, from year to year more and more people are getting immunized. National campaign carried out by the National Influenza Center, Warsaw resulted in over 200-fold increase of number of doses of influenza vaccines distributed in the epidemic season 2001/2002 when compared with the season 1992/93. This fact shows the importance and efficacy of educational activities together with scientific studies for positive changes in patients' and physicians' attitude to influenza vaccinations.

European Union↗
PubMed2003

[Protection against electromagnetic fields 0-300 GHz in Poland. New regulations and perspectives if their harmonization wit the European Union requirements].

A critical review of protection regulations (or their proposals) on work safety regarding electromagnetic fields as well as the general public protection against unwanted exposure to the fields are presented in this paper. The standards of the Western World are illogical in both aspects, biomedical knowledge and technical. The results (permissible exposures) are defined more precisely than the input data. In Poland, two independent acts are in force: one on occupational exposures and the other on non-occupational exposures. The former is "a world-better", but requires to be immediately changed to a standard that is applicable and friendly to its users. The latter can be accepted after introducing several amendments. The enlargement of the environmental standard to include occupational issues may create a good Polish proposal also useful at the international level.

Dose-Response Relationship, Radiation↗
PubMed2003

[Professional profiles of physicians certified in epidemiology in the view of hospital managers in the Silesian Voivodeship of Poland].

In Poland, the target profile of a new medical specialty--epidemiology--is subject to discussion. The objective of this paper was to review opinions concerning the tasks and areas of responsibilities of a physician-epidemiologist, expressed by 55 managers (out of 120 invited) of hospitals located in Silesian Voivodship. The results revealed that the preferable areas of professional activity of a physician-epidemiologist include: (a) control of infectious diseases, (b) design and control of vaccination programmes, (c) provision of health care in case of disasters/catastrophies, including assessment of potential health effects of emergency events, (d) prevention, diagnostics and evaluation of hospital-based infections, (e) planning and conducting population-based health monitoring programmes, (f) planning, designing, supervision and evaluation of population-based preventive measures, (g) design and conduct of investigations of diagnostic and therapeutic procedures and preventive strategies; (i) involvement in planning of local health policies, and (j) assessment of the health impact of new technologies. The findings could be addressed while drafting the curriculum of postgraduate medical training in epidemiology.

Biotechnology↗
PubMed2003

[Infectious diseases in Poland in 2001].

In 2001 surveillance system of infectious diseases in Poland remained unchanged. New cases of infectious diseases were recorded in 103 positions including intoxications. Tuberculosis and sexually transmitted infections were registered in separate systems. Influenza was the most frequently reported infectious disease with 576,449 cases, 63.9% less then in the previous year. The next most numerous were foodborne infections, which were reported in 24,393 cases, including 19,788 cases of infections caused by Salmonella sp. An increase in incidence was observed in the following diseases: viral hepatitis type A, rubella, measles and pertussis. Also the number of recorded cases of Lyme boreliosis and tickborne encephalitis were higher then in 2000. Incidence of AIDS remained within the range recorded during the last few years. In 2001 further drop in incidence of viral hepatitis type B was observed reaching the level of 6.2 per 100,000. It was the result of implemented comprehensive program of prophylactic measures, which brought incidence of this disease from the highest in Europe down to the level close to European average. Infectious diseases contributed to 0.75% of deaths. The most frequent cause of death among infectious diseases was tuberculosis and its sequels (1,061 cases). 13 cases of death due to tuberculosis occurred in people below 30 years of age.

Adolescent↗
PubMed2003

[Measles in Poland in 2001].

The number of notified measles cases in Poland in 2001 was 133, incidence per 100,000 inhabitants was 0.3. The low incidence has been observed for the last 3 years. Only 73 out of 133 cases were serologically confirmed, 6 other cases were epidemiologically linked to the laboratory confirmed cases. Unvaccinated cases have accounted for almost half of cases. Differences in incidence were noticed across the country and ranged from 0 cases in Opolskie and Zachodniopomorskie voivodeships to 0.7/100,000 in Małopolskie and 1.0/100,000 in Swietokrzyskie voivodeship. The highest incidence was observed in the children one year of age (3.7/100,000) and seven years old (2.3/100,000), however, in general, the age distribution of cases has been shifted toward older ages with 44 cases (33% of all cases) in adults. A proportion of children 13-24 months of age vaccinated with first dose of measles vaccine was 77.1%, and proportion of seven years old children vaccinated with second dose of measles vaccine was 81.7%.

Adult↗
PubMed2003

[Pertussis in Poland in 2001].

In 2001 global increase in reported cases of pertussis in Poland was observed. The total number of reported cases was 2411, 142 more than in 2000. A general trend of increase in the fraction of older cases continues since 1992. More cases occurred among females (7.0/100,000) than among males (5.4/100,000) and in urban areas (7.8/100,000) than in rural areas (3.7/100,000). The vaccination coverage for the children below 2 was 98.2%. The quality of the reporting and laboratory confirmation of pertussis has improved. 58.6% of cases were confirmed by ELISA test, 0.1% by culture.

Adolescent↗
PubMed2003

[Mumps in Poland in 2001].

In 2001, 16,724 cases of mumps were reported in Poland. Incidence of 43.3 per 100,000 was slightly lower than in previous year. Approximately 4.5% of mumps cases were hospitalised (751). Children in the 5 to 9 age group were mostly affected (incidence ranged from 272.2 to 483.6). Children in this age group constituted 54.1% of total number of cases. The MMR vaccine is not included into the national programme of immunisation, the vaccination is recommended on voluntary basis for 2-year and 7-year old children.

Adolescent↗