Characteristics of Factors Influencing the Occurrence of Cleft Lip and/or Palate: A Case Analysis and Literature Review

INTRODUCTION

Cleft lip with or without cleft palate (CL/P) stands as the most common congenital facial anomaly, stemming from multifactorial causes.

OBJECTIVE

Our study aimed to ascertain the prevalence and characteristics of cleft palates, identify associated risk factors to inform prevention and prenatal detection for early intervention, and assess postoperative rehabilitation protocols for cleft palates.

DESIGN

This study employs a retrospective descriptive and clinical approach.

PATIENTS

The study includes 103 children with cleft palates treated at the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury.

METHODS

We conducted a thorough evaluation of records, considering variables such as sex, cleft type, maternal occupation, parental education, and family history of clefts. Data analysis was carried out using R software version GPL-3 and ordinal logistic regression analyses.

RESULTS

Notably, children born to mothers who experienced significant stress during pregnancy exhibited a 9.4-fold increase in the odds of having bilateral cleft palates. Conversely, no substantial evidence was found to support the influence of the child's sex, birth order, body mass, maternal exposure to workplace toxins, infections, or drug toxicity on the dependent variable.

CONCLUSIONS

Our findings suggest that children with parents who have a history of clefts and those with less educated mothers are more likely to develop bilateral cleft palates. Additionally, children born to mothers experiencing stress during pregnancy face an increased risk of bilateral cleft palates. It is important to note that there is a paucity of literature on rehabilitation following various cleft palate surgical techniques in children.

Children with Rare Nager Syndrome-Literature Review, Clinical and Physiotherapeutic Management

Nager syndrome is a rare human developmental disorder characterized by craniofacial defects including the downward slanting of the palpebral fissures, cleft palate, limb deformities, mandibular hypoplasia, hypoplasia or absence of thumbs, microretrognathia, and ankylosis of the temporomandibular joint. The prevalence is very rare and the literature describes only about a hundred cases of Nager syndrome. There is evidence of autosomal dominant and autosomal recessive inheritance for Nager syndrome, suggesting genetic heterogeneity. The majority of the described causes of Nager syndrome include pathogenic variants in the SF3B4 gene, which encodes a component of the spliceosome; therefore, the syndrome belongs to the spliceosomopathy group of diseases. The diagnosis is made on the basis of physical and radiological examination and detection of mutations in the SF3B4 gene. Due to the diversity of defects associated with Nager syndrome, patients require multidisciplinary, complex, and long-lasting treatment. Usually, it starts from birth until the age of twenty years. The surgical procedures vary over a patient's lifetime and are related to the needed function. First, breathing and feeding must be facilitated; then, oral and facial clefts should be addressed, followed by correcting eyelid deformities and cheekbone reconstruction. In later age, a surgery of the nose and external ear is performed. Speech and hearing disorders require specialized logopedic treatment. A defect of the thumb is treated by transplanting a tendon and muscle or transferring the position of the index finger. In addition to surgery, in order to maximize a patient's benefit and to reduce functional insufficiency, complementary treatments such as rehabilitation and physiotherapy are recommended. In our study, we describe eight patients of different ages with various cases of Nager syndrome. The aim of our work was to present the actual genetic knowledge on this disease and its treatment procedures.

SMART System in the Assessment of Exercise Tolerance in Adults

Health-oriented physical activity should meet two key criteria: safety and an optimal level of exercise. The system of monitoring and rationalization of training (SMART) was designed to meet them. SMART integrates a custom-configured inertial measurement unit (IMU) and a sensor with real-time heart rate measurement (HR) using a proprietary computer application. SMART was used to evaluate the safety and exercise load with 115 study participants: 51 women (44.35%) and 64 men (55.65%) aged 19 to 65 years. The exercise test was the 6MWT test. In 35% of the participants, the mean HR exceeded the recognized safe limit of HR 75% max. Ongoing monitoring of HR allows for optimal exercise and its safety. Step count data were collected from the SMART system. The average step length was calculated by dividing the distance by the number of steps. The aim of the present study was to assess the risk of excessive cardiovascular stress during the 6MWT test using the SMART system.

The long-lasting effect of early life family structure on social position, well-being, and biological condition in adulthood

BACKGROUND

The absence of even one parent has short- and long-term effects on the child's current and future health. The purpose of the study was to determine whether there is a long-term relationship between the type of family in which men were raised and an individual's adult social position, well-being in adulthood and their biological condition regardless of social status in adulthood.

MATERIALS AND METHODS

Data for 4528 males, aged 25-80 years, were selected from the archives of the Lower Silesian Medical Centre in Wrocław, Poland. A total of 329 men declared that they grew up in incomplete families. Height, weight, % fat, cardiovascular and respiratory systems, blood parameters, and health of men who grew up in complete or incomplete families were compared.

RESULTS

Growing up in an incomplete family reduced chances for better education, decreased life satisfaction in adulthood, and negatively affected the final height. After taking into account the education achieved, the effect persisted only for diastolic blood pressure, creatinine, and serum phosphorus levels.

CONCLUSIONS

Growing up in an incomplete family has a significant impact on male's socioeconomic position (SES), life satisfaction, and final height. A poorer quality of diet is proposed as an early life risk factor for adult health.

Planning of physiotherapeutic procedure in patients after mandible reconstruction taking into account donor site: a literature review

BACKGROUND

Mandible tumors are very rare. One of the main methods of the treatments is resection of the tumor and then reconstruction of the mandible. The donor site is often distant tissue-fibula or ilium. Following this, it is necessary to improve the patient in two ways, on one hand restoring the function of the mandible, and on the other hand, improving the donor site area. For that reason, physiotherapy after tumor resection and reconstruction of the mandible is very complicated. The aim of this bibliographic review was to find the methods of the reconstruction of the mandible in the context of patients' functional assessment after surgeries to create effective physiotherapeutic procedures in the feature.

