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Background: Currently, it remains unknown whether there is an association between body mass index (BMI) and complications during screening colonoscopy; hence, it remains unclear whether BMI should be considered a risk factor in pre-procedural assessments. The aim of this study was to compare mortality and unplanned hospitalization rates before and after colonoscopy stratified by patients' BMI., Material and Methods: This was a retrospective cohort study of individuals who underwent screening colonoscopy as part of the Polish Colonoscopy Screening Program (PCSP). The included individuals were followed up for mortality and hospitalization episodes from 42 days prior to colonoscopy to 30 days after the procedure. Rates for the endpoints were calculated, compared, and adjusted for available data. Weighted averages of stratum-specific rates were calculated. Additional subanalyses were performed for sex and procedure type (screening colonoscopy without biopsy, colonoscopy with biopsy, or colonoscopy with polypectomy)., Results: A total of 55390 individuals who underwent colonoscopy between years 2012-2015 were included. Obese individuals had significantly more hospitalizations than non-obese patients (1.94% versus 0%, p  = .038). Analysis of adjusted hospitalization rates stratified by sex revealed that obese males had significantly higher related hospitalizations' rates before or after and after colonoscopy. Unadjusted and adjusted mortality rates after screening colonoscopy did not reveal significant differences between BMI categories., Conclusions: Overweight and obesity are not clinically relevant risk factors for mortality and hospitalization six weeks before or 30 days after screening colonoscopy. Obese males may be more likely to require hospital care after colonoscopy.

With the introduction of mobile applications that allow short-term rentals, electric scooters (e-scooters) are gaining popularity as a means of micromobility in urban areas. The aim of the study was to assess the circumstances and causes of death in traffic accidents involving electric scooters in Poland. The inclusion criteria for the study were met by 9 cases (7 M,2F; mean age: 40.3 years). Accidents usually occur during working days during the warm months, especially during the morning traffic rush hour. Usually, these accidents involved another vehicle (4/9 cases). In addition, the victim was most often the driver (8/9 cases) and rarely uses a helmet (1/9 cases). In only two cases did the test reveal the presence of alcohol in the blood at the time of the accident. In studied cases, head injuries occurred in every case, and injuries to the limbs and chest occurred in more than half of the cases. Within the head, in addition to minor injuries like bruises and epidermal abrasions, skull fractures, and intracranial bleedings predominated. Similar minor injuries were also observed in the extremities, with significant fractures observed only in the lower extremities. Among chest injuries, lung contusions predominated. The most common cause of death was craniocerebral injury (6/9 cases), but there were two deaths each from chest injuries and polytrauma. To increase the safety of e-scooter users, it is recommended that measures be taken to educate users about the potential risks of using the vehicle and that measures be taken to increase the use of helmets, e.g. through legislative action. Further studies involving larger study groups are needed to assess the correlation between potential risk factors and the fatal outcome of the accident., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Background and Purpose: Wilson's disease (WD) is a rare autosomal recessive disorder causing excessive copper deposition and a spectrum of manifestations, particularly neurological and hepatic symptoms. We analysed the clinical characteristics of patients with WD admitted to the country's only reference centre, which provided long-term care to most adult patients in Poland over seven decades (pre-1959 to 2019)., Methods: Electronic prospective data collection began in the 2000s and, for prior years, medical records were analysed retrospectively. Demographic and clinical characteristics, treatment and outcomes were analysed by decade of diagnosis. Life-years lost were estimated in patients with WD compared with the general population. Kaplan-Meier curves were used for a time-to-death analysis using 2000-2009 as a reference., Results: In total, 929 patients were analysed. The number of patients increased from 21 before 1959 to 315 for 2000 to 2009 period. Mostly males were diagnosed before the 1990s, but the numbers of female patients diagnosed increased thereafter. Initially, most patients presented with neurological manifestations; however, the incidence of hepatic manifestations and asymptomatic presentations increased over time as patients were diagnosed early and consequently were more independent at diagnosis. Fewer Kayser-Fleischer rings were detected recently. Prior to 1970, patients were treated with D-penicillamine (DP); however, since the introduction of zinc, both therapies have been used as often. Since the 1990s, switches between DP and zinc were recorded in 6%-7% of patients. Consistent improvement in survival has been observed over the years., Conclusions: This is the largest cohort of patients with WD reported in Poland, with the longest follow-up. Earlier diagnosis and prognosis have improved over seven decades., (© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Introduction: Visual impairment is a significant public health concern, particularly among older adults in Poland., Objectives: The aim of this study was to determine the impact of socioeconomic factors and health status on visual impairment among older adults in Poland., Patients and Methods: A total of 5987 individuals aged 60 years or older who participated in the PolSenior2 study were analyzed. Near visual acuity was assessed using the Snellen charts, and data on socioeconomic factors and comorbidities were collected using surveys. Univariable and multivariable logistic regression models were created to identify risk factors for visual impairment., Results: In multivariable regression analysis, the odds of visual impairment were 1.72‑fold higher among the individuals aged 75 years and older than in those aged 60 to 74 years. Furthermore, the participants with primary education had 1.66‑fold higher odds of visual impairment, as compared with those with higher education. The individuals engaged in manual / farming work in the past, those who used to be unemployed, and those performing other non-white‑collar jobs in the past had 1.25-, 1.42-, and 1.26‑fold higher odds of visual impairment, respectively, as compared with white‑collar workers. Additionally, obesity was found to be associated with 0.85‑fold lower odds of visual impairment., Conclusions: Our study showed that socioeconomic factors significantly impact visual health. Visual impairment was the most prevalent among older age groups (≥75 years), individuals with lower education levels or no education, the unemployed, and those who used to perform non-white-collar jobs. Additionally, obesity was inversely associated with the odds of visual impairment.

The study aimed to assess the impact of experienced emotional states on the risk of the development of occupational burnout in midwives who experienced the death of a patient while on duty. The study was conducted on 54 midwives in Warsaw, Poland. We used the Oldenburg Burnout Inventory (OLBI) and the author's questionnaire. The average professional burnout level of midwives participating in the study was determined as 5.08 ± 0.67. Helplessness (57.4%) and depression (48.1%) were the most frequently experienced emotions. The number of deaths of patients experienced by the respondents did not affect the severity of burnout (Z = - 0.753; p > 0.05). However, midwives who declared that they had experienced the death of a patient more than 10 times while on duty were more likely to experience a feeling of relief (2.83 vs. 2.00; Z = - 2.30; p < 0.05) and calmness (2.97 vs. 2.24; Z = - 1.95; p < 0.05). The experienced depression positively correlated with the level of exhaustion (rho = 0.465; p < 0.001) and the overall level of occupational burnout (rho = 0.291; p < 0.05). However, it was not correlated with the level of disengagement (p > 0.05). Depression has a significant impact on the risk of developing occupational burnout, which highlights the need to develop and implement effective support methods for midwives experiencing difficult emotions related to the death of patients while on duty., (© 2024. The Author(s).)

