Effect of the PCV 10 vaccination on community-acquired pneumonia hospitalisations after four years of its introduction into the Polish National Immunisation Programme: Follow-up study

BACKGROUND

Vaccination against pneumococci is currently the most effective method of protection against pneumococcal infections. The aim of the study was to analyse changes in hospitalisations and in-hospital deaths due to pneumonia before (2009-2016) and after (2017-2020) the introduction of PCV 10 vaccinations in the National Immunisation Programme in Poland.

METHODS

Data on hospitalisations related to community acquired pneumonia (CAP) in the years 2009-2020 were obtained from the Nationwide General Hospital Morbidity Study. Analyses were made in the age groups: <2, 2-3, 4-5, 6-19, 20-59, 60+ years in 2009-2016 and 2017-2020.

RESULTS

Overall, there were 1,503,105 CAP-related hospitalisations in 2009-2020, 0.7% of which were caused by Streptococcus pneumoniae infections. Children <2 years of age were the most frequently hospitalised for CAP per 100,000 population, followed by patients aged 2-3, 4-5 and 60+ years. In the years 2009-2016, the percentage of CAP hospital admissions increased significantly, and after the year 2017, it decreased significantly in each of the age groups (p<0.001). In the years 2009-2016, a significant increase in hospitalisations for Streptococcus pneumoniae infections was observed in the age groups <2, 2-3 and 4-5 years (p<0.05). A significant reduction in hospitalisations was observed in the age groups <2, 20-59 and 60+ in 2017-2020 (p<0.05). In the years 2009-2020, there were 84,367 in-hospital deaths due to CAP, 423 (0.5%) of which due to Streptococcus pneumoniae, with patients mainly aged 60+.

CONCLUSIONS

Implementation of the PCV vaccination programme has effectively decreased the incidence of CAP hospitalisations, including children <2 years of age. The group that is most at risk of death are persons aged 60+. The results of our study can be useful in evaluating the vaccine efficacy and benefits, and they can be an essential part of public health policy. Effective prevention strategies for CAP should be implemented in different age groups.

The influenza landscape and vaccination coverage in older adults during the SARS-Cov-2 pandemic: data from Several European Countries and Israel

INTRODUCTION

The Raise Awareness of Influenza Strategies in Europe (RAISE) group gathered information about the healthcare burden of influenza (hospitalizations, intensive care unit [ICU] admissions, and excess deaths), surveillance systems, and the vaccine coverage rate (VCR) in older adults in 18 European countries and Israel.

AREAS COVERED

Published medical literature and official medical documentation on the influenza disease burden in the participating countries were reviewed from 2010/11 until the 2022/23 influenza seasons. Information on the framework for monitoring the disease burden and the provision for ensuring older adults had access to vaccination in their respective countries was provided. Data on influenza VCR in older adults were collected for the 2019/20 to 2022/23 influenza seasons. Data are reported descriptively.

EXPERT OPINION

Influenza presents a significant healthcare burden in older adults. Reporting outcomes across participating countries is heterogeneous, highlighting the need for standardized approaches. Although older adults receive free influenza vaccination, vaccine uptake is highly variable among countries. Moreover, hospitalization rates remain high even in countries reporting a high VCR. Increased awareness and education on the burden of disease and the broader use of improved influenza vaccines for older adults may help reduce the disease burden on this population.

Hospitalizations of patients with herpes zoster in Poland during 2012-2021: A population-based study

INTRODUCTION

The varicella-zoster virus (VZV) is an infectious agent that causes both chickenpox and herpes zoster/shingles (HZ). This infection can take various clinical forms, result in permanent complications, and be a marker of immunosuppression, e.g. in the course of a neoplastic disease. The aim of this study is to analyze epidemiological trends in hospitalization and hospital mortality rate among HZ patients in Poland (2012-2021).

METHODS

Our study is a population-based, retrospective analysis of hospital discharge records of patients with HZ. Data were obtained from the National Institute of Public Health in Poland, and they covered the period from 2012 to 2021. All hospitalization records with primary or secondary ICD-10 B02 code diagnosis were included in the study.

RESULTS

We analyzed the total number of 23,432 hospital discharge records of HZ patients in 2012-2021. The study group consisted of 22,169 (94.6 %) hospitalization records of first-time diagnosis of HZ in hospitalized patients: 9,309 males (42 %) and 12,860 females (58 %). In this group, 70.3 % were patients over 60 years old. The mean and median age was 64 and 69 years, respectively. The mean annual first-time hospitalization rate for HZ was estimated to be 5.8 per 100,000 person-years (95 % CI: 4.8-6.7 per 100,000 person-years). The hospitalization rate for HZ was similar during 2012-2019. There was a significant decrease in hospitalizations in 2020-2021 in comparison with the previous years (R2 = 0.42, p < 0.05). Women showed a higher hospitalization rate than men (p < 0.001). Urban residents had a higher hospitalization rate than rural residents (p < 0.001). In the analyzed period, 246 deaths were recorded (1.1 % of all hospitalized HZ patients) -119 males and 127 females.

CONCLUSIONS

The HZ-related number of hospitalizations and mortality in Poland are relatively low, but HZ is still a significant health problem. Risk factors include female gender, older age and residence in urban areas.

Newborn Hospitalizations Before and During COVID-19 Pandemic in Poland: A Comparative Study Based on a National Hospital Registry

Objectives: There are limited data on the impact of the COVID-19 outbreak in Poland on newborn health. The aim of the study is to show recent information on hospitalizations of newborns in Poland in the pre-pandemic and COVID-19 pandemic era. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized in 2017-2021. Results: The data on which the study was based consisted of a substantial number of 104,450 hospitalization records. Annual hospitalization rate was estimated to be 50.3-51.9 per 1,000 in 2017-2019, 56 per 1,000 in 2020 and it rose to 77.7 per 1,000 in 2021. In comparison to the pre-pandemic period, in the COVID-19 era, we observed significantly more hospitalization cases of newborns affected by maternal renal and urinary tract diseases (p < 0.001), syndrome of infant of mother with gestational diabetes (p < 0.001), maternal complications of pregnancy (p < 0.001). In the COVID-19 era, the prevalence of COVID-19 among newborns was 4.5 cases per 1,000 newborn hospitalizations. Conclusion: The COVID-19 pandemic outbreak could significantly contribute to qualitative and quantitative changes in hospitalizations among newborns.

Hospitalizations of patients with sarcoidosis before and during the COVID-19 pandemic in Poland

INTRODUCTION

Sarcoidosis is a multisystemic granulomatous disease that mostly affects the lungs and lymphatic system. Due to its rarity and variable clinical course, analyses of factors related to sarcoidosis should be based on large databases and long observation periods.

OBJECTIVES

The aim of this study was to determine the characteristics of patients with sarcoidosis hospitalized in Poland over a long period (2016-2021).

PATIENTS AND METHODS

We conducted a retrospective study using hospital discharge records compiled by the National Institute of Public Health NIH - National Research Institute. We analyzed the records of patients with sarcoidosis from the entire Polish population at their first hospitalization.

RESULTS

We identified a total of 15 548 first-time hospitalizations for sarcoidosis. The mean annual disease incidence was 6.8 cases per 100 000. The mean (SD) age of the patients was 45.8 (13.6) years, and it was lower in men than in women (42.9 [12.5] vs 49.8 [14.2] years; P <0.001). There were significantly more hospitalizations among city dwellers (62.3% vs 37.3% for rural residents; P <0.001). At the beginning of the COVID‑19 pandemic in Poland there was a decrease in the number of hospitalizations for sarcoidosis, followed by an increase in the subsequent year. The all‑cause in‑hospital death rate was significantly higher during the COVID‑19 pandemic, as compared with the period before the pandemic (7.2 vs 2.3 per 1000; P <0.001).

CONCLUSIONS

Health care changes related to the outbreak of the COVID‑19 pandemic may have increased the health debt for inpatient sarcoidosis treatment. The occurrence of sarcoidosis in Poland may be related to demographic and territorial factors.