METHODS

PEDro, Medline (PubMed), Cochrane Clinical Trials were searched.

RESULTS

767 articles were found. 40 articles were included to this literature review.

CONCLUSIONS

Authors showed different kinds of surgeries strategy for patients with tumors of the mandible. They also showed manners of patients' functional assessment in the localization of transplantation and donor site. It could be useful for physiotherapists during planning of comprehensive physiotherapy.

Scoliotic posture and biological age measured by pubertal growth spurt in adolescent boys and girls

Puberty is a critical period in the development of children and adolescents. The muscular dystonia observed during this period and the environmental factors present at home and school promote the adoption of abnormal posture and impaired physical performance. Early detection of postural changes provides opportunities for prevention and treatment. The aim of this study was to compare the body posture and the size of the rotational deformation of the trunk in children aged 10-15 years, before and after pubertal growth spurt. The study included 40 subjects, 19 boys and 21 girls from Wroclaw, Poland, aged 10.3-15.6 years, who reported for the first time to the Postural Defects Outpatient Clinic with suspected rotational deformity of the trunk. Based on the equations, maturity offset (MO) was determined and the age of peak height velocity (APHV) was assessed. The posture was evaluated using a deflection of the plumb line, scapular asymmetry, finger-to-floor test, angle of trunk rotation ATR at 3 spinal levels: proximal thoracic, main thoracic, and lumbar and the Three Rotation Sum (TRS) parameter. These parameters are the earliest clinical signs of scoliosis. In the examined children and adolescents from Wrocław, irrespective of their calendar age, after the APHV, the characteristics describing lateral curvatures of the spine showed higher values, reaching especially for maximal ATR and for the TRS a highly statistically significant level. Post-pubertal children were also more often characterized by the so-called scoliotic posture - they had a significantly greater trunk deviation measured with the plumb line lowered from C7 (0.3 cm versus 0.9 cm; p = 0.01), a greater difference in the height of lower scapular anles, and a worse score on the finger-to-floor test. In conclusion, scoliometer testing should be permanently incorporated into periodic body measurements at school, especially among 10- to 12-year-old children who are at higher risk for scoliosis progression. Equations for assessing biological age, although associated with an error, appear to be easy to use and useful in screening for risk of developing scoliosis at peri-pubertal age.

Tilt and mobility of the hip girdle in the sagittal and frontal planes in healthy subjects aged 19-30 years

BACKGROUND

Disturbances in pelvic girdle tilt can cause compensatory changes affecting postural dysfunctions, and can lead to hip and groin strain changes and back pain. However, we still have no clear information on the normative values of pelvic girdle tilt and mobility.

OBJECTIVE

The study aimed to (1) evaluate the position and mobility of the pelvic girdle in the sagittal and frontal planes in asymptomatic adults aged 19-30, (2) evaluate the possible variation of results according to gender and to develop a proposal for normative values, and (3) evaluate whether body mass, height and BMI are related to the magnitude of hip girdle position and mobility.

METHODS

The research was conducted in a sample group consisting of 346 men and women using the scaled form of the anthropometric level of the Duometr® The values of position and mobility of the pelvic girdle in the sagittal and frontal planes were analyzed.

RESULTS

Differences were noted in the values of the pelvic tilt (p= 0.033) between the men and women. The women showed slightly higher values of posterior range of motion (p= 0.0002) and total range of motion (p= 0.002). The other parameters did not show any significant variation. There was no clear association between body weight, height and BMI and the study variables, except for a small, significant correlation between BMI and posterior pelvic tilt in women (r= 0.175, p= 0.005). In the frontal plane there were no differences in the analyzed variables in terms of gender or side of the body measured.

CONCLUSIONS

There was no association between the anthropometric variables and the pelvic girdle tilt and mobility. No size variation by gender was observed in the frontal plane. Slight differences were observed in the sagittal plane. Normative values are proposed.

How Stress Is Related to Age, Education, Physical Activity, Body Mass Index, and Body Fat Percentage in Adult Polish Men?

Stressful events and chronic tension are considered a burden and a threat to physical, mental, and social health. The aim of the study was to demonstrate the associations of variation in stress exposure with social factors, physical activity, basic components of physical fitness, body mass index (BMI) and percentage of body fat (BFP). An additional objective was to identify the main BFP modifiers among those analyzed. The material consisted of data of ethnically homogeneous group 355 men (32-87 yrs), invited to the study as part of the Wroclaw Male Study research project. The analyzed features included socioeconomic status (age, educational level), elements of lifestyle (physical activity), major and most important stressful life events-Social Readjustment Rating Scale (SRRS) and basic parameters of the somatic structure of the body (BMI, BFP). Statistical analyses included: chi-square test, Mann-Whitney U test and backward stepwise regression (significance level α = 0.05). Stress exposure showed significant socioeconomic variation among the adult Poles studied. Higher levels of education were associated with higher levels of stress. Significant correlations between SRRS and physical activity were found, especially in men older than 60 years and with higher levels of education. A positive relationship was shown between SRRS and BFP, especially in men under 60 years of age. BFP appeared to depend mainly on age and stress. The main determinants of SRRS were age and education level, while BFP turned out to be more sensitive to stress than BMI. The modifying force of physical activity for SRRS appears to be age dependent.

