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Introduction Marijuana is one of the most widely used psychoactive substance. There is evidence of genetic predisposition for addiction. Objective The aim of the study is to evaluate personality traits measured by the NEO Five-Factor Inventory and State-Trait Anxiety Inventory, combined with analysis of Tag1B rs1079597 and Tag1D rs1800498 located in the DRD2 gene. Material and methods The study group consisted of 214 rural cannabinoid users and 301 controls. The same psychometric test and real-time PCR genotyping were performed in both studied groups. Results The values of Anxiety state, Anxiety trait, NEO FFI: Neuroticism and Openness in the rural cannabis using group were significantly higher than in the control group. On the other hand, lower values were observed among rural people using cannabis compared to the control group for NEO FFI: Extraversion, Agreeability and Conscientiousness. In the Anxiety trait subscale, a 2% association with the polymorphism DRD2 Tag1B rs1079597 was detected in subjects using cannabis. However, for the DRD2 Tag1D rs1800498, there was no effect on the differences in personality traits between rural cannabis users and the control group. Conclusions The study shows differences in personality traits between the cannabis using group and controls. Interaction between genetic factors and personality traits was also detected. The association showing the combination of psychological characteristics and genetic variants can bring us closer to the overall picture of the issue of marijuana addiction.

The COVID-19 pandemic has lasted for two years as of 2022, and it is common knowledge that vaccines are an essential tool to mitigate the health, economic, and social fallout. Unfortunately, vaccine hesitancy is still a serious global problem, both in the general population and among healthcare workers. The authors used an original questionnaire to conduct an anonymous survey study in the University Clinical Hospital in Wrocław, Poland, in April and May of 2021 after acquiring consent from the Medical University of Wrocław, Poland Bioethical Committee. The study results demonstrate that, to a significant extent, the decisions concerning vaccinations are based on factors that are difficult to change with rational argumentation, including people’s personal opinions or beliefs concerning vaccinations and their earlier experiences with vaccinations. The study results suggest that the impregnating effect of one’s own opinions, beliefs, and experiences can be surmounted if vaccines are dispensed free and conveniently while the pathogen is irrationally and emotionally perceived as untamed and possibly severe and life threatening. It makes a significant difference as in such cases that the percentage of participants whose decisions concerning vaccination are influenced by the risks to life or health of one’s own or others rises by about 27 and 36 percent points, respectively. Therefore, in order to succeed, campaigns for vaccinations need to include strong subjective and emotional communication, appealing to negative emotions and exploiting the public’s fear of the unknown while stressing tangible and personal threats possibly resulting from acquiring a vaccine-preventable infectious disease.

Substance abuse significantly influences human health and may induce problems with social functioning worldwide. Numerous genetic and environmental risk factors, as well as their interactions, accelerate the development of drug addiction. Etiologically, the dopaminergic mesocorticolimbic reward pathways are related to psychoactive substance addiction, and the reward properties of heroin are connected with changes in the mesolimbic dopaminergic system.The aim of this study is a haplotypic analysis of subjects addicted to polysubstance. However, with the knowledge that this is not a homogenous subgroup, it was decided to separate and analyze homogenous subgroups of subjects in order to find specific haplotypic variants among them. The subjects in the subgroups were addicted to heroin, and subjects with more than two relapses in the past two years.The study group comprised of 301 polysubstance addicted rural male subjects. From this group, 2 homogenous subgroups of subjects were isolated and additionally analyzed: (1) a group of heroin addicted subjects (n=61), and (2) a group of heroin-addicted subjects with at least two relapses in the last two years (n=21). The group consisting of all polysubstance addicted rural subjects and both homogenous subgroups were analyzed against a control group of non-addicted subjects (n=300), matching gender and age. Five polymorphisms in theA statistically significant haplotype association was found in analysis of the heroin addicted subjects, compared to controls, and two possible trends - when comparing the whole group of addicted subjects to controls, and in relapse subgroups, compared to the controls.The results obtained showed that haplotypes indicate a part of the biological component of addiction.

Contains fulltext : 182502.pdf (Publisher’s version ) (Open Access) BACKGROUND: The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training. OBJECTIVES: Undertaking secondary analysis of the five-country ODHIN study, we test: the extent to which practice, provider and patient characteristics affect the likelihood of patients being screened and advised; the extent to which such characteristics moderate the impact of training in increasing screening and advice; and the extent to which training mitigates any differences due to such characteristics found at baseline. METHODS: A cluster randomized factorial trial involving 120 practices, 746 providers and 46 546 screened patients from Catalonia, England, the Netherlands, Poland, and Sweden. Practices were randomized to receive training or not to receive training. The primary outcome measures were the proportion of adult patients screened, and the proportion of screen-positive patients advised. RESULTS: Nurses tended to screen more patients than doctors (OR = 3.1; 95%CI: 1.9, 4.9). Screen-positive patients were more likely to be advised by doctors than by nurses (OR = 2.3; 95%CI: 1.4, 4.1), and more liable to be advised the higher their risk status (OR = 1.9; 95%CI: 1.3, 2.7). Training increased screening and advice giving, with its impact largely unrelated to practice, provider or patient characteristics. Training diminished the differences between doctors and nurses and between patients with low or high-risk status. CONCLUSIONS: Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised. Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552.

