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Background: The identification of parameters that would serve as predictors of prognosis in COVID-19 patients is very important. In this study, we assessed independent factors of in-hospital mortality of COVID-19 patients during the second wave of the pandemic. Material and methods: The study group consisted of patients admitted to two hospitals and diagnosed with COVID-19 between October 2020 and May 2021. Clinical and demographic features, the presence of comorbidities, laboratory parameters, and radiological findings at admission were recorded. The relationship of these parameters with in-hospital mortality was evaluated. Results: A total of 1040 COVID-19 patients (553 men and 487 women) qualified for the study. The in-hospital mortality rate was 26% across all patients. In multiple logistic regression analysis, age ≥ 70 years with OR = 7.8 (95% CI 3.17–19.32), p < 0.001, saturation at admission without oxygen ≤ 87% with OR = 3.6 (95% CI 1.49–8.64), p = 0.004, the presence of typical COVID-19-related lung abnormalities visualized in chest computed tomography ≥40% with OR = 2.5 (95% CI 1.05–6.23), p = 0.037, and a concomitant diagnosis of coronary artery disease with OR = 3.5 (95% CI 1.38–9.10), p = 0.009 were evaluated as independent risk factors for in-hospital mortality. Conclusion: The relationship between clinical and laboratory markers, as well as the advancement of lung involvement by typical COVID-19-related abnormalities in computed tomography of the chest, and mortality is very important for the prognosis of these patients and the determination of treatment strategies during the COVID-19 pandemic.

The incidence of asthma exacerbation depends on atmospheric conditions, including such meteorological factors as the ambient temperature, relative air humidity or concentration of atmospheric aerosols. An assessment of relations between the frequency of asthma exacerbation and environmental conditions was made according to the meteorological components, the biometeorological index UTCI (Universal Thermal Climate Index), as well as selected air quality parameters, including concentrations of PM10 and PM2.5. The study was conducted on the basis of a retrospective analysis of medical data collected at the Independent Public Hospital of Tuberculosis and Pulmonary Diseases in Olsztyn (Poland). Our analysis of patient data (from 1 January 2013 until 31 December 2017) showed a significant correlation between the number of asthma exacerbation and the UTCI value. More frequent asthma exacerbations are observed in patients aged over 65 years when air humidity increases. The UTCI values contained within class 5, describing thermoneutral conditions, correspond to an average frequency of asthma exacerbation. A decline in the UTCI value leads to a reduced number of asthma exacerbation, while a rise makes the cases of asthma exacerbations increase.

Obesity is considered one of the biggest health problems of the 21st century, becoming a worldwide epidemic, leading to the development of many diseases and increasing the risk of premature death. The first step in reducing body weight is a calorie-restricted diet. To date, there are many different diet types available, including the ketogenic diet (KD) which is recently gaining a lot of attention. However, all the physiological consequences of KD in the human body are not fully understood. Therefore, this study aims to evaluate the effectiveness of an eight-week, isocaloric, energy-restricted, KD as a weight management solution in women with overweight and obesity compared to a standard, balanced diet with the same calorie content. The primary outcome is to evaluate the effects of a KD on body weight and composition. The secondary outcomes are to evaluate the effect of KD-related weight loss on inflammation, oxidative stress, nutritional status, profiles of metabolites in breath, which informs about the metabolic changes in the body, obesity and diabetes-associated parameters, including a lipid profile, status of adipokines and hormones. Notably, in this trial, the long-term effects and efficiency of the KD will be studied. In summary, the proposed study will fill the gap in knowledge about the effects of KD on inflammation, obesity-associated parameters, nutritional deficiencies, oxidative stress and metabolism in a single study. ClinicalTrail.gov registration number: NCT05652972.

Hypertension (HT) affects1/3 of adult populations in developed countries. Several studies reported periodic changes in blood pressure (BP) values depending on atmospheric conditions, and analyzed the impact of outdoor temperature, atmospheric pressure, relative humidity and other meteorological parameters. The Universal Thermal Climate Index (UTCI) is a bio-meteorological index derived from an analysis of human thermal balance that comprehensively describes the impact of meteorological factors, including both cold stress and heat stress and their physiological consequences.Our aim was to assess the relationship between UTCI values and the number of consultations for HT within the framework of the healthcare system.This work presents a retrospective epidemiological study of data collected in Olsztyn (Poland), characterized by cold climate type. The analytical material comprised 5578 consultations in emergency departments (EDs) due to HT.Seasonal differences in the numbers of HT consultations with a significant increase in winter months were noticed, especially as regards women. Under cold stress conditions, the relative risk (RR) related to consultations for HT was 2-fold higher for women as compared to thermoneutral conditions (p 0.001). For men these differences were also statistically significant, though at a much smaller level (p = 0.03). The increased RR of HT due to cold stress was found among younger and older women contrary to the women at the perimenopausal age.Cold stress should be considered as a significant risk factor among patients, particularly women, diagnosed with cardiovascular diseases. The UTCI is an adequate bio-meteorological tool for the assessment of relationships between atmospheric conditions and occurrence of cardiac symptoms.