Age, Education, and Stress Affect Ageing Males' Symptoms More than Lifestyle Does: The Wroclaw Male Study

An increasing number of subjects are affected by health problems related to the advanced involutional processes. It is extremely important to identify the determinants of the rate of occurrence of physiological, psychological, and social manifestations of aging. The aim was to determine how factors such as lifestyle, level of education, or severity of stressful life events indicate the appearance of aging symptoms in adult men. The material consisted of data of ethnically homogeneous group of 355 men (32−87 years), invited to the study as a part of the Wroclaw Male Study research project. The analyzed features included (1) socioeconomic status: age, educational level, marital status, and having children; (2) elements of lifestyle: alcohol drinking, cigarette smoking, and physical activity; (3) major and most important stressful life events—the Social Readjustment Rating Scale; (4) symptoms related to male aging—the Aging Males’ Symptoms. The backward stepwise regression models, the Kruskal−Wallis test, and multiple comparisons of mean ranks were used. Noncentrality parameter δ (delta), two-tailed critical values of the test, and test power with α = 0.05 were calculated. Among the analyzed variables, age was most strongly associated with the intensity of almost all groups of andropausal symptoms in men (p = 0.0001), followed by the level of education (p = 0.0001) and the intensity of stressful life events (p = 0.0108). Selected lifestyle elements turned out to be much less important (p > 0.01). Preventive actions aimed at slowing down the intensification of involutional processes, including teaching strategies for coping with stressful life events, should be implemented in groups of men with specific risk factors from an early age.

Protocol for Multi-Stage Treatment of Temporomandibular Joint Ankylosis in Children and Adolescents

Treatment of temporomandibular ankylosis is challenging and frequently leads to re-ankylosis, relapse, dangerous complications and, in turn, the need for multiple operations. In this article, we present a protocol for the treatment of ankylosis of the temporomandibular joints that assumes earlier intervention with the assistance of 3D virtual surgical planning (3DVSP) and custom biomaterials for better and safer surgical outcomes. Thirty-three patients were treated due to either uni- or bilateral temporomandibular ankylosis. Twenty individuals received temporomandibular prosthesis, whereas seventeen required simultaneous 3D virtual surgical/planned orthognathic surgery as the final correction of the malocclusion. All patients exhibited statistically significant improvements in mouth opening (from 1.21 ± 0.74 cm to 3.77 ± 0.46 cm) and increased physiological functioning of the mandible. Gap arthroplasty and aggressive rehabilitation prior to temporomandibular prosthesis (TMJP) placement were preferred over costochondral autografts. The use of 3DVSP and custom biomaterials enables more precise, efficient and safe procedures to be performed in the paediatric and adolescent population requiring treatment for temporomandibular ankylosis.

Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report

BACKGROUND

Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management.

CASE DESCRIPTION

: In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed.

INTERVENTION

: Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery.

OUTCOMES

: Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food.

CONCLUSIONS

: This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.

Vocal Indicators of Size, Shape and Body Composition in Polish Men

OBJECTIVES

From a human evolution perspective, identifying a link between physique and vocal quality could demonstrate dual signaling in terms of the health and biological condition of an individual. In this regard, this study investigates the relationship between men's body size, shape, and composition, and their vocal characteristics.

MATERIALS AND METHODS

Eleven anthropometric measurements, using seven indices, were carried out with 80 adult Polish male participants, while the speech analysis adopted a voice recording procedure that involved phonetically recording vowels /ɑː/, /ɛː/, /iː/, /ɔː/, /uː/ to define the voice acoustic components used in Praat software.

RESULTS

The relationship between voice parameters and body size/shape/composition was found. The analysis indicated that the formants and their derivatives were useful parameters for prediction of height, weight, neck, shoulder, waist, and hip circumferences. Fundamental frequency (F₀) was negatively correlated with neck circumference at Adam's apple level and body height. Moreover neck circumference and F₀ association was observed for the first time in this paper. The association between waist circumference and formant component showed a net effect. In addition, the formant parameters showed significant correlations with body shape, indicating a lower vocal timbre in men with a larger relative waist circumference.

DISCUSSION

Men with lower vocal pitch had wider necks, probably a result of larynx size. Furthermore, a greater waist circumference, presumably resulting from abdominal fat distribution in men, correlated with a lower vocal timbre. While these results are inconclusive, they highlight new directions for further research.

Adolescent age estimation using voice features

In this paper, a method for evaluating the chronological age of adolescents on the basis of their voice signal is presented. For every examined child, the vowels a, e, i, o and u were recorded in extended phonation. Sixty voice parameters were extracted from each recording. Voice recordings were supplemented with height measurement in order to check if it could improve the accuracy of the proposed solution. Predictor selection was performed using the LASSO (least absolute shrinkage and selection operator) algorithm. For age estimation, the random forest (RF) for regression method was employed and it was tested using a 10-fold cross-validation. The lowest absolute error (0.37 year ± 0.28) was obtained for boys only when all selected features were included into prediction. In all cases, the achieved accuracy was higher for boys than for girls, which results from the fact that the change of voice with age is larger for men than for women. The achieved results suggest that the presented approach can be employed for accurate age estimation during rapid development in children.

