Search

The melanocortin-4 receptor (MC4R) gene harbours one of the strongest susceptibility loci for obesity and obesity-related metabolic consequences. We analysed whether dietary factors may attenuate the associations between MC4R genotypes and obesity and metabolic parameters. In 819 participants genotyped for common MC4R polymorphisms (rs17782313, rs12970134, rs633265, and rs135034), the anthropometric measurements, body fat content and distribution (visceral and subcutaneous adipose tissue, VAT and SAT, respectively), and blood glucose, insulin, total-, LDL-, HDL-cholesterol, triglycerides concentrations, and daily macronutrient intake were assessed. ANOVA or Kruskal-Wallis tests were used, and multivariate linear regression models were developed. We observed that the CC genotype carriers (rs17782313) presented higher VAT, VAT/SAT ratio, fasting blood glucose and triglyceride concentrations when they were stratified to the upper quantiles of protein intake. An increase in energy derived from proteins was associated with higher BMI (Est. 5.74, R 2 = 0.12), body fat content (Est. 8.44, R 2 = 0.82), VAT (Est. 32.59, R 2 = 0.06), and VAT/SAT ratio (Est. 0.96, R 2 = 0.05). The AA genotype carriers (rs12970134) presented higher BMI, body fat, SAT and VAT, fasting blood glucose, triglycerides and total cholesterol concentrations. An increase in energy derived from proteins by AA carriers was associated with higher VAT (Est.19.95, R 2 = 0.06) and VAT/SAT ratio (Est. 0.64, R 2 = 0.05). Our findings suggest that associations of the common MC4R SNPs with obesity and its metabolic complications may be dependent on the daily dietary intake, which may open new areas for developing personalised diets for preventing and treating obesity and obesity-related comorbidities.

Transcription factor-7-like 2 (TCF7L2) is one of the most important susceptibility genes for type 2 diabetes mellitus (T2DM). The aim of our cross-sectional population-based study was to analyze whether daily macronutrient intake may influence the effects of the TCF7L2 rs7901695 genotype on glucose homeostasis and obesity-related parameters. We recruited 810 participants (47.5% men and 52.5% women), 18-79 years old (mean age, 42.1 (±14.5) years), who were genotyped for the common TCF7L2 rs7901695 single-nucleotide polymorphism (SNP), and anthropometric measurements, body composition, body fat distribution (visceral (VAT) and subcutaneous adipose tissue (SAT) content), blood glucose and insulin concentrations after fasting and during OGTTs, and HbA1c were assessed. The VAT/SAT ratio, HOMA-IR (homeostatic model assessment of insulin resistance), HOMA-B (homeostatic model assessment of β-cell function), and CIR30 (corrected insulin response) were calculated. The daily macronutrient intake was evaluated based on 3-day food-intake diaries. Daily physical activity was evaluated based on a validated questionnaire. We performed ANOVA or Kruskal-Wallis tests, and multivariate linear regression models were created to evaluate the effects of dietary macronutrient intake on glucose homeostasis and obesity-related parameters in carriers of the investigated genotypes. This study was registered at ClinicalTrials.gov as NCT03792685. The TT-genotype carriers stratified to the upper protein intake quantiles presented higher HbA1c levels than the CT- and CC-genotype participants in the same quantiles ( p = 0.038 and p = 0.022, respectively). Moreover, we observed higher HOMA-IR ( p = 0.014), as well as significantly higher blood glucose and insulin concentrations, during the OGTTs for those in the upper quantiles, when compared to subjects from the lower quantiles of protein intake, while the CC-genotype carriers presented significantly lower HbA1c ( p = 0.033) and significantly higher CIR30 ( p = 0.03). The linear regression models revealed that an increase in energy derived from proteins in TT carriers was associated with higher HbA1c levels (β = 0.37 (95% CI: 0.01-0.74, p = 0.05)), although, in general, carrying the TT genotype, but without considering protein intake, showed an opposite tendency-to lower HbA1c levels (β = -0.22 (95% CI: 0.47 to -0.01, p = 0.05). Among the subjects stratified to the lower quantile of carbohydrate intake, the TT-genotype individuals presented higher HbA1c ( p = 0.041), and the CC-genotype subjects presented higher VAT ( p = 0.033), lower SAT ( p = 0.033), and higher VAT/SAT ratios ( p = 0.034). In both the CC- and TT-genotype carriers, we noted higher VAT ( p = 0.012 and p = 0.0006, respectively), lower SAT ( p = 0.012 and p = 0.0006, respectively) and higher VAT/SAT ratios ( p = 0.016 and p = 0.00062, respectively) when dietary fat provided more than 30% of total daily energy intake, without any differences in total body fat content. Our findings suggest that associations of the common TCF7L2 SNP with glucose homeostasis and obesity-related parameters may be dependent on daily macronutrient intake, which warrants further investigations in a larger population, as well as interventional studies.

Aim: The purposes of our study were to determine the level of total social support, informational support, instrumental support, appraisal support and emotional support received by patients of primary care as well as factors related to this level with reference to health status and sociodemographic variables., Method: The sample for current analysis included 516 patients of primary care clinics in Poland cooperating with medical universities. Questionnaires: STAI (State-Trait Anxiety Inventory), SCL-90 (Symptom Checklist-90), EPQ-R (Eysenck Personality Questionnaire-Revised), GHQ (General Health Questionnaire)and SSS (Social Support Scale)were used in the study. Results from last two questionnaires are presented in the paper., Results: The highest mean levels were obtained for instrumental support, while the lowest levels were observed for emotional support. The highest means were indicated in the GHQ-28-social dysfunction, the lowest-GHQ-severe depression. Statistically significant relation was found between the level of social support and gender. Less subjectively evaluated total social support as well as instrumental and appraisal support were obtained by women. The highest Spearman score was found in the case of total GHQ-28 score, somatic symptoms, anxiety and insomnia, severe depression and total support. Taking into account the ANOVA findings, it was observed that an increasing GHQ score was associated with intensively increasing emotional support, informative support, appraisal support and the most- instrumental support., Conclusion: The results display the underestimated role of emotional, informational and appraisal support and the overestimated role of instrumental support in primary care. The consequence may be a more frequent using health care accompanied by low level of patients' satisfaction, severity of social dysfunction disorders, particularly in patients with chronic diseases, who constitute an increasingly large group of primary health care.

