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Parenteral nutrition-associated liver disease (PNALD) is diagnosed after at least 2 weeks of total parenteral nutrition (PN). However, its symptoms may occur early during PN. The aim of this study was to determine the early biochemical predictors of PNALD.This cross-sectional retrospective study included 160 patients on total parenteral nutrition. The clinical and laboratory data collected during parenteral nutrition were analyzed. Patients were assessed before the onset, on the 2nd, 7th and on the 14th day of PN according to the definition of PNALD and in search for predominant liver function tests findings.Out of 160 patients, 21 fulfilled the laboratory criteria of PNALD on the 14th day of PN. In the group of patients with PNALD, 14 met these criteria on the 7th day of PN. In multivariate logistic analyses the laboratory criteria of PNALD met on the 7th day of PN (OR = 5637; 95%Cl: 1.162-33.578; p-value = .039) were found to be of predictive value for PNALD on the 14th day. In PNALD group the 1.5-fold elevation of GGTP activity above upper limit of norm was the most prominent laboratory finding during the fourteen-day course of PN. The percentage of patients with 1.5-fold increased activity of GGTP varied in time from 76.2% to 95.2% on the 2nd and 14th day of PN, respectively.PNALD may be predicted by liver function monitoring after seven days of PN.

A theoretical model was selected among three potentially applicable models and then used to analyze the absorption isotherms of the hydrogen storage alloys LaNi5 and LaNi4.75Pb0.25 at three different temperatures (T = 303 K, 313 K, 323 K). The theoretical expressions of the model were based on the statistical physics formalism and simplifying hypotheses. The model selected was the one with the highest correlation with the experimental data. The model had six adjustable parameters: the number of hydrogen atoms per site nα, nβ, the receptor site densities Nα, Nβ and the energy parameters Pα, Pβ. The fitted parameters obtained for the Pb-doped and nondoped alloys were compared and discussed in relationship to the absorption isotherms. Finally, the fitted parameters or the model were further applied to calculate thermodynamic functions, such as entropy, Gibbs free energy and internal energy, which govern the absorption mechanism.

Aims: The present study aimed to analyze the incidence and characteristics of all types of retinal detachment (RD) in the overall population of Polish adults during 2013–2019. Methods: Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund (NHF) database were evaluated. International Classification of Diseases codes (ICD-9 and ICD-10) and unique NHF codes were used to identify RD patients and RD treatment procedures. Results: In the period 2013–2019, 71,073 patients with RD were newly diagnosed in Poland. The average incidence was 32.64/100,000 person-years (95% CI: 31.28–33.99) and it increased with the age of patients, with the highest rate in the group of patients ≥70 years of age. The overall incidences of rhegmatogenous RD, traction RD, serous RD, other RD and unspecified RD were 13.72/100,000, 2.03/100,000, 1.02/100,000, 7.90/100,000 and 7.97/100,000 person-years, respectively. The most common surgical treatment for RD in Poland was PPV performed on average in 49.80% of RD patients. The risk factor analyses showed that rhegmatogenous RD was significantly associated with age (OR 1.026), male sex (OR 2.320), rural residence (OR 0.958), DM type 2 (OR 1.603), any DR (OR 2.109), myopia (OR 2.997), glaucoma (OR 2.169) and uveitis (OR 2.561). Traction RD was also significantly associated with age (OR 1.013) and male sex (OR 2.785) as well as with any DR (OR 2.493), myopia (OR 2.255), glaucoma (OR 1.904) and uveitis (OR 4.214). Serous RD was significantly associated with all analyzed risk factors except DM type 2. Conclusions: The total incidence of retinal detachment in Poland was higher than found in previously published studies. Our study demonstrated that diabetes type 1 and diabetic retinopathy are risk factors of development of serous RD, which is presumably associated with the disruption of the blood–retinal barriers in these conditions.