Social class-specific secular trends in height among 19-year old Polish men: 6th national surveys from 1965 till 2010

The results presented in this study concern the assessment of the secular trend of body height in 10 % a random national sample (N = 134,224) representing all regions of Poland in 8 homogeneous social groups over 45 years in Poland (1965-2010). Very significant political, social and economic changes in Poland occurred in the period studied. The political revolution that began in Poland at the turn of the 1980s and 1990s dramatically changed the picture of social inequalities in the country. It rapidly transformed (in different directions and to a different degree) the economic situation, working conditions, lifestyles and the prestige of particular social classes and professional groups. A positive secular trend was observed in 19-year-old participants in the period analysed in all homogeneous socio-professional groups, however, with different intensity in each group. The highest body height increases in 1965-2010 were observed in the sons of farmers with post-primary father's education (7.77 cm). The lowest were observed among the sons of professionals, only 5.45 cm. Although social distances between extreme socio-economic groups significantly decreased (from 4.89 cm in 1965 to 2.76 cm in 2010), social gradients of body height, despite the improvement in the standards of living of the entire society remained exceptionally stable and unchanged for nearly half a century.

Body balance analysis of children and youth with intellectual disabilities

BACKGROUND

Children and adolescents with intellectual disabilities (IDs) are an identified group with postural disturbances resulting from a lack of integration among the visual, vestibular and proprioceptive systems. The insufficient level of maturity of the sensory systems is at least partly responsible for disturbances in maintaining body balance. More sway can increase the risk of falls and body injuries. The aims of the study were (1) to compare the ability to maintain the body balance of children and youth with a varying degree of ID, both with the eyes open and closed, and (2) to determine to what extent factors such as sex, level of ID, visual stimulus and body height independently affect the ability to maintain body balance in children and adolescents with ID.

METHOD

The study involved 131 people aged 13-21 years (65 girls and 66 boys). The participants were classified as (1) with mild disability (42 girls and 47 boys) and (2) with moderate disability (23 girls and 19 boys), based on IQ test results. Sway measures were collected with the Zebris platform, with the eyes open and closed. Sway path, sway path in anterio-posterior and medio-lateral directions and sway area were analysed.

RESULTS

Boys with moderate ID were characterised by a significantly more sway indicating their worse postural balance ability than boys with mild ID, both in the trials with open eyes and closed ones. The type of test (eyes open/eyes closed) to a small extent had influenced the body balance of the examined children with ID. Results of analyses of covariance had showed that all analysed factors (sex, level of ID, type of the test performance and body height), irrespectively from direction of sway (sway path in anterio-posterior and medio-lateral directions), worked independently influencing body balance.

CONCLUSIONS

It could be assumed that lower height, moderate disability and male sex are factors significantly reducing ability of maintenance of balance of children and youth with ID.

The relationship between: occupational status, biological condition and androgen hormone level among Polish adult men: the Wroclaw Male Study

Population health and its determinants are one of the major challenges to social and economic policy. The aim of this study was to investigate the relationship between occupational activity and biological condition in adult working Polish men. The participants of the study were 300 men (30-65 years), healthy inhabitants of the city of Wroclaw, Poland. Seventeen measures of biological condition were examined. The subjects were divided into three different occupational groups: professionals, soldiers and skilled workers. A comparison of biological age profiles of three occupational groups showed that in the majority of characteristics, professionals had the youngest biological age, whereas skilled workers had the highest biological age. The results for soldiers were not as unambiguous, but biological parameters were generally closer to those for professionals. Inborn biological predispositions and long-term impact of the working environment can influence on the biological condition of various professional groups. Knowledge of the determinants of biological condition might result in efficient use of predisposition to work or may be of help in extending their time of work ability.

Growth, Nutritional Status, and Pulmonary Function in Children with Chronic Recurrent Bronchitis

Bronchitis is a common health problem in children. Frequent bronchitis in infancy increases the risk of developing chronic respiratory diseases. The aim of the study was to assess the level of growth and the nutritional status in children and youths with special regard to the level of body fatness assessed by measuring skin-fold thickness. Relationships between somatic development, pulmonary function and the course of the disease were also explored. The study was carried out using anthropometric and spirometric measurements and also information on the severity and course of the disease in 141 children with chronic or recurrent bronchitis. All of the subjects were patients of the Pulmonary Medicine and Allergology Center in Karpacz, Poland. The mean body height did not differ significantly between the children examined and their healthy peers. However, the infection-prone children had excessive body fatness and muscle mass deficiency. The increased level of subcutaneous adipose tissue occurred especially in children with short duration of the disease, i.e. a maximum of 1 year. The functional lung parameters were generally normal. The presence of atopic diseases such as allergic rhinitis or atopic dermatitis did not impair the course of the children's somatic development. Also, long-term disease or the presence of additional allergic diseases did not impair lung function in the examined children. Taking appropriate preventive measures is recommended to achieve and maintain normal body weight in children who receive therapy due to bronchitis.

Biological costs of economic transition: Stress levels during the transition from communism to capitalism in Poland

At the end of the 1980s, Poland began the transformation from an essentially one-party communist system to a politically pluralistic democratic system. These political and economic changes had major social consequences, among others unemployment and a sharp decrease in real personal income. The aim of the study was to investigate the possible relationship between stress in adult men, measured by the Allostatic Load, and the socio-economic deterioration during the first part of the economic transition. The Allostatic Load included eleven markers assessing adverse nutritional intake, cardiovascular activity, inflammatory processes, and lung, hepatic and renal functions. The results indicate a significantly higher risk of metabolic dysregulation in men examined after 1990, compared to men from previous years. After adjustment for socioeconomic variables and lifestyle variables, men examined in 1991 had a 31% greater risk of higher Allostatic Load compared with men examined in 1985 (OR=1.31; p=0.0541), in 1992, this risk was 50% greater (OR=1.50; p<0.01), and in 1993, the risk was 66% greater (OR=1.66; p<0.05). The conclusion is drawn that significantly more stressogenic factors for men were those directly connected with the financial situation of their families, than a sudden but short increase of prices for goods and services.

