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Abstract Background In Poland, the prevalence of cardiovascular diseases is increasing. This might be associated with the constantly growing proportion of elderly people and inappropriate cardiovascular prevention. This study aimed to evaluate the frequency of use of oral antiplatelet (OAP) and oral anticoagulant (OAC) drugs among older people in Poland and to assess their association with cardiovascular risk factors. Methods The study was based on data collected during the implementation of a multicentre, publicly funded research project called PolSenior. Results The study group consisted of 4,979 people with the average age of 79.35 ± 8.69 years. Among them, 1,787 people (35.9%) used at least one drug in the prevention of cardiovascular diseases. OAPs were used regularly by 1,648 (33.1%) elderly people and OACs were used by 165 elderly people (3.3%). Acetylsalicylic acid was used by 32.2% of elderly people. Use of drugs significantly depended on age (p Conclusions Our study is the first to determine the frequency of use of OAP and OAC drugs among elderly people in Poland in relation to cardiovascular risk factors. The most commonly used drug for cardiovascular prevention is acetylsalicylic acid, but it appears that it is used too rarely in high-risk patients. Educational programs should be developed among general practitioners concerning current recommendations for pharmacological cardiovascular prevention.

Background: The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic., Materials and Methods: The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA)., Results: The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA ( p = 0.001). We found a negative correlation between life satisfaction and EE ( p = 0.001), DEP ( p = 0.001), and SRPA ( p = 0.002)., Conclusions: The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Daria Łaskawiec-Żuławińska et al.)

Background: Endoscopic spine surgery represents a significant advancement in the minimally invasive treatment of spinal disorders, promising reduced surgical invasiveness while aiming to maintain or improve clinical outcomes. This study undertakes a comprehensive review of the literature on endoscopic spine surgery, with a particular focus on cataloging and analyzing the range of complications, from common postoperative issues to more severe, casuistic outcomes like dural tears and nerve damage. Methods: Our methodology encompassed a detailed review of meta-analyses, prospective randomized trials, cohort studies, and case reports to capture a broad spectrum of complications associated with endoscopic spine techniques. The emphasis was on identifying both the frequency and severity of these complications to understand better the procedural risks. Results: The findings suggest that endoscopic spine surgery generally exhibits a lower complication rate compared to traditional surgical approaches. Nonetheless, the identification of specific, rare complications peculiar to endoscopic methods underscores the critical need for surgeons' advanced skills, continuous learning, and awareness of potential risks. Conclusions: Recognizing and preparing for the potential complications associated with the rapid adoption of endoscopic techniques is paramount to ensuring patient safety and improving surgical outcomes in minimally invasive spine surgery.

Objective: Aim: To assess the career satisfaction of physician's in the Silesian Voivodeship, Poland, in relation to selected factors., Patients and Methods: Materials and Methods: The questionnaire survey was conducted among 701 physicians and dentists from the Silesian Voivodeship, Poland, in the period from January to December 2018, using the PAPI (Paper and Pencil Interview) method. Physicians' Career Satisfaction was measured and basic socio-demographic, economic and occupational data, concerning lifestyle and health, and also the level of life satisfaction according to the SWLS (Satisfaction with Life Scale) were collected. Moreover, the occurrence of anxiety and/or depressive symptoms according to the HADS (Hospital Anxiety and Depression Scale) were included in the analyses., Results: Results: The career satisfaction of the surveyed Silesian physicians and dentists was moderate. Wages and combining personal life with work were rated the lowest, while interpersonal opportunities were rated the highest. The predictors: age, economic status and body mass index (BMI) were significant; in addition, in younger age group (25-49 years) - practicing sports and chronic fatigue, and in older age group (50-80 years) - the presence of a chronic disease. A moderate correlation between the level of career satisfaction and life satisfaction was revealed, as well as a lower score in people with the occurrence of anxiety and/or depression symptoms., Conclusion: Conclusions: The diversified level of career satisfaction of physicians in separated aspects makes it necessary to verify them both at the level of health care units and at higher levels.

Background: Based on worldwide estimates, the number of people with dementia will increase significantly in the coming decades. Therefore, knowledge about dementia and its modifiable risk factors plays a crucial role in prevention. Although dementia is still incurable, an early diagnosis might help to slow down its progression and improve the quality of patients' lives. The aim of the study was to assess public knowledge about dementia and its risk factors in Poland., Methods: The research was conducted in 2022 using a self-constructed questionnaire by applying computer-assisted web interviewing (CAWI)., Results: A total of 304 completed surveys were obtained (mean score of 16.95 ± 2.79 points out of 23.6). The scores were significantly higher for people associated with the medical community in comparison to those unrelated to the medical community (18.23 ± 2.61 and 16.15 ± 2.59, respectively; p = 0.0001). A moderate negative correlation was found between the results and the ages of the respondents (R = -0.44; p = 0.001). No statistically significant differences were reported in the results between people involved in providing care to patients with dementia or those who had a patient with dementia in the family and those who were not involved in such care or had no relative with dementia., Conclusions: Knowledge about dementia and its risk factors in Poland is not satisfactory and should be improved. Special attention should be paid to educating the families and caregivers of people with dementia.