The assessment of the impact of meteorological factors on the epidemiology of various diseases and on human pathophysiology and physiology requires a comprehensive approach and new tools independent of currently occurring climate change. The thermal comfort index, i.e., Universal Climate Thermal Index (UTCI), is gaining more and more recognition from researchers interested in such assessments. This index facilitates the evaluation of the impact of cold stress and heat stress on the human organism and the assessment of the incidence of weather-related diseases. This work aims at identifying those areas of medical science for which the UTCI was applied for scientific research as well as its popularization among clinicians, epidemiologists, and specialists in public health management. This is a systematic review of literature found in Pubmed, Sciencedirect and Web of Science databases from which, consistent with PRISMA guidelines, original papers employing the UTCI in studies related to health, physiological parameters, and epidemiologic applications were extracted. Out of the total number of 367 papers identified in the databases, 33 original works were included in the analysis. The selected publications were analyzed in terms of determining the areas of medical science in which the UTCI was applied. The majority of studies were devoted to the broadly understood mortality, cardiac events, and emergency medicine. A significant disproportion between publications discussing heat stress and those utilizing the UTCI for its assessment was revealed.

Hyperuricemia is an independent risk factor for renal and cardiovascular diseases and is closely associated with gout episodes. It is caused, inter alia, by nutritional habits and genetic factors, and also displays seasonal variability conditioned by meteorological factors. The impact of meteorological factors, including both cold and heat stress, on the human physiology is presented based on the Universal Thermal Climate Index (UTCI) - a biometeorological index derived from an analysis of human thermal balance. The aim of our study was to establish whether seasonal variations significantly affect routinely measured urine acid (UA) levels and could eventually support the clinical decision making process, as well as assessing whether UTCI values are correlated with UA levels in blood serum. This work presents a retrospective epidemiological study of data collected in Olsztyn (Poland). Study material comprised 54,536 results of ambulatory tests measuring UA levels, performed during the period 2016-2019. The analysis concerned correlations between UA and the ages of female and male subjects as well as existing biometeorological conditions as represented by UTCI values in an annual cycle. UA levels in females were found to be lower (4.94 ± 1.37 SD) as compared to those of males (6.13 ± 1.43 SD) and demonstrated a strong positive correlation with age. UA values differed significantly (p 0.05) on days characterized by cold stress and heat stress, for the oldest age group. UA levels were found to differ depending on the season, but these relationships were not statistically significant, except for significantly higher UA levels in females in autumn (p 0.001). However, there was an evident difference in population UA levels under cold stress conditions (lower) and heat stress conditions (higher) in the elderly. The UTCI is an adequate predictor of population variations in UA levels since it takes into account the variability of local meteorological conditions.

Background Many literature reports have indicated the fact that the percentage of active smokers among the homeless is high, often several times higher than that of the general population. The homeless are known to have worse spirometric parameters than the general population. Objectives The question of what the principal and exclusive cause of airway obstruction among the homeless is remains unanswered. Verification of the above-mentioned hypothesis is possible by comparing the spirometric parameters in homeless people with those in the general population, based on the data related to subgroups with similar tobacco smoke exposure, which are homogenous in terms of sex, race and age. Material and methods The spirometric parameters in 58 homeless male smokers were compared with those in 55 male smokers living normal lives. Neither group differed in age, duration of smoking or the number of pack-years. All of the subjects were Caucasian. Results The mean values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/ FVC, both corrected and expressed as absolute figures, were lower amongst the smoking homeless men than amongst men living normal lives. In 27.59% of the homeless subjests not receiving treatment for lung diseases, airway obstruction was identified. Conclusions Our results suggest that smoking is not the only cause of the worse spirometric parameters found among the homeless.