Introduction: Metabolic syndrome is a contemporary disease of civilization, an effect of lack of healthy behaviour, a consequence of lifestyle devoid of physical activity, eating poor quality food rich in calories and excessive stress. Apart from a proper diet, physical activity remains an important part of metabolic syndrome management., Objective: The main objective of the work was to evaluate the physical activity of an adult population of patients with metabolic syndrome. materials and method. Adults aged 35-70 fulfilling the criteria of metabolic syndrome according to International Diabetes Federation (IDF) were included. New Lifestyles NL-2000 pedometers were used to assess locomotive physical activity during an entire week., Results: In the group of 100 subjects, as many as 61 people (61%) represented low or sedentary activity, while nearly one fourth of the respondents - 23 (32%) represented the negligible activity type. Average weekly physical activity of those in the study was 6,743 steps/day (in 100 individuals) and ranged from 1,781-15,169. A great diversity was found in the study group, since the highest number of steps per day was 23,347 and the lowest - 409. No significant differences in the number of steps on weekdays and at weekends were observed (mean: 6,676/day and 6,913/day, respectively). A statistically significant negative correlation (r = -0.29) was observed between age and physical activity, between the average daily number of steps in the week and Waist Hip Ratio (WHR) (r = 0.201), as well as between the average daily number of steps in the week and Body Mass Index (BMI) (r = 0.226)., Conclusions: The majority of people with metabolic syndrome represent a low or sedentary activity type and decrease of physical activity corresponds to increasing age, BMI and WHR. No significant differences in physical activity are observed between working days and free days (weekends).

Introduction: Alcohol and tobacco are legal, easily available addictive substances. There are no universal criteria of safe alcohol consumption but some scientific studies have allowed for determination of consumption levels helpful in evaluation of the pattern of drinking and evoking readiness to limit the amount of consumed alcohol., The Aim: The aim of the work was to evaluate and compare the knowledge of 6th year students of the Faculty of Medicine of the Medical University of Biatystok in the academic years 2011/12 and 2012/13 concerning the effects of alcohol abuse, as well as to determine their drinking patterns and tobacco smoking structure., Materials and Methods: The study material was collected by means of anonymous voluntary surveys carried out before classes concerning the issues of addictions within the framework of family medicine subject block., Results: 356 students took part in the study: 226 (63.5%) women and 130 (36.5%) men (p<0.000). 4.86% of the respondents displayed a high level of knowledge on the harmfulness of alcohol abuse; 63.43% had an average level of knowledge and 31.71% - a low one. 51,32% women and 62,3% men drank alcohol in a hazardous way. A relation was found between a low level of knowledge and the amount of alcohol consumed on a typical drinking day (rS=-0.15, p=0.03) as well as between a low level of knowledge and hazardous drinking (rS=-0.13, p=0.03). Among the respondents, 18,58% women and 14,63% men smoked cigarettes regularly. Those who are 6th year students in the academic year 2012/13 usually had started smoking within the first three years of study at the Medical University and drank greater amounts of alcohol on a typical drinking day than students surveyed in the 2011/12 year. A correlation was found between tobacco smoking and a greater frequency of getting drunk occasionally (rS=-0.18, p=0.002) among students of both years., Conclusion: Insufficient knowledge on the effects of alcohol abuse and smoking coexist with a higher risk of drinking alcohol.

Introduction and Objective: Psychiatric disorders (and their high rates of prevalence) in primary care have been widely analyzed, but the problem of underdiagnosis remains unresolved. This becomes increasingly more important in rural health centres in the face of lack of epidemiological data from these centres. The aim of this study is focused on the relationship between general health, psychiatric symptomatology and personality characteristics in the context of an adequate diagnosis., Materials and Methods: 518 primary care patients in 6 Polish urban clinical centres were studied using (in order of administration): a sociodemographic questionnaire, the General Health Questionnaire (GHQ-28) and Eysenck Personality Questionnaire (EPQ-R)., Results: The investigated sample was representative for urban primary care patients. The findings confirmed a significant association between neuroticism and general health. The strongest relation with current functioning and mental distress of the patients (GHQ general score) was observed in case of symptoms of anxiety and insomnia. The symptoms of depression may be the most difficult to identify (psychiatric symptoms assessed using GHQ sub-scales)., Conclusions: According to the GHQ assumptions and confirmed by the presented study, sub-threshold psychiatric symptomatology affects the functioning of primary care patients and their general health. This correlates with personality factors. Improving adequacy of diagnosis becomes extremely important, as it may often be the only chance for appropriate therapy of mental problems for people living in rural areas due to lower availability of specialistic mental services. Further epidemiological studies concerning rural primary care and prevalence of the spectrum of mental disorders need to be conducted.