Background: An obesity paradox has been described in relation to adverse clinical outcomes (e.g., mortality) with lower body mass index (BMI)., Aims: We sought to evaluate the association between BMI and weight loss with long-term all-cause mortality in adult populations under the care of family physicians., Methods: LIPIDOGRAM studies were conducted in primary care in Poland in 2004, 2006, and 2015 and enrolled a total of 45,615 patients. The LIPIDOGRAM Plus study included 1627 patients recruited in the LIPIDOGRAM 2004 and repeated measurements in 2006 edition. Patients were classified by BMI categories as underweight, normal weight, overweight and class I, II, or III (obesity). Follow-up data up to December 2021 were obtained from the Central Statistical Office. Differences in all-cause mortality were analyzed using Kaplan‒Meier and Cox regression analyses., Results: Of 45,615 patients, 10,987 (24.1%) were normal weight, 320 (0.7%) were underweight, 19,134 (41.9%) were overweight, and 15,174 (33.2%) lived with obesity. Follow-up was available for 44,620 patients (97.8%, median duration 15.3 years, 61.7% females). In the crude analysis, long-term all-cause mortality was lowest for the normal-weight group (14%) compared with other categories. After adjusting for comorbidities, the highest risk of death was observed for the class III obesity and underweight categories (hazard ratio, HR 1.79, 95% CI [1.55-2.05] and HR 1.57, 95% CI [1.22-2.04]), respectively. The LIPIDOGRAM Plus analysis revealed that a decrease in body weight (by 5 and 10%) over 2 years was associated with a significantly increased risk of death during long-term follow-up-HR 1.45 (95% CI 1.05-2.02, p = 0.03) and HR 1.67 (95% CI 1.02-2.74, p < 0.001). Patients who experienced weight loss were older and more burdened with comorbidities., Conclusions: Being underweight, overweight or obese is associated with a higher mortality risk in a population of patients in primary care. Patients who lost weight were older and more burdened with cardiometabolic diseases, which may suggest unintentional weight loss, and were at higher risk of death in the long-term follow-up. In nonsmoking patients without comorbidities, the lowest mortality was observed in those with a BMI < 25 kg/m 2 , and no U-curve relationship was observed., (© 2023. The Author(s).)

Encephalitis is a condition with a variety of etiologies, clinical presentations, and degrees of severity. The causes of these disorders include both neuroinfections and autoimmune diseases in which host antibodies are pathologically directed against self-antigens. In autoimmune encephalitis, autoantibodies are expressed in the central nervous system. The incidence of this disease is approximately 4% of all reported cases of encephalitis. Autoimmune encephalitis can be induced by antibodies against neuronal surface antigens such as N-methyl-D-aspartate-activated glutamate receptors (NMDAR), α-amino-3-hydroxy-5-methyl-4-isoxazole propionate receptors (AMPAR) or gangliosides GQ1b, DPPX, CASPR2, LGI1, as well as by antibodies against neuronal intracellular antigens. The paper presents a number of both mental and neurological symptoms of autoimmune encephalitis. Moreover, the coexistence of psychoses, neoplastic diseases, and the methods of diagnosing autoimmune encephalitis are discussed. Attention was also drawn to the fact that early diagnosis, as well as early initiation of targeted treatment, increases the chance of a successful course of the therapeutic process. Strategy and Methodology: The articles on which the following paper was based were searched using search engines such as PubMed and Medline. Considering that anti-NMDAR antibodies were first described in 2007, the articles were from 2007 to 2023. The selection of papers was made by entering the phrases "autoimmune encephalitis and psychosis/paraneplastic syndromes or cancer". The total number of articles that could be searched was 747, of which 100 items were selected, the most recent reports illustrating the presented topic. Thirty-four of them were rejected in connection with case reports or papers that could not be accessed.

Background and Purpose: The abnormalities in EEG of stroke-patients increase the risk of epilepsy but their significancy for poststroke outcome is unclear. This presented study was aimed at determining the prevalence and nature of changes in EEG recordings from the stroke hemisphere and from the contralateral hemisphere. Another objective was to determine the significance of abnormalities in EEG in the first days of stroke for the post-stroke functional status on the acute and chronic phase of disease., Methods: In all qualified stroke-patients, EEG was performed during the first 3 days of hospitalization and at discharge. The correlation between EEG abnormalities both in the stroke hemisphere and in the collateral hemisphere with the neurological and functional state in various time points was performed., Results: One hundred thirty-one patients were enrolled to this study. Fifty-eight patients (44.27%) had abnormal EEG. The sporadic discharges and generalized rhythmic delta activity were the most common abnormalities in the EEG. The neurological status on the first day and the absence of changes in the EEG in the hemisphere without stroke were the independent factors for good neurological state (0-2 mRS) at discharge. The age-based analysis model (OR 0.981 CI 95% 0.959-1.001, p = 0.047), neurological status on day 1 (OR 0.884 CI 95% 0.82-0.942, p < 0.0001) and EEG recording above the healthy hemisphere (OR 0.607 CI 95% 0.37-0.917, p = 0.028) had the highest prognostic value in terms of achieving good status 90 days after stroke., Conclusions: Abnormalities in EEG without clinical manifestation are present in 40% of patients with acute stroke. Changes in EEG in acute stroke are associated with a poor neurological status in the first days and poor functional status in the chronic period of stroke., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Lasek-Bal, Dewerenda-Sikora, Binek, Student, Łabuz-Roszak, Krzystanek, Kaczmarczyk, Krzan, Żak, Cieślik and Bosak.)

Background: The medical profession is associated with a heavy psychological and physical burden. Specific working conditions can negatively affect the assessment of physicians' quality of life. The lack of current studies prompted us to evaluate the life satisfaction of the physicians in the Silesian Province in relation to the selected factors (health status, professional preferences, family and material status)., Material and Methods: The study included 701 physicians and dentists from the Silesian Province aged between 25 and 80 years. It was conducted in 2018 using the Paper and Pencil Interview technique by obtaining non-personalized demographic, anthropometric, socioeconomic, occupational, health and lifestyle data. The following measures were used: the Satisfaction with Life Scale (SWLS), Occupational Satisfaction and the Hospital Anxiety and Depression Scale (HADS). Considering the environmental conditions, the total SWLS scores were analysed in terms of the significance of differences in the groups. Moreover, the SWLS scores underwent multivariate analysis of variance and the correlation analysis of job satisfaction and the presence of anxiety and/or depressive symptoms., Results: Life satisfaction among the physicians and dentists from the Silesian Province was at an average level. Significant predictors included age and economic status. Additionally, significant predictors in the younger subjects (25-50 years) included the Body Mass Index and practising sports. In turn, in the older subjects (50-80 years), these predictors were related to hospital work and being on sick leave. The study found a significant moderate association between life satisfaction and professional satisfaction. Additionally, a significantly lower level of life satisfaction was reported in the subjects who presented with anxiety and/or depressive symptoms., Conclusions: Due to its association with the profession, the mean level of life satisfaction among physicians and dentists prompts verification of crucial spheres related to the physical, emotional, social and material well-being and the activity of the professional group.