Evaluation of factors related to bone disease in Polish children and adolescents with cystic fibrosis

PURPOSE

The aim of the study was to evaluate factors related to bone formation and resorption in Polish children and adolescents with cystic fibrosis and to examine the effect of nutritional status, biochemical parameters and clinical status on bone mineral density.

MATERIALS AND METHODS

The study group consisted of 100 children and adolescents with cystic fibrosis with a mean age 13.4 years old. Anthropometric measurements, included body height, body mass and body mass index (BMI); bone mineral densitometry and biochemical testing were performed. Bone mineral density was measured using a dual-energy X-ray absorption densitometer. Biochemical tests included serum calcium, phosphorus, parathyroid hormone and vitamin D concentrations, as well as 24-h urine calcium and phosphorus excretion. Pulmonary function was evaluated using FEV1%, and clinical status was estimated using the Shwachman-Kulczycki score.

RESULTS

Standardized body height, body mass and BMI were significantly lower than in the reference population. Mean serum vitamin D concentration was decreased. Pulmonary disease was generally mild, with a mean FEV1% of 81%. Multivariate linear regression revealed that the only factors that had a significant effect on bone marrow density were BMI and FEV1%. There were no significant correlations between bone mineral density and the results of any of the biochemical tests performed.

CONCLUSIONS

Nutritional status and bone mineral density were significantly decreased in children and adolescents with cystic fibrosis. In spite of abnormalities in biochemical testing, the factors that were found to have the strongest effect on bone mineral density were standardized BMI and clinical status.

Secular trends in body height and body mass in 19-year-old Polish men based on six national surveys from 1965 to 2010

OBJECTIVES

The aim was to determine whether an intergenerational trend toward increased stature is slowing down, and whether body weight has recently increased among young men in Poland, as it has in Western European countries.

METHODS

Data were taken from six national surveys of 19-year-old Polish male conscripts from cohorts 1965, 1976, 1986, 1995, 2001, and 2010.

RESULTS

The mean stature of this population increased throughout the last 45 years from 170.5 cm in 1965 to 178.3 in 2010. However, the average gain in stature per decade declined from 2.4 cm in the period 1965 to 1976 to 0.8 cm per decade in 1995 to 2001, but increased to 1.0 cm in the last period. The average of body weight increased from 63.2 kg in 1965 to 73.1 in 2010 and body mass index (BMI) rose from 21.73 to 22.94 in the same period. The tempo of increase varied in different periods; between 1965 and 1986 an insignificant increase was observed (of circa 0.12); in 1986 to 1995 there was no increase, whereas the period of 2001 to 2010 witnessed a significant increase (of circa 0.76).

CONCLUSIONS

The trend of body size and stature increase within the Polish population, although decelerating, remained positive and steady during the last 45 years. No significant impact of the past half-century's socioeconomic crises was observed in these measures of growth. We concluded that during the economic crises some effective mechanism protecting the living conditions of the children and youth were operating within the population.

Dietary pattern and its relationship between bone mineral density in girls and boys with cystic fibrosis - preliminary report

BACKGROUND

Nutrition influence on cystic fibrosis (CF) patients survival is well documented and dietary therapy is one of basic elements of their treatment. Prolonged survival of CF patients might yet emerge comorbidities, which include bone mineral disease.

THE AIM

The assessment of the dietary pattern and its relationship between bone density in boys and girls with cystic fibrosis.

MATERIAL AND METHODS

89 patients aged 10-18 years from 3 Polish CF Centres were included into the study. To obtain a knowledge about quality of diet, a 3-day food record was assessed and percent of recommended for CF patients intake of energy, protein, carbohydrates, fat, vitamin D3, calcium, phosphorus was counted. Bone mineral density (BMD) in lumbar spine (L1-L4) was measured and expressed as a Z-score. To assess nutritional status, anthropometric measurements was evaluated (body weight, height and BMI). Descriptive methods, Mann-Whitney test, T-Student test, Spearman correlation and one-way ANOVA were used for statistical analyses.

RESULTS

The patients with cystic fibrosis did not meet specific for CF nutritional guidelines. A deficiency in recommended intake was observed in energy (88%), protein (82%), calcium (78%) and vitamin D3 (71%). The intake of phosphorus was higher than recommended (142%). A nutritional status was significantly reduced, as compared with the reference group (p 0.001). Boys characterized significantly lower body weight (p=0.019) and height (p=0.036) than girls as well as worse caloric (p=0.023) and carbohydrates intake (p=0.005). However, girls had reduced vitamin D3 content in their diet (p 0.001). The bone mineral density in the whole group was reduced and Z-score amounted to -0.95 ± 1.17. Tendency to decreasing of BMD with age was observed. BMI showed important correlation with bone mineral density both in girls (p 0.001) and in boys (p=0.020).

CONCLUSION

CF patients do not follow specific for them dietary recommendations and essential differences were observed between girls and boys. Nutritional status (BMI) showed correlation with bone mineral density in CF patients. Therefore intensive nutritional therapy according to recommendations is needed. .

Secular trends in BMI and the prevalence of obesity in young Polish males from 1965 to 2010

BACKGROUND

Obesity is a serious public health problem, the prevalence of which is increasing dramatically all over the world. The aim of this study was to examine trends in body mass index (BMI) and the proportion of overweight and obese individuals among 19-year-old Polish males reporting for mandatory military fitness exams from 1965 to 2010.

METHODS

Height, weight and BMI [weight (kg)/height (m(2))] in five 10% nationwide random samples of 19-year-old conscripts examined in 1965, 1986, 1995, 2001 and 2010 were analysed.