Stable vesicles for efficient curcumin encapsulation, delivery and controlled release have been obtained by coating of liposomes with thin layer of newly synthesized chitosan derivatives. Three different derivatives of chitosan were obtained and studied: the cationic (by introduction of the stable, quaternary ammonium groups), the hydrophobic (by attachment of N-dodecyl groups) and cationic-hydrophobic one (containing both quaternary ammonium and N-dodecyl groups). Zeta potential measurements confirmed effective coating of liposomes with all these chitosan derivatives. The liposomes coated with cationic-hydrophobic chitosan derivative are the most promising curcumin carriers; they can easily penetrate cell membrane and release curcumin in a controlled manner. Biological studies indicated that such systems are non-toxic for murine fibroblasts (NIH3T3) while toxic toward murine melanoma (B16F10) cell line., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Novel polyelectrolytes were obtained by grafting N-isopropylacrylamide (NIPAM) on the ι-carrageenan (CAR) chain. Two polymers with different grafting degrees were synthesized. The polymers were found to show the lower critical solution temperature (LCST) close to that of PNIPAM. The LCST values were dependent on the concentration of salt and cationic surfactant. The interactions of CAR-graft-PNIPAM with a model cationic surfactant-dodecyltrimethyl ammonium chloride (DTAC) in water and 0.15M NaCl were studied. It was found that both ι-carrageenan and CAR-graft-PNIPAM polymers interact with DTAC. The presence of CAR-graft-PNIPAM in the solution of DTAC induces formation of surfactant aggregates at the critical aggregation concentration much lower than the cmc of the surfactant. Cac increased with ionic strength. The values of cac for CAR-graft-PNIPAM - DTAC system and standard free enthalpy changes attributed to the complexation process were determined. The results obtained for CAR-graft-PNIPAM were compared with these for the non-modified ι-carrageenan. The surfactant interactions with non-modified and grafted polymers were found to be different in nature., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The purpose of this study was to determine quality of life (QoL) and acceptance of illness in patients with chronic respiratory diseases. The study involved 315 adult patients of the mean age of 63.9±15.7 years. The World Health Organization Quality of Life Instrument Short Form and the Acceptance of Illness Scale were used. The mean score for QoL was 2.0±1.3. The highest scores were obtained in the Social Relationship Domain (13.9±2.7) and the lowest in the Environmental Domain (10.5±2.2). The strongest correlations within QoL domains were noted between Physical and Psychological Domains: r=0.611 (p<0.001), Psychological and Social Domains: r=0.605 (p<0.001). The overall degree of illness acceptance was low (26.0±7.8). The strongest correlations were observed between illness acceptance and Physical: r=0.591 (p<0.001) and Psychological Domains: r=0.450 (p<0.001). We conclude that illness acceptance can be augmented by improving the patient's clinical state and by the provision of psychological support and QoL by improving the Psychological and Environmental Domains., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The human coronavirus NL63 is generally classified as a common cold pathogen, though the infection may also result in severe lower respiratory tract diseases, especially in children, patients with underlying disease, and elderly. It has been previously shown that HCoV-NL63 is also one of the most important causes of croup in children. In the current manuscript we developed a set of polymer-based compounds showing prominent anticoronaviral activity. Polymers have been recently considered as promising alternatives to small molecule inhibitors, due to their intrinsic antimicrobial properties and ability to serve as matrices for antimicrobial compounds. Most of the antimicrobial polymers show antibacterial properties, while those with antiviral activity are much less frequent. A cationically modified chitosan derivative, N-(2-hydroxypropyl)-3-trimethylammonium chitosan chloride (HTCC), and hydrophobically-modified HTCC were shown to be potent inhibitors of HCoV-NL63 replication. Furthermore, both compounds showed prominent activity against murine hepatitis virus, suggesting broader anticoronaviral activity., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The purpose of the research was to study kindergarteners' exposition to environmental tobacco smoke (ETS) in houses. Social and economical factors were checked for the improper behavior of grown-up household. Material for the research were data collected from questionnaires filled by children's parents. 272 three years old children were studied (57.7% boys and 42.3% girls). Cotinine--marker of exposition to ETS was measured in the children's urine. In 32.4% houses at least one resident was a tobacco smoker. The most often it was father (22.3%) or mother (10.6%). Most of them (78.7%) affirmed tobacco smoking out of houses. Tobacco smoking correlated to parents education (mothers--college graduate and fathers--high-school graduate smoked tobacco the most often). Tobacco smoking by the parents correlated to low household income (less than 1000 zl), many house occupants (4-5 persons), small house area (less than 15 m2/person). A part of studied group of children (11%) was exposed to ETS out of house. Mean cotinine concentration in urine of children exposed and unexposed to ETS in house were not significantly different an were respectively: 25.60 and 21.22 ng/mg creatinine. Propagation of right behavior among people smoking tobacco in houses and education of small children parents is important.