With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban social or physical environment. However, research on the relationship between urbanization and mental health is lacking. This cross-sectional study aimed to explore the relationships of the physical environment (spatial cohesion and urban environment) and social factors (neighborhood cohesion) with mental health (stress, anxiety and depression symptoms) and physical health and the mediating role of loneliness based on the proposed theoretical model. The study was conducted in Metropolis GZM (Silesia, Poland) in a representative sample of 3296 residents (48% women). The measurements used were the PSS-10, GAD-7, PHQ-9, R-UCLA3 and neighborhood cohesion scale. ANOVA results showed that city residents had better mental health indices than residents of villages and small towns. The network approach revealed that urbanization was one of the most influential nodes and played the role of a bridge between all other nodes. The model was confirmed and showed that the relationships between the physical environment and mental health were consecutively mediated by neighborhood cohesion and loneliness. Spatial cohesion related to factors of the physical environment and physical health, while physical health was directly connected to sociodemographic factors and weakly to stress. Anxiety was the strongest risk factor. Mental health can be improved by social and architectural factors, such as strengthening neighborhood cohesion and improving neglected buildings., (© 2024. The Author(s).)

Background: Eliminating hepatitis C virus (HCV) infections is a goal set by the World Health Organization. This has become possible with the introduction of highly effective and safe direct-acting antivirals (DAA) but limitations remain due to undiagnosed HCV infections and loss of patients from the cascade of care at various stages, including those lost to follow-up (LTFU) before the assessment of the effectiveness of the therapy. The aim of our study was to determine the extent of this loss and to establish the characteristics of patients experiencing it., Methods: Patients with chronic HCV infection from the Polish retrospective multicenter EpiTer-2 database who were treated with DAA therapies between 2015 and 2023 were included in the study., Results: In the study population of 18,968 patients, 106 had died by the end of the 12-week post-treatment follow-up period, and 509 patients did not report for evaluation of therapy effectiveness while alive and were considered LTFU. Among patients with available assessment of sustained virological response (SVR), the effectiveness of therapy was 97.5%. A significantly higher percentage of men (p<0.0001) and a lower median age (p=0.0001) were documented in LTFU compared to the group with available SVR assessment. In LTFU patients, comorbidities such as alcohol (p<0.0001) and drug addiction (p=0.0005), depression (p=0.0449) or other mental disorders (p<0.0001), and co-infection with human immunodeficiency virus (HIV) (p<0.0001) were significantly more common as compared to those with SVR assessment. They were also significantly more often infected with genotype (GT) 3, less likely to be treatment-experienced and more likely to discontinue DAA therapy., Conclusions: In a real-world population of nearly 19,000 HCV-infected patients, we documented a 2.7% loss to follow-up rate. Independent predictors of this phenomenon were male gender, GT3 infection, HIV co-infection, alcohol addiction, mental illnesses, lack of prior antiviral treatment and discontinuation of DAA therapy., (© 2024. The Author(s).)

This single-centre epidemiologic study investigated seasonal/monthly stroke incidence and stroke-related mortality in relation to weather variables, gender, age, as well as stroke subtype and stroke aetiology. The study involved 638 patients hospitalised due to stroke at the Neurology Ward with a stroke unit at the Regional Hospital in Poland, during one complete calendar year. The data collected included the date of admission to the ward, year of birth, sex, type and subtype of stroke relative to the aetiology and location within different arteries as well as mortality. The data related to wind speed, atmospheric pressure, and temperature were acquired from the archive at the weather station in Tarnów, Poland. Majority of the patients in the study group were aged 66-85 years (57.2%), and there were more women than men. Ischaemic stroke was significantly more common than haemorrhagic stroke (87 vs 13%). Large artery atherosclerosis was the predominant cause of stroke, particularly in June and October, and total anterior circulation stroke (TACS) was the most common type, particularly in January and December. The analysis showed that stroke type and aetiology, as well as weather variables such as temperature and pressure, were associated with stroke incidence and mortality rates. The findings suggest that both high and low temperatures may contribute to an increased stroke incidence, as significant differences in the number of stroke cases are observed during periods of extreme temperatures. Therefore, increased vigilance is necessary during periods of both hot and cold weather. Further research is needed to better understand these relationships and develop effective prevention strategies., (© 2024. The Author(s).)

Background/objectives: Eating disorders (EDs) pose a significant health issue affecting athletes, with risk factors varying by sport level, sex, and social media use. This study assesses the risk of EDs among professional and amateur football players, considering these factors, and compares findings with a control group of non-athletes., Methods: The study involved 170 participants, including non-athletes as a control group, categorized by sex and sport level. The mean age of participants was 24.3 ± 4.20, with an age range of 18-36. The Eating Attitudes Test (EAT-26) and body mass index (BMI) assessments were used to determine ED risk., Results: Results showed a higher prevalence of ED risk among professional athletes, especially women, compared to amateurs and non-athletes. Social media use and body comparisons were linked to increased ED risk, with professional athletes exhibiting higher vulnerability due to performance pressures. Women, particularly those in professional sports, showed a higher risk of EDs than men, influenced by social and aesthetic pressures., Conclusions: The findings highlight the need for targeted interventions, promoting healthier body image perceptions and addressing social media's role in shaping body dissatisfaction. Psychological support and sex-specific strategies should be integrated into athlete care programs to mitigate these risks.

Eucoleus aerophilus is the causative agent of respiratory capillariosis in wild and domestic carnivores and has sporadically affected humans. To date, this parasite has been detected in 38 countries, confirming its worldwide distribution. The aim of this study was to evaluate the prevalence of E. aerophilus in red fox populations from Central Europe and to describe the sequence variations in the partial cox1 gene of this parasite recovered from stool samples. An investigation was carried out using 342 samples of red foxes faeces investigated via seminested PCR and coproscopy. PCR results confirmed the presence of E. aerophilus DNA in 230 samples and E. boehmi DNA in 14 samples. Molecular analysis of the retrieved sequences revealed 22 haplotypes of E. aerophilus, EaPL1-EaPL22, and 4 haplotypes of E. boehmi, EbPL1-EbPL4. Coproscopic examination revealed that eggs of the Capillariidae family were most prevalent in all regions, with a mean prevalence of 73%. Furthermore, the following eggs were detected: Taeniidae (21.3%), Toxocara spp. (26.3%), Toxascaris leonina (5.3%), Trichuris vulpis (1.5%), trematodes (23.4%), hookworms (2.3%) and Mesocestoides spp. (1.8%). This study evaluated the prevalence of E. aerophilus in red fox populations in selected regions of Poland. To the best of our knowledge, this is the first molecular study on E. aerophilus in Poland., (© 2024. The Author(s).)

With the widespread use of integrase inhibitors and the expanding use of long-acting cabotegravir in both pre-exposure prophylaxis and antiretroviral treatment, molecular surveillance on the transmission of integrase resistance has regained clinical significance. This study aimed to determine the frequency of INSTI-transmitted drug resistance mutations (DRMs) among treatment-naïve individuals in Poland from 2016 to 2023. INSTI resistance was analyzed in 882 antiretroviral treatment-naïve individuals using Sanger sequencing. Integrase DRMs were defined based on the Stanford HIV drug resistance database scores. Phylogeny was used to investigate subtyping and clustering. For the analysis of time-trends, logistic regression was used. Major (E138K and R263K) integrase mutations were detected in 0.45% of cases with minor resistance observed in 14.85%, most commonly (13.95%) E157Q. Overall, no major clusters of transmitted drug resistance were identified, and the transmission of E157Q showed a decreasing trend ( p < 0.001). While the frequency of sub-subtype A6 increased, it was predominantly found among migrants and associated with L74 mutations. The frequency of major integrase-transmitted DRMs remains low, despite the changes in subtype variability. Surveillance of changing HIV molecular variation patterns is vital from the perspective of the optimal use of integrase inhibitors, especially due to expanding long-acting cabotegravir implementation.