Objectives: The aim of this study was to assess the knowledge, attitudes and the rules of proceeding concerning primary health care (PHC) doctors in the field of screening diagnostics for cognitive disorders in elderly people in Poland., Methods: The study included 175 PHC doctors. A validated anonymous questionnaire was used. The survey was conducted using the PAPI (Paper and Pencil Interviews) and CAWI (Computer Assisted Web Interviews) methods., Results: The vast majority of the respondents (n=159; 91.4%) saw the advisability of screening for cognitive disorders in the age group >65 years of age, but only 53 subjects (30.29%) believed that these tests should be conducted by general practitioners (GPs). According to the surveyed doctors, the main obstacle in the diagnostics of cognitive functions is the lack of time - this was the opinion of 142 (81.14%) respondents. When dementia was suspected, the respondents usually ordered laboratory tests and referred patients to a neurologist (n=111; 63.4%). The Mini Mental Status Examination (MMSE) and the Clock Drawing Test (CDT) were the most popular scales assessing cognitive functions, known by 120 doctors (68.57%), and 122 respondents (69.71%), respectively., Conclusions: Polish GPs are aware of the necessity of screening for cognitive disorders in seniors. Currently, there are no mechanisms within primary health care system that would enable proper early screening for dementia in people at the high risk (i.e.> 65 years of age). The development of standards for the early detection of cognitive disorders within primary health care system in Poland seems to be an urgent need.

The paper presents a case of progressive paraparesis in a 66-year-old man with no history of tick bite, who was finally diagnosed with neuroborreliosis on the basis of the performed tests. Proper diagnosis and introduction of causal treatment resulted in rapid improvement of the patient's condition.

This paper presents the genetic, molecular and neuroanatomical similarities between autism spectrum disorder (ASD) and schizophrenia using the case report of a 34-year-old female patient with a previous diagnosis of schizophrenia as an example. As a result of repeat hospitalization, expanded history, psychological testing and verification of persistent symptoms of psychopathology, a cooccurring diagnosis of autism spectrum disorder was made.

Autoimmune encephalitis (AE) is a non-infectious inflammatory disease caused by the presence of autoantibodies directed against neuronal surface or intracellular antigens. Its incidence in Western countries is about 0.8 per 100,000 people. AE requires differentiation primarily with psychiatric diseases, but it also requires oncological vigilance. On the other hand, in the case of an acute episode of psychosis, differentiation with AE should always be pursued. This paper discusses the most common psychiatric disorders that occur in autoimmune encephalitis.

The purpose of the study was to assess the usefulness of optical coherence tomography (OCT) in the detection of the neurodegenerative process in younger patients with multiple sclerosis (MS). The study group consisted of 61 patients with a relapsing remitting course of MS (mean age 36.4 ± 6.7 years) divided into two groups: short (≤5 years) and long (>10 years) disease duration. OCT, P300 evoked potential, Montreal Cognitive Assessment, and performance subtests (Picture Completion and Digit Symbol) of the Wechsler Adult Intelligence Scale were performed in all patients. Mean values of most parameters assessed in OCT (pRNFL Total, pRNFL Inferior, pRNFL Superior, pRNFL Temporalis, mRNFL, GCIPL, mRNFL+GCIPL) were significantly lower in MS patients in comparison to controls. And in patients with longer disease duration in comparison to those with shorter. Most OCT parameters negatively correlated with the EDSS score (p < 0.05). No significant correlation was found between OCT results and both P300 latency and the results of psychometric tests. OCT, as a simple, non-invasive, quick, and inexpensive method, could be useful for monitoring the progression of disease in MS patients.

Background: Postpandemic stress disorder (PPSD) is an unofficial term that refers to posttraumatic stress disorder (PTSD), a mental disorder resulting from increased stress, anxiety, and trauma associated with unpleasant life experiences. Many scientific studies indicate that symptoms of increased stress, job burnout, anxiety, and depressive disorders are associated with medical personnel performing their professional duties around COVID-19 patients., Objective: The purpose of this study was to assess the prevalence of symptoms that may indicate the presence of PPSD symptoms-depression, anxiety, and stress-in medical personnel. Material and Methods . The survey included 300 people, representatives of medical personnel. The group was divided into two sections. The first section numbered 150 and consisted of personnel in direct contact with COVID-19 patients (FR); the second group also consisted of 150 medical professionals, who but no longer directly involved in helping with COVID-19 cases (SR). The survey was conducted by indirect survey method using CAWI (computer-assisted web interview). The survey used a questionnaire technique. A proprietary tool enriched with standardized psychometric scales: BDI, GAD-7, FCV-19S, and PSS-10 was used. Kruskal-Wallis and Mann-Whitney U statistical tests were used in the statistical processing of the data. The probability level was 0.05., Results: Statistical inference made it clear that mental health problems that may indicate trauma are mainly present in the FR group. These symptoms decreased slightly in comparison between periods 2020 and 2021 ( p < 0.05)., Conclusions: The COVID-19 pandemic significantly increased the prevalence of depression, anxiety, and stress among first responders. To ensure the psychological well-being of first responders, early assessment and care of mild depression, anxiety, and stress should be promoted to prevent the development of moderate and severe forms., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Mateusz Grajek et al.)

Physical and mental well-being are important determinants of medical doctors' lives, including their professional activity, which has a direct impact on the health and lives of patients. The aim of the study was to assess the health condition of medical doctors from the Silesian Voivodeship. The physical health condition, including the prevalence of chronic diseases, drug therapy, and pro-health activities, was assessed. Data on mental health according to the HADS scale (hospital anxiety and depression scale) referred to the selected socio-economic and professional aspects of life, as well as life and job satisfaction. The doctors most often reported diseases of the circulatory system and diseases of endocrine system, nutritional status and metabolic changes, allergies, and degenerative changes in the musculoskeletal system and connective tissue. Chronic diseases and anxiety or depressive disorders affected doctors aged 50-80 years more frequently, and those doctors undertook preventive pro-health activities more often. The higher risks of anxiety and depression were related to their social and professional roles, lower economic status, overweight or obesity, chronic diseases, pharmacotherapy, diets, and chronic fatigue. On the other hand, frequent physical activity, a longer sleep duration, smaller weekly workload, type of rest, a higher sense of job satisfaction, and a higher level of life satisfaction reduced the risk of disorders. The health condition of medical doctors in the Silesian Voivodeship requires decisive remedial actions in the professional and non-professional spheres.