Purpose of the Study: To determine the level of alcohol intake (including risky drinking) and tobacco smoking among students of higher medical schools, as well as the level of students' knowledge about epidemiology and consequences of alcohol abuse., Material and Methods: The study was conducted in 2010-2012 and involved 1054 students of medical school. The majority of the participants were female (82.3%). Average age of respondents was 25.13 years (SD = 6.64, median = 24). The questionnaire was to determine the students' knowledge of alcohol abuse, short version of AUDIT and questions about tobacco smoking., Results: The average 100% alcohol intake in Poland was correctly identified by 32.0% (318) of students. The alcohol level in blood which indicates the state after alcohol intake was correctly determined by 57.2% (571) of respondents. Tobacco was the choice of 13.8% (138) of students as the main health risk factor and cause of premature deaths in Europe, alcohol was chosen by 17.8% (177). Cirrhosis was recognized correctly by 52% of students (521) as the most frequent disease caused by alcohol in European men. Regarding the question about the biochemical indicators helpful in diagnostics of alcohol abuse only 27.6% (275) indicated correctly: MCV and GGT. In short version of AUDIT 32.2% (238) of women gained 4 points and above, 56.2% (91) of men gained 5 points and above. Among women: 3.5% (28) have 14 and above standardized portions of an alcoholic drinks during week. Among men: 6.5% (11) have 28 and above standardized portions of an alcoholic drinks during week. Non-smokers represent 20.6% (205) of respondents. A majority (39.4%, 82) indicate they smoke not more than 5 cigarettes per day. The students first began smoking in secondary (21.7%, 45) and high school (45.9%, 95). Smokers statistically significantly more often (p<0.001) drink alcohol. More than four times higher percentage of smokers (10.0% vs 2.3% non-smokers) drink in a day when they drink 10 or more standardized portions of an alcoholic drink (p<0.001). Those who drink at least once a month drink 6 standardized portions of an alcoholic drink statistically significantly more often (p<0.001)were smokers (21.8% vs 10.8% non-smokers). Smokers were more than four times more likely (13.4%) than non-smokers (3.2%) to drink 6 standardized portions of an alcoholic drink once a week. During the majority of weekdays, 6 standardized portions of an alcoholic drink were taken by 2.48% (5) of smokers (vs 0% non-smokers)., Conclusions: A high percentage of students in medical schools drink riskily. Especially the risky drinking was observed among smoking students. The level of knowledge gained by respondents about alcohol abuse is still insufficient. Programs that promote avoiding tobacco smoking and alcohol abuse are necessary among children during the first years of education (in primary school and earlier).

The mechanisms and factors causing or influencing degenerative diseases require tailor-made solutions. Natural polysaccharides are among the most versatile building units of the novel drug delivery systems. Their properties can be easily tailored to specific needs because they depend not only on the first-order structure, but also on the molecular weight, the type of end-groups and the conformation of the chain. The review presents the current state-of-art in the field of modifications of natural polysaccharides aiming at improving the delivery of anti-degenerative agents. Derivatization includes introducing of ionic or hydrophobic groups in order to adjust polarity or to obtain amphiphilic material, as well as degradable bonds, spacers and targeting moieties. The influence of the modification on the properties of the carrier, such as its size, surface charge, encapsulation efficiency, drug release profile, and stability in vivo, is discussed. Application of the polysaccharide derivatives to enhance the mucoadhesion and to actively target the drug to its site of action is also shown for a variety of carriers: nano and microparticulate systems, coated liposomes, hollow particles and polymer-drug conjugates.

Implementing the National Health Program assumed in Poland for the years 2007 2015, family doctors in their everyday work try to contribute to reducing the popularity of tobacco smoking as well as reducing and changing the structure of alcohol consumption, whose aim is to reduce the negative health effects caused by those substances [9]. Non smoking personnel and prohibition of smoking in health care centres are the basis for effective anti-tobacco counsel. The same dependence occurs in the case of alcohol abuse. The aim of the work was to evaluate the knowledge of the effects of alcohol abuse among students of the 6th year of the Faculty of Medicine of UMB (Medical University of Białystok), as well as to analyze the structure of drinking and smoking among the prospective doctors. The study material was collected by means of anonymous surveys carried out before classes belonging to the family medicine subject block. The obtained data showed that the students had only superficial knowledge of the negative health effects of alcohol abuse and tobacco smoking. 26% of female students and 12% of male students smoke regularly. The results of the shortened Alcohol Use Disorders Identification Test (AUDIT), so-called AUDIT-C, showed that 50% of prospective female doctors and 61.1% of prospective male doctors drink alcohol in a risky way.

Unlabelled: Laryngeal microsurgery is currently the primary method of treatment of many diseases of the larynx. Breakthrough for the development of laryngeal microsurgery was the introduction of laser technology. The laryngeal microsurgery is used mainly laser CO₂. Endoscopic laryngeal microsurgery using the laser poses a unique challenge to the anesthesiologist, ensuring safe conditions of anesthesia, the patient and simultaneously appropriate operating conditions for the surgeon for precisely perform the procedure., Material and Methods: Between 1995 and 2010 carried out in the Department of Otolaryngology SUM 832 microsurgical operations of the larynx using a CO₂ laser., Conclusion: The perioperative management and close cooperation with the surgeon and anesthesiologist are essential for safe and efficient conduct of the operation the larynx using a microsurgical CO₂ laser.