Background: Odanacatib, a cathepsin K inhibitor, reduces bone resorption while maintaining bone formation. Previous work has shown that odanacatib increases bone mineral density in postmenopausal women with low bone mass. We aimed to investigate the efficacy and safety of odanacatib to reduce fracture risk in postmenopausal women with osteoporosis. Methods: The Long-term Odanacatib Fracture Trial (LOFT) was a multicentre, randomised, double-blind, placebo-controlled, event-driven study at 388 outpatient clinics in 40 countries. Eligible participants were women aged at least 65 years who were postmenopausal for 5 years or more, with a femoral neck or total hip bone mineral density T-score between −2·5 and −4·0 if no previous radiographic vertebral fracture, or between −1·5 and −4·0 with a previous vertebral fracture. Women with a previous hip fracture, more than one vertebral fracture, or a T-score of less than −4·0 at the total hip or femoral neck were not eligible unless they were unable or unwilling to use approved osteoporosis treatment. Participants were randomly assigned (1:1) to either oral odanacatib (50 mg once per week) or matching placebo. Randomisation was done using an interactive voice recognition system after stratification for previous radiographic vertebral fracture, and treatment was masked to study participants, investigators and their staff, and sponsor personnel. If the study completed before 5 years of double-blind treatment, consenting participants could enrol in a double-blind extension study (LOFT Extension), continuing their original treatment assignment for up to 5 years from randomisation. Primary endpoints were incidence of vertebral fractures as assessed using radiographs collected at baseline, 6 and 12 months, yearly, and at final study visit in participants for whom evaluable radiograph images were available at baseline and at least one other timepoint, and hip and non-vertebral fractures adjudicated as being a result of osteoporosis as assessed by clinical history and radiograph. Safety was assessed in participants who received at least one dose of study drug. The adjudicated cardiovascular safety endpoints were a composite of cardiovascular death, myocardial infarction, or stroke, and new-onset atrial fibrillation or flutter. Individual cardiovascular endpoints and death were also assessed. LOFT and LOFT Extension are registered with ClinicalTrials.gov (number NCT00529373) and the European Clinical Trials Database (EudraCT number 2007-002693-66). Findings: Between Sept 14, 2007, and Nov 17, 2009, we randomly assigned 16 071 evaluable patients to treatment: 8043 to odanacatib and 8028 to placebo. After a median follow-up of 36·5 months (IQR 34·43–40·15) 4297 women assigned to odanacatib and 3960 assigned to placebo enrolled in LOFT Extension (total median follow-up 47·6 months, IQR 35·45–60·06). In LOFT, cumulative incidence of primary outcomes for odanacatib versus placebo were: radiographic vertebral fractures 3·7% (251/6770) versus 7·8% (542/6910), hazard ratio (HR) 0·46, 95% CI 0·40–0·53; hip fractures 0·8% (65/8043) versus 1·6% (125/8028), 0·53, 0·39–0·71; non-vertebral fractures 5·1% (412/8043) versus 6·7% (541/8028), 0·77, 0·68–0·87; all p

Lipid disorders, especially hypercholesterolemia, are one of the most thoroughly investigated cardiovascular risk factors. Their correlation with biometeorological conditions has been reported, with authors stressing seasonal increases of total cholesterol (TC) levels, mostly occurring in winter. This study aims at determining the correlation between the level of lipid parameters (LP) and meteorological conditions, analyzing seasonal variations in LP levels, and attempting to answer the following questions: do changes in LP levels result from the organism&rsquo, s response to cold or heat stress, or are they secondary to seasonal dietary variations? An observational study comprised ambulatory patients from the city of Olsztyn (Poland), for whom laboratory test were performed in 2016&ndash, 2018, with 106,325 records of TC, high-density lipoprotein (HDL), and triglycerides (TG). LP levels were matched with atmospheric conditions on the day when the test was conducted and expressed by the universal thermal climate index (UTCI). We demonstrated seasonal increases of TC in cold stress (in wintertime) and of TG in heat stress (summer). The analysis of LP levels in specific periods revealed the increase of TC levels after holidays (i.e., Christmas and Easter) in men by 4.56%, and the increase of TG levels in women by 13.46% in the same period. Our results suggest the secondary, diet-dependent underlying cause of the observed changes. This work contributes to the discussion concerning the impact of biometeorological factors on LP levels and may be of significance when planning population-dedicated preventive activities.

The association of fainting with specific situations and circumstances, such as the sight of blood, response to pain, prolonged standing position and fatigue, is well recognized and described in medical literature. Clinical experience also indicates that specific, local physical conditions, such as exposure to heat or remaining in a small, stuffy room may also trigger fainting. This paper verifies the hypothesis concerning the association between atmospheric conditions and the incidence of fainting. This is a retrospective cohort study of data relating to fainting collected in the city of Olsztyn (Poland). In total, 10,449 emergency service interventions in the period 2012-2019 that concluded with the R55 (syncope and collapse) diagnosis according to the ICD 10 were analyzed. The obtained data were matched with meteorological data, including basic parameters (temperature, humidity, atmospheric pressure) and complex parameters, with special attention given to the Universal Thermal Climate Index (UTCI). This index is derived from an analysis of human thermal balance and is particularly useful for describing the organism's response to thermal stress. Statistically significant differences in the occurrences of fainting depending on the season were revealed (more in the summer), but only for women. Among the analyzed meteorological and biometeorological parameters, statistical significance was found for parameters relating to temperature, with the greatest usefulness revealed for the UTCI. Periods with heat stress were more conducive to fainting, whereas the result for the general population was influenced by women in two age groups: 25-45 and 46-60. To our best knowledge, this is the first attempt worldwide to utilize the UTCI as a predictor of fainting. Our results confirmed the applicability of the UTCI as a universal biometeorological tool for the assessment of relationships between atmospheric conditions and the incidence of fainting.