Aim: The aim of the study was to analyze the impact of the COVID-19 pandemic and the related change of the teaching mode from stationary to distance learning on the severity of voice-related ailments among teachers. Materials and methods: A questionnaire survey of teachers was conducted to assess voice disorders during stationary and remote work using the Vocal Tract Discomfort (VTDs) scale and Numeric Rating Scale (NRS), and the respondents’ subjective feelings were assessed. Demographic and environmental factors associated with voice work were examined. Data on sickness absence, which were obtained from the “Health Needs Maps 2020” Ministry of Health’s, were also analyzed. Responses were subjected to statistical analysis. A P-value level below 0.05 was considered statistically significant. Results: 128 teachers participated in the survey. The overall assessment of voice disorders using VTDs and NRS scales showed no statistically significant differences for complaints between stationary and remote work. Detailed analysis revealed more se-vere voice disorders in teachers working more than 6 months remotely (P = 0.049) and having more than 20 lessons per week (P = 0.012). Subjective assessment confirmed a significantly lower percentage of teachers reporting voice disorders when wor-king remotely compared to stationary (P = 0.043). This resulted in less sickness absence and a 40% decrease in sick leave related to voice disorders in 2020 compared to 2019. Conclusions: During the remote learning period of the COVID-19 pandemic, teachers reported lower severity of voice disor-ders and this influenced the reduction of sickness absences. There were no statistically significant differences in voice complaints as assessed by VTDs and NRS scales for both teaching modes. Several factors affecting the severity of vocal tract disorders were identified – the number of class hours per week (>20) for stationary teaching and a long period of remote teaching (>6 months).

Introduction The microarchitecture of the mucosal and submucosal vessels is crucial for diagnosis of vocal fold lesions. Neo-angiogenesis is a confirmed biological parameter that implicates progression and metastasis in laryngeal cancer. Objective This study investigates the correlation between vascular pattern classifications by narrow band imaging and immunohistological microvessel density in different types of intraepithelial vocal fold lesions. Methods Analysis of immunohistological microvessel density using CD31 and CD34 antibodies was performed in 77 lesions including: 20 non-dysplastic lesions, 20 with low-grade dysplasia, 17 with high-grade dysplasia and 20 invasive cancers. The evaluation of vascular patterns with narrow band imaging according to the Ni classification and European Laryngological Society guidelines was performed prior to surgical resection. Results The mean value of CD31 microvessel density was the highest for Ni Type IV lesions (20.55), whereas for the longitudinal and perpendicular patterns according to the European Laryngological Society classification it was 12.50 and 19.45 respectively. The highest mean value of microvessel density with CD 34 was identified in Ni Type Va (35.43) lesions and in the longitudinal and perpendicular patterns according to the European Laryngological Society classification was 15.12 and 30.40 respectively. Conclusions The microvascular morphological changes of intraepithelial laryngeal lesions observed under narrow band imaging endoscopy are positively correlated with angiogenesis indexes of immunohistological evaluation.

Background The aim of the study is to evaluate the reoperation rate after surgical treatment for degenerative spinal diseases (DSD) in Poland and to identify risk factors for reoperation, including comorbidities and other variables. Methods A retrospective analysis of hospitalisations in 2018 that were reported to the National Health Fund (NHF) using ICD-10 codes: M43.1, M47, M48, M50, M51, M53 and Diagnosis Related Group (DRG) codes: A22, A23, A27, H51, H52, H53, H55. Reoperations were identified using the same codes provided that they were reported within 365 days after discharge. The analysis involved demographic factors and patient multimorbidity. A logistic regression model was then performed to assess risk factors for reoperation. Results In 2018, 38,953 surgical hospitalisations for DSD were reported. A total of 3,942 hospitalised patients (10.12%) needed reoperation within 365 days. Patients requiring reoperation were predominantly women (1.34:1) and the elderly (mean age: 56.66 vs. 53.24). The percentage of reoperations correlated with the multimorbidity rate (from 8.81–15.31%). The risk of reoperation was most increased by concomitant depression, neurological diseases, obesity and older age. The risk of reoperation was reduced by instrumented spinal surgery, operations in a neurosurgical department and hospitalisations other than day-surgery. Conclusions Reoperations within the first year of surgical treatment for DSD are common. Identification of risk factors for reoperation, including those related to the presence of comorbidities and the phenomenon of multimorbidity, can be an important tool in reducing the reoperation rate.