Little is known about the epidemiology of subarachnoid haemorrhage (SAH) in Poland, and until now no such research has been conducted for Silesia, which is the second largest province with circa 4.5 million inhabitants. Therefore, the current study was done to assess the data on SAH in the Silesian Province, Poland. The study was based on the data obtained from the administrative databases of the only public health insurer in Poland (the National Health Fund, NHF) from 2009 to 2019. The SAH cases were selected based on primary diagnosis coded in ICD-10 as I60. The total number of SAH cases was 2014 (41.8% men, 58.2% women). The number of SAH hospitalizations decreased from 199 in 2009 to 166 cases in 2019; p < 0.05. The median age increased from 58 in 2009 to 62 years in 2019; p < 0.001. Endovascular treatment or clipping of the aneurysm was performed in 866 cases (43%). An increase in in-hospital mortality was observed from 31% in 2009 to 38% in 2019 (p = 0.013). Despite the number of stroke units increasing, in-hospital mortality in SAH patients is high, and the number of vascular interventions seems insufficient. Better organization for care of SAH patients is needed in Poland.

Multiple sclerosis (MS) is a disease of the central nervous system (CNS), characterized by chronic inflammation associated with autoimmune damage to myelin and axons leading to neurodegeneration. Although the etiology is not fully understood, some factors that increase the risk of disease have been identified. One of the key elements of multidisciplinary approach to the management of MS is a properly balanced diet, e.g. Swank diet. Its main assumption is to reduce the supply of animal fats in favor of fats of plant origin, which contain polyunsaturated fatty acids omega-3. One of the factors influencing the course of the disease is vitamin D deficiency. In 80-90% it is synthesized by exposure to the sun, while the other 10-20% may be supplied with ingested food. Although elevated plasma homocysteine levels have been demonstrated in MS patients, there is no need to modify the supply of B vitamins. Further studies are necessary to show the correlation between the supply of B vitamins and the course of the disease. Due to the antioxidant effect, it is recommended to include products that are sources of vitamin A, E and C, glutathione, coenzyme Q10. It is also beneficial to include compounds from the polyphenol group: quercetin, resveratrol and curcumin. Through proper nutrition model it is also possible to reduce side effects of applied medications, such as constipation, what improves patients' quality of life. Diet therapy is a key element supporting pharmacotherapy in patients with multiple sclerosis.

Objectives: The aim of this study was to analyze psychiatric consultations of patients hospitalized in the Department of Neurology and Stroke Unit (DN/SU) of University Clinical Center in Katowice from 2017 to 2018., Methods: A retrospective analysis of psychiatric consultations, psychiatric diagnoses (according to the ICD-10) and treatment recommendations was done., Results: 719 psychiatric consultations were performed in all hospital departments in the analyzed period. 488 (67.87%) consultations were conducted in the Department of Neurology and Stroke Unit. Most patients who required psychiatric consultations were diagnosed with Huntington's disease (n = 25; 37.31%), Parkinson's disease (n = 60; 23.9%) and epilepsy (n=40; 22.73%). The most commonpsychiatric diagnoses included organic mental disorders (n=229; 55.85%), particularly organic mood disorders (n =73; 14.96%) and organic anxiety disorders (n =32;6.56%) whereas in thecase of vascular diseases themost common diagnoses included disturbances of consciousness associated with delirium (n =30; 40.54%). The majority of consultations (n = 388; 79.51%) resulted in the onset or modification of pharmacological treatment. The most frequently prescribed drugs were: neuroleptics (n =174; 35.66%), mostly atypical (n = 152; 87,36%), and antidepressants (n = 230; 47.13%), mostly SSRIs (n = 216; 93.91%). In patients > 60 years of age organic disorders were more prevalent (n =179; 66.30% vs. n = 49; 35.0%) and neuroleptics were more frequently prescribed (n = 131; 42.12% vs. n= 44; 24.86%) compared to patients < 60 years., Conclusions: Patients in the department of neurology and stroke unit underwent a psychiatric consultation most frequently. Optimizing the care of aneurological patient is related to close cooperation of a neurologist and a psychiatrist, as well as developing and updating common positions for the management of selected disease entities.

Background: Advanced glycation end products (AGEs) are involved in the pathogenesis of many diseases, including neurodegenerative diseases such as multiple sclerosis (MS). The aim of the study was to determine serum concentrations of AGEs and their soluble receptor (sRAGE) in MS patients and healthy controls and to investigate their possible influence on disease activity., Methods: Serum concentrations of AGE and sRAGE in patients with MS and healthy controls were determined by enzyme-linked immunosorbent assay (ELISA)., Results: The mean serum AGE concentration in patients with MS was higher than in healthy controls, whereas the mean serum sRAGE concentration was lower than in the control group. However, the differences were not statistically significant. In MS patients, serum AGE and sRAGE concentrations did not differ significantly, depending on the duration of the disease and the Expanded Disability Status Scale (EDSS) score., Conclusions: Multiple sclerosis may be accompanied by disturbances of the AGE-sRAGE axis. However, further studies are warranted to confirm it. The duration of the disease and the degree of disability do not seem to affect the progression of the glycation process, particularly in the stable phase of the disease.

Objective: The aim: To analyze the nutritional knowledge of women in the reproductive age about nutrients influencing the fetal nervous system's development., Patients and Methods: Materials and methods: The study was conducted with a proprietary anonymous questionnaire using the CAWI (Computer Assisted Web Interviews) method among 263 women aged 18-51 years., Results: Results: In 35.4% of the surveyed women, the level of knowledge was insufficient, in 31.9% - sufficient, in 27% - good, and only in 5.7% - very good. The knowledge of the respondents was influenced by education (p < 0.001) and body mass index (BMI, p < 0.001). Women of reproductive age with higher education and/or lower BMI had a better understanding of nutrients influencing the fetal nervous system's development. Age, place of residence, family status, and professional status did not affect their knowledge., Conclusion: Conclusions: The study showed that it is necessary to conduct nutritional education among women of reproductive age. Increasing the respondents' awareness of the importance of nutrients determining the fetus's proper development, both during the reproductive period and during pregnancy, is extremely important.