RESULTS

From 1965 to 2010, mean BMI in 19-year-old Polish males increased from 21.7 to 22.9. The rate of change was not uniform, with a rapid increase in mean BMI from 1995 to 2010. Beginning in 1965, the proportion of men with a BMI over 25 has been steadily increasing from one decade to the next, and was four times higher in 2010 than it was in 1965. The rate of increase per decade was twice as high from 2001 to 2010 than it was from 1995 to 2001. In 2010, only 70.8% of young men were of ideal weight.

CONCLUSION

Increase in obesity can be attributed to the social and economic changes brought about by the transformation of the country from a communist to a free-market economy in 1989. The challenges of the obesity epidemic for public health services and its impact on morbidity and life expectancy are also discussed.

Influence of neurophysiological hippotherapy on the transference of the centre of gravity among children with cerebral palsy

BACKGROUND

The aim of the study was to present the influence of neurophysiological hippotherapy on the transference of the centre of gravity (COG) among children with cerebral palsy (CP).

MATERIAL AND METHODS

The study involved 19 children aged 4-13 years suffering from CP who demonstrated an asymmetric (A/P) model of compensation. Body balance was studied with the Cosmogamma Balance Platform. An examination on this platform was performed before and after a session of neurophysiological hippotherapy. In order to compare the correlations and differences between the examinations, the results were analysed using Student's T-test for dependent samples at p ≤ 0.05 as the level of statistical significance and descriptive statistics were calculated.

RESULTS

The mean value of the body's centre of gravity in the frontal plane (COG X) was 18.33 (mm) during the first examination, changing by 21.84 (mm) after neurophysiological hippotherapy towards deloading of the antigravity lower limb (p ≤ 0.0001). The other stabilographic parameters increased; however, only the change in average speed of antero - posterior COG oscillation was statistically significant (p = 0.0354).

CONCLUSION

1. One session of neurophysiological hippotherapy induced statistically significant changes in the position of the centre of gravity in the body in the frontal plane and the average speed of COG oscillation in the sagittal plane among CP children demonstrating an asymmetric model of compensation (A/P).

Some evidence for health-related marriage selection

OBJECTIVES

Married people live longer and are healthier than unmarried people. This can be explained in terms of marriage protection and marriage selection. The aim of the present study was to examine the direct effect of marriage selection on health status.

METHODS

Data were collected from the archives of the Lower Silesian Medical Center (DOLMED) in Wrocław, Poland. The sample consisted of 2,265 adult (never married or currently married) men. Subjects were assigned to categories for selected variables, including age, level of education, military category upon conscription, height, hearing acuity, and visual acuity. Military category, objective data gathered upon military conscription at age 18, was used to assess initial health status. To identify any relationships between marital status and health status, generalized linear models with binomially distributed dependent variable were used.

RESULTS

The never-married subjects were more likely to have been assigned to lower military categories, which indicates that their health status at age 18 was inferior to those conscripts who would later marry. Hearing acuity and visual acuity were generally worse in never-married subjects than in married subjects. Never-married subjects were also more likely to be short and less likely to be tall.

CONCLUSIONS

The results provide evidence for direct health-related marriage selection in men between 25 and 60 years of age. Poor health status reduces the likelihood of marriage.

Life satisfaction and cardiovascular disease risk in Poland

INTRODUCTION

Cardiovascular disease is the most common cause of death. Life satisfaction is a predictor of morbidity and mortality, irrespectively of objective measures of health status. The aim of the study was to evaluate the relationship between life satisfaction (LS) and cardiovascular disease risk (CVD) assessed with the Framingham Risk Score (FRS) in Polish adults.

MATERIAL AND METHODS

Past, present and projected LS were estimated. The FRS reflecting 10-year CVD risk was calculated from health indices and lifestyle parameters. Relationships between LS and FRS were tested by two-way analysis of variance in 489 men and 591 women, 40-50 years of age.

RESULTS

Subjects with a reduction in LS over time had a higher FRS compared to peers with an improvement in LS. The relationship between current LS and FRS had a J-shape in men; FRS was lowest in men with an LS of 5-7 (average LS), slightly higher in men with an LS of 8-10 (highest LS), and highest in men with an LS of 1-4 (lowest LS). Among women, there was an inverse linear relationship between LS and FRS: the higher the LS, the lower FRS. There was a strong linear relationship between predicted LS and CVD risk. Highest risk was evident in subjects with low LS in whom low LS was predicted over the next five years.

CONCLUSIONS

Low LS (dissatisfaction) thus has a long-term negative effect on CVD risk in Polish adults of both sexes.

Efficacy of manual lymphatic drainage in preventing secondary lymphedema after breast cancer surgery

This study evaluated the effectiveness of manual lymphatic drainage (MLD) in the prevention of secondary lymphedema after treatment of breast cancer. The study consisted of 67 women, who underwent breast surgery for primary breast cancer. From the second day of surgery, 33 randomly chosen women were given MLD. The control group consisted of 34 women who did not receive MLD. Measurements of the volumes of both the arms were taken before surgery and on days 2, 7, 14, and at 3 and 6 months after surgery. At 6 months after breast cancer surgery, among the women who did not undergo MLD, a significant increase in the arm volume on the operated side was observed (p=0.0033) when compared with the arm volume before surgery. At this time, there was no statistically significant increase in the volume of the upper limb on the operated side in women who underwent MLD. This study demonstrates that regardless of the surgery type and the number of the lymph nodes removed, MLD effectively prevented lymphedema of the arm on the operated side. Even in high risk breast cancer treatments (operation plus irradiation), MLD was demonstrated to be effective against arm volume increase. Even though confirmatory studies are needed, this study demonstrates that MLD administered early after operation for breast cancer should be considered for the prevention of lymphedema.