PURPOSE - C-reactive-protein (CRP) is useful for diagnosis of lower respiratory tract infections (RTIs). A large international trial documented that Internet-based training in CRP point-of-care testing, in enhanced communication skills, or both reduced antibiotic prescribing at 3 months, with risk ratios (RRs) of 0.68, 0.53, 0.38, respectively. We report the longer-term impact in this trial. METHODS - A total of 246 general practices in 6 countries were cluster-randomized to usual care, Internet-based training on CRP point-of-care testing, Internet-based training on enhanced communication skills and interactive booklet, or both interventions combined. The main outcome was antibiotic prescribing for RTIs after 12 months. RESULTS - Of 228 practices providing 3-month data, 74% provided 12-month data, with no demonstrable attrition bias. Between 3 months and 12 months, prescribing for RTIs decreased with usual care (from 58% to 51%), but increased with CRP training (from 35% to 43%) and with both interventions combined (from 32% to 45%); at 12 months, the adjusted RRs compared with usual care were 0.75 (95% CI, 0.51-1.00) and 0.70 (95% CI, 0.49-0.93), respectively. Between 3 months and 12 months, the reduction in prescribing with communication training was maintained (41% and 40%, with an RR at 12 months of 0.70 [95% CI, 0.49-0.94]). Although materials were provided for free, clinicians seldom used booklets and rarely used CRP point-of-care testing. Communication training, but not CRP training, remained efficacious for reducing prescribing for lower RTIs (RR = 0.7195% CI, 0.45-0.99, and RR = 0.76; 95% CI, 0.47-1.06, respectively), whereas both remained efficacious for reducing prescribing for upper RTIs (RR = 0.60; 95% CI, 0.37-0.94, and RR = 0.58; 95% CI, 0.36-0.92, respectively). CONCLUSIONS - Internet-based training in enhanced communication skills remains effective in the longer term for reducing antibiotic prescribing. The early improvement seen with CRP training wanes, and this training becomes ineffective for lower RTIs, the only current indication for using CRP testing.

AimTo test if training and support, financial reimbursement and option of referring screen-positive patients to an internet-based method of giving advice (eBI) can increase primary health-care prov ...

AimTo test if training and support, financial reimbursement and option of referring screen-positive patients to an internet-based method of giving advice (eBI) can increase primary health-care providers' delivery of Alcohol Use Disorders Identification Test (AUDIT)-C-based screening and advice to heavy drinkers.DesignCluster randomized factorial trial with 12-week implementation and measurement period.SettingPrimary health-care units (PHCU) in different locations throughout Catalonia, England, the Netherlands, Poland and Sweden.ParticipantsA total of 120 PHCU, 24 in each of Catalonia, England, the Netherlands, Poland and Sweden.InterventionsPHCUs were randomized to one of eight groups: care as usual, training and support (TS), financial reimbursement (FR) and eBI; paired combinations of TS, FR and eBI, and all of FR, TS and eBI.MeasurementsThe primary outcome measure was the proportion of eligible adult (age 18+ years) patients screened during a 12-week implementation period. Secondary outcome measures were proportion of screen-positive patients advised; and proportion of consulting adult patients given an intervention (screening and advice to screen-positives) during the same 12-week implementation period.FindingsDuring a 4-week baseline measurement period, the proportion of consulting adult patients who were screened for their alcohol consumption was 0.059 per PHCU (95% CI 0.034 to 0.084). Based on the factorial design, the ratio of the logged proportion screened during the 12-week implementation period was 1.48 (95% CI = 1.13–1.95) in PHCU that received TS versus PHCU that did not receive TS; for FR, the ratio was 2.00 (95% CI = 1.56–2.56). The option of referral to eBI did not lead to a higher proportion of patients screened. The ratio for TS plus FR was 2.34 (95% CI = 1.77–3.10), and the ratio for TS plus FR plus eBI was1.68 (95% CI = 1.11–2.53).ConclusionsProviding primary health-care units with training, support and financial reimbursement for delivering Alcohol Use Disorders Identification Test-C-based screening and advice to heavy drinkers increases screening for alcohol consumption. Providing primary health-care units with the option of referring screen-positive patients to an internet-based method of giving advice does not appear to increase screening for alcohol consumption.