Background: The COVID-19 pandemic affected the functioning of healthcare systems (HSs) in a way that was difficult to foresee earlier. It quickened the introduction of e-medicine, and changed the manner and number of services provided in the open medical setting. Aim: To assess variations in the consultation rate of patients in primary healthcare centers (PHCs) in consecutive months of the pandemic. Method: Data collected from two PHCs located in Olsztyn (Poland) were analyzed retrospectively. Collectively, these two centers provide care for approximately 20,000 inhabitants and perform approximately 100,000 medical services annually. The analysis was based on data covering the period April&ndash, July of the years 2010&ndash, 2020, consisting in total of 337,510 medical services records. Results: A large, statistically significant decrease in the consultation rate (consultation rate understood as the number of individuals seeking consultation in relation to the number of people under care in a given time period) was revealed in each age group in the initial phase of the pandemic. In consecutive months, the approximated consultation rate achieved mean long-term values. Conclusions. The largest reduction in the consultation rate was revealed in the youngest age group, with the smallest occurring in the oldest. In the group of patients older than 65 years of age, the consultation rate after 3 months of the pandemic was the same as before the outbreak. Variations in the consultation rate were independent of the epidemiological situation. During the study, we observed an increased level of the administrative and paperwork activities carried out by PHC physicians.

Respiratory tract infections (RTI) are one of the most frequent reasons for medical consultations. As air temperature decreases, but also in connection with other meteorological parameters, evident seasonal fluctuations in the number of consultations for RTI can be observed. The Universal Thermal Climate Index (UTCI) is a complex meteorological index derived from an analysis of human thermal balance that depends on air temperature, air humidity, and wind speed. Our aims were to check if this index, although never used before for that purpose, is an adequate tool for forecasting seasonal increases in RTI prevalence. This study is a retrospective analysis of patients’ consultations with general practitioners in the period of 2012–2015 (453,674 records) recorded in the city of Olsztyn (Poland), which is characterized by a cold climate type (Dfb). The values of air temperature, atmospheric pressure, relative air humidity, wind speed, and UTCI were used for a statistical analysis and a mathematical analysis of curve fitting in order to determine correlations between analyzed meteorological parameters and a number of medical consultations for RTI. Analysis of the number of medical consultations for RTI revealed an evident seasonal pattern in a 4-year observation period, with a strong inverse correlation between the number of patients with RTI and the UTCI. A statistically significant increase in the number of patients with RTI appeared when the UTCI decreased, especially when it reached the classes of strong cold stress and very strong cold stress. In conclusion, the UTCI is a valuable predictive parameter for forecasting seasonal increases in RTI cases. Its decrease may initiate a seasonal increased prevalence. This effect is strongest about the 10th day following a change in the thermal climate conditions and is not continuous. A larger number of consultations for RTI after weekends and holidays (the Monday effect) may blur the results of statistical analyses.

The effect of red cabbage fermentation on anthocyanin bioavailability and plasma antioxidant capacity in humans was studied. In a randomized crossover study, 13 volunteers consumed fresh and fermented red cabbage. Blood and urine samples were collected before and after consumption. Analyses of anthocyanins by HPLC-MS/MS and plasma antioxidant capacity by photochemiluminescence assay were conducted. Red cabbage products contained 20 different nonacylated and acylated anthocyanins with the main structure of cyanidin triglucosides. The anthocyanins ingested were present in physiological fluids in form of 18 native anthocyanins and 12 metabolites (methylated, glucuronided, sulfated). Among cyanidin metabolites identified, methylated forms were predominant. Bioavailability of anthocyanin from fresh red cabbage was over 10% higher than from fermented red cabbage. Upon fresh cabbage consumption, volunteers plasma showed higher antioxidant capacity than after fermented cabbage intake. The study has shown that fermentation process affects red cabbage anthocyanins bioavailability and human plasma antioxidant capacity.

