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Iodized salt consumption, urinary iodine concentration and prevalence of goiter in children from four districts of north-western Poland (Szczecin coordinating center).

The study was aimed at evaluation of iodized salt consumption, urinary iodine concentration and incidence of goiter in children from four districts of north-western Poland: Szczecin, Koszalin, Słupsk and Gorzów Wlkp. The study was a part of the national programme: "Investigations of iodine deficite and iodine prophylaxis in Poland". The investigations were performed in ten schools randomly selected by Coordinating Centre in Kraków. Altogether 1793 children attending these schools (838 boys and 955 girls) of age between 6 ad 13 years, living in the cities and villages of coastal and lowland region were studied. The examination included interview in the form of a standard questionnaire, physical examination of the thyroid according to the WHO criteria, ultrasonographic evaluation of thyroid volume and determination of iodine concentration in single urine specimen. It appeared that only 11.2% of children used to consume iodized salt. Mean iodine concentration in urine was 76.2 micrograms/l both in children consuming and not consuming iodized salt, indicating dietary iodine deficiency. The incidence of goiter in country population of children (12.9%), indicated that the region of north-western Poland should be considered as an area of mild goiter endemy. These results suggest a need for iodine supplementation of edible salt in this region of Poland.

Adolescent↗

History of 400 years of struggle against cancer in Poland.

The over 400-year history of struggle against cancer in Poland is presented in this work, from its beginning, marked by the establishment of the first hospital for cancer patients in Warsaw in 1592, up to the achievement of the main aim of the National Cancer Programme, i.e., the recent construction of a large modern cancer centre in Warsaw. In the meantime, a number of significant events have taken place in Poland for example, studies on cancer conducted in the 17th-19th centuries, a report on cancer mortality data which was published in 1888, and the Warsaw Committee on Cancer Research and Control, established in 1906. As regards the 20th century, the National Cancer Research and Control programmes were carried out (in 1924, 1952 and 1975), among other activities. An oncological network was built up in Poland based on 11 comprehensive cancer control centres and provincial outpatient clinics. At present, out of each 100,000 new cancer cases more than 70,000 die every year in Poland. The leading localizations in males are: lung (30.5%), stomach (9.8%), larynx (5.5%), prostate (5.1%) and urinary bladder (5.0%); in females: breast (17.5%), cervix uteri (9.8%), lung (6.6%), stomach (6.2%) and ovary (6.2%). Cancer patients' estimated probability of surviving 5 years is 26.4% (males) and 39.8% (females).

Academies and Institutes↗

Striking differences in the epidemiological picture of breast cancer in urban and rural areas in Poland.

Poland is a European country of medium female breast cancer risk but a steady, mean incidence growth of 3.5% per year makes this cancer the most frequent malignancy and a leading cause of cancer-related deaths among the women of the 1980s. Our analysis is based on data collected by the Warsaw Cancer Registry in the years 1963-1987. The crude incidence rate in Poland doubled against 1963 and was nearly 40/100,000 in 1988. In 1988 eight thousand women developed breast cancer. In Poland, the incidence of 37.7 was higher in Warsaw than the rate of 16.6 obtained for Warsaw Rural Areas (WRA) in 1963. The trend continued until 1988 to reach 59.7 and 33.5 in the respective areas. Incidence rapidly grew with age, starting in the group of 30 to reach its peak of 149.2 at 65 and over in Warsaw and 86.6 in WRA. Mortality rates in Warsaw grew from 16.6 in 1963 to 30.7 in 1988 and, from 10.8 to 17.4 in WRA in the respective years. The urban/rural ratio declined from 1.7 to 1.5 during this period. The unfavourable proportion (patient distribution according to clinical staging in Warsaw was: 0 + I-17.2%; II-34.1%; III-29.1%; IV-23.6%. The relative 5-year survivals in Warsaw were 58.7% and they improved little compared to the former periods. These figures were even lower in WRA and they showed a downward trend for women aged over 65. A steady increase in breast cancer risk observed after 1963 and the large proportion of advanced breast cancers diagnosed, were followed by poor results of treatment causing about 5,000 breast cancer deaths in Poland annually.