Curcumin shows huge potential as an anticancer and anti-inflammatory agent. However, to achieve a satisfactory bioavailability and stability of this compound, its liposomal form is preferable. Our detailed studies on the curcumin interaction with lipid membranes are aimed to obtain better understanding of the mechanism and eventually to improve the efficiency of curcumin delivery to cells. Egg yolk phosphatidylcholine (EYPC) one-component monolayers and bilayers, as well as mixed systems containing additionally dihexadecyl phosphate (DHP) and cholesterol, were studied. Curcumin binding constant to EYPC liposomes was determined based on two different methods: UV/Vis absorption and fluorescence measurements to be 4.26×10(4)M(-1) and 3.79×10(4)M(-1), respectively. The fluorescence quenching experiment revealed that curcumin locates in the hydrophobic region of EYPC liposomal bilayer. It was shown that curcumin impacts the size and stability of the liposomal carriers significantly. Loaded into the EYPC/DPH/cholesterol liposomal bilayer curcumin stabilizes the system proportionally to its content, while the EYPC/DPH system is destabilized upon drug loading. The three-component lipid composition of the liposome seems to be the most promising system for curcumin delivery. An interaction of free and liposomal curcumin with EYPC and mixed monolayers was also studied using Langmuir balance measurements. Monolayer systems were treated as a simple model of cell membrane. Condensing effect of curcumin on EYPC and EYPC/DHP monolayers and loosening influence on EYPC/DHP/chol ones were observed. It was also demonstrated that curcumin-loaded EYPC liposomes are more stable upon interaction with the model lipid membrane than the unloaded ones., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Respiratory diseases are the most common cause of the child and family practice physicians are one of the main reasons for referral to a specialist clinic and hospital pediatric wards. The severity of respiratory disease in adolescence influenced by various factors, endo- and exogenous. Some of them, especially environmental factors can be eliminated or reduced and thus reduce the risk of developing this disease. The most common source of pollutants in dwellings is tobacco smoke. The aim of this study was to assess exposure to tobacco smoke in three years old children of attending local kindergartens in Białystok and its influence on the type of recovery from acute respiratory infections by the respondents. The study included 313 children from among the 1,200 who attend the local 51-kindergartens in Bialystok. Information on the structure of tobacco use in three-years-old-children's families and respiratory illnesses among random children were obtained, based on anonymous questionnaires completed by their carers. Exposure to tobacco smoke was based on questionnaires and serum cotinine in relation to creatinine in the urine of patients (K/K). In the 150 families surveyed children found 210 smoking people. Every day smoked 37.3% of fathers and 23.6% of mothers. Of the children surveyed--34% of the houses which where there was a prohibition on tobacco use, 35% of the houses which were smoked in enclosed areas, in 31% of homes have not been established no-smoking rules. Children who during the six-month period to attend kindergarten gone lower respiratory tract infection had mean K/K (59.57 ng/mg) higher than the ones that were healthy and underwent upper respiratory tract infection. Used by the parents of the children tested in part to reduce the exposure to tobacco smoke in the home environment was ineffective and did not influence the decrease in the incidence of lower respiratory tract.

Prevention of tobacco smoking amongst youths and young adult could limit deaths because of illness tobacco related to 2050. The assessment of the level of smoking was the aim of examinations amongst medical students. An anonymous questionnaire containing questions on the subject of tobacco smoking was carried amongst 6th year students of the Medical Department of Wroclaw Medical University in the academic year 2008/2009. Two hundreds then students took part in the study. 62% of examined came from the provincial capital, the 11.4% from the town with the population above 100 hundred of inhabitants, 22.4% of towns with the population below 100 hundred of inhabitants and 3.8% of students--from country centers. 14.8 % respondents admitted to smoking cigarettes, 75.2% were non-smoking persons, 10% were smokers but ceased smoking cigarettes in the sequence of a few last years. Amongst smokers--the most (59% of students and 71% of students) is smoking to 5 cigarettes per day. The most students (56% of women and 60% of men) began smoking in the secondary school. In studied group 67.6% (142) examined is claiming that the anti-tobacco advice should give family doctors, and 43% thinks that a patient which isn't able to cease the smoking in spite of strong motivation should be seen by a family doctor. The percentage of smokers amongst medical students didn't take turns in the sequence of two last years, however amongst smokers--biggest percentage is smoking to 5 cigarettes per day. The students most often begin smoking in the secondary school. The straight majority of the medical students is paying attention, that family doctors should take up giving the anti-tobacco advice and helping patients which isn't able to cease the smoking in spite of strong motivation. The ones smoking the small number of cigarettes and which began smoking in the secondary school are predominating amongst smokers. Overbalancing percentage of examined is located anti-tobacco therapy into competence of a family doctor.

Smoking tobacco in our society is the primary risk factor in the emergence of many diseases, including cardiovascular and cancer, elevating the risk of mortality before 65 years of age. Very important is the fact that this is a removable, which can be completely eliminated. The smoker health could be in better conditions and also other people from his environment. A man who is messed up is the sick man who, while having the motivation to stop smoking, need a comprehensive and specialized medical treatment. Respondents nursing and midwifery students in Opole PMWSZ most important in providing advice to patients students choose family doctors (34.1%) and internists (17.9%). According to the respondents, patients who, despite a strong motivation to stop smoking can not, should find help in specialized anti-tobacco clinic (27.8%), substance abuse treatment clinic (16.5%), and psychological counseling (11.4%). Half of the surveyed students (51.35%) declared the ability to advice patients, while only 18.7% of respondents correctly answered the question what is the minimum intervention of tobacco control, 56% of respondents claimed that it is information to the patient of the consequences of smoking. Important in reducing the health effects of smoking is to prepare health workers to diagnose the problem of addiction and comprehensive professional treatment.

It was stated explicitly that smoking was increasing the risk of the death about 25-40% because of cardiovascular diseases, about 30-40% because of malignant tumors and is causing about 70% of deaths from illness of the respiratory system (no cancerous). It was also proved that basic means increasing the effectiveness of taken attempts to limit the smoking were useful and easy to apply by every doctor independently of the medical specialty. An anonymous questionnaire containing questions on the subject of the realization of problems connected with the tobacco addiction in the route of medical studies was carried amongst 6th year students of the Medical Department of Wroclaw Medical University in the academic year 2008/2009. 210 students took part in the study. 62% of examined came from the provincial capital, the 11.4% from the town with the population above 100 hundred of inhabitants, 22.4% of towns with the population below 100 hundred of inhabitants and 3.8% of students--from country centers. Only 78% of students is claiming that problems concerning nicotinism were being brought up on the university. 56.7% of examined is judging that he is able to give an anti-smoking advice to a patient. The correct answer in the question about the Fagerströma test and describing physical addiction gave 47% of students, only 39.5% examined--in the question about the assessment of motivation test (the Schneider scale), and 37.2% of students responded to the question what is consists in minimum anti-tobacco intervention. An insufficient frequency of bringing up the problem of smoking on medical studies is visible harmfulness, a consequence is a lowering knowledge amongst students. Little over 3 of students is confirming students that problems concerning the nicotinism were being brought up during studies (mainly during classes in the field of internal medicine), however every sixth of examined students is declaring the knowledge in the case of the patient addicted to the nicotine and every fourth has the knowledge. The preparing graduates of the Medical Faculty for the participation in realization of basic schedules of the promotion of the health and the diseases prevention is developing unusually pessimistically towards above data, the fight against the nicotine addiction is filling one of the essential positions, independently on the medical specialty.