Time Trend Analysis of Comorbidities in Ankylosing Spondylitis: A Population-Based Study from 53,142 Hospitalizations in Poland

BACKGROUND

(1) Influence of comorbidities on life expectancy and treatment outcomes is one of the main concerns of modern rheumatology, due to their rising prevalence and increasing impact on mortality and disability. The main objective of our study was to analyze the time trends and shifts in the comorbidity profile and mortality over 10 years in the Polish population with ankylosing spondylitis (AS). (2) Data from 2011-2020 years were acquired from the General Hospital Morbidity Study in the National Institute of Public Health-National Institute of Hygiene (NIH-PIB) as ICD-10 codes. Based on ICD10 codes, we calculated the percentage shares for comorbidities, with the relative risk ratios and odds ratios. We analyzed the hospitalization rates and mortality from the overlapping conditions. Also, we analyzed age and sex related differences in the clinical manifestations of AS patients. (3) Results: From 53,142 hospitalizations of patients with AS, we found that the male population presented higher rates of cardiovascular (2.7% vs. 1.3% p < 0.001) and pulmonary conditions (1.2% vs. 0.8% p < 0.025). Inflammatory bowel diseases were more common in the female population than in males (2.3% vs. 1.7%, p < 0.001). In the years 2011-2020, we observed a decline in the number of hospitalized patients due to cardiovascular (p < 0.001) and respiratory system conditions (p < 0.001), yet the relative risk and odd ratios remained high. In the years 2011-2020, 4056 patients received biological treatment (7%). The number of initiated biological therapies correlated negatively with the number of reported hospitalizations due to ischemic heart diseases (IHD) (p < 0.031, r = -0.8). Furthermore, in the logistic regression model, we found strong collinearity between cardiovascular and pulmonary comorbidities (VIF = 14; tolerance = 0.1); also, the number of reported IHD's correlated positively with the number of pulmonary infections (p < 0.031, r = 0.7) (4).

CONCLUSIONS

Cardiopulmonary comorbidities are a main factor associated with increased mortality in patients with AS, especially in hospitalized patients. The mortality rates among patients with AS admitted to hospital due to other conditions other than movement disorders exceed the populational risk. The number of biologically treated patients correlated negatively with hospital admissions due to IHD.

Plant-Based Diets and Metabolic Syndrome Components: The Questions That Still Need to Be Answered-A Narrative Review

Metabolic syndrome (MetS) is defined as the co-occurrence of at least three of the following metabolic disorders: abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), high blood glucose, and hypertension. The treatment of MetS involves lifestyle changes, including following an appropriate diet. In addition to weight reduction, it is crucial to search for optimal nutritional patterns that are highly effective in optimizing other MetS markers, such as glucose and lipid metabolism, and reducing blood pressure. To date, the effects of a Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet on MetS have been extensively evaluated. Recent epidemiological studies suggest that plant-based diets (PBDs) may be effective in treating MetS; however, there is still a lack of experimental data. This review aims to analyze the potential benefits of different PBDs on MetS determinants based on the available studies. The findings may help personalize dietary interventions and improve patient care for those with MetS.

Relationship between eating patterns and emotional distress, and perceived quality of life in women with polycystic ovarian syndrome

INTRODUCTION AND OBJECTIVE

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with numerous hormonal, metabolic, and reproductive manifestations. Because of the variety of adverse consequences associated with the condition, women with PCOS suffer emotional distress, resulting in reduced health-related quality of life. Similar to other chronic conditions, eating patterns have been shown effective in impacting the quality of life of PCOS patients. Therefore, lifestyle modifications are recommended as a first-line therapy for PCOS, before prescribing any pharmaceutical management of the PCOS. The aim of the study was to investigate the relationship between dietary patterns, emotional distress, and perceived quality of life in women with diagnosed PCOS.

MATERIAL AND METHODS

The cross-sectional study included 130 women with PCOS aged 18 - 60 years from the Polish population. The respondents were asked to complete a self-administered questionnaire developed for the purpose of the study, inspired by the Food Frequency Questionnaire (FFQ), Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ), Three-Factor Eating Questionnaire (TFEQ-R18), and the Eating attitude questionnaire (Eat-26).

RESULTS

Respondents were found to experience emotional distress regardless of how healthy their diet. Nonetheless, the results showed that women who followed a healthier eating pattern had lower occurrence of experiencing mood swings, and less often felt triggered in the social context. The group did not show a tendency to over-eat, gain weight, or binge eating.

CONCLUSIONS

Healthier eating habits, besides providing advantages in weight management, may mitigate symptoms of emotional distress and improve the quality of life in women with PCOS.

Colonization with drug-resistant pathogens among patients in long-term care facilities and under home hospice care - a cross-sectional study

INTRODUCTION AND OBJECTIVE

The spread of drug-resistant bacteria is deemed a worldwide threat. Patients in long-term care, including those under palliative care, are exposed to a high risk of colonization and infection with drug-resistant pathogens. This refers primarily to long-term care facilities as opposed to home care. A cross-sectional study was carried out between 1 January 2018 - 30 June 2019. The study was approved by the Bioethics Committee at the Medical University of Warsaw (KB/222/2017).

OBJECTIVE

The aim of the study was to assess the frequency and type of colonization with drug-resistant pathogens among patients in long-term care facilities and those under home hospice care. An additional aim was evaluation the risk of pathogen transmission according to the type of provided long-term care.

MATERIAL AND METHODS

The study included 129 participants: 68 patients under the care of 3 long-term care facilities in Warsaw, Poland, 42 patients under home hospice care, and 19 household members of hospice patients. All included participants provided written informed consent. Oropharyngeal and rectal swabs were obtained from all participants for microbiological assessment.

RESULTS

Colonization with pathogens was more common in long-term care facilities residents (82.4%) than in at-home hospice patients (42.9%). Risk of colonization was significantly lower in patients staying at home than in long-term care facilities patients (OR 0.16; 95% CI 0.06-0.38).

CONCLUSIONS

Conclusions. Risk of colonization with drug-resistant pathogens depends on the type of care and is significantly higher in patients staying at long-term care facilities. Systemic measures, such as microbiological screening, are necessary to provide optimal patient care and to ensure epidemiological safety, both to patients and their caregivers.

Ukrainian migrants' and war refugees' admissions to hospital: evidence from the Polish Nationwide General Hospital Morbidity Study, 2014-2022

BACKGROUND

Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning. The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland.

METHODS

The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022.

RESULTS

In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) - 26.1%, pregnancy, childbirth and the puerperium (O00-O99) - 18.4%, and factors influencing health status and contact with health services (Z00-Z99) - 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common - 14.9%, followed by abnormal clinical and lab findings (R00-R99) - 11.9%, and infectious and parasitic diseases (A00-B99) - 11.0%.

CONCLUSIONS

Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.

Trends in Hospitalization Duration for Rare Diseases: A Retrospective Analysis of Sarcoidosis, Still's Disease, and Systemic Sclerosis in Poland (2009-2018)

BACKGROUND A rare disease is a health condition that rarely occurs in the population. It is estimated that up to 400 million people around the world suffer from a rare disease. This retrospective study aimed to investigate factors associated with length of hospitalization in 78 626 patients with sarcoidosis, 3294 patients with adults-onset Still's disease, and 35 549 patients with systemic sclerosis between 2009 and 2018 using data from the National Institute of Public Health in Poland. MATERIAL AND METHODS In this population-based study, we analyzed hospital discharge records of first-time and subsequent hospitalizations. To perform the statistical analyses, R software was used. RESULTS The average length of hospitalization over the selected period in the diseases was 5.39 days for sarcoidosis, 6.22 days for scleroderma, and 7.44 days for Still's disease, and was shorter for each of the diseases analyzed compared with the length of hospitalization for second and subsequent stays. There were no substantial differences in length of hospitalization between males and females. The average length of hospitalization increased with each additional comorbidity. CONCLUSIONS The study showed that hospitalizations for selected rare diseases do not cause a significant burden on the healthcare system. The results also showed that advanced age and comorbidities are important factors determining the length of hospitalization. The average length of hospital stay for selected rare diseases in Poland is not longer than the European Union (EU) average, so it can be assumed that the process of inpatient treatment in Poland is optimal.