Adolescent↗

Cancer in Poland.

As in other European countries, cancer is the second most frequent cause of death in Poland. Estimates say that some 100,000 Poles will have developed various cancers every year by the end of the 1980s. The number of cancer-related deaths reached 71,509 by 1989. The constantly growing number of new cases and deaths from cancer is one of the most characteristic features of malignant neoplasms in Poland. The recent decades have seen major changes in the structure of cancer in Poland. This is true for both sexes. By the end of the 1980s, the predominating neoplastic disease in men was cancer of the lung. It was the cause of 34.3% of cancer-related deaths in 1989. In women, malignant neoplasms of the breast, large bowel, and stomach represent about 33% of all cancer localizations. Geographic distribution of mortality ascribed to cancer shows an east-west pattern. This is true particularly for such cancer sites as the large bowel, gall bladder, pancreas, uterine cervix, urinary bladder, breast, ovary; it seems to have a clear connection with the geographic pattern of urbanization in Poland.

Female↗

Female sickness absenteeism in Poland.

It is observed that the working activity period has recently been decreasing in Poland; this applies to both the male and female populations. Since women constitute 48% of all workers employed in the national economy, this tendency may pose an important problem for the community and public health. The main information source for the absenteeism analysis are medical certificates which in Poland obligatorily document every instance of a sick-leave from work, irrespective of the length of sickness. A 15% random sample of all sickness certificates constitutes a database for the monitoring system of sickness absence. The lost time rate is the main parameter analysed by the system. In 1994 the rate of female sickness absence in Poland amounted to 25.1 days per one employee. In Poland the main causes of female sickness absence are: respiratory diseases--18% of all sickness absence (in the 16-19 age group--49%), and disorders of female genital tract and complications of pregnancy, childbirth and puerperium (17% of all sickness absence and 48% in the 20-29 age group). The most important chronic diseases that substantially contribute to the level of sickness absence include: musculoskeletal diseases (15%), diseases of the circulatory system (15%) and the nervous system and sense organs (11%). Over the period of 1990-1994 the highest rate of the female sickness absence related to gynecological diseases and pregnancy complications (mean annual increase--22%), and the musculoskeletal diseases (mean annual increase--10%).

Absenteeism↗

[Tick-borne encephalitis--etiopathogenesis and implications for public health in Poland].

Tick-borne encephalitis (tbe) belongs to infectious units being under study in Poland since over 40 years: clinical, virological, immunological, epidemiological (see eg. fig. 1 of the review) observations succeeded in developing tbe map of Poland, and organization of satisfactory diagnostic virological control of the disease. This article covers most important data since the early (1952-1953) expeditions to the endemic districts of Poland, studies of human beings, animal reservoir, both wild and domestic animals, biological vectors, migrating and local birds, frequency of virus isolations from man, ticks, mosquitos, wild rodents, with special reference to specific (vaccines, immunoglobulins) prophylaxis and associated unexpected and negative reactions. The article points also on north-east districts as of high tbe exposure, on described milk-associated outbreaks. The problems are discussed in relation with analogical and/or probable reactions related with other viral infections. Because of so meritorically differentiated and long-time performed studies and observations, the tbe is still in center of medical and public interest in Poland.

Adult↗

[Prevention using folic acid--a good method for reduction of neural tube defects in Poland].

Incidence of neural tube defects in Poland in the 90's was 2.68 in 1000 births. The value of incidence has not been changed within last twenty years. Mortality caused by neural tube defects in Poland is much higher than in many other European countries and the United States. High rates of incidence of neural tube defects in Poland is probably caused by low utilisation of methods of secondary prevention in a group of low-risk pregnant women. Since methods of primary prevention of neural-tube defects are available; primary prevention with folic acid, should be immediately implemented in Poland.