Smoking is the most widespread addiction and for years is a basic addiction hazard among youngsters. The beginning of nicotine addiction is occult, during time runs as habit and biological nicotine addiction. The health consequences are seen after time. Children have their first contact with cigarettes in their own families and the problem of smoking is the consequence of following adults' example. The risk of smoking addiction rises because of negative influence of background and because of the need of being approved among men of the same age. The objective of the study was the analysis of spreading of smoking among students of PMWSZ in Opole during years 2006-2009.688 students of nursery and obstetrics faculty were investigated. Among them 175 (25.4%) were smokers and 513 (74.6%) were non-smokers. More than half of smokers (61.2%) started smoking in secondary grammar school. 110 (62.9%) of them tried to overcome their addiction. These failed attempts confirm the necessity of multi-aspect anti-nicotine help given by health professionals: doctors, psychologists, addiction therapeutics and pedagogues.

Minimal anti-tobacco intervention (MIA) is an efficient and inexpensive method of smoking cessation intervention. The ability for practical use of MIA could be acquired by a majority of physicians-practitioners in Poland and other European Union countries. The objective of the work was to establish a practical knowledge in the scope of anti-tobacco strategies of senior students of the Medical Faculty of the Medical University of Bialystok after six-year education. We also assessed the prevalence of tobacco smoking among students of Medical Faculty. The percentage of tobacco smokers between the last course students of Medical Faculty average at 15% of women and 29% of men. Only 3 of all woman and half of men think they could effectively help in smoking cessation, but most of the assessed students have not acquired sufficient knowledge for an anti-tobacco intervention as well as they don't know practical tools like Fagerstöm Test for Nicotine Dependence or Schneider's Smoker Complaint Scale.

Problem of prophylaxis of nicotine-related diseases and leading of programs of the fight against tobacco addiction are being given out to be shared nominative case of main plans led in the framework of health care in majority of European countries. An anonymous questionnaire containing questions concerning students' opinion on the subject of the fight against tobacco addiction was carried amongst students of the 6th year of the Medical Department of Wroclaw Medical University in the academic year 2007/2008. 177 students took part in the study (64% of women, 34% of men). 72.4% of students came from cities with the population above 100 hundred of inhabitants. 64.4% of students is regarding problem of nicotinism in Poland as important. 62.2% of students think that promoting not-smoking in media is most effective method. 76.7% of students is justifying total smoking ban in public places and is behind accepting such regulations in Poland. 1.14% of students is against smoking ban in public places regarding it as limiting their freedom. Majority of students thinks that nicotinism is an essential problem in Poland. Dominating percentage examined thinks that promoting not-smoking in media is most effective method. Majority of students is justifying a total smoking ban in public places and is behind accepting such regulations in Poland. Only scarce percentage examined is against a smoking ban in public places regarding it as limiting their freedom. Undoubtedly students notice problem of tobacco smoking in Poland as important, at the same time rarely taking into consideration keeping anti-tobacco programs on the level of health care--are handing responsibility for realization of these programs to media or government organizations. Students are supporting regulations introducing a ban on smoking in public places.

Within the framework of "Schedule of health care, economic and social policy pursuing to reduction of tobacco consumption" involving numerous institutions including universities, educated persons will be responsible for the treatment and prophylaxis of tobacco smoking-evoked diseases. The aim of this study was assessment of the tobacco smoking prevalence among undergraduates of last-year course of Medical Faculty and Nursing Faculty of Medical University of Bialystok and evaluation of theirs attitude in the face of the nicotinism question after 5 years of occupation. The percentage of tobacco smokers on Medical Faculty average out 27.7% and 17.8% on Nursing Faculty. Students of both faculties opined that nicotinism in Poland was a heavyweight issue (8 points in decagrade scale). Our data shown that about one third of assessed students have not to do with a nicotinism theme and were not acquired sufficient knowledge to help tobacco smoking patients. Thus, continuation of nictonism issue education within the framework of seminaries and classes of family medicine course in both faculties will be purposeful action.

The promotion of health is a science and art of helping people to change their environment and lifestyle to a health friendly one, in order to strengthen and build up their wellbeing. Smoking cigarettes is a most disadvantageous element of a lifestyle. Important elements of promotion of non-smoking lifestyle, by our students, as future Health Service members, are: promoting of smoke-free environment, encouraging of non-smoking fashion, education of health consequences of smoking cigarettes, motivation to quit smoking, advisement in the field of smoking addiction treatment. Public health and health promotion, these are classes where smoking cigarettes' problem has been discussed mostly. Over 90% of students' respondents claim that were able to give a nonsmoking advice to any patient. Because of the awareness of health threats caused by smoking cigarettes and because of the role of education in prevention and addiction fighting, over 82.4% of students were convinced that every doctor should ask every patient, about his/her attitude towards smoking cigarettes.