Social marketing in gynecological cancers prevention after the COVID-19 pandemic

OBJECTIVES

Assessment of the development and description of the characteristics of social marketing in Poland and the United States with regard to the prevention of gynecological cancers and achievements of these countries.

MATERIAL AND METHODS

Collective case study based on an analysis of five social campaigns in Poland and five social campaigns in the United States that were focused the gynecological cancers prevention.

RESULTS

In the United States, there are more materials available on social campaigns dedicated to the prevention of gynecological cancers, and there are more public organizations that are involved in health promotion activities than in Poland. As opposed to American campaigns, Polish social campaigns did not cover all types of gynecological cancer. The study revealed that Facebook is the most commonly used social media platform by the social campaign organizers.

CONCLUSIONS

Social marketing tools still have not been fully implemented in the prevention of gynecological cancers either in Poland or in the United States. However, social marketing in the US seems to be more effective in gynecological cancers prevention than Poland.

Key Considerations during the Transition from the Acute Phase of the COVID-19 Pandemic: A Narrative Review

The COVID-19 pandemic has been met with an unprecedented response from the scientific community, leading to the development, investigation, and authorization of vaccines and antivirals, ultimately reducing the impact of SARS-CoV-2 on global public health. However, SARS-CoV-2 is far from being eradicated, continues to evolve, and causes substantial health and economic burdens. In this narrative review, we posit essential points on SARS-CoV-2 and its responsible management during the transition from the acute phase of the COVID-19 pandemic. As discussed, despite Omicron (sub)variant(s) causing clinically milder infections, SARS-CoV-2 is far from being a negligible pathogen. It requires continued genomic surveillance, particularly if one considers that its future (sub)lineages do not necessarily have to be milder. Antivirals and vaccines remain the essential elements in COVID-19 management. However, the former could benefit from further development and improvements in dosing, while the seasonal administration of the latter requires simplification to increase interest and tackle vaccine hesitancy. It is also essential to ensure the accessibility of COVID-19 pharmaceuticals and vaccines in low-income countries and improve the understanding of their use in the context of the long-term goals of SARS-CoV-2 management. Regardless of location, the primary role of COVID-19 awareness and education must be played by healthcare workers, who directly communicate with patients and serve as role models for healthy behaviors.

Respiratory Syncytial Virus Infections in Polish Pediatric Patients from an Expert Perspective

Respiratory syncytial virus (RSV) is the most common pathogen causing respiratory tract infections in infants, affecting over 90% of children within the first two years of life. It may cause lower respiratory tract infections, which constitute a significant healthcare burden both in the primary and secondary care settings. Meanwhile, the data regarding RSV disease in Poland is scarce, and published data significantly differs from the numbers reported for other countries with longstanding surveillance and reporting systems. A literature review and an expert panel were conducted to (1) understand the healthcare burden of RSV infections in Poland; (2) collect data on infection seasonality, patient pathway, and management patterns; and (3) evaluate RSV infection surveillance in Poland. According to the literature, RSV is the major agent responsible for non-influenza respiratory diseases in Poland. The reported rates of hospitalization for RSV infections are 267.5/100,000 for children under 5 years of age and 1132.1/100,000 for those under 1 year of age. Comparisons with data from other countries suggest that these values may be underestimated, possibly due to insufficient access to microbiological testing and a low awareness of RSV. Infections occur mainly between December and April, however, this pattern has changed following the implementation of preventive measures for coronavirus disease 2019 in the past few years. According to available reports, bronchodilators, antibiotics, corticosteroids, and X-ray imaging have been frequently used. The surveillance system in Poland has limitations, but these may be overcome due to recent changes in healthcare law as well as the availability and reimbursement of diagnostic tests.

Guidelines of the Polish Society of Gynecologists and Obstetricians, the Polish Society for Vaccinology, and the Polish Society for Family Medicine on vaccinating women with reproductive plans and pregnant or breastfeeding women

The following Guidelines present the most up-to-date treatment and management recommendations, which may be modified and altered after detailed analysis of a specific clinical situation, which in turn might lead to future modifications and updates.

Efficiency and Effectiveness of Patient Care Provided by Physicians in Rural and Urban Areas in Poland

BACKGROUND The health sector in Poland is currently facing challenges such as limited financial resources, poor infrastructure, and insufficient human resources. To address these issues, increasing cost-effectiveness at the individual physician level has become essential. This study aimed to evaluate the efficiency and effectiveness of patient care at the level of individual primary health care physicians and to compare the performance of physicians working in urban and rural areas. MATERIAL AND METHODS Thirteen original effectiveness indicators were developed based on a literature review, expert consultations, and a pilot study at the Medical and Diagnostic Center in Siedlce. The indicators were used to evaluate the effectiveness of physicians and compare physicians' characteristics working in rural and urban areas. The study extracted data on physicians' characteristics and used the indicators to evaluate their effectiveness. RESULTS Physicians working in rural areas treated more patients due to staff shortages. However, physicians working in urban areas demonstrated greater effectiveness in performing routine and advanced health checks and mammograms. Despite this advantage, the average life expectancy of patients was higher among patients of physicians working in rural areas. CONCLUSIONS Five indicators developed in the study formed a scale, which is a step toward developing a uniform effectiveness indicator. Further research on consistently measuring effectiveness could significantly impact the development of sociometric research methodology. This study highlights the differences in efficiency and effectiveness of physicians working in rural vs urban areas and underscores the need for healthcare policymakers to consider these differences in addressing healthcare resource allocation.

Congenital toxoplasmosis among hospitalized infants in Poland in the years 2007-2021: study based on the national hospital registry

Congenital toxoplasmosis (CT) is a rare entity and it may pose a life-threatening risk for the newborns. The aim of the study was to evaluate the incidence and other selected factors of CT in Poland. Our study is a population-based study on CT patients in 2007-2021. The study was based on 1504 hospitalization records of first-time diagnosis of CT in newborns. In the study group, we observed 763 males (50.7%) and 741 females (49.3%). The mean and median age was 31 days and 10 days, respectively. Based on the hospital registry, the mean annual CT incidence was estimated to be 2.6 per 10,000 live births (95% CI 2.0-3.2 per 10,000 live births). The incidence of CT cases fluctuated over the years 2007-2021, with the highest incidence in 2010 and the lowest one in 2014. There were no statistically significant differences between the incidence of CT in relation to sex or place of residence. The periodic fluctuations in the number of cases of congenital toxoplasmosis indicates the need to develop effective prevention programs to effectively counteract the disease and its consequences.

Lifestyle intervention towards Mediterranean Diet, physical activity adherence and anthropometric parameters in normal weight women with Polycystic Ovary Syndrome or Hashimoto's Thyroiditis - preliminary study

INTRODUCTION

Overweight and obesity are frequently present in both women with polycystic ovary syndrome (PCOS) and with Hashimoto's thyroiditis (HT). This is a limited study regarding the benefits of lifestyle changes, including dietary habits, dedicated to patients with HT and PCOS.

OBJECTIVE

The aim of the study was to assess the effectiveness of an intervention programme based on the Mediterranean Diet (MD) without caloric restriction and increased physical activity to change selected anthropometric parameters in women with both health conditions.

MATERIAL AND METHODS

The intervention programme consisted of changing the participants diet towards MD rules and increasing physical activity for 10 weeks according WHO recommendation. The study involved 14 women diagnosed with HT, 15 with PCOS and 24 women from a control group. The intervention programme consisted of educating patients in the form of a lecture, dietary advice, leaflets and a 7-day menu based on MD. During the programme, patients were required to implement recommended lifestyle changes. The mean intervention time was 72 ± 20 days. Nutritional status was analyzed by body composition, degree of implementation of the principles of the MD by using the MedDiet Score Tool, and the level of physical activity by the IPAQ-PL questionnaire. The above-mentioned parameters were evaluated twice, before and after the intervention.