Background The homeless constitute a subpopulation particularly exposed to atmospheric conditions, which, in the temperate climate zone, can result in both cold and heat stress leading to the increased mortality hazard. Environmental conditions have become a significant independent risk factor for mortality from specific causes, including circulatory or respiratory diseases. It is known that this group is particularly prone to some addictions, has a shorter life span, its members often die of different causes than those of the general population and may be especially vulnerable to the influence of weather conditions. Materials and methods The retrospective analysis is based on data concerning 615 homeless people, out of which 176 died in the analyzed period (2010-2016). Data for the study was collected in the city of Olsztyn, located in north-east Poland, temperate climatic zone of transitional type. To characterize weather conditions, meteorological data including daily minimum and maximum temperatures and the Universal Thermal Climate Index (UTCI) were used. Results The average life span of a homeless person was shorter by about 17.5 years than that recorded for the general population. The average age at death of a homeless male was 56.27 years old (SD 10.38), and 52.00 years old (SD 9.85) of a homeless female. The most frequent causes of death were circulatory system diseases (33.80%). A large number of deaths were attributable to smoking (47.18%), whereas a small number was caused by infectious diseases, while a relatively large proportion of deaths were due to tuberculosis (2.15%). Most deaths occurred in the conditions of cold stress (of different intensity). Deaths caused by hypothermia were thirteen-fold more frequently recorded among the homeless than for the general population. A relative risk of death for a homeless person even in moderate cold stress conditions is higher (RR = 1.84) than in thermoneutral conditions. Conclusions Our results indicate excessive mortality among the homeless as well as the weak and rather typical influence of atmospheric conditions on mortality rates in this subpopulation, except for a greater risk of cold related deaths than in the general population. UTCI may serve as a useful tool to predict death risk in this group of people.

Lung cancer is rated with the highest incidence and mortality every year compared with other forms of cancer, therefore early detection and diagnosis is essential. Artificial Neural Networks (ANNs) are “artificial intelligence” software which have been used to assess a few prognostic situations. In this study, a database containing 193 patients from Diagnostic and Monitoring of Tuberculosis and Illness of Lungs Ward in Kuyavia and Pomerania Centre of the Pulmonology (Bydgoszcz, Poland) was analysed using ANNs. Each patient was described using 48 factors (i.e. age, sex, data of patient history, results from medical examinations etc.) and, as an output value, the expected presence of lung cancer was established. All 48 features were retrospectively collected and the database was divided into a training set (n=97), testing set (n=48) and a validating set (n=48). The best prediction score of the ANN model (MLP 48-9-2) was above 0.99 of the area under a receiver operator characteristic (ROC) curve. The ANNs were able to correctly classify 47 out of 48 test cases. These data suggest that Artificial Neural Networks can be used in prognosis of lung cancer and could help the physician in diagnosis of patients with the suspicion of lung cancer.

Scope The exposure to quercetin (Q) has not been studied in breastfed infants whose mothers were consuming a Q-rich diet. The objective of the study was to determine whether plant-origin antioxidant-Q passes from the mother's diet to her milk and to calculate the pharmacokinetic parameters of this phenomenon. Methods and results Eleven breastfeeding women were included in this controlled case study. Volunteers followed a Q-restricted diet for 5 consecutive days with the exception of the 3rd day when they received a single meal providing 1 mg of Q per kg of body weight. Urine analysis showed the presence of Q already in the first collected samples after the test (1.5–4 h), which indicated its rapid absorption from the meal. The Cmax = 68 ± 8.44 nmol/L concentration of Q in the milk was calculated for Tmax = 11.89 ± 3.37 h. It was significantly different (p = 0.007) from 40 nmol/L and (p = 0.016) from 42 nmol/L of Q concentration before and 48 h after the test, respectively. Conclusions Q was shown to be a component of human milk at the nmol/L level. Infants breastfed by mothers consuming a diet rich in Q are exposed to a dose of approximately 0.01 mg of Q daily.

In 2005, the European Commission presented a report on the current situation associated with the protection, promotion and support of breastfeeding in 29 European countries. According to the report, exclusive breastfeeding was undertaken by 71% of the mothers in Poland. We concluded that an attempt shall be made to verify these data values. The aim of our survey was to assess the duration of breastfeeding and identify the potential medical and social factors affecting this parameter in Poland. We surveyed 427 women aged 18 to 40 from Northeastern Poland. The duration of breastfeeding and the presence of selected potential factors that may affect this parameter were assessed in 591 children. The mean duration of exclusive breastfeeding was 4.73 months with breastfeeding being initiated in 97.87% and continued beyond 12 months (following the introduction of complementary foods) in 32.49 % of the children. In our region, nearly all mothers attempt to breastfeed. Exclusive breastfeeding is continued by 75.46% and 29.27% of the mothers by 3 and 6 months of the baby’s life. Breastfeeding with complementary feeding is continued by 56.01% and 32.49% of the mothers by 6 and 12 months of the baby’s life.