Objective: The aim: The study aimed to assess the content of selected toxic compounds in mineral and spring waters available on the Polish market regarding potential health risks to consumers., Patients and Methods: Materials and methods: Selected mineral and spring waters available on the Polish market were the study's objects. The content of such chemical compounds as arsenic, cadmium, lead, copper, and mercury in selected mineral and spring waters was analyzed. The content of metals in the samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). Additionally, a literature review was performed to determine nitrates contamination of bottled waters available on the Polish market. Based on the collected data, an assessment of exposure and health risk to consumers was performed., Results: Results: Arsenic had the highest mean concentration in the analyzed water samples. Consumption of such contaminated waters may be a significant health risk factor for consumers. Literature data indicate a relatively low content of nitrates in bottled waters available on the Polish market. Consumption of such mineral waters is not a significant source of exposure and does not translate into a significant health risk for consumers., Conclusion: Conclusions: To ensure consumers' health safety, there is a need to monitor the content of potentially harmful compounds in mineral and spring waters available on the Polish market.

Objective: The aim: To examine the level of knowledge and attitudes of high school students in the field of eating disorders., Patients and Methods: Materials and methods: The study group consisted of students of a randomly selected village school (Jendrzejow) and the municipal school (Siemianowice Slaskie). The study was conducted using an original survey consisting of 10 questions regarding the knowledge and attitudes of respondents towards eating disorders., Results: Results: A total of 313 students (242 female and 71 male) participated in the study. 44.7% of respondents from the village school and 56.6% of respondents from the municipal school were dissatisfied with their appearance; 21.6% and 27.9%, respectively, were currently using the diet. 68% of students from Jędrzejow and 53.3% of students from Siemianowice Slaskie made an attempt to reduce body weight at least once in their lives. 55.1% of the village school respondents and 47.4% of the municipal school respondents noticed the influence of the media on the desire to achieve a slim figure. Girls showed better knowledge about eating disorders than boys (p = 0.008). Over 70% of students of both surveyed high schools believed that people with eating disorders are unable to cope with the disease on their own. Only 6.7% of students of the municipal school and 12.92% of students of the village school gave themselves a very good grade., Conclusion: Conclusions: There is a need to educate young people more broadly about eating disorders and the risk factors for their occurrence.

Introduction: Even though uremic pruritus (UP) is very troublesome for haemodialysis (HD) patients, its underlying mechanism is not fully understood., Aim: Due to the possible role of brain-derived neurotrophic factor (BDNF) and its higher serum concentration in haemodialysis diabetic patients compared to non-diabetic ones, this study is aimed to evaluate its association with UP among diabetic and non-diabetic patients on maintenance HD., Material and Methods: A total of 94 patients were enrolled into the study. A visual analogue scale (VAS) was used to assess pruritus., Results: No differences were found between the observed study groups in terms of BDNF serum concentration, other biochemical markers, sleep disturbances, or pruritus presentation., Conclusions: BDNF serum concentration was not found to be associated with UP among HD patients, however further studies are worth performing on a larger group of individuals., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2019 Termedia Sp. z o. o.)

Introduction: Advanced glycation end-products (AGE) are involved in the pathogenesis of many diseases, including neurodegenerative diseases such as multiple sclerosis (MS). The aim of the study was to evaluate the intensity of the protein glycation process in patients with multiple sclerosis and its possible involvement in disease activity., Material and Methods: The study group ( n = 45) consisted of patients suffering from MS, and the control group ( n = 31) consisted of healthy adults. Concentrations of selected glycation markers such as carboxymethyllysine (CML) and carboxyethyllysine (CEL) in sera of patients with MS and healthy volunteers were determined by enzyme-linked immunosorbent assay (ELISA)., Results: Serum CML and CEL concentrations in patients with MS were higher than in healthy volunteers but only for CML the difference was statistically significant. CML concentrations positively correlated with CEL concentrations only in the healthy persons. In MS patients the serum CML and CEL concentrations did not differ significantly depending on the duration of the disease and depending on the EDSS (Expanded Disability Status Scale) score., Conclusions: Multiple sclerosis is accompanied by an intensification of protein glycation processes, especially within the pathways leading to the formation of carboxymethyllysine. The duration of the disease and the degree of motor impairment do not appear to affect the progression of the glycation processes. However, the disease process associated with multiple sclerosis may affect the relationship between CML and CEL concentrations., Competing Interests: The authors declare no conflict of interest, (Copyright: © 2020 Termedia & Banach.)

Objective: The aim: To assess the knowledge of young adults about neurodegenerative diseases and neuroprotective food., Patients and Methods: Material and methods: The study was conducted using an anonymous self-constructed questionnaire. 150 people aged 18 - 30 participated in the study, including 69% (n = 104) women and 31% (n = 46) men., Results: Results: Most of the respondents had sufficient or good knowledge of neurodegenerative diseases and neuroprotective nutrition. The obtained results did not depend on gender, place of residence, and age. However, knowledge was influenced by education (p < 0.05; better-educated respondents indicated more correct answers), and the occupation performed (p < 0.05; respondents performing medical professions gave correct answers more often)., Conclusion: Conclusions: It seems essential to introduce additional school classes in the field of neurodegenerative diseases and neuroprotective nutrition. Only modern nutritional education from an early age can help implement appropriate eating habits in the field of prevention of neurodegenerative diseases and their application in adulthood.

Trigeminal neuralgia (TN) is one of the most common cranial neuropathies. Pathologies located alongside the long nerve can also cause its mechanical compression or secondary involvement in the inflammatory process, and thus cause pain. TN is characterised by severe paroxysmal unilateral facial pain in the innervation area of branches I-III of the nerve V when provoked by light touch or slight movement. Multiple therapeutic methods are available, but most of them yield unsatisfactory results. According to guidelines (AAN and EFNS) the first-line therapy in trigeminalgia is carbamazepine/oxcarbazepine, and if there is a poor response - surgical treatment [1]. The array of surgical options includes percutaneous retrogasserian glycerol injection, radiofrequency thermocoagulation, balloon decompression, thermal rhizotomy, and stereotactic radiosurgery [2-4]. This paper presents our own experiences with CyberKnife (CK), a new type of radiosurgical (RS) treatment of 64 TN patients. CONCLUSIONS: CyberKnife radiotherapy is characterised by high efficacy in 80% of patients with trigeminalgia, minimal invasiveness, and subsiding mild side effects. Radioablation of nerve V root in patients with neuralgia allows us to entirely stop antiepileptic therapy or reduce its doses, which in turn reduces the risk of potential side effects. CyberKnife can be a therapeutic option in those patients who have been offered ineffective therapies, or treatments with limited efficacy, and/or in older patients with comorbidities.