RESULTS

The intervention programme consisting in implementing the principles of the MD and increasing physical activity to effect a change in the anthropometric parameters of all groups of women studied; all women had a reduction in body fat and body mass index. A decrease in waist circumference was observed in the group of patients with Hashimoto's disease.

CONCLUSIONS

An intervention programme based on the Mediterranean Diet and physical activity can be a good way to improve the health of HT and PCOS patients.

Knowledge about the COVID-19 and ways of its prevention among Medical University of Warsaw students

BACKGROUND

The aim of the study was to assess the state of knowledge of Medical University of Warsaw (MUW) students on COVID-19, modes of transmission and preventive measures.

MATERIAL AND METHODS

The study was conducted in October 2020. The participants were all the students attending classes at MUW - 8922 persons. All had completed the online training "Work safety and hygiene during COVID-19." To assess their state of knowledge an online questionnaire was made available on the MUW e-learning platform. The questionnaire comprised 4 parts: (1) awareness of rules of hand hygiene, (2) medical aspects of COVID-19, (3) preventing SARS-CoV-2 infection transmission in health care facilities, and (4) preventing infection transmissions in the society.

RESULTS

The majority of students (93.9%) demonstrated a sufficient level of knowledge. The highest passing threshold was found on the medical programme (96.7% of students with satisfactory level of knowledge), dentistry (96.2%) and pharmacy (95.5%). The statistically significant factors that differentiated student results proved to be faculty (p < 0.001), study programme (p < 0.001), year of studies (p = 0.001), form of studies (p < 0.001). The participants most often showed full knowledge (100% correct answers in sub-area) of preventing infection transmissions in the society (93.3%) and medical aspects of COVID-19 (91.8%), less complete in terms of ways of preventing infection transmission in health care facilities (85.4%), and in particular hand hygiene rules (78.3%). All the variables characterizing academic status (study programme, faculty, year and form of studies) were statistically significant differentiating factors for students' full knowledge in all of the 4 analyzed sub-areas, while students' sex only in the sub-area of COVID-19 medical aspects.

CONCLUSIONS

There is a clear need for conducting systematic educational activities among students of all medical study programmes and assessing their level of knowledge in those areas that were identified as least frequently controlled, namely, hand hygiene and infection transmission in health care facilities. Med Pr. 2022;73(5):369-81.

Health Care Accessibility and Breast Cancer Mortality in Europe

BACKGROUND

Breast cancer is the most common cause of death, due to malignant neoplasms in women worldwide. The nature of the symptoms associated with breast cancer depends on the stage of the disease. In this case, any cancerous changes in the initial phase of the disease can only be detected during imaging tests. Participation in mammography screening can reduce breast cancer mortality by up to 40%, if only 70% of the eligible population participates in preventive programs. The purpose of the study was to assess the impact of accessibility to health care resources on breast cancer mortality.

METHODS

Eurostat aggregated health care data was extracted. Hierarchical cluster analysis of average breast cancer mortality identified four groups of countries with similar mortality rates and trends. The data was then analyzed, in terms of access to health care.

RESULTS

It was observed that the higher the financial expenditure on health care and the better the health care accessibility, the lower the mortality rates of breast cancer.

CONCLUSIONS

There are examples indicating that the studied elements are not the only factors affecting the improvement of population health. The authors would like to emphasize the need to influence lifestyle factors, direct cancer risk, and introduce a multidisciplinary approach to breast cancer prevention.

Hospitalizations of Ukrainian Migrants and Refugees in Poland in the Time of the Russia-Ukraine Conflict

BACKGROUND

In the face of a sudden influx of several million migrants and war refugees from Ukraine to other European countries, knowledge about the health of Ukrainian citizens becomes increasingly important. The aim of the study is to identify the main health problems of hospitalized Ukrainian citizens residing in Poland in the period from 2014 to June 2022.

METHODS

This study is based on hospitalization data of Ukrainian patients in Poland taken from the Nationwide General Hospital Morbidity Study.

RESULTS

The study group covered 8591 hospitalization records. We observed two hospitalization peaks, one in patients aged 0-5 and the other one in those aged 20-35. After the official outbreak of the war, 2231 Ukrainian citizens were hospitalized in Poland. At this time, the most often reported principal reasons for the hospitalizations of adult women were diseases related to pregnancy, childbirth and the puerperium, whereas in groups of adult men diseases were related to injury, poisoning and certain other consequences of external causes, and in children and adolescents diseases were infectious and parasitic diseases.

CONCLUSIONS

Our findings may have implications for healthcare policies and service provision to newly arrived migrants and war refugees in target European countries.

Recommendations of the Polish Society of Gynaecologists and Obstetricians, Polish Paediatric Society, Polish Society of Family Medicine, Polish Society of Vaccinology, Polish Society of Oncological Gynaecology and Polish Society of Colposcopy and Pathophysiology of the Uterine Cervix on prophylactic vaccinations against infections with human papillomaviruses in Poland

Several hundred million people are infected with genital genotypes of the human papillomavirus (HPV) annually in the world. The infections transmitted mainly through sexual routes are usually asymptomatic, but can lead to the development of cervical, vulvar, vaginal, anal, penile cancers, some head and neck cancers and genital warts (condylomas). The fraction HPV-related cancers range from nearly 100% in the case of cervical cancer to several/over a dozen percent in the case of other cancers and diseases. There are no effective drugs against HPV, but prophylactic HPV vaccines are available free of charge in immunization programmes in many countries around the world. In Poland, HPV vaccinations have so far been executed out on the pocket or in free-of-charge, local-governmental prevention programs, but the vaccination coverage of the target population does not exceed 10%. From November 2021, one of the vaccines is available with a 50% reimbursement, work is underway to reimburse the next ones, and the National Oncology Strategy assumes the implementation of the HPV immunization programmes and vaccination of 60% of the teen population by 2028. Three prophylactic HPV vaccines are registered. All of them are safe and their effectiveness in the prevention of diseases caused by vaccine genotypes reaches almost 100%, provided that full post-vaccination immunity is obtained before the contact with the virus. Girls aged 11-13 are the priority target cohort for HPV vaccination in Poland. The implementation of routine, free-of-charge HPV immunization in the Preventive Immunization Program (PIP) for all adolescents should be pursued. Persons over the age of 13 may also benefit from HPV vaccination and should be vaccinated according to product specifications. In addition to free access under the PIP, the key element for the success of the implementation of HPV vaccinations in Poland will be the education of medical personnel and parents of adolescents to be vaccinated.

Congenital herpes simplex virus infection among hospitalized infants in Poland

INTRODUCTION AND OBJECTIVE

Congenital herpes simplex virus infection (cHSV) is a rare entity and may pose a life-threatening disease for the newborns. Due to the public health and clinical importance of cHSV infection in infants, the recent data on this disease in Poland should be investigated. The aim of the study was to evaluate the incidence and other factors related to cHSV.

MATERIAL AND METHODS

The study is retrospective, population-based that utilised the hospital discharge records of cHSV patients. Data were obtained from National Institute of Public Health NIH - National Research Institute in Warsaw, Poland, covering the period 2014-2019.

RESULTS

The study group consisted of 1,573 cHSV newborns (841 males and 732 females). Among this group, 70.1% were infants up to 90 days of age and 3.6% were neonates up to 28 days of age. The mean and median age was 98 days (95% CI: 94.5-101.8, SD 74) and 70 days (IQR: 53-104), respectively. Based on the hospital registry the overall average cHSV incidence over the study period was estimated to be 69 per 100,000 live births. The number of cHSV infection fluctuated over the years 2014-2019 with a significant decreasing trend from 2015-2019 (P<0.01). A significantly higher cHSV incidence was observed among patients from urban than rural areas of Poland (88 vs 40/100,000 live births; P<0.001).

CONCLUSIONS

CHSV incidence may be related to multifactorial conditions for the occurrence of this disease. Further studies on changes in the incidence of cHSV are needed.

Patient care efficiency in primary healthcare - pilot study in Medical and Diagnostical Centre

In Poland, there is a niche that can be filled with original research in the area of performance indicators of individual health care professionals.

AIM

The aim of the study was the empirical verification of original effectiveness indicators and the identification of the degree of patient care effectiveness of selected primary health care professionals with the application of the developed indicators.