Adult↗

A deletion in CHEK2 of 5,395 bp predisposes to breast cancer in Poland.

To investigate the contribution of a founder deletion in the CHEK2 gene to the burden of breast cancer in Poland we studied 4,454 women with breast cancer and 5,496 population controls. Cases and controls were genotyped for the presence of a 5,395 bp founder deletion that removes exons 9 and 10 of the CHEK2 gene. This deletion has recently been described in a Czech and Slovak population. The cases and controls had previously been tested for two protein-truncating (IVS2 + 1G > A and 1100delC) and one missense CHEK2 mutation (I157T) which are characteristic for the population. The exons 9 and 10 deletion was present in 0.4% of the controls, in 1.0% (19 of 1,978) of unselected breast cancer cases (OR=2.2; 95% CI: 1.2-4.0; p = 0.01) and in 0.9% (28 of 3,228) of the early-onset cases (OR=2.0; 95% CI: 1.3-1.8; p = 0.02). One of the three truncating CHEK2 mutations (del5395; 1100delC or IVS2 + 1G > A) was seen in 101 of 4,454 (2.3%) cases and in 58 of 5,496 controls (1.1%) (OR=2.2; 95% CI: 1.6-3.0 p < 0.0001). A 5,395 bp founder deletion contributes to the burden of breast cancer in Poland. The deletion was present in 0.9% of the women with breast cancer diagnosed under the age of 51 and in 0.9% of women with breast cancer over the age of 50. This is one of the most common protein-truncating CHEK2 variants in Poland. Overall, 2% of all breast cancers in Poland can be attributed to one of three protein-truncating mutations in CHEK2.

Breast Neoplasms↗

Monitoring environmental pollution in Poland by chemical analysis of Scots pine (Pinus sylvestris L.) needles.

Maps of the distribution of environmental pollution by sulfur (S), zinc (Zn), cadmium (Cd), lead (Pb), copper (Cu), and arsenic (As) for the territory of Poland and the Warsaw (Warszawa) district were developed on the basis of chemical analysis of Scots pine (Pinus sylvestris L.) needles collected from randomly selected sampling points during 1983-1985. The maps show deposition zones for the studied elements and can help in identification of sources and directions of air pollution dispersion. This study indicated that vegetation in Poland is greatly endangered by sulfur dioxide (SO(2)) and other sulfurous air pollutants, whereas Zn, Cd, Pb, and As do not pose an immediate threat to vegetation in most of the country's territory. However, in the urban-industrial agglomeration of Katowice-Cracow, very high pollution with Z, Cd, Pb and As could limit growth and development of some sensitive plant species. Higher than normal levels of As in some areas of Poland (Upper Silesia, Glogow-Lubin Copper Region, and areas close to the Russian border near Braniewo) might affect the health of humans and animals. Results of this study indicated that Poland's environment was not contaminated with Cu.

Journal Article↗

Poland's syndrome associated with childhood non-Hodgkin's lymphoma.

Poland's syndrome is a congenital absence of the sternal portion of the pectoralis major muscle, often associated with ipsilateral upper-limb anomalies. We describe two children with non-Hodgkin's lymphoma associated with Poland's syndrome, ie, an association between childhood cancer and congenital anomalies previously unreported and unlikely to be due to chance. In addition, we report another case of acute leukemia in a child with Poland's syndrome. In view of the rarity of Poland's syndrome in the general pediatric population, we conclude that there is an increased association of the syndrome with both leukemia and non-Hodgkin's lymphoma, the biologic basis of which is unclear.

Adolescent↗

Poland's syndrome and Wilms tumor: an unusual association.

Poland's syndrome, a rare congenital disorder with pectoralis muscular girdle defect, have been reported in association with lymphoreticular malignancies in the past. Childhood solid tumors in association with this congenital anomaly have not been reported so far. We describe this rare association of Poland's syndrome and Wilms tumor. Due to the possibility of increased risk of leukemogenesis in patients with Poland's syndrome, chemo-radiation therapy of Wilms tumor in our patient may increase the risk of secondary leukemia. Therapeutic modification of primary cancer in these patients may be necessary with careful long-term follow-up for early detection and treatment of secondary cancer.