Background/Objectives: Dietary habits are among the most significant determinants of health. The aim of this study was to assess the nutritional quality and cardiovascular profiles of individuals following plant-based diet. Methods: The study population comprised 199 individuals (136 women, 63 men; mean age 33.9  ±  8.9 years) including vegans (VG; n = 50), vegetarians (VN; n = 101) and omnivores (OV; n = 48). In this analysis the following procedures were assessed: a questionnaire interview, anthropometric and blood pressure measurements, and a blood sample collection. Dietary patterns were evaluated using the Food Frequency Questionnaire and a 24-h dietary recall. Results: Vegans exhibited the lowest protein intake relative to the other groups ( p < 0.05) and a significantly higher intake of polyunsaturated fatty acids and lower intake of cholesterol compared to VN and OV ( p < 0.05). Vegans had significantly lower levels of serum cholesterol, LDL cholesterol, and triglycerides, fasting glucose and high-sensitivity C-reactive protein ( p < 0.05). No cases of overweight or obesity were observed among VN and VG participants. No instances of impaired fasting glucose or elevated blood pressure were noted among vegans. Hypercholesterolemia was identified in 56.2% of OV, 26.7% in VN and 16.0% in VG ( p < 0.05), elevated blood pressure was recorded in one vegetarian and in 6.2% of OV participants. Conclusions: Our research indicates that plant-based diets are associated with a better cardiovascular profile compared to traditional diets. Moreover, suboptimal intake of essential nutrients, underscores the need for more effective public health interventions and improved nutrition education regardless of dietary patterns.

The aging population in Poland poses significant socioeconomic and health challenges, particularly regarding malnutrition among seniors. This study examines the impact of place of residence on the nutritional status and related health outcomes of older adults. Data were collected from 338 community-dwelling seniors and those in long-term care facilities. The results indicate that long-term care residents exhibited significantly higher frailty and depression levels and poorer nutritional status, functional fitness, gait, and balance compared to those in communities. Self-reported quality of life did not differ significantly between groups. Regardless of residence, having a family correlated with better nutritional status, quality of life, and functional fitness and lower frailty and depression levels. Malnutrition was significantly associated with reduced functional fitness across all residences, and well-nourished individuals in care facilities had lower functional fitness than those who were at home. Community-dwelling residents had significantly lower frailty levels, with frailty negatively correlating with nutritional status. Normal nutritional status was linked to higher balance and gait scores, indicating a lower fall risk, with the risk further reduced for those living in community settings. Additionally, normal nutritional status correlated with lower depression levels and higher quality of life, with malnourished individuals experiencing better quality of life in community-dwelling settings. These findings underscore the critical role of residence and family support in elderly nutrition and health outcomes.

Background/objectives: The aim of this work was to understand the factors influencing the prevalence of dietary behaviors, as well as determinants of unhealthy eating and diet quality among primary care physicians and nurses in Poland., Methods: A cross-sectional study involving 161 doctors and 331 nurses was conducted in the years 2020-2022 in primary healthcare settings., Results: Unhealthy eating habits affected GPs aged 40-54 years (42.9%), females (64.3%), those of normal body weight (67.9%), representing private medical practice (67.9%), who had over 20 years of work experience (42.8%). Similarly, among the group of nurses, unhealthy eating habits were reported in subjects aged 40-54 (46.5%), individuals with normal body weights (49.5%), those with one chronic disease (38.4%), representing public medical practice (63.6%), with over 20 years of work experience (40.4%), seeing ≤100 patients during the work week (84.8%). The univariable logistic regression analyses for unhealthy dietary habits showed that overweight GPs had lower odds of unhealthy eating habits (OR = 0.35; 95% CI: 0.11-1.08; p < 0.05). Among the nurses, the odds of unhealthy eating habits increased with the number of years of work. Nurses with 10-20 years of work experience had 1.23 times greater odds of unhealthy eating habits, while people working for more than 20 years had 1.81 times greater odds of unhealthy eating habits than individuals working for a period shorter than ten years (OR = 1.23; 95% CI: 0.68-2.23; p > 0.05 vs. OR = 1.81; 95% CI: p < 0.05). The multivariable logistic regression analysis did not show statistically significant results., Conclusions: These issues should be addressed when planning educational activities aimed at supporting healthcare professionals in implementing lifestyle changes.

Background: Acid sphingomyelinase deficiency (ASMD) is an autosomal recessive lysosomal storage disease (LSD) associated with biallelic pathogenic variants in the sphingomyelin phosphodiesterase 1 (SMPD1) gene., Objectives: The aim of this study was to provide the 2024 update on chronic visceral and neurovisceral ASMD diagnosed in the infancy/childhood in Polish patients., Material and Methods: All the patients diagnosed in the pediatric age (0-18 years) with ASMD, both chronic neurovisceral and visceral type, and then systematically followed up, were enrolled into the study., Results: A total number of 7 patients were enrolled into the study. Four patients were previously reported. Two patients were newly recognized with ASMD - 1 with chronic visceral and 1 with chronic neurovisceral ASMD. Splenomegaly was noted in all the patients while a mild liver enlargement was observed in 4 of 7 patients. All patients presented with decreased high-density lipoprotein cholesterol (HDL-C) and decreased serum 25-hydroxy-vitamin D concentration while almost all (6 of 7) with hypercholesterolemia. Cherry-red spot was observed in 5 of 7 patients, including 1 patient with neurovisceral type. Seven various SMPD1 gene variants were identified and missense variants were the most common types of genetic lesions, comprising 71% of all alleles. In all the screened patients, lyso-sphingomyelin (lyso-SM) in dried blood spot (DBS) was found elevated; however, the greater values were observed for patients with chronic neurovisceral type., Conclusion: Chronic acid sphingomyelinase deficiency (ASMD) is a slowly progressive disease. Pediatric ASMD is characterized by spleno-hepatomegaly, dyslipidemia (with decreased HDL-C as the most characteristic) and infiltrative (interstitial) lung disease. Both visceral and neurovisceral chronic ASMD patients could present with cherry-red spot. Both acid spingomyelinase activity and lyso-spingomyelin concentration in DBS should be regarded as a first-tier screening method into ASMD.