The main goal of our study is the analysis of data obtained from molecular modeling for a series of imidazole derivatives that possess strong antifungal activity. The research was designed to use artificial neural network (ANN) analysis to determine quantitative relationships between the structural parameters and anti-Streptococcus pyogenes activity of a series of imidazole derivatives. ANN in association with quantitative structure-activity relationships (QSAR) represents a promising tool in the search for drug candidates among the practically unlimited number of possible derivatives. In this work, a series of 286 imidazole derivatives presented as cationic three-dimensional structures was used. The activity was expressed as a logarithm of the reciprocal of the minimal inhibitory concentrations, log 1/MIC. Multilayer perceptron ANN was used for predictions of antimicrobial potency of new imidazole derivatives on the basis of their structural descriptors. The obtained correlation coefficient equaled 0.9461 for the learning set, 0.9060 for the validation set and 0.8824 for the testing set of imidazole derivatives. Hence, satisfactory and practically useful predictions of anti-Streptococcus pyogenes activity for a series of imidazole derivatives was obtained, supporting the future successful interpretation of QSAR analysis for those compounds.

Testicular cancer is rare but is the most common cancer in males between 15 and 34 years of age. Two principal types of testicular cancer are distinguished: seminomas and non-seminomas. If detected early, the overall cure rate for testicular cancer exceeds 90%. In this study, artificial neural network (ANN) analysis as a prognostic tool was demonstrated regard to five year recurrence after the non-seminoma treatment. Data from 202 patients treated for non-seminoma were available for evaluation and comparison. A total of 32 variables were analysed using the ANN. The ANN approach, as an advanced multivariate data processing method, was demon-strated to provide objective prognostic data. Some of these prognostic factors are consistent or even imperceptible with previously evaluated by other statistical methods.

We report a case of an apparently well-documented indapamide-induced hyponatremia. The initial diagnosis was made on the basis of dechallenge and rechallenge performed on two occasions. Further course of the disease, which proved inconsistent with our expectations, prompted us to look for another aetiology leading to the final diagnosis of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) complicated by indapamide treatment.

The study is a retrospective analysis of data obtained from a cardiovascular disease prevention program financed by the National Health Fund (Poland). The aim of the study was to evaluate the population to demonstrate the prevalence of favourable and unfavourable lipid parameters and blood pressure values depending on age and BMI. A total of 2,616 subjects were included in the study (811 men and 1805 women aged between 35 and 55 years of age) who perceived themselves as completely healthy individuals and in whom no cardiovascular disease or diabetes mellitus had been diagnosed. We evaluated blood pressure values, body weight, height, BMI, fasting glucose, total cholesterol, triglycerides, HDL and LDL in the serum of venous blood. The above-mentioned parameters were compared in women and men depending on BMI and age. It was demonstrated that the epidemiological situation of women in the analysed age group, regardless of the studied parameter and method of its evaluation, is much more favourable than that of men. We have demonstrated that evaluation of the analysed lipid parameters and blood pressure should be performed with consideration to gender and age. Otherwise conclusions may be obtained which are not satisfied by 75-95% of the population in a given age group. Obesity was highlighted as a factor triggering further lipid disturbances and blood pressure increase.

Thiazide diuretics such as hydrochlorothiazide (HCT) are a widely used first-line treatment for hypertension, but most patients will not achieve blood pressure (BP) control with HCT alone and so will require combination therapy. In this study the efficacy, safety and tolerability of a single-pill combination (SPC) of the direct renin inhibitor aliskiren with HCT were investigated in patients non-responsive to HCT 25 mg therapy.In this study, 722 patients with hypertension and an inadequate response to 4 weeks of HCT 25 mg (mean sitting diastolic BPor =90 and110 mmHg) were randomized to once-daily, double-blind treatment for 8 weeks with an SPC of aliskiren/HCT 300/25 mg or 150/25 mg, or continued HCT 25 mg monotherapy. Least-squares mean changes in mean sitting systolic/diastolic BP (msSBP/DBP) from double-blind baseline were analyzed for the ITT population at week 8 endpoint.Aliskiren/HCT 300/25 mg and 150/25 mg SPCs lowered msSBP/DBP from baseline by 16.7/10.7 and 12.9/8.5 mmHg, respectively, both significantly greater reductions than HCT 25 mg alone (7.1/4.8 mmHg; both p0.001). Rates of BP control (140/90 mmHg) were also significantly higher with aliskiren/HCT 300/25 mg (58%) and 150/25 mg (49%) than with HCT (26%; both p0.001). Aliskiren/HCT 300/25 mg provided significantly greater msSBP/DBP reductions and rates of BP control than the 150/25 mg SPC dose (all p0.05). Aliskiren/HCT SPC treatment showed similar tolerability to HCT alone and a numerically lower incidence of hypokalemia (serum potassium3.5 mmol/L; aliskiren/HCT, 1.3-2.2%: HCT alone, 3.4%).Aliskiren/HCT SPCs provide clinically significant BP reductions and improved BP control rates in patients who are non-responsive to HCT 25 mg monotherapy. Limitations of the study were the mainly Caucasian patient population and the non-responder design.

