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Humans are transforming natural habitats into managed urban green areas and impervious surfaces at an unprecedented pace. Yet the effects of human presence per se on animal life-history traits are rarely tested. This is particularly true in cities, where human presence is often indissociable from urbanisation itself. The onset of the SARS-CoV-2 outbreak, along with the resulting lockdown restrictions, offered a unique, “natural experiment” to investigate wildlife responses to a sudden reduction in human activity. We analysed four years of avian breeding data collected in a European capital city to test whether lockdown measures altered nestbox occupancy and life-history traits in terms of egg laying date, incubation duration and clutch size in two urban adapters: great tits (Parus major) and blue tits (Cyanistes caeruleus). Lockdown measures, which modulated human presence, did not influence any of the life-history traits investigated. In contrast, the interaction between year and tree cover, a distinct ecological attribute of the urban space, was positively associated with clutch size, a key avian life-history and reproductive trait. This highlights the importance of inter-year variation and habitat quality over human activity on urban wildlife reproduction. We discuss our results in the light of other urban wildlife studies carried out during the pandemic, inviting the scientific community to carefully interpret all lockdown—associated shifts in biological traits.

Humans are transforming natural habitats into managed urban green areas and impervious surfaces with unprecedented pace. Yet the effects of human presence per se on animal life-history traits are rarely tested. This is particularly true in cities, where human presence is often indissociable from urbanisation itself. The onset of the SARS-CoV-2 outbreak, along with the resulting lockdown restrictions, offered a unique, “natural experiment” context to investigate wildlife responses to a sudden reduction of human activities. We analysed four years of avian breeding data collected in a European capital city to test whether lockdown measures altered nestbox occupancy and life-history traits in two urban adapters: great tits (Parus major) and blue tits (Cyanistes caeruleus). Lockdown measures, which modulated human presence, did not influence any of the life-history traits inferred. In contrast, tree cover, a distinct ecological attribute of the urban space, positively influenced clutch size, a key avian life-history and reproductive trait. This highlights the importance of habitat and food webs over human activity on animal reproduction in cities. We discuss our results in the light of other urban wildlife studies carried out during the pandemic, inviting the scientific community to carefully interpret all lockdown - associated shifts in biological traits.

Introduction Pseudomonas aeruginosa cross-infections are related to increased morbidity and mortality in cystic fibrosis (CF). Objectives The aim of the study was to evaluate the incidence of cross-infections with P. aeruginosa in children with CF. Methodology CF patients from whom at least one P. aeruginosa strain had been isolated were included in the study. The strain genotyping was performed using pulse-field gel electrophoresis. The history of contacts between patients was established based on questionnaires. Results The study group consisted of 75 patients (aged 1.0-19.2 years) and the material included 170 P. aeruginosa strains. Cross-infections occurred in a group of 26 patients. In this group, the risk of the predicted occurrence of forced expiratory volume in 1 second ≤ 70% was five times greater and the risk of longer cumulative hospitalization time for intravenous antibiotic therapy (>14 days/year) was almost five times greater. In the clonal groups of strains, the multidrug-resistance rate was significantly higher than in other groups. In 2011, all tested strains were susceptible to colistin, whereas in 2012, three strains from the largest clonal group showed high levels of resistance to colistin. Conclusion Cross-infections with P. aeruginosa occurred in our group of patients and were associated with poor clinical outcomes. Antimicrobial resistance rate in the strains isolated from such infections was significantly higher, and this included three strains resistant to colistin.

Purpose/Aim: So far no research concerning the omentin-1 (ITLN1) rs2274907 and vaspin (SERPINA12) rs2236242 polymorphisms has been carried out in a healthy pediatric population. We analyzed...