(1) Background: Malignant tumours of the salivary glands have different clinical and histopathological characteristics. They most commonly involve the parotid gland. Histopathologically, the most common are mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (AdCC), acinic cell carcinoma (AcCC), adenocarcinoma, carcinoma in pleomorphic adenoma (CPA), and squamous cell carcinoma (SCC). (2) Methods: We analysed 2318 patients with malignant parotid gland tumours reported to the National Cancer Registry (NCR) in Poland over 20 years (1999–2018). The demographic characteristics of patients, clinical factors, and overall survival (OS) were analysed. (3) Results: The average age was 61.33 ± 16.1 years. The majority were males (55%) and urban citizens (64%). High percentage of carcinomas was diagnosed in locoregional (33.7%) and systemic (10.4%) stadium. The most prevalent diagnoses were SCC (33.3%) and adenocarcinoma (19.6%). Surgical resection with adjuvant RT (42.1%) was the most common treatment. The OS analysis showed a median survival time of 5.6 years. The most favorable median OS was found in patients with AcCC (18.30 years), the worst for SCC (1.58 years). (4) Conclusion: AcCC has the best prognosis and SCC the worst. Tumour stadium, treatment, and demographic factors affect prognosis. Improvements in diagnosis and re-evaluation of treatment standards are necessary to enhance the outcome of patients with parotid gland cancers in Poland.

Propose Identification of relevant features acquired on preoperative evaluation of parapharyngeal space (PPS) tumors or related to the performed surgical approach that are predictive of the most important complication of surgical treatment of these tumors, cranial nerve palsy. Methods This was a retrospective analysis of 68 patients with PPS tumors treated with surgical resection in a tertiary referral center from 2009 to 2019. The preoperative clinical symptoms, age, sex, tumor size, location, histopathological type, surgical approach, radical resection, intraoperative bleeding and the occurrence of complications were collected, evaluated and compared. Results Cross-table and chi-square test results revealed that cranial nerve deficits were more common in neurogenic tumors than in other types, including malignant tumors (χ2 = 6.118, p = 0.013); the cervical approach was selected more often for neurogenic tumors (χ2 = 14.134, p χ2 = 6.424, p = 0.011); and neurogenic tumors were more likely to be located in the poststyloid area (χ2 = 17.464, p t test revealed a significant correlation between age and the prevalence of cranial nerve complications (t = 2.242, p = 0.031). The mean age in the group of patients with cranial nerve palsy was 45.89 years, and that of the group without complications was 54.69 years. The results of logistic regression confirmed that the risk of nerve deficits was almost 8 times higher for neurogenic tumors (OR = 7.778, p = 0.01). None of the other analyzed variables related to tumor or surgery was significantly correlated with an increased risk of cranial nerve dysfunction. Conclusion Surgical resection of tumors other than neurogenic tumors of the PPS reveals no significant risk for permanent neural dysfunction. Tumor size also had no significant effect on the risk of postoperative nerve palsy.

BackgroundEarly and proper diagnosis of laryngeal lesions is necessary to begin treatment of the patient as soon as possible with the possibility of preserve organ functions. Imaging examinations are oft aided by artificial intelligence (AI) to improve quality and facilitate appropriate diagnosis. The aim of the study is to investigate of the diagnostic utility of AI in laryngeal endoscopy.MethodsFive electronic databases (PubMed, Embase, Cochrane, Scopus, Web of Science) were searched for studies published before October 15, 2021 implementing artificial intelligence (AI) enhanced models assessing images of laryngeal lesions taken during laryngeal endoscopy. Outcomes were analyzed in terms of accuracy, sensitivity and specificity.ResultsAll 13 included studies presented overall low risk of bias. The overall accuracy of AI models was very high (from 0.806 to 0.997) and the number of images used to build and evaluate the models ranged from 120 to 24,667. The accuracy was significantly higher in studies using larger database. The pooled sensitivity and specificity for identification of healthy laryngeal tissue (8 studies) was 0.91 (95% CI: 0.83-0.98) and 0.97 (95% CI: 0.96-0.99), respectively. The same values for differentiation between benign and malignant lesions (7 studies) were 0.91 (95% CI: 0.86-0.96) and 0.95 (95% CI: 0.90-0.99), respectively. The analysis was extended to a comparison of sensitivity and specificity of AI models assessing Narrow Band Imaging (3 studies) and white light endoscopy images (4 studies). The results were similar for both methods, no subgroup effect was revealed (p = 0.406 for sensitivity and p = 0.817 for specificity).ConclusionsIn assessing images of laryngeal lesions, AI demonstrates extraordinarily high accuracy, sensitivity, and specificity. AI enhanced diagnostic tools should be introduced into everyday clinical work. The performance of AI diagnoses increases efficacy with the size of the image database when using similar standards for evaluating images. The multicentre cooperation should concentrate on creation of huge database of laryngeal lesions images and implement their sharing, which allows building AI modes with the best performance, based on vast amount of images for learning and testing.