Background: The human body requires folic acid (FA) to produce blood cells, secure cell division, and growth. Moreover, this vitamin is important in the prevention of cardiovascular disease (CVD). Because the results of studies on the use of FA in the prevention of CVD are ambiguous, it seems necessary to conduct further research, which will explain in which cases supplementation is effective. Aim: To assess the impact of FA supplementation on the coagulation, inflammatory, lipid parameters, and kidney function in subjects with atherosclerosis risk factors, depending on the content of FA in their diet. Methods: The study enrolled 97 young adult Caucasian individuals (34 males and 63 females) with atherosclerosis risk factors. This population was divided into two groups: A — with low content of FA in the diet (< 40% of reference daily intake) and B — with moderate content of FA in the diet (40–90% of reference daily intake). The participants were asked to take FA in the low-dose of 0.4 mg/24 h for 3 months. Results: Low-dose FA supplementation resulted in elevation of FA concentrations (79% vs. 75.1%) in the studied groups and, concomitantly, a decrease in homocysteine concentrations (21% vs. 20.3%). Mean level of creatinine decreased after FA supplementation in both groups (0.93 ± 1.1 vs. 0.72 ± 0.15 mg/dL and 0.83 ± 0.16 vs. 0.77 ± 0.15 mg/dL). These differences were statistically significant (p < 0.0001). The difference in mean estimated glomerular filtration rate values before and after FA supplementation was statistically significant in group A (p = 0.002) and on the border of statistical significance in group B (p = 0.06). Conclusions: FA supplementation has no influence on the coagulation, inflammatory and lipid parameters in subjects with atherosclerosis risk factors depending on the content of FA in their diet. However FA supplementation may have a beneficial effect on kidney function in subjects with low content of FA in the diet.

Telomeres are located at each end of eukaryotic chromosomes. Their functional role is genomic stability maintenance. The protective role of telomeres depends on various factors, including number of nucleotides repeats, telomere-binding proteins, and telomerase activity. Organ transplantation is the preferred replacement therapy in the case of chronic kidney disease and the only possibility of sustaining recipients' life in the case of advanced liver failure. While the prevalence of acute rejection is constantly decreasing, prevention of transplanted organ long-term function loss is still challenging. It has been demonstrated that post-transplant stressors accelerate aging of the allografts manifested through telomere shortening. The aim of this paper was to evaluate the importance of telomere length assessment for prediction of organ transplantation outcome. Literature review included the 10 most important studies regarding linkage between allograft function and telomere erosion, including 2 of our own reports. Telomere length assessment is useful to predict organ transplantation outcome. The importance of telomere length as a prediction marker depends on the analyzed material. To obtain reliable results, both graft cells (donor material) and lymphocytes (recipient material) should be examined. In the case of kidney transplantation, assessment of telomere length in the early post-transplant period allows prediction of the long-term function of the transplanted organ. To increase the accuracy of transplantation outcome prediction, telomere length assessment should be combined with evaluation of other aging biomarkers, like CDKN2A (p16). Large-scale clinical studies regarding telomere length measurement, including genome wide association analysis introducing relevant genetic factors, are needed for the future.

In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire, and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers’ screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity.

Background Folic acid (FA) is one of the B complex vitamins. It is thought that FA deficiency promotes atherosclerosis formation in arterial endothelium. FA, acting through reducing homocysteine (Hcy) levels, may contribute to decreased cholesterol (Ch) synthesis. The aim of this study was to analyze the association of low-dose folic acid supplementation with blood lipids concentrations in subjects with atherosclerosis risk factors. Material/Methods The study enrolled 124 Caucasian individuals (60 M, ages 20–39; and 64 F, ages 19–39) with atherosclerosis risk factors (family history of premature ischemic stroke, arterial hypertension, dyslipidemia, overweight and obesity, cigarette smoking, and low level of physical activity). The participants were asked to take FA at a low dose of 0.4 mg/24 h for 12 weeks. Results FA levels increased in females (6.3 vs. 12.5 ng/dL; p=0.001) and males (6.4 vs. 11.4 ng/dL; p=0.001) and Hcy levels decreased (10.6 vs. 8.3 μmol/L; p=0.001 and 11.5 vs. 9.3; p=0.001, respectively). A significant reduction in mean concentration of total cholesterol in females (203.4 vs. 193.1 mg/dL; p=0.001) and in males (209.5 vs. 201.9; p=0.002) was observed. The low-density lipoprotein cholesterol (LDL-C) levels decreased in females and in males (107.4 vs. 99.9 mg/dL; p=0.001 and 121.5 vs. 115.1; p=0.002, respectively). The apoAI concentrations increased in smoking women and in men with BMI ≥25 kg/m2 (p=0.032 and p=0.024, respectively). Conclusions Low-dose FA supplementation has a beneficial effect on blood lipids through decreasing concentrations of total cholesterol and LDL-C and increasing concentrations of apoAI.