Ezrin is a protein that functions as a cross-linker between actin cytoskeleton and plasma membrane. Its clinical role in osteosarcoma is unclear. The aim of this study was to investigate, in osteosarcoma, the prognostic value of ezrin expression at biopsy and changes in expression levels after preoperative chemotherapy. Thirty-eight newly diagnosed osteosarcoma patients aged 6-23 years were included. At diagnosis, 20 patients had localized disease, the others had distant metastases. Median follow-up was 75 months (range 13-135). Ezrin expression was assessed immunohistochemically in biopsy tissue and primary tumour specimens resected after chemotherapy. The influence on survival of changes in ezrin expression after chemotherapy was analysed. Ezrin expression was significantly higher after preoperative chemotherapy and changes compared to biopsy tissue were significantly lower in patients with early progression than in patients with relapse or no further evidence of disease (p = 0.006 and p = 0.002, respectively). Similarly, ezrin expression was higher after preoperative chemotherapy and exhibited less change in expression in deceased patients compared to patients surviving more than 5 years (both p = 0.001). Ezrin expression at biopsy was significantly associated with both histopathological aggressiveness (p

The identification of prognostic factors in cutaneous melanoma allows choosing the most effective treatment, especially in group of patients with locoregional disease. Markers related to carcinogenesis and angiogenesis in particular have effect on the course of the disease. The aim of this study was to evaluate clinical utility of vascular endothelial growth factor (VEGF), matrix metalloproteinase 2 (MMP-2), MMP-9, tissue inhibitors of metalloproteinase 1 (TIMP-1), and YKL-40 in serum of melanoma patients at pathological stages I–III. We included 148 adult patients with melanoma. The median follow-up was 40 months. Disease recurrence was observed in 43 patients; 3-year disease-free survival (DFS) rate was 71.7 %; 35 patients died; and the 3-year overall survival (OS) rate was 85 %. Concentrations of VEGF, MMP-2, MMP-9, TIMP-1, and YKL-40 were measured by ELISA kits. VEGF, MMP-9, TIMP-1, and YKL-40 were significantly higher in group of patients than in controls. Increased concentrations of TIMP-1 were related to patient survival, which in the group of lower and increased TIMP-1, disease-free survival amounted to 81 vs. 61 % (p = 0.014) and overall survival −88 vs. 82 % (p = 0.050), respectively. An increased concentration of YKL-40 was observed in 59 % of patients with ulceration and in 26 % of patients without ulceration (p = 0.012). We have found a clinically significant correlation between YKL-40 and MMP-9 (rho = 0.363; p = 0.004) as well as YKL-40 and VEGF (rho = 0.306; p = 0.018). In melanoma patients at stages I–III, the high concentrations of TIMP-1 in serum predicted adverse prognosis. YKL-40 was associated with ulceration of primary tumor, which is a very important prognostic factor.

Objectives Birth outcomes in migrants vary, but the relative explanatory influence of obstetric practice in origin and destination countries has been under-investigated. To explore this, birth outcomes of Scots and Polish migrants to Scotland were compared with Polish obstetric data. Poles are the largest group of migrants to Scotland, and Poland has significantly more medicalized maternity care than Scotland. Study design A population-based epidemiological study of linked maternal country of birth, maternity and birth outcomes. Methods Scottish maternity and neonatal records linked to birth registrations were analysed for differences in modes of delivery and pregnancy outcomes between Polish migrants and Scots, and compared with Polish Health Fund and survey data. Results 119,698 Scottish and 3105 Polish births to primiparous women in Scotland 2004–9 were analysed. Poles were less likely than Scots to have a Caesarean section and more likely to have a spontaneous vaginal or instrumental delivery. The Caesarean section rate in Poland is significantly higher and instrumental delivery rate lower than for either group of women in Scotland. Conclusions Methodologically, comparing a large group of migrants from one country with the host population has advantages over grouping migrants from several countries into a single category, and allows more informed analysis of the effect of health services. Polish mothers' being slightly healthier explains some of their lower Caesarean section rate compared to Scots in Scotland. However, dominant models of obstetrics in the two countries seem likely to influence the differences between Poles delivering in Poland and Scotland. Further investigation of both is required.