Oncology trends are based on data coming from different countries and ocular melanoma is the most common primary eye cancer in adults.To investigate the incidence and characteristics of ocular melanoma in the overall population of Poland.The retrospective survey of both the National Cancer Registry (NCR) and National Health Fund (NHF) databases was performed to identify all ocular melanoma cases in Poland in 2010-2017.The mean incidence of ocular melanoma was 8.76/1,000,000 person-years; the lowest incidence was observed in the 19-29 age group (1.17/1,000,000 person-years) and the highest in the group over 70 (22.88/1,000,000 person-years). There were no statistically significant trends in the incidence rates over the study period. The overall incidences of uveal, eyelid and conjunctival melanoma were 6.67/1,000,000, 0.47/1,000,000 and 0.28/1,000,000 person-years, respectively. The 5-year overall survival (OS) was 60.76%; the higher risk of death was associated with male sex (hazard ratio (HR) = 1.2959), older age at diagnosis (HR = 1.0379), chemotherapy treatment (HR = 1.6774), metastasis (HR = 1.5716), loco-regional hyperplasia (HR = 1.5936), and systemic tumor spread (HR = 3.9872), compared to the carcinoma in situ. The risk of death was reduced by radiotherapy treatment (HR = 0.6645).The incidence rate of ocular melanoma in Poland is in the middle of the range worldwide, and the 5-year OS is relatively low.

The risk factors of rehospitalization and death post-discharge in diabetes-related hospital admissions are not fully understood. To determine them, a population-based retrospective epidemiological survey was performed on diabetes-related admissions from the Polish national database. Logistic regression models were used, in which the dependent variables were rehospitalization due to diabetes complications and death within 90 days after the index hospitalization. In 2017, there were 74,248 hospitalizations related to diabetes. A total of 11.3% ended with readmission. Risk factors for rehospitalization were as follows: age < 35 years; male sex; prior hospitalization due to acute diabetic complications; weight loss; peripheral artery disease; iron deficiency anemia; kidney failure; alcohol abuse; heart failure; urgent, emergency, or weekend admission; length of hospitalization; and hospitalization in a teaching hospital with an endocrinology/diabetology unit. Furthermore, 7.3% of hospitalizations resulted in death within 90 days following discharge. Risk factors for death were as follows: age; neoplastic disease with/without metastases; weight loss; coagulopathy; alcohol abuse; acute diabetes complications; heart failure; kidney failure; iron deficiency anemia; peripheral artery disease; fluid, electrolytes, and acid–base balance disturbances; urgent or emergency and weekend admission; and length of hospitalization. We concluded that of all investigated factors, only hospitalization within an experienced specialist center may reduce the frequency of the assessed outcomes.

Background: The aim of this study was a comprehensive analysis of the incidence of different salivary gland pathologies in the adult population of Poland. Methods: A retrospective analysis of salivary gland pathologies diagnosed in Poland in 2010–2019 based on the National Health Fund (NHF) database was performed. Non-neoplastic diseases, and benign and malignant lesions were identified using ICD-10 codes. Demographic characteristics, incidence rates, and the number of inpatient and outpatient medical services were analyzed. Results: Salivary gland pathologies were diagnosed in 230,589 patients over 10 years (85.5% were non-neoplastic lesions, 11.53% benign and 2.93% malignant neoplasms). Incidence rate for all pathologies was 59.94/100,000. The mean incidence for malignant neoplasms was 1.78, and decreasing trend was observed over the analyzed period. Contrarily, for benign neoplasms (mean incidence—6.91), an increase in numbers was noted annually. The incidence for non-malignant lesions was quite stable (mean: 51.25) over the time. The highest number of medical services per patient concerned malignant neoplasms (on average, two hospital stays, and eleven outpatient consultations). Conclusions: An increase of benign salivary gland tumors, and a decrease of malignant neoplasms was observed during the studied period. The number of medical services related to salivary gland pathologies increased during the period under study.