Detailed description of applied implementation strategies. (PDF 971 kb)

Background: Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation. Methods: In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. Results: Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups. Conclusions: The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners attitudes, their actual behaviour and care improvement strategies to enhance implementation science. Funding Agencies|European Union [259268]; Netherlands Organisation for Health Research and Development (ZonMW, Prevention Program) [200310017]; Polish science financial resources - project ODHIN [2304/7.PR-COOPERATION/11/2012/2]; National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust; Kings College London; NIHR Collaborations for Leadership in Applied Health Research and Care South London at Kings College Hospital NHS Foundation Trust

Background. Disease prevention and health promotion are important tasks in the daily practice of all general practitioners (GPs). The objective of this study was to explore the knowledge and attitudes of European GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care, to describe GPs’ perceived barriers to implementing these recommendations and to assess how GPs’ own health behaviors affect their work with their patients. Methods. A postal multinational survey was carried out from June to December 2000 in a random sample of GPs listed from national colleges of each country. Results. Eleven European countries participated in the study, giving a total of 2082 GPs. Although GPs believe they should advise preventive and health promotion activities, in practice, they are less likely to do so. About 56.02% of the GPs answered that carrying-out prevention and health promotion activities are difficult. The two most important barriers reported were heavy workload/lack of time and no reimbursement. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who smoked felt less effective in helping patients to reduce tobacco consumption than non-smoking GPs (39.34% versus 48.18%, P b 0.01). GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs (59.14% versus 49.70%, P b 0.01). Conclusions. Significant gaps between GP’s knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care.

The Polish results of the international Happy Audit 2 project are reported which objective was to present therapeutic decisions made by general practitioners (especially antibiotics prescribed) and diagnostic methods applied to patients with respiratory tract infections (RTI).[corrected] Following each visit of patient with respiratory tract infection, general practitioners participating in the study completed the questionnaire. The questionnaire included patient's data (age, gender), the duration of disease, clinical symptoms, diagnosis, prescribed antibiotics, additional testing as well as the influence of various factors on therapeutic decision.Having considered the results of HappyAudit in Poland, a total of 5,137 office visits of patients reporting symptoms of RTIs were analyzed. The average duration of symptoms before visiting GP was 4.8 days (compared to average 4.4 in other countries). Worth noting is that additional testing in diagnosis of RTIs was performed less frequently in Poland: rapid streptococcal test was conducted in 0.4% of cases (European average: 4.45%), CRP--in 2.2% of patients (average from other countries: 14.2%) and chest X-ray in 2.3% of cases compared to 14% in other project's participants. In Poland, the most frequently applied antibiotic was amoxicillin, which was used in 28.9% of cases ended with antibiotic prescribing (amoxicillin/pivampicillin were also predominant in other countries, excluding Sweden). In Poland, macrolides (22.4% of all prescriptions for antibiotic) and cephalosporins (12.1%) were frequently used. The results indicate that narrow-spectrum antibiotics are prescribed in Poland less frequently, with the example being penicillin V which was prescribed in 6.7% of patients with RTIs who were given antibiotic.Comparing the results of Happy Audit 2 in Poland and other project's participants, the major differences consist in rare use of phenoxymethylpenicillin in favour of amoxicillin and macrolides as well as infrequent use of additional testing in diagnosis of RTIs in Poland.

Objectives: To find out family doctors' opinions on the role of health promotion and its possible tasks in the changing healthcare system in Poland.Methods: Survey by means of a postal, self-administered questionnaire sent to all 451 family doctors who had started working as such before 1997.Results: Of a total of 451 questionnaires sent out, 326 were filled in and returned, making the response rate 72%. The majority of respondents (92%) accept the necessity of health promotion in their daily practice and 67% would like to be supported in it by family/community nurses. The forms of health promotion most frequently used were leaflets in waiting rooms (94%) and informing patients about harmful effects of addiction (88%). Issues on health promotion, which according to our respondents should be the domain of family doctors, do not correspond with doctors' competence and personal engagement in these particular fields. The surveyed family doctors declared poor nutrition (91%), lack of physical activity (88%), a...

Rheumatoid arthritis (RA) is a chronic, autoimmune-based disease of the connective tissue with still unknown etiology. Numerous studies have indicated the association between Copper (Cu) and ceruloplasmin (Cp) concentrations and pathogenesis of RA.To compare the concentrations of Cu and Cp in different biological samples and their correlation with the inflammatory process, between a group of patients with RA and a control group of healthy individuals.The study enrolled 74 Caucasian patients (20 men and 54 women), aged 29-50 (mean age 39.8±6.1 years) diagnosed with RA. The control group consisted of 30 healthy Caucasian individuals. Copper levels were assessed by atomic absorption spectroscopy.Among RA patients the mean Cu level was significantly higher in serum and hair compartments and significantly lower in erythrocytes, compared with the control group (p0.01). The Cp concentration was also higher in serum of RA patients (p0.001). A statistically significant, positive correlation between the Cp serum concentration and the ESR values (r(s)=0.38; p0.007) was found. No significant influence of pharmaceutical treatment (methotrexate, non-steroidal anti-inflammatory drugs, glucocorticoids, calcium, vitamin D3 and sulphasalazine) on serum Cu was found.It seems that the 'copper status' in patients with RA, based on the measurement of Cu and Cp levels in blood serum is correlated with presence of the inflammatory process. The hair could serve as a useful, additional diagnostic material. Some other factors, different from the applied treatment, can probably influence the Cu levels in patients with RA.