The lipophilic character of quercetin suggests that it can cross enterocyte membranes via simple diffusion. Therefore, it should be more bioavailable than its glucosides, which require preliminary hydrolysis or active transport for absorption. However, the published human studies show that quercetin is less bioavailable than its glucosides. Assuming that low bioavailability of quercetin aglycone provided to humans as a pure substance is the result of its low solubility in the digestive tract, we studied its bioavailability from dietary sources in which quercetin was dispersed in the food matrix. In a randomized crossover study, 9 volunteers took a single dose of either shallot flesh (99.2% quercetin glucosides and 0.8% quercetin aglycone) or dry shallot skin (83.3% quercetin aglycone and 16.7% quercetin glucosides), providing 1.4 mg quercetin per kg of body weight. Blood samples were collected before and after consumption of shallot preparations. Plasma quercetin was measured on HPLC with electrochemical detection after plasma enzymatic treatment. The maximum plasma quercetin concentration of 1.02 +/- 0.13 micromol/L was reached at 2.33 +/- 0.50 h after shallot flesh consumption compared with 3.95 +/- 0.62 micromol/L at 2.78 +/- 0.15 h after dry skin consumption. The area under the concentration-time curve after dry skin consumption was 47.23 +/- 7.53 micromol x h(-1) x L(-1) and was significantly higher than that after shallot flesh intake (22.23 +/- 2.32 micromol x h(-1) x L(-1)). When provided along with dietary sources, quercetin aglycone is more bioavailable than its glucosides in humans. Results point to the food matrix as a key factor.

The incidence of tuberculosis (TB) declined more than two-fold, compared with the national average, in the northeastern region of Poland in the period of 2003–2012. During that time, four programs of active case finding of TB were conducted as part of which a total of 944 homeless individuals were examined and 21 cases of active TB were detected. The objective of the present study was to find out whether the observed beneficial epidemiological trend could be a result of those programs. We addressed the issue of how the active case finding programs in the homeless community affected the TB incidence in the general population using a modified crisscross SIS-type (Susceptible – Infected – Susceptible) model which describes the dynamics of TB spread between the homeless and non-homeless populations. The values calculated from our model proved highly congruent with the actual epidemiological data. Our analysis showed a significant decline in TB incidence within 1 year of completion of each active case finding program. The model shows that each identified and cured case in the homeless community reduced the number of new cases in the general population by 3–4 within 1 year and by up to 20 within 5 years.

Background: Homelessness is a form of social pathology, which is for various reasons undesirable and as far as possible limited by efforts such as programmes that assist in transitioning out of homelessness. Because, as time passes, the homeless population undergoes both quantitative and qualitative changes, the process of developing these programmes requires up-to-date information on the extent and profile of this phenomenon that takes into account the characteristics of a given country. Methods: A 12-month study of homeless individuals (ETHOS categories 1.1, 2.1 and 3.1) was conducted between December 2013 and November 2014 in Olsztyn, Poland. Demographic, sociological, psychological, and medical data were collected. Results: The study population comprised 98 homeless individuals. The average homeless individual in our study population was a single (93.88%), most commonly divorced (59.18%), alcohol-dependent (78.57%), smoking (84.69%), middle-aged (54.33 years, SD 9.70) male (92.86%) with a low level of education (10.19 years of completed education, SD 3.09). The individual was most commonly an unemployed person suffering profound privation, living off various types of benefits, and spending a significant proportion of his income on alcohol and cigarettes. The person often resigned from social welfare due to his alcohol dependence. Almost a third of the study population (32.65%) declared that they occasionally went hungry. The principal source of food were meals provided by welfare services (89.80%). Conclusions: Our results indicate that the design of the social welfare system for homeless people should always take into account issues related to alcohol dependence, and each homeless person should be evaluated for possible alcohol dependence. Institutionalised material support provided to homeless individuals should be organised in such a way as to minimise the risk of promoting alcohol and nicotine dependence.

Tuberculosis (TB) is a disease particularly affecting the poorest socioeconomic groups. One such group in Central Europe are the homeless. We developed a prevention programme that targets, among others, homeless individuals in Warmia and Mazury Province (in the northeast of Poland). We investigated 121 homeless persons. We performed surveys, X-rays and microbiological tests of the sputum for TB. Five cases of pulmonary TB were found. The prevalence of TB in this community was estimated at 4132 per 100,000 (4.13%). Efficient TB control justifies continued prevention programmes aimed at the systematic monitoring of the homeless population.