Cigarette smoking has been main reason of the Polish society health hazard and one of the most widespread unhealthy element of the human life style. Aim of the study is to evaluate the attitude of the nursing students of Public Higher Medical Professional School in Opole towards the smoking problems in Poland. Most of respondents considered the nicotinism problem in Poland as very important--3 of them evaluate importance of problem on the scale of 0 - 10, estimated it from 8, 9 and 10 points. 74.3% of respondents support the opinion to put the total injunction from smoking at public areas into practice. According to respondents, the most effective forms to express a non-smoking lifestyle is to promote the idea of the total injunction from smoking at public areas and the promotion of the nonsmoking people at the mass media.

Quitting by current smokers is therefore the only way in which tobacco-related mortality can be reduced in the medium term. An anonymous questionnaire containing questioners on the subject of the realization of problems connected with the tobacco addiction in the route of medical studies was carried amongst students of the 6th year of the Medical Department of Wroclaw Medical University in the academic year 2007/2008. 177 students took part in the study (64% of women, 34% of men). 72.4% of students came from cities with the population above 100 hundred of inhabitants. 8.5% of students isn't regarding the nicotine addiction as illness. 94.4% of students is claiming that problems concerning nicotinism were being brought up on the university. 81.7% of students is judging that he is able to give an anti-smoking advice to a patient. 89.8% of students think that every doctor should ask each patients opinion about smoking cigarettes independently of whether he is an ill or healthy person. It is surprising that persons not regarding nicotine addiction as illness are still amongst students of 6th year of the Medical Department. Not all examined also confirmed that they had met with discussing the problem of nicotinism during medical studies. Majority examined thinks that he is able to give an anti-smoking advice to a patient. Dominating percentage examined thinks that every doctor should ask each of patients' opinion about smoking cigarettes independently of whether he is an ill or healthy person. Knowledge is being passed down to students on the subject of nicotine addiction during main subjects realized during medical studies. However this knowledge seems insufficient in spite of high self-assessment of students.

The main aim of health promotion and diseases prophylactic is a struggle with smoking, which is a well known factor in many disorders, i.e. malignant carcinomas, noncarcinomatous diseases of respiratory system and cardiovascular diseases. The aim of the study was the analysis of the knowledge level of smoking harm and its consequences in 1051 students of Wroclaw Medical University, Bialystok Medical University and the Public Higher Medical Professional School in Opole. The respondents answered to the anonymous, voluntary questionnaire. The little percentage of students in all centres gave correct answer to the subject of amount of carcinogens contained in the tobacco and the tobacco smoke still correct answers concerning concrete carcinogens were rare. Students aren't also convinced that the smoking can cause so strong psychophysical addiction, like taking drugs: heroine and cocaine. Majority polled is confirming that the smoking is a cause of the cancer of larynx, vascular diseases or chronic bronchitis, as well as an influence on a birth weight in newborn babies. Depending on the examined centre--convincing that smoking is the risk factor of bladder cancer isn't already so universal, the similar situation is taking place at examining the knowledge on the subject of association between smoking and osteoporosis. Admittedly the knowledge on the subject of nicotine substitute therapy isn't alien to students, they have the difficulty with correct giving available preparations on the Polish market. The knowledge of students is also scarce on the subject of changes in the total number of smokers in Poland.

In the years 1998-2005 in Poland a National Health Program was being implemented. One of its chief guidelines was to reduce the popularity of tobacco smoking, recognised as a proven, single factor influencing the etiology and the course of many diseases. The objective of the work was to establish whether the program's guidelines were reflected in individual attitudes of senior students of the Faculty of Medicine and of the Division of Public Health of Medical University of Bialystok. The research was conducted with the use of an anonymous questionnaire, filled in by the students before the classes dedicated to the issues of nicotine addiction within the framework of the family medicine thematic block. The analysis of the results did not show a decrease in the number of student smokers in comparison to the previous years; however, it was observed that more than a half of the current smokers had tried and was going to try to give up smoking, and the non-smokers strongly objected to passive smoking.

Introduction: In obliterative type of otosclerosis the stapes footplate is greatly thickened and diffusely replaced by a massive otosclerotic masses that fill in the oval window niche, often annular ligament cannot be visualized. In the case of obliterative otosclerosis the only effective way of treatment is surgery., Material and Methods: The analysed group consisted of 53 patients with primary obliterative otosclerosis. In the control group there were 30 consecutive patients treated for otosclerosis. The auditory organ was assessed on the ground of the following criteria for the frequencies 0.5, 1, 2 and 4 kHz.: 1. Change of pure tone thresholds of air conduction (AC) 2. Change of pure tone thresholds of bone conduction (BC) 3. Change of pure tone thresholds of air-bone gap (ABG) as the difference between the mean AC and BC thresholds before the operation (AC0 and BC0) and 12 months after the operation (AC1 and BC1)., Results: Postoperatively mean value of change of AC thresholds in the analysed group was about 24 +/- 2 dBHL and in the control group about 25 +/- 2 dBHL (no significant difference). In the analysed group the mean value of BC thresholds varied about 8 dBHL and in the control group about 11 dBHL (no significant difference). The average values of ABG after the operation varied about 14 +/- 1 dBHL in both--the analysed and the control group. Postoperatively the mean value ABG was amounted to 20 +/- 1 dBHL in the analysed group and in the control group to 18 +/- 1 dBHL (no significant difference). On the basis of the subjective assessment completely subsidence of aural tinnitus reported 70% patients in the analysed group and 80% patients in the control group., Conclusion: 1. The incidence of obliterative otosclerosis represents 9,6% of all otosclerotic patients treated surgically. 2. Stapedotomy is the treatment of choice in patients with obliterative otosclerosis, because significant improvement of AC, BC and ABG 12 months after the operation was reported, mean values did not differ between the above and control group. 3. Complete subsidence of aural tinnitus was reported in 70% patients with obliterative otosclerosis.