PURPOSE Imaging may produce unexpected or incidental fi ndings with conse- quences for patients and ordering of future investigations. Chest radiography in patients with acute cough is among the most common reasons for imaging in primary care, but data on associated incidental fi ndings are lacking. We set out to describe the type and prevalence of incidental chest radiography fi ndings in primary care patients with acute cough. METHODS We report on data from a cross-sectional study in 16 European pri- mary care networks on 3,105 patients with acute cough, all of whom were under- going chest radiography as part of a research study workup. Apart from assess- ment for specifi ed signs of pneumonia and acute bronchitis, local radiologists were asked to evaluate any additional fi nding on the radiographs. For the 2,823 participants with good-quality chest radiographs, these fi ndings were categorized according to clinical relevance based on previous research evidence and analyzed for type and prevalence by network, sex, age, and smoking status. RESULTS Incidental fi ndings were reported in 19% of all participants, and ranged from 0% to 25% by primary care network, with the network being an independent contributor (P

Background: For preventive interventions in general practice to succeed, patients' points of view must be taken into account in addition to those of GPs. Objective: To explore patients' views and beliefs about the importance of lifestyle and preventive interventions, to assess their readiness to make changes to their lifestyle and their willingness to receive support from GPs. Methods: Cross-sectional survey conducted by EUROPREV in primary care practices in 22 European countries. Patients were consecutively selected and interviewed from September 2008 to September 2009. Results: Seven thousand nine hundred and forty-seven participants, 52.2% females. Only 30.5% of risky drinkers think they need to change, as opposed to 64% of smokers, 73.5% of patients with unhealthy eating habits and 73% with lack of physical activity. Risky drinkers reported that GPs initiated a discussion on alcohol consumption less often (42%) than on smoking (63%), eating habits (59%) or physical activity (55%). Seventy-five per cent, 66% and 63% of patients without hypertension, diabetes or hypercholesterolaemia, respectively, think blood pressure, blood sugar and serum cholesterol should be checked yearly. Women (80%) think they should be screened with the cervical smear test and 72.8% of women aged 30-49 years with mammography, yearly or every 2 years. Conclusions: A high proportion of patients attending primary care with unhealthy lifestyles (especially risky drinkers) do not perceive the need to change their habits, and about half the patients reported not having had any discussion on healthy lifestyles with their GPs. Patients overestimate their need to be screened for cardiovascular risk factors and for cancer., peer-reviewed

Cigarette smoking is the strongest modifiable factor, which shortens the life span and deteriorates the quality of life. It increases the risk of development of cancer, cardiovascular and respiratory system diseases. The objective of the study was evaluation of the prevalence of cigarette smoking among the adult population of the Lublin Region, and investigation of the relationship between nicotinism and respondents? place of residence, and other selected socio-economic factors. Data concerning the cigarette smoking habit was obtained from 3,993 people - 2,447 females and 1,546 males; 23.0 percent of respondents in the study were smokers - 35.6 percent of males and 15.1 percent of females. The percentage of male smokers was similar in rural and urban areas. Urban females were smokers more often than those living in rural areas. A decrease was noted in the difference which has been observed to-date between the percentage of urban and rural female smokers. The highest percentage of smokers occurred among the population aged 41-50, while the lowest - among the youngest and the oldest respondents. The percentage of smoking farmers was lower than that of respondents performing non-agricultural occupations, also among rural inhabitants. Those who were occupationally active were smokers more frequently than those not engaged in occupational activity. The lowest percentage of smokers was noted among respondents who had the highest education level, while the highest percentage was observed among those who had vocational education.

BACKGROUND: Few studies focus on the progeny of stroke patients with respect to the occurrence of other potential risk factors. METHODS: The study group covered 60 males and 62 females whose parents had suffered premature ischemic stroke (PIS); the control group comprised of 41 males and 47 females whose parents had no history of premature vascular event (mean age: 28.4 and 27.1 years, respectively). Examination of both the groups consisted of evaluation of their diet, measurement of arterial blood pressure and body mass index (BMI). Moreover, blood test was carried out and concentration of biochemical stroke risk factors was determined. RESULTS: The adult progeny of parents with a history of PIS followed a deficient, unbalanced, and nonvaried diet. Their average blood pressure and BMI reached higher values, compared with the results obtained in the control group (125.7±16.06 vs. 122.64±10.83 mmHg; 24.27±3.98 vs. 22.54±2.69 kg/m, respectively; P

Patients with metabolic syndrome (MS) are characterized by enhanced procoagulant activity caused by an increased fibrinogen (Fb) level, impaired fibrinolysis, and platelet activation. Fibrate treatment usually normalizes these conditions. The aim was to determine the effect of fenofibrate treatment on Fb level, fibrinolysis, and platelet function in patients with MS with regard to smoking status and type 2 diabetes.Sixty-four patients with MS, including 20 active smokers, without clinical features of coronary heart disease were enrolled in the study. Before and during treatment with fenofibrate all patients took antihypertensive drugs and 25 patients with type 2 diabetes used oral antidiabetic drugs. Before and after the treatment the levels of lipids, fasting glucose insulin, Fb, PAI-1, t-PA, and platelet function expressed as closure time (CT, after Coll/Epi and Coll/ADP) were measured.Fenofibrate treatment resulted in normalization of abnormal lipid profiles and a reduction in Fb level. In smokers an increase in PAI-1 level and CT shortening after Coll/Epi and after Coll/ADP were found. In nonsmokers, CT was prolonged only after Coll/Epi. A slight reduction in PAI-1 and a reduction in fasting glucose were noted in the diabetics.Fenofibrate partially corrected procoagulant state in patients with MS, which was manifested by a significant reduction in Fb level in all patients and inhibition of platelet function exclusively in nonsmokers. Smoking neutralizes the effects of treatment with fenofibrate as absence of inhibition of platelet function and a lack of improvement of the fibrinolysis system were observed in them.