MATERIALS AND METHODS

The study population consisted of physicians employed in the primary care in Medical and Diagnostic Centre (MDC) in Siedlce, Poland. The final study sample consisted of 29 respondents. 14 original indicators in three areas: structure, process and effect were developed and verified.

RESULTS

The distribution of indicator values for the physicians included in the study demonstrated a diverse level of their effectiveness. The factor analysis performed for the 14 original indicators demonstrated that a highly reliable scale can be created out of 5 of the original indicators.

CONCLUSIONS

In our pilot study we assessed the reliability of the designed tools. However, unfortunately, our research did not offer the opportunity to identify any dependencies of variables. A study on a larger sample of physicians would therefore be needed.

Safety and Impact on Training of the Influenza Vaccines in Elite Athletes Participating in the Rio 2016 Olympics

OBJECTIVE

The aim of the study was to evaluate the safety and tolerance of influenza vaccines for the northern and southern hemispheres in Polish elite athletes participating in the Rio 2016 Olympics.

DESIGN

Prospective, observational, cohort study.

SETTING

Institutional level.

PARTICIPANTS

Ninety-seven athletes vaccinated only with the northern hemisphere vaccine; 98 athletes received the southern hemisphere vaccine alone, whereas 39 athletes were vaccinated with both vaccines.

INTERVENTIONS

The athletes were vaccinated with a trivalent, inactivated influenza vaccine recommended for the northern hemisphere 2015/2016 and then with the vaccine recommended for the southern hemisphere 2016. Athletes kept a diary of adverse events and effects (if any) on training for 6 days after vaccination.

MAIN OUTCOME MEASURES

The percentage of general and local adverse events, number of lost or modified training sessions.

RESULTS

Significantly more local adverse events (pain and redness) were found in the group immunized with the vaccine for the northern hemisphere. There were no differences in the frequency of general adverse events and influence on training between groups. Of total 273 athletes who had 1911 training days during 6 days after vaccination, 6 athletes (2.2%) lost 13 training days (0.7%) and 16 athletes (5.9%) had to modify 34 (1.7%) training days within first 2 days after vaccination.

CONCLUSIONS

Athletes tolerated influenza immunization well. If they are going to travel to the other hemisphere during the influenza season, the use of the second influenza vaccine should be advised. Athletes should anticipate modification of trainings for 2 days after vaccination.

Adult-onset Still's disease in Poland - a nationwide population-based study

INTRODUCTION

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology, which affects young adults and is associated with multiple organ involvement and life-threatening complications. The aim of the study was to establish the incidence and prevalence of AOSD in Poland, and factors related to this disease among hospitalized patients.

MATERIAL AND METHODS

A retrospective, population-based study was conducted, using data from hospital discharge records compiled by the National Institute of Public Health in 2009-2018.

RESULTS

Based on hospitalization records and census data in a group of the 1,050 patients included in the study, women were predominant (60%) and patients' mean and median ages at hospitalization were 42 (95% CI: 40.8-42.8) and 38 years, respectively. The average annual incidence rate of AOSD during the 10-year period was established at the level of 0.32/100,000 (95% CI: 0.30-0.34), and the point prevalence at the end of 2018 was 2.7/100,000. The most common comorbidities were: cardiovascular diseases (14%), diseases of the musculoskeletal system and connective tissue (14%), endocrine, nutritional and metabolic diseases (9%).

CONCLUSIONS

AOSD is a rare disease Poland with gender and territorial differences in incidence ratek, and predominance of cardiovascular diseases among comorbidities. The presented data may be useful for comparisons of the Polish population with other geographical regions. Predominance of patients from urban regions and predominance of women may suggest environmental and personal factors in AOSD development; however, further research seems to be necessary.

Hospitalizations for COVID-19 in Poland: a study based on data from a national hospital register

INTRODUCTION COVID‑19 has been identified by the World Health Organization as a pandemic. Poland introduced extensive antiepidemic measures relatively early in order to slow down the spread of the disease. OBJECTIVES The study aims to present recent data on COVID‑19 hospitalizations during the first months of the disease outbreak in Poland. PATIENTS AND METHODS This is a retrospective, population‑based study conducted using hospital discharge records that included a diagnosis of COVID-19. Data were obtained from the National Institute of Public Health, where they had been originally collected for a Polish hospital morbidity study. They included 8840 hospitalization records from the period between February and September 2020. RESULTS Overall, there were 8252 records of patients hospitalized for COVID‑19 for the first time, which accounted for 93% of all hospitalizations. The study group consisted of 4161 men (50.4%) and 4091 women (49.6%). Significantly more patients from urban than rural areas were hospitalized (21.8 per 100 000 vs 20.5 per 100 000; P <0.02). In the period subject to analysis, 1073 in‑hospital deaths were observed (13% of all patients), 965 of which occurred during first‑time hospitalizations (11.7% of all patients). In the study group, patients who died during hospitalization compared with those who survived hospitalization were significantly older, more frequently lived in urban areas, and had more comorbidities. CONCLUSIONS The findings of our study, especially the differences between survivors and nonsurvivors with COVID-19, may be helpful in recognizing patients requiring special medical care and preventive measures during hospitalization.

Prophylactic medical examination of 15/16 year old from the Warsaw Agglomeration. Evaluation of the implementation of standards in practice

Prophylactic medical examinations - called well-child visit - are among the benefits guaranteed under basic health care. The prophylactic visit should include, among others: physical examination and an interview (with the adolescent and the parent), as well as individual pro-health education.

AIM

The aim of the study was to answer the question whether preventive medical visits of 15/16 year olds from the Warsaw Agglomeration are carried out within the scope defined by the Minister of Health and in accordance with standards.

MATERIALS AND METHODS

The course of well-child visit was evaluated on the basis of 359 anonymous questionnaires filled in by students from randomly selected 11 schools from the Warsaw Agglomeration.

RESULTS

In 3.3% of the respondents, the doctor did not carry out any of the physical examinations asked in the questionnaire. The most often doctor auscultated chest organs (94.4% of respondents), the least frequently examined genitals in girls (2.1%). During the visit, the doctors raised less than 4 topics on average. The most frequent subjects of discussion were menstruation (80.0% of girls), chronic diseases in the adolescent's family (59.1%) and physical activity (51.0%); the rarest ones were depression and suicidal thoughts (3.1%), violence (1.9%) and the influence of the family on the patient's well-being (1.4%). The compatibility of the gender of the patient and the doctor increased the number of topics discussed.

CONCLUSIONS

The confrontation of the data obtained by us with the content of the Minister of Health's regulation and the standards in force in Poland provides the basis for a negative assessment of the implementation of medical prophylactic examinations in the adolescents in the Warsaw Agglomeration.

Evaluating the Virucidal Activity of Disinfectants According to European Union Standards

The disinfection of surfaces in medical facilities is an important element of infection control, including the control of viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Preparations used for surface disinfection are typically characterized via their activity against test organisms (i.e., viruses, bacteria and fungi) in the laboratory. Typically, these methods use a suspension of the test organism to assess the bactericidal, fungicidal or virucidal activity of a given preparation. However, such suspension methods do not fully imitate real-life conditions. To address this issue, carrier methods have been developed, in which microorganisms are applied to the surface of a carrier (e.g., stainless steel, glass and polyvinyl chloride (PVC)) and then dried. Such methods more accurately reflect the applications in real-life clinical practice. This article summarizes the available methods for assessing the virucidal activity of chemical disinfectants for use in medical facilities based on the current European standards, including the activity against coronaviruses.

[What is the effect of social distancing on the course of COVID-19 epidemic?]