Background: Differentiated thyroid carcinoma (DTC) in children is uncommon; clinical presentation over recent decades is incompletely characterized. Methods: This retrospective cohort study analyzed demographic and disease characteristics of consecutive juveniles with DTC treated from 1970 to 2015 at Poland's largest pediatric DTC referral center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, who had available records. Sex, age, histopathological characteristics, and DTC stage were documented. We aimed to identify changes in these variables over time and independent risk factors for lymph node or distant metastases. Trends in these variables were assessed using the Cochran-Armitage test and Spearman correlation. Multivariable logistic regression was performed to identify risk factors associated with lymph node or distant metastases. Results: 475 of 479 patients (99.2%) were included in the analysis; roughly half were age ≥15 years, 10%, <10 years. Papillary thyroid carcinoma (PTC) represented 88% of cases and follicular thyroid carcinoma (FTC) 11%. Tumors ≤2 cm constituted 56% of cases with relevant data; those >4 cm accounted for 12%. Multifocality was observed in 37% and extrathyroidal invasion in 22%. Lymph node metastases were noted in 59% and distant metastases in 16%. Over the observation period, significant trends among new cases included: increased proportion of adolescents >15 years; increased frequency of tumors ≤2 cm, decreased multifocality rates, and increased proportion of PTC versus FTC. Extrathyroidal invasion rates remained appreciable throughout, ranging from 17 to 28% during the 5-year study subperiods after 1990. Lymph node metastases significantly increased in frequency in the central neck, remaining consistently common in lateral sites; presence of distant metastases significantly decreased. In multivariable analysis, multifocality, extrathyroidal invasion, and tumor size were independently associated with lateral lymph node metastases and multifocality, larger tumor size, and N1b metastases with distant spread. Conclusions: Our observations of a rising proportion of diagnoses in adolescence, reductions in primary tumor size, and decreased frequency of multifocality and distant metastases may reflect increased detection of patients with less aggressive DTC at earlier disease stages. Nonetheless, we found persistently substantial rates of locoregionally advanced disease features (multifocality, extrathyroidal invasion, and lymph node metastases), which multivariable analyses suggested have significant associations with lateral lymph node and/or distant metastases.

Background: Hepatitis C virus (HCV) infection affects 50 million people worldwide with around 242,000 deaths annually, mainly due to complications such as cirrhosis and hepatocellular carcinoma (HCC). Portal hypertension (PH) caused by cirrhosis leads to severe consequences, including esophageal varices (EV). This study aimed to evaluate the effectiveness and safety of direct-acting antiviral (DAA) treatment in patients with and without EV., Methods: This retrospective analysis involved consecutive HCV-infected adults undergoing DAA therapy at 22 Polish hepatology centers from July 1, 2015, to December 31, 2022. Patients with cirrhosis were categorized based on the presence of EV diagnosed by gastroscopy. Treatment effectiveness was measured by sustained virologic response (SVR), with safety outcomes monitored for 12 weeks post-treatment., Results: A population of 3393 HCV-infected patients with cirrhosis was divided into groups with (A, n = 976) and without (B, n = 2417) EV. Group A showed a significantly higher prevalence of comorbidities and concomitant medications. Genotype (GT)1b infections predominated in both groups, and GT3 infections were more common in the EV group. Group A exhibited more severe liver disease, and higher rates of decompensation, HCC, and HBV co-infection. SVR was significantly higher in group B (91.5% vs. 96.3%, p < 0.0001). Male gender, GT3, EV presence, and Child-Pugh grade B were identified as independent negative SVR predictors. Group A had a worse safety profile, with notably higher adverse event incidence and mortality., Conclusions: DAA therapies are highly effective and well tolerated in patients with cirrhosis, but EV presence predicts poorer virologic responses., (© 2024. The Author(s).)

The lack of data on drug-drug interactions in pediatrics represents a relevant problem in making appropriate therapeutic decisions. Our study aimed to investigate the incidence and risk factors for potential drug-drug interactions (pDDIs) in pediatric pneumonology units, including cystic fibrosis patients. We performed a 6-month prospective observational study during which clinical pharmacists, using the Lexicomp Drug Interactions checker, screened medical records to identify pDDIs. Spearman's rank coefficient, logistic regression, and the Mann-Whitney U test were used to identify correlations, analyze risk factors for pDDIs, and compare cystic fibrosis patients with the rest, respectively. Recommendations were provided for the D and X pDDIs categories. Within the 218 patients, 428 pDDIs were identified, out of which 237 were classified as clinically significant. Almost 60% of patients were exposed to at least one relevant interaction. The number of pDDIs correlated with the number of; drugs (r s = 0.53, P <  .001), hospitalization length (r s = 0.20, P <  .01), and off-label medicines (r s = 0.25, P <  .001). According to the multivariate analysis, at least 6 administered medications (OR = 4.15; 95% CI = 2.21-7.78), 4 days of hospitalization (OR = 6.41; 95% CI = 2.29-17.97), and off-label therapy (OR = 3.37; 95% CI = 1.69-6.70) were the risk factor for pDDIs. Despite significant differences in the number of medications taken, comorbidities, and off-label drugs, cystic fibrosis patients were not more exposed to pDDI. Given the lack of data on pDDIs in the pediatric population, the need for close cooperation between clinicians and clinical pharmacists to improve the safety and efficacy of pharmacotherapy is highlighted., (© 2024, The American College of Clinical Pharmacology.)

The COVID-19 pandemic was a major challenge for all health care employees, but it was also difficult for patients to gain access to health care services. Myxedema coma (MC) is an extremely rare but potentially fatal endocrine emergency. The aim of the study was to report an increased incidence of life-threatening myxedema coma that occurred in relation to the COVID-19 pandemic. In this paper, we report a cohort of 11 patients with MC who were treated at the University Hospital in Krakow, Poland, in the period from 2015 to 2023. Only 1 case of MC was recorded in the period from 2015 to 2019, and, in the same area, 10 cases of MC were recorded after the start of COVID-19 pandemic until present. Hypothyroidism was diagnosed de novo in 2 (18%) patients; the remaining patients were severely hypothyroid due to therapy non-compliance. Nine patients had primary hypothyroidism, and 2 had central hypothyroidism. Besides longstanding hypothyroidism, an additional precipitating factor for MC was identified in 4 (36%) of the patients. Due to the inaccessibility of parenteral levothyroxine, patients were treated with oral, mostly liquid, form of levothyroxine. The mortality rate in this cohort was 27.2%. In conclusion, the increase of the incidence of MC, which is a life-threatening complication of inadequately treated hypothyroidism, during the COVID-19 pandemic, when resources were limited, and in the post-pandemic era, underlines the importance of adequate communication with patients and of long-term availability of primary care for patients with thyroid disease., (© 2024. The Author(s).)

Background: Autoimmune cytopenias (ACs), including immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA) and autoimmune granulocytopenia, are rare complications observed in lymphoma patients. They may appear before, during or after lymphoma diagnosis, whether the patients had disease progression or not., Objectives: This study aims to correlate ACs with lymphoma type, disease course and prognosis. We performed a multicenter retrospective analysis of adult patients with malignant lymphoma and ACs coexistence diagnosed and treated in centers aligned with the Polish Lymphoma Research Group (PLRG)., Material and Methods: The analysis covers the years 2016-2022 and included 51 patients comprised of 23 women and 28 men. Of these, 35 patients were diagnosed with AIHA, 15 patients with ITP and 1 patient with both AIHA and ITP., Results: The most common type of lymphoma was Hodgkin lymphoma (HL) (12 patients) and diffuse large B-cell lymphoma (DLBCL) (14 patients). At the time of diagnosis, 31 (61%) of patients had stage 4 of HL or DLBCL, according to Ann Arbor classification. In total, the response to treatment was evaluated in 50 patients, with 25 being in complete remission and 6 in partial remission. We observed that B cell symptoms (p = 0.036), bone marrow involvement (p = 0.073), splenomegaly (p = 0.025), and more than 2 lines of treatment were more common in AIHA compared to ITP patients. Conversely, eucopenia (p = 0.056) and ACs without lymphoma progression (p = 0.002) were more often diagnosed in ITP patients., Conclusions: In the study group, relapsed and refractory disease was observed more often, and shorter overall survival (OS) was noted in patients with DLBCL. We found that AC is associated with a worse prognosis in comparison to the general population of lymphoma patients. There were no differences in response to AC therapy. To have more accurate data, a larger group, as part of a multicenter study, should be evaluated.