Medical students' attitude towards euthanasia is a very important ethical problem because they may grapple with this question as future doctors. The aim of the study was to compare the attitude to euthanasia in the group of first year medical students from Pomeranian Medical University in Szczecin, Ernst-Moritz-Arndt University Greifswald (Germany) and Lund University (Sweden).The study is based on anonymous filling out of the questionnaire about euthanasia by first year medical students. 233 students (61%) answered the questionnaire. There were 65 Polish students, 71 German and 97 Swedish ones. In the group of respondents there were 129 (55%) women and 104 (45%) men. The average age was 22.3 years.82% of questioned German students declared the acceptance of euthanasia and it was a significantly higher percentage than in comparison to 61% of Swedish students (p0.007) and 48% Polish ones (p0.0001). Poles were more often against euthanasia (29%) in comparison to 12% of Swedes (p0.02) and 3% of Germans (p0.001). Unnatural support of patient's life was the most often accepted by students clinical situation to use euthanasia. Significantly more Germans than Poles (79% vs 48%; p0.005) and Swedes (79% vs 50%; p0.02) accepted euthanasia in the group of questioned students declaring themselves as believers.German students in the highest percentage declared the acceptance of euthanasia and Polish ones--the highest objection. It may be connected with religious beliefs as the element of cultural differences among above three countries. It seems very proper to continue the study among older medical students.

There are currently multiple reports which conclude that there is a correlation between cardiovascular risk factors, including wrong dietary habits, and occurrence of these factors in families.To evaluate daily intake of selected dietary items, which have influence on premature development of atherosclerosis, in adult offspring of patients who underwent premature ischemic stroke.54 patients were included in the study: 21 males, aged 21-38 years (average 25.8 yrs.) and 33 women aged 19-39 years (average 28.2 yrs.). All of them were examined including medical history, physical examination and fasting blood draw. Dietary habits were evaluated with the method of 24-hour history using a questionnaire developed by Institute of Food and Diet in Warsaw, Poland (Instytut Zywnosci i Zywienia). Intake of selected dietary components (dietary cholesterol, fiber, vitamins E, C, B6, B12 and folic acid) was assessed using a computer program "Dietician 2" ("Dietetyk 2") which had been developed by the Institute of Food and Diet.In males, compared to females, there was a significantly higher (p0.05) level of daily calorie intake (2400.8 +/- 716.2 vs 1583.1 +/- 584.3 kcal) as well as intake (expressed in percentage of daily allowance) of dietary cholesterol (106.8 +/- 46.2 vs 62.9 +/- 42.8), fiber (70.6 +/- 28.2 vs 52.0 +/- 22.2), vitamin E (98.4 +/- 49.8 vs 63.5 +/- 33.9), folate (53.9 +/- 23.1 vs 37.8 +/- 16.4) and vitamin B12 (99.0 +/- 58.3 vs 57.2 +/- 44.5). There were also significantly higher levels of the following parameters in 22 normal-weight females compared to 11 overweight/obese females: daily calorie intake (1735.2 +/- 613.2 vs 1278.9 +/- 387.7 kcal) as well as intake (expressed in percentage of daily allowance) of dietary cholesterol (73.9 +/- 44.8 vs 40.9 +/- 29.2), folate (42.3 +/- 17.0 vs 28.7 +/- 10.9) and vitamin B12 (68.2 +/- 48.0 vs 35.1 +/- 26.4).The examined offspring (especially daughters) of a parent with premature ischemic stroke ate insufficient, unbalanced and monotonous diet, which impaired their nutrition. This should motivate family physicians to put greater interest in primary prevention in this group of patients. Overweight and obese women were put at even greater risk because such diet was added to other atherosclerosis risk factors, i.e. family history of premature ischemic stroke and increased body mass.