COVID-19 pandemic challenged both public health specialists and authorities to implement non-pharmaceutical interventions aimed at limiting the spread of SARS-CoV-2 infections. The concept of social distancing is about limiting contacts between people, which breaks virus transmission chains, delays the increase in the number of infected people in the population and prevents overloading of health care systems. Many countries, including Poland, implemented a number of interventions aimed at limiting the number of infections and slowing down the tempo of the pandemic's spread. These are, among others, mass-scale testing, isolation of infected individuals, hand hygiene, breath etiquette and wearing mascs. Apart from these, a number of restrictions were enforced to ensure social distancing, such as closing down schools and universities, forbidding organising large parties and mass gatherings, limiting travels and use of public transport, increasing awareness of the public opinion on the necessity to stay at home, up to even introducing full lockdown with only the right to go out to buy food and medication or use the health care system. These interventions were gradually introduced in particular countries, in different ways, to a greater or lesser extent. Their effectiveness is largely influenced by the socio-economic and cultural factors, the nature of political and healthcare systems as well as the operating procedures used during their implementation. The implemented social distancing strategies prove to be effective, especially when combined with such actions as mass-scale testing, tracking contact chains, isolation and quarantine. The current work aims at making an overview of selected social distancing strategies and assessing their effectiveness in slowing down COVID-19 epidemic.

Determinants and coverage of seasonal influenza vaccination among women of childbearing age in Poland

OBJECTIVES

Vaccination is the most effective method of controlling influenza in the human population, where pregnant women belong to a risk group that is especially vulnerable to influenza-related morbidity and mortality. The objectives of the survey were to report estimates of maternal vaccination coverage and assess reasons for the lack of influenza vaccination among Polish women of childbearing age.

MATERIAL AND METHODS

The survey analysis included 564 pregnant women who had been surveyed in a self-reported questionnaire during the 2017-2018 influenza season in Warsaw, Poland.

RESULTS

Over 95% of Polish women of childbearing age did not vaccinate against influenza due to the low perception of risk and a lack of providing evidence-based information on vaccine by physicians and midwives. General practitioners were most often indicated as healthcare workers who educated women about influenza risk factors and recommended influenza vaccine to them.

CONCLUSIONS

The results of the survey suggest that women of childbearing age did not vaccinate against influenza due to the low perception of risk and a lack of providing evidence-based information by healthcare workers (including obstetrician-gynaecologists and midwives), while their recommendations appear to be a powerful method of overcoming barriers to influenza vaccination among patients.

Congenital cytomegalovirus infections in Poland - a national hospital register-based study

INTRODUCTION AND OBJECTIVE

Congenital cytomegalovirus (cCMV) infections are common worldwide. CCMV infected newborns are mostly asymptomatic at birth. However, cCMV remains the major infectious cause of congenital abnormalities in the developing foetus and newborns. The aim of the study was to provide recent data on cCMV in Poland.

MATERIAL AND METHODS

Aretrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized from 2009-2018. CCMV incidence rates were estimated on the basis of data taken from a Polish hospital morbidity study, carried out by the National Institute of Public Health.

RESULTS

The study group consisted of 1,916 hospitalized patients with the first-time diagnosis of cCMV. Among them, 52% were patients up to 30 days of age. The median age was 28 days. The average annual incidence of cCMV was 48 per 100,000 live births (95% CI 23.5-73.4). A significantly higher cCMV incidence rate was observed in patients from more urban than rural regions of Poland (55 per 100,000 vs 39 per 100,000; P<0.001). In the study period, 9 hospital deaths (0.5 % of all patients) were reported. The coexistence of nervous system diseases was observed in 26% of cases and hearing loss in 6% of cases.

CONCLUSIONS

The significantly more cCMV cases were observed in patients from more urban than rural regions of Poland may suggest the presence of territorial factors related to the cCMV incidence in Poland. The relatively high percentage of newborns with hearing loss or neurologic diseases may require activities aimed at reducing the cCMV incidence. The epidemiological data presented may be useful for comparisons with other geographical regions.

The impact of selected educational and information interventions on the coverage rate and attitudes to influenza vaccination in nursing staff

BACKGROUND

Influenza vaccinations are recommended for medical staff as an effective and safe form of preventing influenza and its complications. The aim of the study was to assess the impact of selected educational and information interventions on the influenza vaccination coverage (IVC) in nursing personnel and their attitude towards this procedure.

MATERIAL AND METHODS

The study participants (N = 320) were randomly divided into 4 groups. Group 1 participated in stationary training, whereas group 2 participated in distance learning. Additionally, 2 subgroups were established in each of the groups above: 1 subgroup received a reminder about the vaccination in the form of a short text message, and the other group did not receive any such reminder. The IVC rate in each group was determined; the attitude towards influenza vaccination was measured using the health belief model.

RESULTS

The highest IVC was obtained after stationary training followed by a reminder in the form of a short test message (36%). The reminder significantly affected IVC in the group attending stationary training (p < 0.05, OR = 2.5, 95% CI: 1.16-5.58); however, it had no impact on the IVC in the group participating in distance learning (p > 0.05, OR = 1.2, 95% CI: 0.51-2.83). Both stationary training and distance learning positively influenced the attitude towards influenza vaccinations. A major change in attitudes towards influenza vaccinations was observed only in the case of stationary training followed by a reminder in the form of a short text message (positive changes in perceived susceptibility and severity took place, perceived vaccination benefits increased, and perceived barriers were reduced).

CONCLUSIONS

Stationary training followed by a reminder in the form of a short text message is more effective in increasing the IVC rate compared to distance learning. It also promotes positive changes in attitudes to this prophylactic procedure, which is why it should be recommended for wider implementation. Med Pr. 2020;71(6):665-85.

Impact of parental smoking on influenza and others respiratory infections in children

BACKGROUND

The predisposition of cigarette smokers for the development of respiratory infections, including influenza, have been well documented. As well, those exposed to side stream smoke are prone to viral and bacterial infections of the respiratory tract.

AIM

The study aimed to evaluate whether the prevalence of smoking parents is higher among children with respiratory tract infections, including influenza, in comparison to the general population.

MATERIAL AND METHODS

Observational, cohort study. The authors surveyed a cohort of patients and their families, hospitalized in the Paediatric University Hospital in Warsaw during 2018 influenza season. Patients were diagnosed with influenza (using PCR) or other respiratory tract infections. A questionnaire on smoking habits was performed.

RESULTS

Overall, 72 patients were included in the study, median age 2 years and 9 months (IQR: 1.4 - 7.2), influenza was diagnosed in 43% (n= 31) of patients. The percentage of regularly smoking parents in the whole cohort amounted to 33.3% (44 of 132) and was statistically significantly higher (p < 0.05) than in the general population (22.7%), whereas in the subgroup with influenza and non-influenza infections it reached 32.2% and 34.2%, respectively.

CONCLUSIONS

The prevalence of smoking parents of children with acute respiratory tract infections is higher than in the general population: exposing children to tobacco smoke is one of the risk factors for acquiring influenza and others respiratory tract infections. Quitting smoking can decrease the risk of infectious diseases.

Nutrition Behaviors in Polish Adults before and during COVID-19 Lockdown

Unexpected isolation, which has not yet been seen on a global scale, has created the conditions for evaluating nutrition in a situation of reduced spatial activity. The study aimed to assess the influence of lockdown on selected eating habits of Polish adults. An anonymous questionnaire was conducted, including questions about eating habits and self-reported anthropometric measurements, referring to “before” and “during” lockdown. We reported the findings of 312 adults (aged 41.12 ± 13.05 years). Overall, 64.1% of the participants were women, 77.7% urban inhabitants and 78.6% employed. The average length of social isolation was 50.79 ± 10.53 days. The majority (51.6%) of the respondents did not eat outside the house during lockdown (p < 0.0001). The number of meals eaten during the day during lockdown increased significantly, 11.2% of the respondents ate 5 and more meals (p < 0.0001). The percentage of people snacking between meals increased by 5.1% during lockdown (p = 0.0001). Eggs, potatoes, sweets, canned meat and alcohol were consumed considerably more commonly during lockdown, while fast-food products, instant soups and energy drinks were eaten or drunk significantly less frequently. A marked decrease in the number of daily servings of the following products was observed: bakery products, red meat, fast food, instant soups, sweet beverages and energy drinks. Conversely, the number of daily servings of sweets and canned meat significantly increased. Two thirds of the respondents reported body weight changes, with 45.86% of the participants being overweight during lockdown. Significant changes in the diet of Polish adults were found during lockdown due to COVID-19.