Objective: Introduction: Lifestyle modification, including changing eating habits, plays an essential role in the prevention of stroke. The aim: The study aimed to assess the nutritional prevention of cerebrovascular diseases in adult inhabitants of Poland., Patients and Methods: Material and Methods: The study was conducted using the author's questionnaire among 145 women and 76 men, aged 18 - 30 (53.9%) and 50 - 70 (46.1%) years., Results: Results: The following stroke risk factors were found in the examined group: overweight or obesity (46.6%), lack of regular physical activity (48%), smoking (33%), hypertension (22.1%), dyslipidemia (8.6%), diabetes (5.9%), and cardiac arrhythmias (6.3%). The younger subjects compared to older ones more often declared the daily consumption of whole-grain cereal products and vegetables, fish at least once a week, and they preferred vegetable oils. On the other hand, older subjects declared the consumption of sweets, sweet drinks, salt, and fast food less frequently than younger ones. Also, fruits were more often chosen by older people. Both groups declared similar moderate consumption of milk and dairy products with reduced fat content, lean meat, and alcohol. Only 38% of respondents considered their eating habits to be appropriate., Conclusion: Conclusions: The eating habits of examined adults only partially met the recommendations regarding the nutritional prevention of stroke. In some elements, younger people were more likely to follow appropriate dietary recommendations, while older people were more appropriate in others. The education regarding the principles of the nutritional prevention of cerebrovascular diseases is still necessary and should be age-appropriate.

Objective: The aim: The study aimed to assess the association between the physical activity level and eating habits of primary school students., Patients and Methods: Material and methods: 139 children attending one of the Polish primary school or football school were included. The research tool was author's anonymous survey., Results: Results: The high physical activity level was observed in 34.1% of boys and in 8.8% of girls. As the level of physical activity increased, the consumption of vegetables and fruits also increased. Whole grain bread, coarse-grained groats, whole grain pasta and brown rice were more popular among students with a high physical activity level. The greater the physical activity, the greater the amount of water drank by students. The consumption of sweets, fast food, and ready-made meals, such as frozen pizza or Chinese soup, decreased with increased physical activity. The choice of healthier substitutes for unhealthy snacks was declared by students with moderate or high physical activity level. There was no correlation between BMI and age and the physical activity level. Girls were less active than boys., Conclusion: Conclusions: More active physically children had better eating habits and were more aware of healthy eating principles than less active people.

Objective: Introduction: Following a Mediterranean diet significantly reduces the risk of cardiovascular and neurodegenerative diseases. The aim of the study was to assess nutritional knowledge among adult residents of the Silesian Province on the Mediterranean diet in the prevention of cardiovascular and nervous system diseases., Patients and Methods: Material and methods: The study was conducted using an anonymous self-made questionnaire. 190 adults from the Silesian Province participated in the study., Results: Results: The respondents had a good or sufficient level of knowledge on the Mediterranean diet. Respondents as the benefits of using the Mediterranean diet more often indicated a reduction in the risk of cardiovascular diseases than prevention of nervous system diseases., Conclusion: Conclusions: The inhabitants of Silesian Province have a fairly good level of knowledge on the preventive use of the Mediterranean diet. Public knowledge on the prevention of cardiovascular diseases, as well as knowledge on the principles of the Mediterranean diet, and on the benefits of its use, can reduce the incidence of cardiovascular and nervous system diseases.

Introduction: The aim of this project was to assess the prevalence of four selected SNPs rs4977574 and rs7857345 (CDKN2B-AS1 gene) and rs3798220 and rs10455872 polymorphisms (the LPA gene) in the subpopulation of patients with symptomatic and asymptomatic carotid stenosis. Material and Methods: This study included 623 individuals (244 patients with symptomatic carotid artery stenosis, 176 patients with asymptomatic carotid artery stenosis and 203 healthy people. All the participants underwent neurological examination, duplex Doppler ultrasound examination and molecular procedures. Results: In the first part of the analysis the assiociation of SNPs with stroke/TIA was investigated. The association was seen in symptomatic vs. control group for two SNPs: rs4977574 and rs7857345 (CDKN2B-AS1 gene); genotype distributions for rs4977574 and rs7857345 showed the statistically significant differences between patients and controls ( p = 0.043 and 0.017, respectively). No association was observed for rs3798220 and rs10455872 located in the LPA gene. There were statistically significant differences between asymptomatic patients vs. control group in genotype distribution for the SNPs located in CDKN2B-AS1: rs4977574 and rs7857345 ( p = 0.031 and 0.0099, respectively); and for the rs3798220 (LPA gene; p = 0.003); however, statistically significant differences did not occur for the rs10455872 polymorphism located in the LPA gene. In the next part of the evaluation, a comparison between symptomatic and asymptomatic patients was performed. Significant differences in genotype distribution were seen only for the rs3798220 polymorphism located in the LPA gene ( p = 0.0015). The analysis of the prevalence of the polymorphisms in the total group (symptomatic and asymptomatic) patients in comparison with the control group showed significant differences for three polymorphisms: rs4977574 and rs7857345 (CDKN2B-AS1 gene; p = 0.015 and 0.0046, respectively) and rs3798220 (LPA gene, p = 0.044). Conclusions: The present research on the carotid artery stenosis patient cohort suggests the significant association between the rs4977574, rs7857345 and rs3798220 polymorphisms and carotid artery stenosis as well as between the rs4977574 and rs7857345 polymorphisms and atherogenic stroke. The rs4977574 and rs7857345 polymorphisms in patients with carotid artery stenosis appear to affect a person's susceptibility to atherogenic brain ischemia. Our results need to be replicated in future studies., (Copyright © 2019 Lasek-Bal, Kula, Urbanek, Puz, Szymszal, Jarzab, Halczok, Cyplinska, Bal, Łabuz-Roszak, Cieślik, Jasnos, Jarzab and Ziaja.)