Background. Valid clinical predictors of influenza in patients presenting with lower respiratory tract infection (LRTI) symptoms would provide adequate patient information and reassurance. Aim. Assessing the validity of an existing diagnostic model (Flu Score) to detect influenza in LRTI patients. Design and Setting. A European diagnostic study recruited 1801 adult primary care patients with LRTI-like symptoms existing ≤7 days between October and April 2007–2010. Method. History and physical examination findings were recorded and nasopharyngeal swabs taken. Polymerase chain reaction (PCR) for influenza A/B was performed as reference test. Diagnostic accuracy of the Flu Score (1× onset

Early diagnosing and modification or elimination of atherosclerosis risk factors with the descendants of the ill with past ischemic stroke (IS) might reduce risk of subsequent stroke incidence in the family, or myocardial infarction or other disease being atherosclerosis - derivative. This subject seems to be essential because it concerns young people. The purpose of the present study is identification and assessment of metabolic atherosclerosis risk factors with adult progeny of the ill with past IS at young age. There were examined 43 adult children of the parents who fell ill at young age (between 39 and 55 years in case of men and 60 years in case of women) with IS. The test group included 21 men and 22 women aged from 19 to 39 years (average age - 26.3 years). The reference group consisted of 40 persons, including 18 men and 22 women aged from 22 to 39 years (average age - 26.8 years). The persons from reference group were corresponding (in respect of structural aspects, such as age and sex) to the test group, their parents had negative history towards atherosclerosis - derivative illnesses. None of the patients under examination was a cigarette smoker. Examination of both groups consisted in conducting anamnesis, measurement of body weighing and height, blood pressure as well as evaluation of biochemical atherosclerosis risk factors. Blood testing (blood serum or plasma) consisted of blood cell count and ESR as well as blood glucose level, creatinine, urea, transaminase and bilirubin levels as well as total cholesterol, LDL cholesterol and HDL cholesterol fractions, apolipoprotein B, apolipoprotein AI, lipoprotein (a), triglycerides, homocysteine, folate, fibrinogen, von Willebrand factor and C-reactive protein level. Among persons whose parents were affected, at young age, with IS higher average level of BMI (24.2 +/- 3.8 kg/m2) was detected as compared with that in the reference group (22.4 +/- 2.5 kg/m2), LDL cholesterol fraction (2.7 +/- 0.8 mmol/l vs 2.4 +/- 0.6 mmol/l) and triglycerides (1.1 +/- 0.4 mmol/l vs 0.8 +/- 0.4 mmol/l) as well as lower level of apolipoprotein Al (1.5 +/- 0.2 g/l vs 1.6 +/- 0.2 g/l). Average values of other factors in the blood serum were not significantly different in both with compared groups. In case of women, whose parents were affected with IS, higher levels of the following indicators were detected: BMI (24.3 +/- 3.9 kg/mz vs 21.5 +/- 2.3 kg/m2), total cholesterol (5.1 +/- 0.7 mmol/l vs 4.4 +/- 0.5 mmol/l, LDL cholesterol (2.7 +/- 0.6 mmol/l vs 2.1 +/- 0.4 mmol/l), apolipoprotein B (1.0 +/- 0.1 g/l vs 0.8 +/- 0.1 g/l), lipoprotein (a) (0.3 +/- 0.2 g/l vs 0.2 +/- 0.1 g/l) and triglycerides (1.0 +/- 0.4 mmol/l vs 0.7 +/- 0.2 mmol/l). In group of men whose parents were affected with IS lower levels of apolipoprotein Al (1.3 +/- 0.2 g/l vs 1.5 +/- 0.2 g/l) and of von Willebrand factor (71.4 +/- 23.9% vs 87.1% +/- 16,8%) were detected. Descendents of the ill with past IS should be treated as higher risk group especially when supranormative values of metabolic atherosclerosis risk factors are detected with them. In case of persons with positive family history of IS, having higher values of metabolic atherosclerosis risk factors, it is necessary to apply intensive actions towards change of their life styles, and if necessary - also to include pharmacological treatment.

The aim of the present paper was evaluation of the impact of the three-months' supplementation with low doses of folic acid on concentration of homocysteine and other biochemical atherosclerosis risk factors with patients endangered with ischemic stroke or other disease being atherosclerosis-derivative.The examined group consisted of 34 adult children of parents of which at least one fell ill at a young age with ischemic stroke. There were examined 9 men and 25 women aged from 19 to 36 years (average age 24.8 years). The testing procedure consisted in three-months' supplementation with folic acid (a 0.4 mg a day) and in check-up of blood parameters. The tests were performed prior to and after 3 months of taking folic acid. There were following laboratory tests performed: lipid profile [triglycerides, total cholesterol as well as LDL-cholesterol and HDL-cholesterol fractions, apolipoprotein B and Al, lipoprotein(a)] and folic acid, homocysteine, fibrinogen, von Willebrand factor as well as blood cell count, thrombocytes, ESR and basic biochemical parameters.Increased average concentration levels were detected for folic acid by 5.4 ng/dl (increase by 62.8%), apolipoprotein Al by 2.3 mg/dl (1.5%) and for fibrinogen by 0.2 g/l (7.1%). Decreased average concentration levels were detected for: homocysteine by 2.1 micromol/ l (drop by 18.9%) and for LDL-cholesterol by 4.4 mg/dl (4.4%/1). Furthermore, a significant increase in average concentration level of uric acid was detected as well as drop in average hemoglobin value, erythrocytes, creatinine and urea. Other blood cell count elements, thrombocytes, ESR and biochemical parameters did not show, in a check test, any significant differences.Low doses of folic acid, owing to its reducing influence on some risk factors, may be recommended with precautions in the atherosclerosis prevention, e.g. for families with past premature cardiovascular episode. However, insufficient number of tested persons does not permit to draw more radical conclusions. The tests should be conducted on a bigger group of patients.