Objectives The aim of the study was to determine the influence of oral, oropharyngeal, laryngeal and hypopharyngeal dysplasia and cancer diagnosis on motivation to smoking cessation in patients. Consecutively, we assessed the competence of ENT specialists in counseling anti-smoking therapies. Methods Questionnaire of expected support, Schneider motivation test and Fagerström Test for Nicotine Dependence (FTND) were administered to 50 smoking patients. The online survey was collected from 152 ENT doctors. Results Mean FTND score was 4.58 and Heaviness of Smoking Index (HSI) was 3.1. Patients with oral cavity and oropharyngeal cancer showed the greatest dependence to nicotine 7.67 and 5.25, respectively, and with hypopharyngeal cancer had the lowest 3.5, (p = 0.039). The ranges of HSI were significantly higher for younger patients (p = 0.036). 35 patients were adequately motivated to quit smoking, and their mean age was statistically higher (p = 0.05). Self-reported motivation to smoking cessation was 76%. Of 152 surveyed doctors, only 39% declared knowledge of the diagnostic and therapeutic cessation interventions. 75% showed interest in the training programs.

Objective The promotion of neovascularisation is a crucial aspect of carcinogenesis. The study evaluates the microvascular density (MVD) and expression of hypoxia-induced factor (HIF-1α) in hypertrophic vocal fold (VF) lesions of different histopathological states including non-dysplastic, low-grade, high-grade dysplasia and invasive glottic cancer. Materials and methods Histological specimens collected from patients diagnosed and treated in a single centre with different histological grades were immunohistochemically stained with CD31, CD34 and HIF-1α. Of the total number of 77 analysed VF specimens, 20 were non-dysplastic, 20 had low-grade dysplasia, 17 high-grade dysplasia and 20 were invasive cancers. Results The highest mean value for MVD evaluated with expression of CD31 (MVD CD31) was 21.23 ± 14.46 and identified in the low-grade dysplasia group. The average MVD CD31 was 13.74 ± 5.56 and 20.11 ± 9.28 in the high-grade dysplasia and invasive cancer group, respectively. The highest MVD evaluated with CD34 (MVD CD34) was revealed for invasive cancer 35.64 ± 17.21. The MVD CD34 was higher for low-grade than in high-grade dysplasia (25.87 ± 12.30 vs 24.65 ± 15.92, respectively). The expression of HIF-1α was strong or very strong in 60% of non-dysplastic lesions, 100% of low-grade dysplasia cases, 53% of high-grade dysplasia cases and 50% of invasive cancer cases. The comparison of MVD CD31 with MVD CD34 revealed a strong positive correlation (ρ value 0.727). The comparison of both MVD CD31 and MVD CD34 with HIF-1α resulted in no linear relationship (ρ value of 0.143 and 0.165, respectively). Conclusion The stage of low-grade dysplasia in intraepithelial vocal fold lesions is related to significant advancement of angiogenesis together with the highest hypoxia level. Electronic supplementary material The online version of this article (10.1007/s00405-019-05355-2) contains supplementary material, which is available to authorized users.