Introduction: Cystic fibrosis is a genetically determined disease. It is currently detected right after birth thanks to a screening program. This early detection allows for quick treatment inclusion. Cystic fibrosis therapy has a comprehensive character. The way of nutrition is also very important. The aim of this study was to evaluate the benefits and risks of enteral nutrition in patients with cystic fibrosis., Material and Methods: 53 people with cystic fibrosis participated in the study (15 men, 38 women). Qualification for the study required the fulfillment of three conditions: enteral nutrition used for at least one month, no increase in body weight when using a high energy diet, underweight. The research was carried with use of self-constructed questionnaire., Results: The mean age of the respondents was 19.9 ± 4 years. The median weight gain after enteral nutrition was 7 kg. Most (n = 42, 79.2%) did not report any side effects. Few reported local infections (n = 9; 17%) or prolapse of the balloon (n = 2, 3.8%). On the other hand, everyone reported benefits - it was mainly weight gain and improved quality of life. In some cases (n = 22, 41.5%) with the use of enteral nutrition, a decrease in the frequency of respiratory infections was observed., Conclusions: Enteral nutrition is a beneficial method in those patients with cystic fibrosis, in whom high-energy oral nutrition is inefficient.

Competing Interests: The authors declare no conflict of interest.

Objectives: Pain is one of the most frequently reported symptoms of multiple sclerosis (MS). It affects the daily functioning of patients, limits the ability to work and reduces the joy of life. The aim of the study was to analyze the impact of pain on quality of life as well as symptoms of anxiety and depression in patients with MS., Methods: The study included 144 patients with diagnosed MS (mean age 41±12 years, mean illness duration 10.3±8.6 years). The study was carried out on the basis of the author's survey on current and previous pain - the Quality of Life Self-esteem Questionnaire (EuroQol5D) and the Hospital Anxiety and Depression Scale (HADS)., Results: Among all respondents, 117 (81.3%) reported current pain, and 120 (83.3%) declared the occurrence of pain in the past. Currently, patients have reported: pain in one or more extremities - 79 people (54.9%), headache and facial pain - 72 (50%), back pain - 72 (50%), painful muscle spasms - 54 (38.6%), ocular pain - 37 (25.7%), Lhermitte's sign - 32 (22.2%). Patients reporting pain experienced significantly more severe symptoms of anxiety and depression (HADS-L: 8.0±4.3 vs. 5.1±4.3; p< 0.01; HADS-D: 6.0±4.2 vs. 3.4±3.7; p< 0.01), and had significantly worse quality of life (EQ 5D: 8.1±1.9 vs. 6.3±1.4; p< 0.0001). An association between presence of pain and gender (p< 0.01), age (p< 0.05), the degree of disability (p< 0.05), education (p< 0.001), and the professional activity (p< 0.01) was found., Conclusions: Pain in MS is associated with more severe symptoms of anxiety and depression, and worse quality of life. Female sex, older age, lower level of education, greater disability, and lack of occupational work predispose to the occurrence of pain in MS.

In the population of Poland, as well as in other European countries, an aging process is taking place. It is expected that in Poland in 2050, up to 35% of the population may be seniors. With increasing age, there are numerous changes in the body that necessitate the modification of the current diet. Incorrect diet is a risk factor for many old age diseases, including neurodegenerative diseases, osteoporosis, atherosclerosis, stroke, type 2 diabetes and hypertension. The aim of this study is to review the nutrition recommendations in selected diseases of the elderly. The diet of seniors should provide the right amount of nutrients and be adapted to existing diseases. A proper diet can reduce the risk of complications from senile diseases.

Generalized or partial epileptic seizures may be accompanied by autonomic dysfunction. They may also take the form of self-inflicted seizures or be present during interictal period. Arrhythmias, resulting in haemodynamic disturbances in the circulatory system and prolonged hypoxia of the central nervous system, may itself provoke secondary episodes of seizure morphology. The doctor when diagnosing patients with epileptic seizures should always be aware of the potential for cardiogenic disorders. Consideration should be given to the effect of epilepsy on the structure of the autonomic nervous system, the effect of antiepileptic drugs, and the potential for mutations within the ion channels.

Clinical Rationale for the Study: Neurological deficits and progressing disability in patients with multiple sclerosis (MS) may hamper daily oral hygiene, but their relations with oral problems have not yet been clearly determined., Aim of the Study: The aim of this study was to identify the most significant dental problems and limitations of daily oral hygiene in Polish patients with MS., Material and Methods: 199 patients with diagnosed MS (median age 37 years) treated in the neurological outpatient clinic were interviewed using a paper-based questionnaire. They provided answers on oral health, behaviours and the limitations of their daily oral hygiene. Clinical information regarding symptoms, MS phenotype, relapses, medication and degrees of disability was based on medical records., Results: The most frequent symptoms were dry mouth (43.2%) and bleeding from gums (28.1%). Dry mouth was more frequent in patients with secondary-progressive MS (SPMS) than relapsing-remitting MS (65.4% vs 41.3%, p = 0.023). Patients with bleeding from gums had had MS for a longer duration (median 6 vs 4 years, p = 0.002). Difficulties in daily oral hygiene were more frequent in patients with SPMS (24.0% vs 8.1%; p = 0.016). Greater proportions of patients with muscle weakness of limbs, imbalance or pain brushed their teeth irregularly. Frequent (i.e. at least every six months) visits to the dentist's surgery were uncommon in patients with SPMS (12.0% vs 39.7%, p = 0.010)., Conclusions and Clinical Implications: Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS. Daily oral hygiene and oral health self-control is limited in patients with MS, mainly due to motor deficits, balance problems and pain, and this becomes worse with disease duration. To minimise the burden of the disease, patients with MS require better education and improvement in their awareness regarding proper oral health control, such as the use of electric toothbrushes. In addition, patients with chronic and progressive disability from multiple sclerosis may benefit from better organised access to dental care.