1 BACKGROUND: COVID-19 pandemic had a major impact on the healthcare system globally. This work aims to evaluate COVID-19 impact on local treatment in bone sarcoma treated in a single, high-throughput institution. 2 METHODS: We have analyzed the local outcomes (i.e., possibility of limb sparing surgery) in all bone sarcoma patients treated between January 2016 and November 2022 in the main sarcoma reference center in Poland. Patients treated in the 2016-2019 period were regarded as "pre-pandemic" group, patients treated in 2020-2022 - "pandemic". Mann-Whitney U and Chi-square tests were used in the statistical analysis. No correction for multiple testing was applied. Tests with p < 0.05 were deemed significant. 3 RESULTS: There were 302 eligible patients identified. The group characteristics are presented in table 1. There were no differences in patient-related variables and histological subtypes of tumors between two groups. The tumor size did not differ (p = 0.053), when all tumor grades were considered, but high grade tumors were larger in the "pandemic" group (p = 0.034). This was reflected in the percentage of limb sparing surgeries which dropped from 83.3 % to 68.2 % ("pre-pandemic" vs. "pandemic", p = 0.004). This difference was even more stark in case of high grade tumors - 78 % vs. 54 % respectively (p = 0.001). 4 CONCLUSION: To our knowledge, this is the first report of the long lasting impact of COVID-19 pandemic on oncologic treatment outcomes in patients with malignant bone tumors., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: In the Spring of 2020, the world was hit with unparalleled impact by the coronavirus pandemic. Antibiotics were widely used, even without good rationale. The aim of our study was to compare the use of antibiotics in patients with confirmed COVID-19 from three hospitals across Europe (Poland, the Netherlands and Spain) between two subsequent periods in the early days of the pandemic., Method: We analysed data (antibiotics used and variation in the use of antibiotics, patients, admission and disease-related characteristics) from 300 patients admitted in three hospitals (University Hospital in Cracow, University Medical Center in Utrecht and Vall d'Hebron University Hospital in Barcelona) with confirmed infection of SARS-CoV-2 during Q1 2020 and Q4 2020., Results: There was ample variation in terms of patient mix and outcomes across the 3 hospitals. The majority of patients (225 out of 300) in all 3 hospitals received at least 1 antibiotic during the hospitalisation period. A minority of patients (68 out of 300) had their bacterial test results positive during their hospitalisation period. Throughout the 2 study periods, third-generation cephalosporins (ceftriaxone in 170 out of 300 patients) emerged as the most commonly used class of antibiotics. There was an apparent shift towards more rational utilisation of antibiotics, in all three hospitals., Conclusions: Our study shows that during the early stage of COVID-19 pandemic in 2020, antibiotics were frequently used in three European teaching hospitals despite the relatively low incidence of microbiologically confirmed bacterial infections. While in the early days of the COVID-19 pandemic antibiotic prescribing was full of trial and error, we could also confirm a learning curve over time., (© 2024. The Author(s).)

Introduction: The aim of the study was to investigate longitudinal trajectories of change in anxiety and depression symptoms in Polish adolescents during the second year of the COVID-19 pandemic and after the outbreak of the war in Ukraine. Additionally, we aimed to identify risk/protective factors and outcomes associated with these trajectories., Method: We collected data in three waves between November 2021 and May 2022. Adolescents ( N = 281 in the first wave) completed the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Filial Responsibility Scale for Youth, and questions related to the COVID-19 pandemic and war in Ukraine., Results: We identified three trajectories of depressive symptoms: resilient with low, stable symptoms (71% of participants), chronically elevated symptoms (11%), and acute symptoms followed by recovery (18%). We distinguished two trajectories of anxiety symptoms: resilient (75%) and chronic (25%). Non-resilient trajectories were predicted by higher levels of familial unfairness (perceived lack of equality and reciprocity in the family), relationship difficulties at school and at home, older age, and poor socioeconomic status. Chronic depressive and anxiety symptoms were associated with higher war-related concerns., Discussion: These findings can inform preventive and therapeutic interventions for at-risk adolescents to reduce negative long-term outcomes of social crises.

Background: An increased incidence of group A Streptococcus (GAS) infections has been observed in pediatric population post-COVID-19 pandemic. While the majority of reports refer to scarlet fever or invasive GAS disease, detailed data on pulmonary manifestations such as complicated community-acquired pneumonia (CAP) are scarce. The aim of this study was to assess the contribution of GAS to complicated CAP in children during the 2022/2023 infectious season., Methods: We retrospectively analyzed the etiology and clinical presentation of complicated CAP patients hospitalized in our tertiary care center in Warsaw, Poland, between August 2022 and May 2023., Results: Among 91 patients with complicated CAP, GAS was the dominant cause constituting 24.2% (22/91; 95% CI 15.8-34.3%) of the study group. 68.2% of GAS pneumonia patients presented symptoms of scarlet fever, and 27.3% had preceding or concurrent viral infection. GAS complicated CAP was associated with longer hospitalization, higher incidence of chest tube insertion, but shorter duration of chest tube drainage than complicated CAP of other etiology. Children with GAS complicated CAP had higher procalcitonin concentration (28.1 vs. 1.5 ng/dL; p<0.0001) and a lower platelets level (254.5 vs. 422 × 10 3 /μL; p = 0.0031) than those with non-GAS infection., Conclusions: GAS is currently the predominant pathogen of complicated CAP in children. Clinicians should be aware of the current epidemiological situation and a more severe course of GAS pneumonia in this age group, and should monitor patients presenting with symptoms of scarlet fever and preceding viral infection closely., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Introduction: Anaplasma phagocytophilum are tick-borne bacteria affecting both human and animal health. The aim of the study was to examine the prevalence of A. phagocytophilum in questing I. ricinus ticks collected in Lublin Province, eastern Poland., Material and Methods: Ticks were collected by the flagging method. Total DNA from ticks was extracted by boiling in ammonium hydroxide. Detection of A. phagocytophilum was performed by amplifying a fragment of the 16S rDNA gene., Results: Overall, 626 I. ricinus ticks were tested for the presence of A. phagocytophilum DNA. The prevalence of the pathogenic bacteria was 1.28%. The occurrence of A. phagocytophilum among adults was 1.8%, whereas none of the collected I. ricinus nymphs were infected., Conclusions: The study revealed the presence of A. phagocytophilum in I. ricinus in eastern Poland, which constitutes a potential health risk for residents, tourists, forestry, and agricultural workers.