OBJECTIVE The aim of the present study was to verify whether selected functional single nucleotide polymorphisms in LEP, LEPR, and ADIPOQ loci are associated with the development of obesity and serum levels of the respective adipokines in prepubertal white children with obesity. METHODS Frequencies of -2548G>A LEP (rs7799039), Q223R (rs1137101) and K656N (rs8129183) LEPR, and -11377C>G (rs266729) and -11426A>G (rs16861194) ADIPOQ polymorphisms were analyzed by restriction fragment length polymorphism in 101 obese (standard deviation score [SDS]-body mass index [BMI] >2) and 67 normal-weight (SDS-BMI ) children. Serum adipokine concentrations were measured using the enzyme-linked immunosorbent assay method. RESULTS The GC/GG genotypes of -11377C>G ADIPOQ polymorphism were associated with a higher risk of obesity (P = 0.022, odds ratio 2.08 [95% confidence interval 1.11-3.90]). Individuals carrying the GG genotype had a higher leptin/total adiponectin ratio by 25% than CC homozygotes (P trend = 0.05). In the multivariate linear regression model, we found differences among particular genotypes of this polymorphism in concentrations of high molecular weight (HMW) adiponectin (P trend = 0.043) and HMW/total adiponectin ratio (P trend = 0.048), with the lowest values in GG homozygotes. Positive correlations between SDS-BMI and dietary reference intake percentage were observed in individuals homozygous for allele C (r = 0.403, P = 0.01) and CG heterozygotes (r = 0.428, P = 0.004). No significant correlations between both parameters were found in the GG homozygotes. CONCLUSIONS Among the analyzed polymorphisms, only -11377C>G ADIPOQ single nucleotide polymorphism was associated with obesity during the prepubertal period. Adipokine abnormalities coexisting with the lack of relations between SDS-BMI and dietary intake may predict a higher risk of future obesity-related disorders in obese children carrying the GG genotype than in those with other genotypes.

Early diagnosis of cystic fibrosis (CF) made by the introduction of CF NBS (Cystic Fibrosis Newborn Screening) provides the opportunity to undertake preventive measures and provide treatment before the development of irreversible changes in the respiratory tract and other complications. CF NBS was conducted as a pilot programme in four Polish districts in the period 1999-2003. In 2006 CF NBS started again and was gradually extended across the country. The aim of this study was to show the evolution of the Polish CF NBS strategies and assess the diagnostic consequences of this programme.The study involved children diagnosed and treated only in the IMiD Centre. The strategy in Polish CF NBS was modified over time. Firstly, the model IRT/IRT and IRT/IRT/DNA with one mutation was implemented, which was followed by IRT/DNA with a gradually expanding number of CFTR mutations (tab. I). Newborns with positive results of CF NBS were called to the CF IMiD Centre, and sweat tests were performed. The children diagnosed and children with mutations in both alleles of the CFTR gene even if at least one of them had undefined pathogenicity) were taken under IMiD Centre care. Sensitivity, specificity and positive predictive values during subsequent stages of CF NBS were calculated (tab. III).During the 1999-2003 pilot study 444 063 newborns underwent CF NBS and in 74 cases CF was diagnosed. 582 693 newborns were screened from September 2006 to December 2011 in four regions and 100 children were diagnosed with CF. The frequencies of CF in the Polish population in both screening periods were 1:5767 and 1:5712 respectively. Firstly, the IRT/IRT model was implemented, but the number of newborns called to the CF Centre was high - the PPV was 7.6%. In the next step CF NBS DNA analysis was used. Here sensitivity and specificity were high - nearly 100%. In the following years the number of mutations detected was expanded (including 16 most common ones in the Polish population). Due to the panel changes, the number of calls declined and the PPV (predictive positive value) improved (to 26.1%) after the application of expanded genetic analysis. Expanding the panel of mutations resulted in an increased number of carriers and observational subjects.IRT/DNA strategy with expanded DNA analysis provides the opportunity for earlier CF diagnosis even in children with normal sweat test values. However, this model caused frequent carrier detection and inconclusive diagnosis in comparison to IRT/IRT or IRT/IRT/DNA with a limited number of mutations. Further research and changes in Polish CF NBS are needed to increase the PPV, while preserving high sensitivity and specificity..