Heart failure has accompanied mankind since the dawn of time. The first mentions of the disease, which today we describe as heart failure, come from ancient times. Epidemiology of symptomatic heart failure is well known , especially in Europe. Heart failure affects approximately 2% of the adult population in Europe. The article presents: definition, epidemiology and prognosis of patients with heart failure. The article presents current methods of pharmacotherapy and treatment of heart failure. An important element in the management of patients with heart failure is medical rehabilitation and the prevention of cardiovascular diseases, according to the ESC guidelines. The topic also discussed in the article is the analysis of socio-economic costs of heart failure. The article concludes that: heart failure is a medical problem, because despite the introduction of new treatment methods, it is a disease that is still characterized by poor prognosis; heart failure is an economic problem because its treatment is expensive and absorbs 2% of all costs of healthcare; heart failure is a social problem because it is a disorder affecting mainly elderly people, leading to a significant reduction in their ability to live independently, which results in their exclusion from social life.

Background and Aim: There is a lack of recent epidemiological studies on recurrent stroke (RS) in Poland. The aim of this study was to analyse all hospitalisations related to RS in Silesia - an industrial region covering 12% of the Polish population., Material and Methods: We carried out statistical analysis of data contained in stroke questionnaires transferred to the Polish National Health Fund by hospitals in Silesia, Poland, between 2009 and 2015., Results: In the analysed period, the number of RS hospitalisations in Silesia was 18,063 (22.2% of all acute strokes). The percentage of RS significantly decreased during the period under consideration (p < 0.001). The same observation concerned recurrent ischaemic stroke (RIS), but not recurrent haemorrhagic stroke (RHS). The median hospitalisation time was 14 days for RHS, and 11 days for RIS. Large-artery atherosclerosis and cardioembolisms were significantly more often recognised in RIS than in first-ever ischaemic stroke (FIS) (consecutively, 38.2% vs 36.0%, and 21% vs 18.1%; p < 0.001). The in-hospital mortality rate was significantly higher for RS than for first-ever stroke (18.4% vs 17.2%; p < 0.001). The same observation was done for RIS vs FIS (16.2% vs 13.9%; p < 0.001), and for RHS vs FHS (39.8% vs 36%; p = 0.004). The rtPA therapy was applied to 5.3% of FIS and 3.2% of RIS patients (p < 0.001)., Conclusions: This is the first such comprehensive and long-term analysis of recurrent stroke in Silesia, Poland. It could help in the implementation of appropriate educational programmes, and thus help to improve the health status of society.

Objective: Introduction: Dietary trends such as consumption of lactose-free and gluten-free products or the use of alternative slimming diets are gaining increasing popularity, especially among young people. They determine their dietary choices, which are important from the point of view of human health. Unconventional diets are still considered as effective weight loss methods. The use of alternative diets may cause shortages of an essential nutrients, increase the risk of chronic non-communicable diseases and lead to the formation of incorrect eating habits. Balanced diet, in contrast to the alternative diet, takes into account the principles of rational nutrition and nutritional recommendations of the Institute of Food and Nutrition (IŻŻ). The aim: To investigate the influence of popular dietary trends on nutrition of high school adolescences., Patients and Methods: Material and methods: Subjects were adolescences in the age of 17-21 years attending high schools in Ruda Slaska (262 students, including 157 women and 105 men). Self-constructed questionnaire was applied in the study. Participation in the study was anonymous and voluntary., Results: Results: In more than a half of young women (54,8%) and men (52,4%) the body mass deficiency was revealed (BMI<18 kg/m2). 33,6% of the respondents were on the non-balanced diets at least once in their lives. High school students knew gluten-free and lactose-free products but dietary trends, such as the consumption of gluten-free and lactose-free products, did not affect their diet. The main source of nutritional knowledge among respondents were their friends (78,2%)., Conclusion: Conclusions: The results of the conducted research indicate the need to implement educational programs on the principles of proper nutrition. The increasing awareness of the youth in this regard may contribute to reducing the interest in still popular alternative diets among young people and taking appropriate health behaviors by them.

Introduction: The association between changes in magnetic resonance imaging (MRI) and clinical symptoms in patients with low back pain (LBP) is unclear., Aim: To evaluate correlations between combined MRI findings of the lumbar spine (LS) and pain intensity, depressive and anxiety symptoms and quality of life in patients with LBP., Material and Methods: 200 subjects (93 men and 107 women; mean age 51.42 ± 13.21 years) with LBP referred for MRI were enrolled in the study. All patients completed the Hospital Anxiety and Depression Scale (HADS), Quality of Life Scales (EQ-5D, EQ-VAS) and the Visual Analogue Scale (VAS). MRI scans were assessed according to a scoring system prepared by the authors, and the total MRI score was calculated., Results: The mean total MRI score was 11.59 ± 6.73 points (range 0-50 points) and was higher in men than in women (p = 0.015). A correlation was observed between total MRI score and age (p < 0.001) and between total MRI score and BMI (p = 0.005). An association was found between total MRI score and EQ-5D (p = 0.012) and HADS-D results (p = 0.003). VAS and HADS-A results did not correlate with MRI score. When multivariate analysis was done, the total MRI score was only significantly related to age and BMI, and association between the total MRI score and EQ-5D or HADS-D results was not confirmed. Decreased quality of life was associated with increased intensity of pain and depressive and anxiety symptoms., Conclusions: Combined MRI changes in LS do not correlate with pain intensity, depressive and anxiety syndromes or quality of life in patients with LBP.

Heart failure appears in 2% of the adult population in Europe. One in five people aged 40 years will develop heart failure during their lifetime. Heart failure touch 20,000 people in the Opole province. Heart failure is the second, after acute coronary syndromes, urgent cause of admissions to the Clinic of Cardiology at the University Hospital in Opole. The paper presents the prognosis of hospitalization of patients with heart failure for the years 2015-2050 taking into account the processes of depopulation taking place in our region. The analysis makes it possible to predict that the age group particularly exposed to heart failure in the coming decades will be people who today belong to teenagers and young adults. The article presents current methods of treatment of heart failure. Improvement in the prognosis of patients with heart failure can occur through the implementation of the guidelines for treatment of heart failure recommended by the ESC. This goal is to be achieved by introducing the "Comprehensive care for patients with heart failure (KONS)" program in our country. The shift of the burden of care for patient with heart failure to outpatient unit will result in a significant reduction in the number of hospitalizations.