In order to understand the situation of Polish industry, and in particular the chemical industry, during the second half of the nineteenth century some general historical background is necessary. Poland and Lithuania formed one realm in the eighteenth century and this ‘Commonwealth of Both Nations’ was the largest, although not the strongest, country in Europe. From an economic point of view the raw materials found in different parts of this vast country were complementary and formed a good basis for the development of a chemical industry. However the partitioning of Poland between Russia, Prussia and Austria at the end of the eighteenth century put an end to this unity. The three regions that resulted, fragmented and kept apart by state frontiers, constituted peripheral economic districts of the occupying nations. After the Vienna Congress (1815) the three regions inhabited by Poles were: 1) The so-called Polish Congress Kingdom, with Warsaw as the capital and after 1832 incorporated into the Russian Empire; 2) Upper Silesia, with its Polish population for centuries under Austrian and later German rule, and the regions afterwards known as the Grand Duchy of Poznan and East Pomerania, which were, after an earlier annexation by Prussia, in 1871 formally incorporated into the German Empire; and 3) The part annexed by the Austrian Empire, called Galicia, with the capital in Lwow (now Lviv in Ukraine), and which after 1872 achieved some measure of autonomy under the Poles (see figure 4.1).

An examination was performed to assess the hemolytic activity of phosphorite and apatite dust in vitro by a method used by Potts et al. (1978). After evaluation of dispersion, a certain contents of elements was established, using a spectrometer of X-ray fluorescence. Phosphorite dusts caused 50.4% of hemolyse that is about 5 times more than those caused by dust of apatites. The mean hemolysis index for phosphorite dust was 0.799 and for apatite dust 0.142. Thus, phosphorites are much more toxic to a human being than apatites. A higher level of hemolytical activity in phosphorite dust as compared to apatite one can be explained by significant difference in the contents of certain elements, SiO2, in particular. The mean SiO2 level in samples containing phosphorites was 6.3 +/- 0.1% compared to samples of apatites (3.8 +/- 0.09%).

A preliminary report on the results of studies on the relationship between alcohol abuse and upper gastrointestinal tumours is presented. Alcohol abuse was measured with the aid of a questionnaire. GGTP and mean MCV were determined. Within the 1st September, 1986--30th September, 1987, 75 patients with the cancer of the upper gastrointestinal tract and 107 patients with benign lesions to this area were examined. Alcohol abuse was found in 33% of patients with the cancer and 19% of patients with benign lesions to the upper gastrointestinal tract. This difference is statistically significant (p greater than 0.05). The results of GGTP and MCV values were statistically insignificant in both groups. The authors have found more marked correlation of alcohol abuse with the cancer of the upper gastrointestinal tract in relation to the oral cavity and pharynx than the stomach. Further studies including larger groups of patients are recommended.

The analysis of the intensity excess function for the infrared CD stretching band of deuterated chloroform in mixtures with acetone, acetophenone and benzophenone as well as the analysis of the position of the PMR chloroform signal in the above mentioned mixtures are the basis for elucidation of the structure of complexes formed between chloroform and ketones.

The Job's continuous variation method [1] is modified for binary mixtures. On this base the composition of chloroform adducts to n and π electron containing molecules (e.g. amines, ketones and ethers with aliphatic and aromatic substituents) is discussed. The structure of these adducts is considered.

The effect of various electron acceptor molecules on the intensities of the ν1 ν12 Raman bands of pyridine has been studied quantitatively; the changes in the Raman tensor invariants have been evaluated and are discussed.

The depolarization degree ρ of ν 1 = 459 cm −1 band of CCl 4 , of ν 1 = 2254 cm −1 and ν 2 = 652 cm −1 bands of CDCl 3 were measured for pure liquids and its solutions in several solvents. The ratio χ of the principal components of polarizability derivative tensor was calculated on this basis. The observed variations of ρ and χ values are interpreted as the influence of intermolecular interactions on the isotropy of molecular properties. This influence is on ν 1 vibration of CCl 4 and on ν 1 vibration of CDCl 3 opposite to that observed for ν 2 vibration of CDCl 3 .

The concept of spectroscopic and statistical intermolecular complexes is discussed. A method of determining the composition of the complex is given. Th

This study presents the results of surgery in 19 patients with cerebral ischaemia caused by an elongated internal carotid artery. Nine of them had a history of transient ischaemic attacks, eight—reversible stroke, and two—completed stroke. Angiography revealed a kink in 10 cases and a loop in 9. An aneurysm was also found in 2 cases. 8 re-implantations, 5 arterioplasties, 4 re-insertions and 2 aneurysmectomies were performed. Re-insertion was a supplementary procedure in 3 patients. There were no neurological complications, save one case of TIA. Follow-up studies during a period of 1 to 6 years revealed no recurrence of cerebral ischaemia.