Childhood and adolescent body fat and its relationship with health outcome in 50 year old males and females: the Wrocław Growth Study

The aim of the study was to estimate the association between relative weight in childhood and adolescence and its relationship with adult health outcome. Longitudinal data of the body mass index (BMI) from the Wrocław Growth Study (WGS) covering ages 8 to 18 and then a follow-up at 50 were used. At the age of 50, 124 males and 139 females in the longitudinal study underwent medical examination. Systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TCH), high density lipoprotein cholesterol level (HDL), low density lipoprotein cholesterol level (LDL), triglyceride level (TGL) and fasting glucose level (GLUC) were assessed by using standard techniques. The values of BMI were standardised with the LMS method. Multiple linear regression was used to assess the relationship between health parameters and BMI at ages 8-18, adjusted for BMI at the age of 50, separately for different age categories and parameters, except for blood pressure where the usage of anti-hypertension medication was additionally used as a control variable. In males total cholesterol concentration showed a significant negative correlation with standardised BMI at ages 9-12 and 16 and 17. In females, only blood pressure showed a significant negative relationship with standardised BMI in all age categories reaching the highest values at age 15. The BMI in childhood and adolescence have only a weak effect on health outcome at age 50.

Social mobility by marriage and risk of cardiovascular disease among adults in Southwestern Poland

BACKGROUND

The social position of a husband or wife can influence the health status of the individual and his/her partner. Also, social position can change over time as a result of education, job, income, marriage and/or divorce.

AIM

To examine the association of mobility by marriage based on educational discrepancy between spouses and risk of cardiovascular disease (CVD) among Polish men and women of 40-50 years of age.

SUBJECTS AND METHODS

The sample included 394 married men and 453 married women of 40-50 years of age. All were residents of Wrocław located in southwestern Poland. Risk of CVD was assessed with the Framingham Risk Score (FRS). The sex-specific effect of social mobility on CVD risk (FRS) was tested by multiple regression analyses.

RESULTS

Among Polish married men and women, social mobility by marriage had a significant association with risk of CVD. Downwardly mobile men and women had a higher risk of CVD, while upwardly mobile men and women had a lower risk of CVD compared with individuals from homogamous marriages. The sole exception to this trend was poorly educated men among whom marriage with a better educated wife did not affect CVD risk.

CONCLUSION

Social mobility by marriage influences CVD risk. The results provide additional insights for studies examining socioeconomic differentials in CVD risk.

The negative health consequences of unemployment: the case of Poland

In the 1990s Poland began to make a transition to a free-market economy: a transition accompanied by a variety of negative socio-economic developments, most notably a rise in unemployment. The aim of this study is to shed light on the relationship between occupational status (including unemployment) and the risk of cardiovascular disease (CVD), by examining the experience of 542 men and 572 women between the ages of 40 and 50 of the town of Wroclaw in 2006. The Framingham Risk Score (FRS), which uses certain health and life-style parameters to predict the risk of major coronary problems over a 10-year period, was calculated, and the effect of occupational status on the FRS was assessed. The results showed that the FRS varied according to sex and to occupational status, with the highest FRS rating among unemployed men. Thus governmental policies to counter the adverse effects of unemployment should be developed to remedy the problem.

Biological condition of adult migrants and nonmigrants in Wrocław, Poland

Human migration and its economic, social, and demographic effects can lead to health consequences for individuals and populations. In the present study, we estimated differences in health status between migrant (those who had come to Wrocław at the age of > or =16 years) and nonmigrant (those who had lived in Wrocław since birth or had come with their parents) inhabitants of Wrocław, Poland. Three hundred and sixty seven males and 496 females aged 40 and 50 underwent medical examination, and were asked to fill out a questionnaire comprising social, demographic, and life style information. Health status was assessed by blood pressure, heart rate, fasting lipid profile, glucose, height, and measures of fatness (BMI, WHR, sum of skinfolds). Comparisons were made based on Borkan's and Norris's profiles. Student's t-test showed significant differences in diastolic blood pressure, heart rate, total cholesterol, and glucose levels between two groups of males, in favor of migrants. Male migrants were also significantly taller than their peers born in Wrocław. In females, migrants had significantly lower blood pressure and heart rate than nonmigrants. In interpreting the results two possible, not mutually exclusive, mechanisms are proposed: selective spatial mobility, and changes toward healthier life style as an adaptation to new urban environment.

SOCIOECONOMIC STATUS DURING CHILDHOOD AND HEALTH STATUS IN ADULTHOOD: THE WROCŁAW GROWTH STUDY

It has been widely observed that socioeconomic status (SES) is associated with frequency of cardiovascular disease. Both men and women of low socioeconomic position have increased risk of cardiovascular disease morbidity and premature death. In this study the relationship between SES in childhood, and health status at the age of 50 years was examined. Socioeconomic status in childhood was measured using objective (father’s educational level and number of children in the family) and subjective (self-assessed SES in childhood declared in early adulthood) indicators. Data from the Wrocław Growth Study were completed when subjects were 50 years old, and information concerning health status was added. The results indicated that the objective, universally used measures of SES in childhood such as father’s educational level and size of family did not show any essential relationships with health outcomes in adulthood, both for men and women. By contrast, retrospective, self-assessed SES (as better, average or worse as compared with peers) in childhood was significantly associated with the appearance of cardiovascular disease among women aged 50 years. Women who at the beginning of their adult life declared better socioeconomic condition in childhood were significantly healthier at the age of 50 years (OR=3·43; p=0·02). Moreover, this appeared to be independent of BMI, SES and life-style in adulthood. For men, retrospective self-assessed SES showed no relation to health status at the age of 50 years. The gender differences in the relationships between self-assessed SES in childhood and health status in adulthood are explained by possible selective premature mortality among men from lower childhood SES and/or sex differences in cognitive abilities.