Introduction and Objective: The medical records were examined of 222 patients of the Osteoporosis Treatment Clinic at the Central Clinical Hospital of the Medical University of Łódź, Poland. The influence was analyzed of 27 clinical risk factors on the occurrence of low-energetic fractures in this population. The aim of the research was to find possible dependencies between different risk factors, and the actual fractures that were recorded in the database., Material and Methods: For each risk factor and for each category (e.g., patients with diabetes and patients without diabetes), the percentage was computed of patients who had incidents osteoporotic fractures, and the percentage of those without fractures. Student's t-test and Pearson's chi-squared test were used to find statistically significant risk factors., Results: Statistically significant risk factors were found: age, chronic kidney disease, T-scores of the femoral neck and T-score of the lumbar spine, serum phosphate levels, FRAX-BMD, FRAX-BMI, and the type of diet., Conclusions: Some observations concerning the influence of individual risk factors on the occurrence of fractures are consistent with those presented in the literature. However, it was also noticed that the patients with hyperthyroidism, rheumatic diseases, diabetes, cancer or gastrointestinal diseases, had a smaller percentage of fractures than the patients who did not have these diseases. This may be explained by the small number of those having these diseases, or by the fact that they had already received appropriate treatment.

Introduction and Objective: The disruption of daily activities caused by the COVID-19 pandemic had health consequences, especially during peak lockdown periods. The aim of the study is to assess the impact of the first year of the COVID-19 pandemic on the process of weight change among Polish adults., Material and Methods: Two representative studies involving Polish adults aged 18-65 years were conducted, the first in June 2020 (N = 2527, from the perspective of the last 2-3 months), and the second a year later, in June 2021 (N = 2087, covering the last 12 months). Both surveys included two groups of respondents, and conducted using the CAWI method - computer-assisted web interview., Results: In the first period of the COVID-19 pandemic, there were more individuals with obesity than a year later (18.7% vs 19.9%), and more respondents reported weight change in 2020 than in 2021 (53% vs 49.6%). In both surveys, women were more likely to report weight gain than men (p<0.001). Statistically significant factors for weight change in 2020 and 2021 were gender, age, and in 2021, education and relationship status. Multinomial logistic regression showed that BMI, age of 18-29 and 30-49, being male, and education below high school, was significant for weight gain. While for weight loss, BMI, age 18-29 and 30-49, being male, and year of study, were statistically significant., Conclusions: The findings confirmed that body weight changed throughout the pandemic, depending on the time of the pandemic and selected socio-demographic factors.

Introduction and Objective. Lyme borreliosis (LB) causes hundreds of thousands of new human infections worldwide annually. This is the first study connecting the LB risk to children with environmental factors. Materials and Method. The potential impacts were assessed of environmental factors (deer density in forests, coverage of potential broadleaved forest plant communities, urbanization index) on the number of LB cases in children. Analysis covered the medical records of 196 children diagnosed with LB (ICD- A69.2) from 1 January 2012 - 30 October 2021 in Wielkopolska Province (Poland). Results. All examined factors were positively correlated with LB cases. The highest correlation with the number of patients diagnosed with LB was presented by the degree of urbanization (percentage of the population living in cities in the total inhabitants of the study region). The number of cases was much higher in the second research period (2017-2021). Conclusions. The number of LB cases in children is increasing as the coverage of potential broadleaved forest plant communities increases. The number of cases among males is positively correlated with the coverage. Deer density is positively correlated with the number of LB cases among children - the higher the deer density, the greater the risk of LB infection. LB cases in children are positively correlated with the urbanization index - the more people that live in cities, the greater the risk to children of LB infection.

Introduction and Objective: The profession of a physiotherapist is associated with various risks related to manual work, repetitive activities, an uncomfortable prolonged position of joints in some body postures forced by the work, and the standing position, which all impose considerable load on the upper and lower extremities and the spine. The aim of the study was to analyse ailments reported by physiotherapists in relation to their age, gender, seniority, the number of working hours per day, and body position during work., Material and Methods: The study involved 120 physiotherapists working in various types of employment. The research was carried out using an author-design questionnaire based on the Nordic Musculoskeletal Questionnaire. The occurrence of the ailments was analysed in relation to respondents' age, gender, seniority, number of working hours per day, and body position during work. An analysis of the relationships between the variables was carried out. The analysis of qualitative variables was performed using the χ2 test., Results: The results showed that the majority of physiotherapists complained of fatigue (78.8%), leg pain (61.9%), spine pain (60.2%), headache (59.3%), and shoulder pain (52.5%). It was shown that such symptoms as fatigue, dizziness, leg pain, finger pain, headache, wrist pain, drowsiness, and numbness, were correlated with age., Conclusions: The pain symptoms reported by the surveyed physiotherapists affected different parts of the body and appeared with different frequency and intensity. The majority of the physiotherapists declared problems with the lower spine, neck, wrists, hands, upper spine, and shoulders. Thigh pain was the most commonly reported symptom, whereas neck pain was reported the least frequently. The lower spine and ankles were indicated as body areas with the most severe and the weakest pain, respectively.

Introduction and Objective: Vaccination is the most effective and reliable strategy for preventing the morbidity of tetanus. The aim of the study is to investigate the seroprevalence of antibodies to tetanus toxoid among healthy persons across all age groups to determine the level of vaccine-induced immunity in the population, and to identify which age group should be targeted for a booster dose., Material and Methods: A total of 2,842 serum samples collected between 2010 - 2019 from individuals aged from 1 month - 97 years were investigated. Anti-tetanus IgG antibody concentrations (IU/ml) were measured by an enzyme-linked immunosorbent assay. In addition, the avidity of antibodies was determined using an in-house ELISA., Results: The results showed that among the 2,842 individuals, 147 (5.2%) had anti-tetanus toxoid IgG antibody levels below 0.1 IU/ml and another 1,519 (53.4%) subjects showed only basic protection (0.1-1.0 IU/ml) and needed immediate booster. High levels of anti-tetanus toxoid IgG antibodies (>1.0 IU/ml) were found more often in young adults at the age 21-40 years (55.5%, GMT=1.15). Importantly, these antibodies also had the highest avidity. With age, the percentage of high positives decreased, as well as the geometric mean and avidity of antibodies, reaching the lowest level in subjects over 70 years of age (13.3%; GMT=0.19). Characteristically, a higher percentage of high positive results was observed in men (42.6%) than in women (34.3%)., Conclusions: The study showed adequate immunity levels to tetanus amongst the Polish population, especially in children, adolescents, and young adults. However, those from older age groups should receive booster doses of the vaccine.

Background: The COVID-19 pandemic has brought significant attention to the role of dietary supplements, particularly Vitamin D, in enhancing immunity and possibly mitigating the severity of the disease. The pandemic has highlighted the importance of nutritional health in preventing severe outcomes from infections. Objective: This study aimed to assess consumption patterns of dietary supplements, with a focus on Vitamin D, among the Polish population during the COVID-19 pandemic and to identify the demographic factors influencing these patterns. Methods: An anonymous survey was conducted in March 2021 among 926 pharmacy patients in Poland. The study analyzed the use of dietary supplements such as vitamin D, magnesium, and others in relation to variables like age, gender, and education level. Statistical analyses were performed using the Pearson chi-square test. Results: The study revealed that 77.1% of the respondents reported using dietary supplements, with Vitamin D being the most frequently mentioned, used by 64.6% of participants. Magnesium was also widely used, with a higher overall prevalence of 67.3%, making it the most commonly consumed supplement. The use of supplements was significantly higher among women and individuals with higher education. Younger age groups, particularly those aged 18-30, were more likely to use supplements. Conclusions: The use of supplements was significantly higher among women, individuals with higher education, and those aged 18-30. However, the findings also indicate a growing awareness and increased use across the general population. This trend reflects increased public awareness of the potential health benefits of these supplements in boosting immunity. However, the study also highlights the need for public education on the risks of over-supplementation and the importance of appropriate dosages.