The authors present 18 patients with malignant neoplasms of the ear and temporal bone who were treated in the Clinic of Laryngology Medical University of Silesia in Katowice in the years 1991-2001. The most frequent was squamous cell carcinoma (11 patients--61%). The neoplasm was located on the auricle in 7 patients (39%), in the external auditory canal in 4 (22%) patients, in the middle ear in 5 patients (28%) and in 2 cases (11%) it was difficult to establish primary site. Ten patients (55.5%) were treated in stage T4. All patients had surgery and in advanced cases the radiotherapy was added. The best outcomes were in auricular neoplasms. The treatment results were much worse in neoplasms of the external auditory canal and the middle ear. Over 3 year follow-up in 10 patients (55%) with ear and temporal bone neoplasms shows no recurrence.

One of the problems in the stapes surgery is the floating footplate. The frequency of incidence of this complication is 2% to 5.8% of all operations. The authors present the results of stapes operations in a group of 28 cases (2.5%) from all the 1120 operations, in which the surgeon experienced a floating footplate. The hearing results were evaluated on the base of the average gain of air-conduction thresholds and air-bone gap levels at 500, 1000, 2000 and 3000 Hz. The improvement of hearing we observed in 24 patients, 4 patients heard worse.

According to the guidelines of the National Health Program, assumed by the Polish Ministry of Health for the years 1996 - 2005, it could be expected that, particularly at medical universities, education of future doctors in the field of problems connected to addiction to nicotine is taken into consideration. However, the research conducted in the form of anonymous survey among the sixth year students of the Faculty of Medicine at the Medical University of Białystok in the academic years 2001/2002 and 2004/2005 does not corroborate those expectations. The survey proves that the future graduates' knowledge of the aforementioned topic is fragmentary and confirms the necessity of including that issue in the educational curriculum in the area of family medicine.

Addiction to tobacco smoking is very popular among young and middle age people in Poland, who are parents of pre-school children as well. Respiratory tract diseases are the main reason of visits of pre-school children in General Practice surgery. Anonymous questionnaires were given to the random sample of mothers of three years old children. 311 respondents were chosen from whole population of 1200 children attending kindergartens in Białystok. The questionnaires showed that half of the examined children are involuntary exposed to tobacco smoke at home 20% also outside home (neighbors, homes and, cafeterias, cars etc). We did not find any relationship between exposure to smoke and occurrence of respiratory tract infection in children. We presume that this may be apparently the result of the fact that many smoking parents try to not to smoke in the presence of their children. Increasing awareness of harm resulting from passive smoking is the benefit of educational campaigns in Poland.

34 patients with otosclerosis operated at the ENT Clinic, were enrolled in this study. Prior and 4 months after stapedotomy the signal of DPOAE and the threshold levels for air and bone conduction were evaluated. No signal of otoacoustic emissions was registered in any of the patients prior stapedotomy. After operation DPOAE was registered in 23 out of 34 examined patients (67.6%).

This study reports the results of otosclerosis surgery performed during the past thirty years (1973-2002) in the ENT Clinic in Katowice. The authors present difficult anatomic relationships in the tympanic cavity which might have an influence on stapes surgery. Audiometric evaluation of 100 bilateral stapedotomies performed in 50 patients revealed that a small--hole stapedotomy is a safe technique and could be performed bilaterally. The group of 55 stapedotomies with stapedial tendon preserved was compared to the group of 55 stapedotomies with dissected tendon. SRT was better in the group where the tendon was preserved. In the group of 32 patients ABR before and after stapedotomy was recorded. The latency of V wave after the operation was reduced to the normal values what indicated a correct function of the ossicular chain postoperatively. In the group of 60 patients DPOAE prior and after stapedotomy was evaluated. Prior to the operation no signal of otoacoustic emission was registered, in 37 patients out of 60 the signal was present after the operation. DPOAE obtained postoperatively indicated successful ossicular chain restoration and inner ear function. Audiometric evaluation in reference to the group of 905 stapedotomies performed in years 1992-2001 showed that most of the patients were in group B--443/905 and C--402/905 according, in A group--60/905 according to Shambaugh. A-B gap < or = 10 dB was obtained in 469/905 (51.8%), the mean of the hearing threshold at 500, 1000, 2000 and 4000 Hz was 24.3 dB (+/- 8.3, med. 25.0) in A group and 32.0 dB in B and C group. The result of stapedotomy in reference to tinnitus based on the patients' subjective opinion. We may conclude that the key to the stapes surgery lies in the training and skillfulness of the surgeon using save small hole technique with stapedial tendon preservation to obtain the optimal physiologic function of the middle ear and to gain the best hearing results.

The aim of the study was evaluation of the hearing ability on the base of air conduction threshold at extended range of high frequencies in young subjects with primary arterial hypertension. Lack of internationally accepted reference value of air conduction hearing threshold at extended frequency range resulted in own evaluation of the audiometric zero point for air conduction at the range 8-18 kHz in "otologically healthy" subjects younger than 20 years. Detection of impaired hearing of the extended high frequencies range in young subjects with primary arterial hypertension may be useful in diagnostics of hypertension as well as in prophylactic examinations in the group of individuals with high risk of primary hypertension. Evaluation of air conduction threshold at extended frequency range allows to detect sensorineural hearing impairment undetectable with application of conventional frequency range.