Relationship between early puberty and the risk of hypertension/overweight at age 50: evidence for a modified Barker hypothesis among Polish youth

The objective of this paper is to evaluate: (a) the association between BMI in childhood and adolescence and BMI at age 50, and (b) the association between timing of maturation at puberty and BMI at age 50 and the occurrence of high blood pressure. We explore whether differences in somatic and physiological factors observed among children with early or late onset of puberty indicates that this period of life could be critical for appearance of some CVD risk factors later in the life cycle. Our data include 135 males and 148 females, born in 1953, participants in the Wrocław Longitudinal Study. Data pertaining to their growth and several indices of sexual and skeletal maturation were collected yearly between age 8 and 18. Subsequently, their anthropometric traits were measured and cardiovascular health status was assessed at age 50. We find that BMI at distinct stages in the life cycle were positively correlated. Also BMI at 50 were positively associated with blood pressure at 50. Moreover, earlier maturation at puberty is associated with higher values of BMI at age 50. We also find that earlier pubertal maturation is an independent factor that influences the appearance of high blood pressure in adulthood.

Hypertension among Polish males during the economic transition

In the late 1980s and early 1990s Polish society experienced deep political, economic and social changes. The aim of the study is to investigate whether changes that occurred in Poland during the transformation significantly influenced the risk of hypertension among adult men. We find that irrespective of age, marital status, education, degree of urbanization, lifestyle variables (smoking, drinking alcohol, and physical activity), and BMI the risk of hypertension after 1989 was higher than before transformation (odds ratio=1.45, p<0.001). Psychosocial factors are proposed as factors which might at least partly explain the higher risk of hypertension during the first years of economic transition in Poland.

Marital differences in blood pressure and the risk of hypertension among Polish men

The aim of the study was to evaluate the relationship between marital status and blood pressure, and to assess the risk of hypertension in adult Polish men, after adjustment for BMI. Material comprised the data of 2,271 healthy men, aged 25-60, occupationally active inhabitants of Wroclaw (south-western Poland). Arterial hypertension was diagnosed when systolic blood pressure (SBP) > or =140 mm Hg and/or diastolic blood pressure (DBP) > or = 90 mm Hg. The following categories of marital status and educational level were applied: never married vs. currently married, and well-educated vs. poorly educated, respectively. The data on lifestyle elements were obtained from questionnaires. Multi-factorial analyses of covariance (ANCOVA) were used to compare mean values of SBP and DBP in married vs. never married in subsequent age categories with BMI as a covariate. Independent effects of marital status, life-style variables and body mass index (BMI) on the risk of hypertension in men were analysed using the multifactorial models of logistic regression. In our analysis an interesting epidemiological phenomenon was observed. Never married men had on average higher SBP and DBP than married men. Never married had also a higher risk of hypertension when compared to married men, even when adjusted for different demographic, socio-economic, life-style variables, and even that never married men had lower BMI than married subjects. Marital differences in psychological status (prolonged stress and low social support), dietary intake (mainly sodium and potassium intake) and economic aspects of living alone are suggested as factors, which might explain at least partly the marital diversity in blood pressure and the risk of hypertension in men.

Effect of husbands' education on fatness of wives

The aim of the study was to examine the relationship between social position of females achieved by marriage and level of fatness and relative fat distribution. The data of 588 healthy, occupationally active, married women, age 21-62 years, with 12 years of education (completed secondary school) were used. The body mass index (BMI, kg/m(2) ), triceps and subscapular skinfold thicknesses, and summed skinfold thicknesses were used as indicators of fatness. The waist-hip ratio, the waist-thigh ratio, and waist, hip, and thigh circumferences were used as indicators of fat distribution. According to the educational level of husbands, women were grouped as 1). moving up the social scale (spouse with complete university education), 2). stable (equal level of education), and 3). moving down the social scale (spouse who never passed beyond the level of basic vocational school, i.e., skilled and unskilled manual workers). The two opposite groups were analyzed, i.e., moving up and moving down. Women with secondary schooling who married up were consistently leaner than women who married down. A similar pattern was observed for fat distribution. Women marrying down had more abdominal body fat compared to women marrying up.

Body mass index, overweight and obesity in married and never married men and women in Poland

The study examined the relationship between marital status and the body mass index (BMI) and the prevalence of overweight and obesity in the Polish population. The sample included 2,266 men and 4,122 women, 25-60 years of age, who were occupationally active inhabitants of Wroclaw, in southwestern Poland. Marital status was defined by two categories: never married and presently married, and two groups in each category were established on the basis of educational level: well-educated (12 or more years in school) and poorly educated (less than 12 years in school). The subjects were also divided into four age groups: 25-30, 31-40, 41-50, and 51-60 years. Height and weight were measured and the BMI was calculated. Three categories of the BMI were established: normal, BMI < 25.0 kg/m(2), overweight, BMI > or = 25 < 30 kg/m(2), and obese, BMI > or = 30 kg/m(2). In each age and educational group, married individuals had a higher BMI than those who were never married. With the exception of well-educated males 51-60 years, differences in the BMI between married and never married individuals increased with age. In general, married men and women were more likely to be overweight and obese than never married individuals. The results indicated a significant association (P < 0.001) between marital status and the BMI in both sexes. After age, marital status was the most important predictor of overweight/obesity among men (P < 0.001), whereas educational level did not have a significant role. Among women, age, marital status, and education were significantly (P < 0.001) related to the BMI.