Background/objectives: Orthorexia Nervosa (ON) is an emerging behavioral pattern characterized by an obsessive focus on healthy eating. Despite its prevalence, ON lacks formal diagnostic criteria in major classification systems like the DSM-5 and the ICD-10. This study aims to investigate the impact of socio-cultural attitudes towards body image and the role of social media on the risk of ON among female football players from Poland, Turkey, and India. This study hypothesizes that socio-cultural pressures and media usage significantly influence the risk of developing ON, particularly in cultures more exposed to Western beauty ideals., Methods: The study was conducted from May to August 2024, employing the Computer-Assisted Web Interview method. A total of 142 female football players aged 16-36 from Poland, Turkey, and India participated. Data were collected using a structured questionnaire that included demographic information and health metrics, the Socio-Cultural Attitudes Towards Appearance Questionnaire, and the Duesseldorf Orthorexia Scale. Statistical analyses included an ANOVA, the Kruskal-Wallis test, the chi-square test, and Pearson's correlation coefficient., Results: The study found that nearly half of the participants were at risk of or presented with ON, with the highest prevalence being among Indian athletes. Statistically significant relationships were observed between the risk of ON and factors such as age, dietary exclusions, social media usage, and sources of nutritional information. However, no significant correlation was found between socio-cultural attitudes and the risk of ON, suggesting that other factors may play a more critical role., Conclusions: While socio-cultural pressures and media use are contributing factors to the risk of ON, psychological factors and individual behaviors appear to be equally, if not more, significant. This study highlights the importance of targeted educational programs and psychological support for young athletes, with a focus on promoting healthy dietary practices and positive body image perceptions across varying cultural contexts. Additionally, the results suggest the need for further research into the specific psychological and behavioral mechanisms underlying ON.

Purpose: People living with HIV are twice as likely to develop cardiovascular diseases (CVDs) and myocardial infarction related to atherosclerosis than the uninfected population. This study aimed to evaluate the prevalence of subclinical atherosclerosis in a young, mid-eastern European population of PLWH receiving ART for undetectable viremia., Patients and Methods: This was a single-centre study. We included 34 patients below 50 years old, treated in Szczecin, Poland, with confirmed HIV-1 infection, treated with antiretroviral therapy (ART), and undetectable viremia. All patients underwent coronary artery computed tomography (CACT), carotid artery intima-media thickness (IMT) evaluation, and echocardiography., Results: In the primary assessment, only two (5.8%) patients had an increased CVD risk calculated using the Framingham Risk Score (FRS), but we identified coronary or carotid plaques in 26.5% of the patients. Neither traditional risk factors nor those associated with HIV significantly influenced the presence of the plaque. IMT was significantly positively correlated with age and the FRS (R=0.38, p=0.04). Relative wall thickness assessed in echocardiography was higher in those with plaque (0.49 vs 0.44, p=0.04) and significantly correlated with IMT (R=0.38, p=0.04)., Conclusion: In our population, more than a quarter of PLWH with undetectable viremia had subclinical atherosclerosis in either the coronary or carotid arteries. The FRS underpredicted atherosclerosis in this population. The role of RWT as a possible early marker of atherosclerosis needs further studies., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Jachymek et al.)

Background: The hedgehogs have been recently identified as possible reservoir of Middle East respiratory syndrome coronavirus like (MERS-CoV-like). These viruses were classified as a distinct Betacoronavirus erinacei (BCoV-Eri) species within the MerBCoV-Eriirus subgenus. As coronaviruses are known for their ability to jump between different hosts, including humans, this can pose a particular threat to people in direct contact with hedgehogs, such as those working at animal asylums. Our previous studies have shown the presence of BCoV-Eri strains in animals collected in the wildlife rehabilitation centre. This study aimed to investigate the presence of CoV in subsequent hedgehogs collected from the urban area of Poland and their molecular characteristics., Results: Monitoring for the presence of coronavirus infection in hedgehogs revealed five positive individuals. The presence of BCoV-Eri was found in a total of 20% of animals tested. Our analyses revealed no correlation between CoVs positivity and animal health conditions but a higher probability of such infection in juveniles and females. The whole genome of two Polish Hedgehog coronavirus 1 strains were sequenced and compared with available counterparts from European and Asian countries. Phylogenetic analysis showed that both CoV strains formed common cluster with other similar MerBCoV-Eriirus, but they were also found to be genetically variable and most changes in the S protein were identified. Our analysis revealed that some S protein sites of the Hedgehog coronavirus 1 strains evolved under positive selection pressure and of five such sites, three are in the S1 region while the other two in the S2 region of the Spike., Conclusions: BCoV-Eri is to some extent prevalent in wildlife asylums in Poland. Given that the S protein of BCoVs-Eri is highly variable and that some sites of this protein evolve under positive selection pressure, these strains could potentially acquire a favourable feature for cross-species transmission. Consequently, the threat to humans working in such asylums is particularly high. Adequate biosecurity safeguards, but also human awareness of such risks, are therefore essential., (© 2024. The Author(s).)

Background: The war invasion of Ukraine in February 2022 led to mass migration. By January 3, 2023, nearly a million people sought refuge in Poland. The Polish Act on Assistance to Ukrainian Citizens provided comprehensive support, ensuring legal residence, free medical insurance, social benefits, and access to education and employment. Simultaneously, the global public health crisis persisted, with the fifth wave of the COVID-19 pandemic driven by the Omicron variant. The epidemic state in Poland was lifted on May, 2022., Objective: This paper aims to summarize the epidemiological situation of HCV infections in Poland in 2022, a year characterized by dual crises., Material and Methods: Epidemiological surveillance case-based data on HCV for 2022, diagnosis rates from bulletins for the years 2014-2022, and the number of deaths for 2022 from Statistics Poland were compared with previous years' data., Results: In 2022, the rate of new HCV diagnoses rose to 6.68 per 100,000, totaling 2,528 cases (a 46% increase from the previous year). Polish nationals accounted for 87% of cases. Gender distribution was equal. There was an overall increase in HCV diagnoses across all voivodeships, with a return to pre-pandemic trends observed only in Zachodniopomorskie. Diagnoses were predominantly made in primary healthcare (one-third) and during hospitalization (one-fourth). Twenty-six cases of acute hepatitis C (1%, PL definition) were identified. At diagnosis, 5.6% of infected showed signs of liver damage. Hepatitis C was responsible for 86 deaths. Imported infections accounted for 5.7% of cases. 2.7% of HCV infections in 2022 were diagnosed in refugees from Ukraine, mainly in women aged 40 to 59. All persons of Ukrainian nationality accounted for 10.4% of HCV cases detected in 2022., Conclusions: Expanding the availability and accessibility of testing is essential, particularly addressing the needs of key populations, including non-Polish speakers. The strategy for HCV elimination should encompass comprehensive measures aimed at prevention, diagnosis, and treatment to effectively curb the virus's spread among subgroups and mitigate its long-term health impacts.