Retinoblastoma is the most common intraocular paediatric eye cancer. It accounts for approximately 11% of primary cancers occurring in the first age of life, with 95% of diagnoses before 5 years of age [1-3]. Since retinoblastoma is very aggressive, early diagnosis and prompt treatment are vital for children to preserve their sight and life. In western countries in Europe and North America, retinoblastoma is diagnosed early so the chances of saving the patient’s life and preserving vision are good. However, in large regions of Africa and Asia, where the diagnosis of retinoblastoma is delayed, the deadly effect is observed [2-5]. In these regions, socioeconomic factors and poor recognition of the seriousness of the disease result in a high mortality rate of up to 70%. At the same time, the mortality rate in Europe and North America is 3-5 % [2]. Besides, the incidence of retinoblastoma also varies by race and region, from 40 to 60 per million live births, which corresponds to 1 per 16,000 - 24,000 live births, with the greatest disease burden recorded in the countries of Asia and Africa where the highest birth rates are recorded [2,3 However, the nationwide studies of the retinoblastoma epidemiology have been conducted in many countries, such as Sweden, Finland, Netherlands, Singapore, Great Britain, United States of America, Korea and Taiwan, there is a lack of data from Eastern European countries like Poland [1,3-11]. The management of retinoblastoma may also differ between developed and developing countries. The current strategy of retinoblastoma treatment aims to save the life, eye, vision and cosmetics of the child, in order of priority. Medical management of retinoblastoma includes surgical treatment (enucleation), external beam radiotherapy, systemic chemotherapy with or without focal therapies such as cryotherapy, laser photocoagulation and plaque radiotherapy. Recently, intra-arterial and intravitreal chemotherapies have been used to treat retinoblastoma with the ability to save globes that otherwise would have been enucleated [2,3]. The present study aimed to investigate the incidence and characteristics of retinoblastoma in the overall population of Poland in the years 2010-2017 and to report the changes that occurred during that period.

Background This study investigates relevance of narrow band imaging (NBI) in stratifying risk of malignant transformation within leukoplakia. Methods We conducted a prospective analysis that included 62 patients with 91 changes of leukoplakia on vocal folds. The NBI was obtained before microsurgery. Categorization of the lesion as benign was made when vessels of surrounding epithelium were classified as type I, II, or IV according to Ni classification. If there were visualized intraepithelial papillary capillary loops of type V, the lesion was classified as malignant. Results were compared to the histopathological diagnosis. Results The NBI assessment classified 75 lesions (82.4%) as benign and 16 (17.6%) as malignant. Histopathological results revealed the diagnosis of no dysplastic changes or low grade dysplasia in 77 cases (84.6%). Another 14 cases (15.4%) occurred with high-grade dysplasia, carcinoma in situ, and invasive cancer. Sensitivity, specificity, and accuracy of NBI in predicting malignancy within leukoplakia were 100%, 97.4%, and 97.8%, respectively. The kappa index was 0.92 (95% confidence interval 81.1%-100%). Conclusion The noninvasive procedure of an NBI endoscopy may be recommended as an accurate method in predicting the risk of malignant transformation within the vocal fold leukoplakia and, therefore, would be useful in the clinic for planning the patient's therapy.

ObjectivesThe study was designed to evaluate the tissue expression of NRP-1 and serum level of sNRP-1 in the same patients with intraepithelial laryngeal lesions or early staged laryngeal cancer to identify the clinical significance of these biomarkers in the diagnosis of laryngeal lesions.Material and methodsA prospective analysis of tissue was performed on specimens and blood samples from 49 patients, who were admitted for surgical resection due to suspicious vocal fold lesions and were diagnosed as non-dysplasia, low-grade dysplasia, high-grade dysplasia and invasive cancers.ResultsELISA was conducted on 48 blood samples. The minimum level of sNRP-1 was 0.15 ng/ml and maximum- 37.71 ng/ml. The Kruskal-Wallis one-way analysis of variance revealed no differences in sNRP-1 levels between different histopathological stages of vocal fold lesions (p = 0.234). IHC was conducted in 49 tissue samples. The evaluated mean scores of NRP-1 tissue expression were compared to histopathological stage of the lesion. The Kruskal-Wallis one-way analysis of variance revealed no differences in NRP-1 tissue expression between different histopathological stages of vocal fold lesions (p = 0.536). The correlation of tissue NRP-1 expression and serum levels of NRP-1 within analyzed group was insignificant. The Spearman's rank correlation coefficient was 0.076 (p = 0.606).ConclusionsThe NRP-1 tissue expression and serum levels are unlikely to be a prognostic factor for identification of laryngeal dysplasia or early stage laryngeal cancer. Further studies investigating biomolecules involved in laryngeal carcinogenesis are necessary.