[Benzo(a)pyrene in atmospheric and indoor air, health hazards and possibilities of limitation]

The work discusses the occurrence of benzo (a) pyrene in atmospheric air and indoor air, as well as health threats caused by this environmental pollution. The results of research conducted worldwide and in Poland were referred to. Poland belongs to the European Union country, where high levels of benzo(a)pyrene are recorded in both atmospheric air and indoor air (residential houses) exceeding 1ng/m3. Considering the fact that this pollution is highly carcinogenic one should strive to reduce the concentration of benzo(a)pyrene in the air in Poland, recognizing and eliminating its sources. Installation of dedusting equipment in residential areas is possible but expensive. This creates an inequality in the access to fresh air in the rooms. The World Health Organization strongly promotes measures to reduce emissions of benzo(a)pyrene. On the other hand, extensive information campaigns should be carried out to make the public aware of the exposure, its sources and options of prevention.

No-Touch Automated Room Disinfection after Autopsies of Exhumed Corpses

Autopsies of exhumed bodies pose a risk of infections with environmental bacteria or fungi, which may be life-threatening. Thus, it is important to use effective methods of disinfection in forensic pathology facilities. In this study, we investigated the effectiveness of no-touch automated disinfection (NTD) system after autopsies of exhumed bodies. Directly after 11 autopsies of exhumed bodies, we used an NTD system based on a peroxone vapor to disinfect the air and surfaces. We measured microbial burden in the air and on surfaces before and after NTD. The NTD system reduced the mean bacterial burden in the air from 171 colony forming units (CFU)/m³ to 3CFU/m³. The mean fungal burden in the air decreased from 221 CFU/m³ to 9CFU/m³. The mean all-surface microbial burden was 79 CFU/100 cm² after all autopsies, and it decreased to 2 CFU/100 cm² after NTD. In conclusion, the peroxone-based NTD system was effective for decontamination of the air and surfaces in a dissecting room after autopsies of exhumed bodies.

Asbestosis hospitalizations in Poland (2006-2016): results from the National Hospital Discharge Registry

INTRODUCTION AND OBJECTIVE

Occupational asbestos exposure is one of the major public health issues. Although asbestos use in Poland has decreased, asbestosis continues to remain an important health concern in the area of occupational medicine. The aim of the study is to perform a descriptive analysis of hospitalization cases in patients suffering from asbestosis in Poland.

MATERIAL AND METHODS

The authors used hospital discharge records to conduct a retrospective, population-based study. To estimate the asbestosis hospitalization rate, data from the Nationwide General Hospital Morbidity Study conducted by the National Institute of Public Health were used. Events were defined as in-patient hospital discharges during 2006-2016. 1,101 hospitalization records of 764 patients were included in the study.

RESULTS

In the study group of first-time hospitalized patients, the mean and median ages were 68.1 and 69 years, respectively; CI: 67.3-68.9; SD: 11.1, min-max:16-99 years. In this group, significant gender differences were observed (560 males vs. 204 female; P<0.001). No statistical differences were observed regarding the place of residence. During the observation period, 61 in-hospital deaths were reported (8% of all patients), 40 of whom (5.2 % of all patients) took place during the first-time hospitalizations. Asbestosis hospitalizations were mainly clustered in the south-western region, whereas the highest hospitalization rates were clustered in several areas of Poland.

CONCLUSIONS

The authors believe this study to be the first evaluation of asbestosis in Poland made on the basis of the hospital morbidity database. The data presented may be helpful in comparative studies on the epidemiology of asbestosis across European countries.

Nutritional Status and Dietary Patterns in Adults with Severe Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is associated with daytime sleepiness, obesity, and lifestyle and dietary changes. The potential role of diet in OSA has been largely unexplored. The aim of the study was to assess nutritional status and dietary patterns in OSA patients. The study was conducted in 137 adult patients (48 women and 89 men) aged 31-79 suffering from OSA. The following diagnostic procedures were undertaken: polysomnography, anthropometric measurements, and a dietary pattern questionnaire. We found that 128 (93.4%) patients were overweight or obese with the mean body mass index (BMI) of 33.2 ± 6.1 kg/m² and weight of 98.0 ± 20.2 kg. The mean percentage of total body fat was 45.0 ± 5.5% in women and 32.5 ± 5.5% in men. Obesity was associated with the severity of OSA, expressed by apnea/hypopnea index. We further found that the waist-to-hip ratio in women, but the neck circumference or percentage of body fat in men, characterizes best the OSA patients. Referring to dietary habits, half of the patients consumed white bread on a daily basis, 35.8% of them had whole grain bread in the diet, and only 16.8% consumed fish at least two portions a week. A third of patients used butter as a spread for bread or a source of fat for cooking, 2.9% of them used soft margarine, and 20.4% used olive or canola oil. Fruits and vegetables were consumed by 60% and 38% of patients, respectively. Refined sugar and sweets were used by 31.4% of patients every day. We conclude that excessive body weight, which may portend the development of OSA, is characterized by different anthropometric variables in men and women. Further, improper dietary habits seem conducive to the gain in body weight and thus may be at play in the pathogenesis of OSA.

Assessment of tolerability and acceptability of an alcohol-based hand rub according to a WHO protocol and using apparatus tests

Background

The effectiveness of alcohol-based hand rubs (ABHRs) depends substantially on their acceptability and tolerability. In this study, we assessed the acceptability and tolerability of a new ABHR (product EU 100.2018.02).

Methods

Among physicians, nurses, and cosmetologists who used the ABHR for 30 days, we assessed the product’s acceptability and tolerability according to a WHO protocol. Additionally, we used instrumental skin tests. Participants assessed the product’s color, smell, texture, irritation, drying effect, ease of use, speed of drying, and application, and they gave an overall evaluation. Moreover, they rated the tolerability, i.e. their skin condition, on the following dimensions: intactness, moisture content, sensation, and integrity of the skin. The tolerability was also assessed by an observer as follows: redness, scaliness, fissures, and overall score for the skin condition. Instrumental skin tests included transepidermal water loss, skin hydration, sebum secretion, and percentage of skin affected by discolorations. All assessments were made at baseline (visit 1), and 3–5 days (visit 2) and 30 days (visit 3) later.

Results

We enrolled 126 participants (110 [87%] women) with a mean age of 34.3 ± 11.65 years. Sixty-five participants (52%) were healthcare professionals (physicians, nurses), and 61 (48%) were cosmetologists. During visit 2 and visit 3, about 90% of participants gave responses complying with the WHO’s benchmark for acceptability and tolerability. Similarly, the ABHR met the WHO criteria for observer-assessed tolerability: on all visits, in more than 95% of participants, the observer gave scores complying with the WHO benchmark. Transepidermal water loss decreased from baseline to visit 3 (p < 0.001), whereas skin hydration, sebum secretion, and the percentage of skin affected by discolorations did not change significantly during the study (p ≥ 130).

Conclusions

The EU 100.2018.02 had both high acceptability and tolerability, meeting the WHO criteria. The WHO protocol proved useful in the analysis of acceptability and tolerability of ABHRs.

Vaccination of healthcare personnel in Europe: Update to current policies

We investigated and compared current national vaccination policies for health-care personnel (HCP) in Europe with results from our previous survey. Data from 36 European countries were collected using the same methodology as in 2011. National policies for HCP immunization were in place in all countries. There were significant differences in terms of number of vaccinations, target HCP and healthcare settings, and implementation regulations (recommended or mandatory vaccinations). Vaccination policies against hepatitis B and seasonal influenza were present in 35 countries each. Policies for vaccination of HCP against measles, mumps, rubella and varicella existed in 28, 24, 25 and 19 countries, respectively; and against tetanus, diphtheria, pertussis and poliomyelitis in 21, 20, 19, and 18 countries, respectively. Recommendations for hepatitis A immunization existed in 17 countries, and against meningococcus B, meningococcus C, meningococcus A, C, W, Y, and tuberculosis in 10, 8, 17, and 7 countries, respectively. Mandatory vaccination policies were found in 13 countries and were a pre-requisite for employment in ten. Comparing the vaccination programs of the 30 European countries that participated in the 2011 survey, we found that more countries had national vaccination policies against measles, mumps, rubella, hepatitis A, diphtheria, tetanus, poliomyelitis, pertussis, meningococcus C and/or meningococcus A, C, W, Y; and more of these implemented mandatory vaccination policies for HCP. In conclusion, European countries now have more comprehensive national vaccination programs for HCP, however there are still gaps. Given the recent large outbreaks of vaccine-preventable diseases in Europe and the occupational risk for HCP, vaccination policies need to be expanded and strengthened in several European countries. Overall, vaccination policies for HCP in Europe should be periodically re-evaluated in order to provide optimal protection against vaccine-preventable diseases and infection control within healthcare facilities for HCP and patients.