The aim of the study was to compare the patients with abnormal result of newborn screening for cystic fibrosis (CF NBS), with or without meconium ileus (MI), in regard to their clinical status at the diagnosis and early childhood somatic development.The survey comprised patients with abnormal results of CF NBS which was carried out during years 2006-2011. Cohort of 92 children remaining under care of Institute of Mother and Child was followed in the period 09.2006-12.2011. In our study there were two groups compared: 19 children with MI and 73 children without MI. Clinical characteristics and genotype were evaluated and biochemical tests assessing pancreatic insufficiency and hepatic dysfunction were performed at the time of diagnosis, then annual weight and height Z-scores as well as clinical status based on ShwachmanKulczycki score were collected. Cox proportional hazards regression model was used to assess the effect of MI and genotype on development of pancreatic insufficiency.MI was observed in 19 (20.6%) of 92 CF infants. MI and non-MI patients did not differ in respect of sex, gestational age and birth weight. The presence of severe genotype was more frequent in MI than non-MI group (94.7 and 64.4% respectively), whereas no significant difference was found in F508del mutation distribution. At the time of diagnosis inadequate weight gain and hepatic function disturbances prevailed more often in MI (68.4% and 31.6%) than non-MI group (39.7% and 9.6%). Pancreatic insufficiency was diagnosed in all children in MI group and in 76.1% of non-MI group and the risk of PI development was 2.3 (1.4-4.0) times higher in MI than in non-MI patients. MI children had smaller weight-for-age Z-score at the age of 12 months (-0.95) when compared to non-MI children (-0.13). Weight Z-scores compared at the age of 2 and 3 years as also height-for-age Z-scores did not differ significantly between groups. No statistically significant difference in clinical status according to Shwachman-Kulczycki score was found between MI and non-MI groups at the age of 12 months, 2 years and 3 years.Our results suggest that the history of MI in children with CF may predispose them to more severe clinical course of disease in early childhood: insufficient weight gain and liver disturbances at the time of diagnosis, higher risk of developing pancreatic insufficiency and smaller weight at the age of 12 months, although clinical status according to Shwachman-Kulczycki score did not differ from non-MI group. Patients with MI, may require more intensive care and supervision in treatment. Further research is needed to asses MI impact on development of CF children in subsequent years. .

Sporting dogs, including sled dogs, are particularly prone to tick-borne infection either due to training/racing in forest areas or through visits to endemic areas. The aim was to present tick-borne infections in a 6-dog racing team after a race in Estonia.On the 4th day after return to Poland, the first dog presented with babesiosis symptoms and was diagnosed and treated accordingly. Next morning, the dog showed neurological symptoms and was diagnosed with tick-borne encephalitis (TBE). Diagnosis was confirmed by a high level of IgG antibodies (922 IU/ml), detected in serum 3 months later. The second dog presented with babesiosis symptoms on the 7th day after return. Babesia DNA was extracted from blood, amplified and sequenced to answer the question of whether the dogs became infected during the race in Estonia or in Poland.Sequencing of a fragment of Babesia 18S rDNA revealed that these two isolates were identical to one another and closely related to the B. canis sequence originally isolated from the dog and Dermacentor reticulatus ticks in Poland. Thus, this is the first confirmed case of B.canis and TBEV co-infection and first confirmed case of TBE in a dog in Poland.

In obese individuals, weight loss might be affected by variants of the adipokine-encoding genes. We verified whether selected functional single nucleotide polymorphisms in LEP, LEPR and ADIPOQ are associated with changes in serum levels of the respective adipokines and weight loss in 100 prepubertal obese (SDS-BMI > 2) Caucasian children undergoing lifestyle intervention. Frequencies of the -2548G > A LEP, Q223R LEPR, K656N LEPR, -11377C > G and -11426A > G ADIPOQ polymorphisms were analyzed by restriction fragment length polymorphism. Serum adipokine and soluble leptin receptor (sOB-R) concentrations were measured using the ELISA method. Among the analyzed polymorphisms, only LEPR polymorphisms were associated with changes of SDS-BMI or sOB-R concentrations in children after therapy. Carriers of the wild-type K665N and at least one minor Q223R allele had the greatest likelihood of losing weight (OR = 5.09, p = 0.006), an increase in sOB-R (ptrend = 0.022) and decrease in SDS-BMI correlated with the decrease of fat mass (p < 0.001). In contrast, carrying of the wild-type Q223R and at least one minor K665N allele were associated with a decrease in sOB-R concentrations and a decrease in SDS-BMI correlated with a decrease in fat-free mass (p = 0.002). We suggest that the combination of different LEPR variants, not a single variant, might determine predisposition to weight loss in the prepubertal period.