Humans↗

Occurrence and prevention of coal miners' pneumoconiosis in Poland.

BACKGROUND: Coal production is one of the largest industries in Poland and incidence of coal miners' pneumoconiosis is high. METHODS: Data concerning the epidemiology of coal miners' pneumoconiosis stem from the national register and previous investigations performed in Poland. Improvements in medical and technical methodologies for the prevention of pneumoconiosis is discussed. RESULTS: Analysis of the dust concentration measurements shows that TLV values are exceeded in 90% of underground workplaces. The number of new pneumoconiosis cases diagnosed annually ranges from 400-800 and has been showing a diminishing tendency in the last five years. Recently, a new system of medical and technical prevention has been introduced in seven collieries. CONCLUSIONS: The current epidemiological situation of coal miners pneumoconiosis in Poland is unfavorable and needs vast improvement.

Coal Mining↗

Poland anomaly in mother and daughter.

We report on Poland anomaly in a mother and her daughter. Further family history was negative for abnormalities of the hands or the pectoralis major muscle. A review of published cases of familial Poland anomaly is presented. Implications concerning the possible etiology of familial cases of Poland anomaly are given.

Adult↗

Possible common pathogenetic mechanisms for Poland sequence and Adams-Oliver syndrome.

We report on 2 families having members affected with the Poland sequence and Adams-Oliver syndrome. In the first family, a 5-month-old boy presented with Adams-Oliver syndrome; his mother had Poland sequence. In the second family, a 12-year-old boy and his mother presented with findings suggestive of Adams-Oliver syndrome and Poland sequence. This suggests that the same genetic predisposition may result in either or both conditions.

Female↗

Germline mutations 657del5 of the NBS1 gene contribute significantly to the incidence of breast cancer in Central Poland.

Recent studies have demonstrated that heterozygous carriers of the NBS1 657del5 mutation have an increased risk for familial and bilateral breast cancer, but similar studies in consecutive breast cancer patients were inconclusive. Here, in a study of 562 nonselected breast cancer patients from Central Poland, we found 11 (1.96%) 657del5 mutation carriers vs. 3.47 expected (OR 3.21, 95%CI: 1.36-7.61, p = 0.0107) and only 9 (1.6%) carriers of the 5382insC mutation of the BRCA1 gene, most frequently found among breast cancer patients in Poland. No carriers of R215W, another pathogenic mutation of the NBS1 gene, were found in the present study. All carriers of the 657del5 mutation had sporadic breast tumors while 5 of 9 5382insC carriers had a family history of breast/ovarian cancer or bilateral breast carcinoma. In the pooled group of patients from the present and our previous study, carried out also in patients from Central Poland, we obtained the following risk estimates (OR) for 657del5 carriers, as related to the age at breast cancer diagnosis: < 40 years: 8.36; (95%CI: 2.57-27.27) p = 0.0003; < 50 years: 4.27 (95%CI: 1.67-10.89) p = 0.003; > or = 50 years: 2.40 (95%CI: 0.91-6.35) p = 0.1250; all ages: 3.13 (95% CI: 1.40-7.00) p = 0.0066. These findings demonstrate conclusively that NBS1 657del5 mutation carriers have a significantly, though moderately increased, age-related risk of breast cancer, and imply that in populations with a high 657del5 carrier frequency this mutation may contribute substantially to the overall incidence of breast cancer, particularly in younger age groups.

Adult↗

A prospective study of thyroid nodular disease in children and adolescents in western Poland from 1996 to 2000 and the incidence of thyroid carcinoma relative to iodine deficiency and the Chernobyl disaster.