Sarcoidosis among hospitalized patients in Poland: a study based on a national hospital registry

INTRODUCTION

Sarcoidosis is a systemic granulomatous disease mainly affecting the lungs, although granulomas can also involve any other organ.

OBJECTIVES

We sought to describe patients during their first hospitalization for sarcoidosis in Poland from 2008 to 2015. To our knowledge, this is the first evaluation of the disease in Poland based on a hospital morbidity database.

PATIENTS AND METHODS

We conducted a retrospective, population‑based study, using hospital discharge records compiled by the National Institute of Public Health in the years 2008 to 2015.

RESULTS

Among the 23 097 patients included in the study, men were predominant (54.7%). The mean and median ages at hospitalization were 44.7 years (95% CI, 44.5-44.9) and 42 years, respectively. Most patients (65%) resided in urban areas. The average annual incidence rate of sarcoidosis was 7.5 per 100 000 (95% CI, 7.1-7.9). The lungs were the most commonly affected organ (57.9%), while the remaining cases included sarcoidosis of lymph nodes and no lung involvement (18%), the skin (1.4%), and other or unspecified sites (22.7%). Skin sarcoidosis occurred significantly more frequently in women, while sarcoidosis of the lungs with coexisting sarcoidosis of lymph nodes was significantly more prevalent in men. Seasonal variability in sarcoidosis incidence was observed.

CONCLUSIONS

Sex and age may have a significant impact on the occurrence of sarcoidosis in Poland. Changes in seasonality may suggest the role of environmental factors. These data on sarcoidosis in Poland may be helpful in comparative analyses with other European countries.

Polyarteritis nodosa: decreasing incidence in Poland

INTRODUCTION

There are many studies on the epidemiology of the orphan disease polyarteritis nodosa (PAN) in European countries. The use of a hospital morbidity database is an important element of epidemiological analysis. The study is the first such analysis in Poland and may provide an opportunity to compare the data in a European context.

MATERIAL AND METHODS

We conducted a retrospective, population-based study using hospital discharge records with a PAN diagnosis. PAN incidence was estimated based on data from a Polish hospital morbidity study carried out by the National Institute of Public Health. Data on all inpatients discharged from non-psychiatric hospitals in Poland were collected between 2008 and 2013. We identified 557 patients with first-time hospitalizations for PAN.

RESULTS

The sample consisted of 202 (36.3%) males and 355 (63.7%) females. The median and mean age was 53 and 50 years, respectively. The average annual incidence of PAN in Poland was estimated to be 2.4 per million. PAN incidence decreased significantly over time in Poland between 2008 and 2013 (3.3 per million vs 1.9 per million, p < 0.001) and it may be associated with a decrease in hepatitis B incidence observed in Poland.

CONCLUSIONS

Incidence of PAN in Poland was estimated to be 2.4 per million and was comparable to the incidence found in other European countries. PAN incidence decreased during 2008-2013. The decrease in PAN incidence may be related to environmental, infectious (hepatitis B) or other unknown factors. Future research is needed to identify the cause of the decrease and potential triggers of the disease.

Dietary macronutrients and fluid intakes in a sample of pregnant women with either gestational diabetes or type 1 diabetes mellitus, assessed in comparison with Polish nutritional guidelines

OBJECTIVES

Pregnancy is a critical period during which environmental factors such as nutrition can affect development. Maintaining proper nutrition becomes even more significant when pregnant women have diabetes. The aim of this study was to measure changes in energy and macronutrient intakes among pregnant women and patients diagnosed either with gestational diabetes mellitus (GDM) during pregnancy, or, type 1 diabetes mellitus (T1DM) before pregnancy, and to assess the pregnant women's dietary intakes in comparison with Polish Institute of Food and Nutrition nutritional guidelines.

MATERIAL AND METHODS

The analysis was conducted among 83 pregnant women (29 GDM patients, 26 T1DM patients and 28 normal pregnancy patients - the control group) from whom we gathered nutritional data during the second part of their pregnancies. Data on each woman's diet during pregnancy was collected is self-completed dietary records during seven consecutive 24-hour periods.

RESULTS

The mean macronutrient intake of the GDM patients was 32.1% fat, 19.5% protein, and 48.3% carbohydrates; in the T1DM group the results were 34.2%, 19.4% and 46.4% respectively; and in control group they were 31.8%, 17.6% and 50.5% respectively. This study showed that many of the pregnant women did not reach the recommended level of energy intake during pregnancy. Moreover, most of the women exceeded their fat requirements, and fat intake as a proportion of energy intakes also exceeded the guidelines in more than 60% of the women across all groups.

CONCLUSIONS

The implications and possible causes of excessive fat intake during pregnancy and pregnancies complicated by diabetes are underestimated and undertreated by obstetricians and warrant further investigation, especially in association with gestational weight gain, maternal and fetal perinatal complications, and post-gestational diabetes.

[Influenza vaccine coverage rates in Polish nurses]

Medical personnel, including nursing staff, can become a source of influenza virus infections for their patients and co-workers. However, patients can infect the personnel, too. Therefore, influenza vaccinations are recommended for medical staff as an effective and safe form of preventing influenza and its complications.

AIM

The aim of the study was to evaluate the current influenza vaccine coverage rate in nursing personnel and identify of incentives and disincentives for the performance of influenza vaccinations in nursing staff.

MATERIALS AND METHODS

The cross sectional study was carried out a group of 770 nurses, using the research questionnaire, previously validated.

RESULTS

The influenza vaccine coverage rate in the study group was 15%. The probability of having a vaccination this season and in the previous seasons was higher in medical staff working in out-patient health care (p <0.05, OR 5.15, 95% CI 3.33-7.96), with work experience >40 years (p <0 , 05, OR 6.93, 95% CI 2.04-23.78), dealing with chronic diseases (p <0.05, OR 1.57, 95% CI 1.00-2.46). The most important encouraging factor for influenza vaccination was that the employer paid for the vaccine available in the workplace, the desire to protect oneself from the disease, the belief in the safety and efficacy of the vaccine. The most important factor discouraging vaccination against influenza was the lack of reimbursement of the vaccine and the inconvenience of its implementation in the workplace, as well as doubts related to the safety and effectiveness of the vaccine.

CONCLUSIONS

The influenza vaccine coverage rate is very low and certain activities should be undertaken to increase it. Measures taken to increase the influenza vaccine coverage rate for nursing staff should be targeted and include identified disincentives and incentives for vaccination.

[The effect of selected vitamins, minarals and antioxidants on age-related macular degeneration]

Age-related macular degeneration (AMD) is a progressively degenerative disease at the central area of the retina, which results in severe visual impairment. It is the leading cause of irreversible blindness among people aged over 65 in developed countries. Therapies that focus on prevention through optimization of modifiable risk factors such as diet and nutritional status are key approaches to reducing the burden of disease. An adequate diet, especially rich in antioxidant compounds, seems to play an important role in this case. Available scientific data suggest that vitamins A, E, C and carotenoids, in particular lutein and zeaxantine and some minerals, may play an important role in the prevention and / or delay of AMD. There are also new data on the importance of other ingredients such as flavonoids in the AMD development. In this work, based on the available data, the study reviews the relationship between the intake of selected antioxidant nutrients and age-related macular degeneration.