Background Gastrointestinal stromal tumors (GIST) mutational status is recognized factor related to the results of tyrosine kinase inhibitors therapy such as imatinib (IM) or sunitinib (SU). Arterial hypertension (AH) is common adverse event related to SU, reported as predictive factor in renal cell carcinoma. The aim of the study was to analyze the outcomes and factors predicting results of SU therapy in inoperable/metastatic CD117(+) GIST patients after IM failure. Methods We identified 137 consecutive patients with advanced inoperable/metastatic GIST treated in one center with SU (2nd line treatment). Median follow-up time was 23 months. Additionally, in 39 patients there were analyzed selected constitutive single nucleotide polymorphisms (SNPs) of VEGFA and VEGFR2 genes. Results One year progression-free survival (PFS; calculated from the start of SU) rate was 42% and median PFS was 43 weeks. The estimated overall survival (OS, calculated both from start of SU or IM) was 74 weeks and 51 months, respectively. One-year PFS was 65% (median 74 weeks) in 55 patients with AH vs. 22% (median 17 weeks) in patients without AH. Patients with primary tumors carrying mutations in KIT exon 9 or wild-type had substantially better 1-year PFS (68% and 57%; median 65.5 and 50.5 weeks, respectively) than patients having tumors with KIT exon 11 or PDGFRA mutations (34% and 15%; median 36.8 and 9 weeks, respectively). We identified two independent factors with significant impact on PFS and OS in univariate and multivariate analysis: primary tumor genotype and presence of AH. The most common adverse events during therapy were: fatigue, AH, hypothyroidism, hand and foot syndrome, mucositis, skin reactions, dyspepsia, and diarrhea. Two deaths were assessed as related to tumor rupture caused by reaction to SU therapy. The presence of C-allele in rs833061 and the T-allele in rs3025039 polymorphism of VEGFA were associated with significantly higher risk of hypothyroidism (OR: 10.0 p = 0.041 and OR: 10.5; p = 0.015, respectively). Conclusions We confirmed that many advanced GIST patients benefit from SU therapy with OS > 1.5 year. Primary tumor KIT/PDGFRA genotype and SU-induced AH, as surrogate of its antiangiogenic activity are two independent factors influencing both PFS and OS. Note The preliminary data of this study were presented during Annual Meeting of American Society of Clinical Oncology, 4-8 June 2011 and Connective Tissue Oncology Society Meeting, 26-28 October 2011 in Chicago, IL.

Despite the notion that the future of our society depends on children; their health is neither a key target in national health programmes, nor a key priority for research. Further improvement in child and adolescent health in Poland depends partly on appropriate data and on indicators applicable for planning, monitoring and evaluating purposes. Mortality statistics do not provide adequate description of the burden of disease in this age group and new indicators are required due to on increase in chronic diseases, and mental health problems. The aim of the paper is to discuss the concept of child and adolescent health and to stress the need of reliable data, correctly collected, analysed and interpreted. The paper compares the biomedical and biopsychosocial paradigms concerning children's health and well-being. Main determinants of health as alternative outcome measures, commonly used in health promotion, are also discussed. CHILD (The Child Health Indicators of Life and Development) project indicators are presented and their availability in Poland is described. A short international comparison based on five indicators related to health and health determinants, showed that Poland, a relatively low-income country in EU, is affected by health problems typical for Central and Eastern Europe (physical, such as relatively high mortality, poor oral health, and psychological, such as lower life satisfaction). However, new problems typical for more developed West European countries are expected to increase (like asthma and eating disorders). On the other hand, by comparison to other countries more children in Poland live in full families with supportive parents. In conclusion, there is a great progress in measuring children's health all over the world, although most of the new approaches have not been yet implemented in Poland. There is a special need to develop and implement multidimensional measures with well-established validity and reliability, such as quality of life scales and health profiles.

The authors present a case of an 18-year-old woman, were referred to an allergologist because of a suspicion of bronchial asthma. She had complained of respiratory symptoms: chronic bronchitis for three years, cough and dyspnoea. Auscultation revealed wheezies and rales. Spirometry showed severe airway obstruction. Because of negative result of a reversibility test, ex iuvantibus treatment with prednisone was used but no results were obtained. The next step of diagnostic procedure was computed tomography which revealed the trachea compression by the dilated oesophagus. Finally she was found by us to have esophageal achalasia. Pharmacological treatment with nifedipine did not give an improvement. After operation the asthmatic symptoms disappeared and marked improvement was found in the flow-volume curve and in the chest radiogram. The demonstrated case proves that esophageal achalasia should be considered as one of the differential diagnoses of pathological respiratory symptoms suggesting asthma difficult to treat.