BACKGROUND: In Poland, where soil is deficient in iodine, supplementation of iodine was introduced in 1935, discontinued in 1980, and then re-introduced in 1997. One of the effects of inadequate iodine intake, prior to 1997, was an increase in the prevalence of thyroid nodular disease (TND) in children. Chernobyl, located in the neighbouring country of Ukraine, suffered a catastrophic nuclear explosion in April 1986. PROCEDURE: A total of 411 children with TND (an incidence of 7.53/100,000) were diagnosed and registered in western Poland between 1996 and 2000 and further evaluated as a population-based study. RESULTS: Based on the patient's clinical status, ultrasound examination, scintiscan, laboratory tests, cytology and the family history, many of the patients qualified for surgery and, as a result, histopathologic data were obtained from 155 of the 411 patients operated on to date (37.7% of all TND). Thyroid carcinoma was detected in 37 of the operated children, i.e. 23.9% or 9.0% of all children with TND with a median incidence of 0.68/100,000. Papillary carcinoma was the predominant histologic type (26-70.3%) compared to follicular carcinoma (10-27.0%) and medullary carcinoma (1-2.7%). Retrospective analysis of the figures for the 23 years (1972-1995) showed that in that period a total of 23 thyroid carcinomas were registered. However, only 12 of these were detected in the 20-year period between 1972 and 1991, none in the years 1992-1993 and, significantly, 11 from 1994 to 1995. CONCLUSIONS: Thyroid carcinoma appears to be an ongoing and increasing problem in the children and adolescents of our region, and it is developing more intensively when compared, both to other parts of Poland and to previous statistics (2000 vs. 1985; P<0.002). Iodine deficiency and radiation resulting from the Chernobyl disaster might be important risk factors in the development of thyroid carcinoma in the young population analysed in our region in the period since 1994. The high percentage of follicular carcinoma and follicular adenoma with an undetermined prognosis (19 out of 46) indicates that the long-term iodine deficiency in our region may be more significant in the pathogenesis of malignant transformation than has previously been postulated.

Adenocarcinoma, Follicular↗

Patients' satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden.

There has been an increasing interest in patient satisfaction assessment across nations recently. This paper reports on a cross-cultural comparison of the comprehensive assessment of satisfaction with care (CASC) response scales. We investigated what proportion of patients wanted care improvement for the same level of satisfaction across samples from oncology settings in France, Italy, Poland and Sweden, and whether age, gender, education level and type of items affected the relationships found. The CASC addresses patient's satisfaction with the care received in oncology hospitals. Patients are invited to rate aspects of care and to mention for each of these aspects, whether they would want improvement.One hundred and forty, 395, 186 and 133 consecutive patients were approached in oncology settings from France, Italy, Poland and Sweden, respectively. Across country settings, an increasing percentage of patients wanted care improvement for decreasing levels of satisfaction. However, in France a higher percentage of patients wanted care improvement for high-satisfaction ratings whereas in Poland a lower percentage of patients wanted care improvement for low-satisfaction ratings. Age and education level had a similar effect across countries. Confronting levels of satisfaction with desire for care improvement appeared useful in comprehending the meaning of response choice labels for the CASC across oncology settings from different linguistic and cultural background. Linguistic or socio-cultural differences were suggested for explaining discrepancies between countries.

Adult↗

The vaccine origin of the 1968 epidemic of type 3 poliomyelitis in Poland.

A clear association was demonstrated between the use of USOL-D-bac type 3 poliovirus live-attenuated vaccine and the 1968 poliomyelitis epidemic in Poland. The epidemic followed small-scale trials with Sabin and USOL-D-bac type 3 vaccine strains carried out in seven countries including Poland. Factors that might have contributed to the genesis and development of the epidemic were the pattern of virus excretion from vaccinees, mutations found in viruses from the epidemic, and the particular vaccination policies in Poland during the previous years. These findings may provide essential insights into the strategies for stopping polio immunisation once wild poliovirus has been eradicated.

Antigens, Viral↗