Background: Factors associated with the development of atrial fi brillation (AF) in general population have been described, but it is still unknown whether the same risk factors apply to heart failure (HF) patients. The aim of this study was to identify clinical factors related to various forms of AF in HF patients. Methods: The clinical and echocardiographic characteristics were assessed in 155 HF patients: 50 with sinus rhythm, 52 with non-permanent AF, and 53 with permanent AF. Results: Multivariate logistic regression analysis showed that the increase in the NYHA class was an independent risk factor for both forms of AF. The occurrence of permanent AF in comparison to sinus rhythm group was independently associated with hs-C-reactive protein (CRP) elevation above 1 mg/dL (OR 1.87, 95% CI 1.05–3.35), left atrial dimension above 4 cm (OR 3.78, 95% CI 1.29–11.06) and tricuspid maximal pressure gradient elevation above 35 mm Hg (OR 5.01, 95% CI 1.38–18.27). The presence of coronary disease was independently associated with less frequent occurrence of permanent AF in comparison to sinus rhythm group (OR 0.21, 95% CI 0.06–0.67). Conclusions: More advanced congestive HF was associated with presence of both types of AF. Non-ischemic etiology of HF and elevated CRP are independently associated with permanent AF compared to sinus rhythm. Left ventricular diastolic dysfunction indicators (increased tricuspid maximal pressure gradient and left artial dimension) are independently associated with permanent AF. (Cardiol J 2013; 20, 4: 364–369)

The lipophilic character of quercetin suggests that it can cross enterocyte membranes via simple diffusion. Therefore, it should be more bioavailable than its glucosides, which require preliminary hydrolysis or active transport for absorption. However, the published human studies show that quercetin is less bioavailable than its glucosides. Assuming that low bioavailability of quercetin aglycone provided to humans as a pure substance is the result of its low solubility in the digestive tract, we studied its bioavailability from dietary sources in which quercetin was dispersed in the food matrix. In a randomized crossover study, 9 volunteers took a single dose of either shallot flesh (99.2% quercetin glucosides and 0.8% quercetin aglycone) or dry shallot skin (83.3% quercetin aglycone and 16.7% quercetin glucosides), providing 1.4 mg quercetin per kg of body weight. Blood samples were collected before and after consumption of shallot preparations. Plasma quercetin was measured on HPLC with electrochemical detection after plasma enzymatic treatment. The maximum plasma quercetin concentration of 1.02 +/- 0.13 micromol/L was reached at 2.33 +/- 0.50 h after shallot flesh consumption compared with 3.95 +/- 0.62 micromol/L at 2.78 +/- 0.15 h after dry skin consumption. The area under the concentration-time curve after dry skin consumption was 47.23 +/- 7.53 micromol x h(-1) x L(-1) and was significantly higher than that after shallot flesh intake (22.23 +/- 2.32 micromol x h(-1) x L(-1)). When provided along with dietary sources, quercetin aglycone is more bioavailable than its glucosides in humans. Results point to the food matrix as a key factor.

This report comprises an analysis of results of examinations performed as a part of a cardiovascular disease prevention programme funded by the National Health Fund.To determine the relationship between body mass index (BMI) and blood pressure, blood glucose and lipid metabolism abnormalities in an ethnically homogeneous population of males and females aged 35 to 55 years with sense of full health without prior diagnosis of cardiovascular disease or diabetes.The study was carried out in the population of a 175,000-resident city during 9 months, involving 1080 subjects (696 females and 384 males) aged 35 to 55 years (mean age - 47.2+/-5.4). The following variables were assessed: systolic and diastolic blood pressure, body weight and height, BMI, fasting blood glucose, total cholesterol, triglycerides and HDL cholesterol levels.The studied male population had significantly higher blood pressure, blood glucose, total cholesterol, triglycerides and lower HDL cholesterol levels compared to age-matched females. The female population was found to have a more prominent relationship between increased BMI and blood pressure, blood glucose and serum cholesterol levels than males. Significant differences in favour of females regarding systolic blood pressure, blood glucose and serum cholesterol failed to be present in the obese women subgroup (no statistically significant differences were found compared to obese males). In females aged 45 to 55 years, significantly higher body weight, blood pressure as well as blood glucose, cholesterol and triglyceride levels were observed than in younger women (35-45 years old).Overweight and obesity are associated with increase of arterial blood pressure, lipid metabolism disturbances and elevation of blood glucose. The relationship between BMI and studied risk factors was influenced by age and gender. Menopause is associated with increasing body weight and unfavourable evolution of studied risk factors.