The importance of subjective health measures has increased over the recent years. Prevention of acute and chronic diseases and early intervention in children depend upon availability of measures that can be routinely used for monitoring purposes. Traditional outcome measures (survival, laboratory tests) have limited value when assessing health status of chronically ill persons or screening population. Research on quality of life has a solid methodological background. High importance is attached to psychometric characteristics of developed questionnaires. However, only a few (especially generic) instruments have been developed for children and youth. The aim of the study is: 1) to describe the main concepts and methods in quality of life research in relation to paediatric practice; 2) to present the KIDSCREEN project sponsored by European Commission, currently in progress. The KIDSCREEN multicenter project is being developed by 13 European countries, including Poland, within the 5th Framework Programme Quality of Life and Management of Living Resources. The project will provide the opportunity to measure the HRQL in children and adolescents across different countries and cultures using a standardized multidimensional instrument developed at the same time in all participating countries. It is expected that it will improve medical, psychological and educational care of children and adolescents and will be very useful in changing the system of preventive health care provided in Polish schools. Applying the KIDSCREEN questionnaire in selected EU candidate countries will anticipate the problems that could affect other countries in the same economic situation.

The aim of the study was to assess the efficacy of a combination of gemcitabine and cisplatin in advanced non-small cell lung cancer. Twenty-five patients were included (13--IIIB, and 12--IV stage). Gemcitabine--1000 mg/m2 was given intravenously on days 1, 8, and 15, and cisplatin--100 mg/m2 on day 2. In 13 patients partial remission was obtained, in 8--stabilisation, and in 4--progression. Median survival was 12 months (range: 1.5-32 months). Mean time to progression was 6 months. Toxicity was tolerable and included mainly thrombocytopenia, neutropenia and anemia. In 11 patients pain relief was obtained. Furthermore cough, dyspnoea and hemoptysis disappeared in a proportion of patients. These results indicate the efficacy of the combination of gemcitabine and cisplatin regimen in advanced non-small cell lung cancer, and its acceptable toxicity.

Neural Tube Defects (NTD) Primary Prevention Programme has been developed in Poland since 1997. The Programme directed by Professor Z. J. Brzezinski is based on an information and education campaign directed at health professionals, women in childbearing age and high school students. The Central Programme Office has been directing the development and implementation of the Programme through a network of provincial programmes. In the present paper the main principles of NTD primary prevention were presented as well as some principles of Programme building and evaluation. Due to the relatively short period of Programme implementation, it is too early to perform the full evaluation. However, some examples were presented including process evaluation and testing the main tools (questionnaires, school programme project). It was assumed that the effectiveness of NTD Primary Prevention Programme in Poland will be assessed by: 1) changes in women's knowledge, attitude and behaviour concerning folic acid supplementation, 2) changes in NTD mortality and morbidity rates, 3) changes in the amount of sold tablets containing 0.4 mg of folic acid. For each of these indicators some international results and Polish baseline results were discussed.

Folic acid supplementation before conception and during the first trimester of pregnancy prevents about 70% of all neural tube defects (NTD). Folic acid is a cofactor in the homocysteine metabolism. Its product--S-adenosylmethionine is a major methyl donor for reactions taking place in a cell. The 677 C--T mutation in the methylene tetrahydrofolate reductase gene leads to thermolability and decreased activity of the enzyme. In the individuals homozygous for that mutation hyperhomocystynemia and lowered plasma folate level are observed. Presence of the MTHFR 677 C--T mutation increases the requirements for folic acid, especially at the time of rapid foetal growth. Studies showed higher rate of TT homozygotes in people with NTD and their parents compared with the control group. Hyperhomocystynemia has been associated with higher risk of recurrent miscarriages in women. It was also proved that stillbirths are a risk factor associated with NTDs. TT homozygosity varies among different country populations, from 6% to 16%. An additional risk factor for NTD is MTHFR 1298 A--C mutation. Combined heterozygosity for the 1298 A--C and 677 C--T mutations is associated with increased homocysteine and lowered plasma folate levels. This genotype is more frequent in NTD patients compared with controls. Further investigations in the field of genetic aspects of NTD in Poland will be very important for the primary prevention of NTD.