Background: Despite the fact that the last cases of fully-symptomatic diphtheria were recorded in Poland in 1996 and 2000, infections caused by non-toxin-producing strains of Corynebacterium still occur. According to the epidemiological reports from ECDC in the second half of 2022, there was an increase in the number of diphtheria cases in European Union countries. As a result, the current issue becomes the appropriate preparation of microbiological laboratories for the diagnosis of Corynebacterium microorganisms., Objective: Reidentification of diphtheria bacilli isolated from clinical samples and to assess the drug susceptibility of C. diphtheriae strains isolated in Poland., Material and Methods: The subject of the research were 18 strains isolated from clinical samples in Poland in 2023. Microbiological and genetic methods were used for the reidentification of the strains. Drug susceptibility was assessed using the disk diffusion method, following the new EUCAST recommendations effective from 2023., Results: It was confirmed that all examined strains belonged to the genus Corynebacterium. It was de-monstrated that C. diphtheriae strains proved to be susceptible to increased exposure to benzylpenicillin and cefotaxime. Results obtained using ciprofloxacin allowed categorizing the strains into the intermediate susceptibility category WZE, except for one strain which was resistant to this antibiotic. All tested bacterial strains were susceptible to erythromycin. The C. ulcerans strain exhibited a similar antibiotic resistance profile to penicillin, cefotaxime, and ciprofloxa-cin, with additional detection of resistance to clindamycin. The toxigenicity of the tested strains was excluded., Conclusions: Based on epidemiological data regarding the emergence of new cases of infections caused by Corynebacterium strains, it is advisable to prepare theoretically and practically laboratories for diagnostics to detect potentially toxigenic diphtheria bacilli. Effective methods for the microbiological diagnosis of diphtheria bacilli are available. It is recommended to monitor the susceptibility to antimicrobial agents in all C. diphtheriae isolates.

The time after the COVID-19 pandemic posed a threat to engagement in prosocial behaviors within charity organizations. In the current study, we intended to test how three motivational paths: affective empathy-based, life satisfaction-based, and perceived social support-based shaped the change in intentions to give money and time to charity organizations over a yearly period (right after revocation of the most essential anti-COVID-19 laws and at the same time, outbreak of the war in Ukraine in 2022, in May 2022 and after a year, in late April-early May 2023). We also tested how past negative and present hedonistic time perspectives-namely, those most robust in predicting emotional states - shaped the changes in the abovementioned motivational paths and giving intentions. We conducted our longitudinal study on the general population of Poland (N = 566). We found that there has been a significant drop in the willingness to give time to organizations over the year after loosening the COVID-19 restrictions and the outbreak of war in Ukraine. We found that affective empathy helped sustain the intentions to give time to organizations, whereas past negative time perspective contributed to the decrease in such intentions. Our study suggests threats to organizations and highlights potential ways to encourage supporting them and caring for their volunteers' well-being., Competing Interests: The Authors declare no conflicts of interest or competing interests., (Copyright: © 2024 Nowakowska et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Monitoring of meningitis and/or encephalitis regardless of etiology is part of routine epidemiological surveillance in Poland. In this study, we discuss in detail meningitis and/or encephalitis in 2022 caused by Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, and tick-borne encephalitis virus., Objective: The aim of this study was an epidemiological assessment of the occurrence of meningoencephalitis and encephalitis in Poland in 2022, taking into account the analysis of the impact of the COVID-19 pandemic., Material and Methods: To analyze the epidemiological situation of neuroinfections in Poland, we used data sent to NIPH NIH-NRI by the Sanitary and Epidemiological Stations and published in the annual bulletins: "Infectious Diseases and Poisons in Poland in 2022" and "Vaccinations in Poland in 2022" as well as individual epidemiological interviews registered in the EpiBase system., Results: In 2022, a total of 1747 cases of meningitis and/or encephalitis were registered in Poland. This was a 79.4% increase in the number of cases compared to 2021, when 974 cases were recorded. For infections of bacterial etiology, including cases of neuroborreliosis, the number of cases increased by 62.3% . The incidence of meningitis and/or encephalitis of N. meningitidis etiology meningitidis increased by 30.8%, with etiology of H. influenzae compared to 2021 increased by 300%, and for S. pneumoniae by 71.9%. Infections of viral etiology accounted for 52% of all registered cases. There was an increase in their number by 99.1% compared to 2021. Among viral infections, tick-borne encephalitis was the most numerous group, with 466 cases compared to 210 in 2021., Summary and Conclusions: The year 2022 showed an overall upward trend in the number of registered cases of bacterial and viral meningitis and/or encephalitis compared to 2021. Still, the observed number of cases of meningitis and/or encephalitis of both bacterial and viral origin remains below the levels observed in the period before the COVID-19 pandemic.

Background: Tularemia is a zoonotic disease caused by the bacterium Francisella tularensis. It may manifest itself in various clinical forms, but in Poland the ulcerative-glandular or glandular forms of tularemia predominate. One of the routes of infection with F. tularensis is through a tick or insect bite. A patient may show no symptoms or report flu-like symptoms and painful lumps adjacent to the bite site. The differential diagnosis of localized lymphadenopathy accompanied by flu-like symptoms should include tularemia, especially in endemic areas. Lymphadenitis usually requires surgical intervention and is often unsuccessfully treated with beta-lactam antibiotics before the diagnosis of tularemia is established., Objective: The aim of the study was to analyze and present the epidemiology and clinical presentation of tularemia in a highly endemic area, in which ticks are an important vector of F. tularensis., Material and Methods: We have analyzed epidemiological and medical reports on the confirmed tularemia cases from Hajnówka County in 2014-2022. We describe three patients from the specific endemic area who were diagnosed with granular tularemia in 2022., Results: We have found high local exposition to Francisella tularensis infection in the Narewka community, generally consistent with the seasonality of tick activity and human activity outdoors., Conclusions: The medical practitioner in such endemic areas must be aware that tularemia should be considered when diagnosing of flu-like symptoms accompanied by lymphadenopathy in patients bitten by ticks or insects in the summer and early autumn months. Early diagnosis and targeted antibiotic therapy are the basis for effective treatment of tularemia.

The article raises the issue of the quality of life (QoL) of adolescents during the COVID-19 pandemic, its relationships with coping and mediating role of the received social support (RSS). The nationwide survey was conducted from September 13, 2021 to October 1, 2021. The total of 4970 individuals aged 10-18 years old were researched in Poland. The KIDSCREEN-27, the Brief COPE by Charles S. Carver in the Polish adaptation and the Berlin Social-Support Scales were employed in the research. SPSS and PROCESS macro were used for descriptive, correlational, and mediation analyses. The results indicate the relationship between the perceived QoL (QoL) with active coping, seeking social support coping and helplessness coping. The essential mediating role of the RSS was confirmed for the relationship between coping with stress and QoL in the group of the individuals researched. The findings imply that both in daily and difficult situations, social systems of support should be activated to provide environment for optimal development of adolescents, diminish consequences of potential risk factors, and enhance the significance of protective factors., (© 2024. The Author(s).)

BACKGROUND The purpose of the study was to determine the level of antihemagglutinin antibodies in the serum of patients in the geriatric population in Doctor's Surgery NZOZ Nucleus Warsaw, Poland, during the epidemic season 2021/2022 using the hemagglutination inhibition assay (HAI), according to anti-influenza and anti-COVID-19 vaccination, age, and sex. MATERIAL AND METHODS Serum samples taken from 256 patients aged 65 to 99 years were examined for anti-hemagglutinin antibodies and protective levels of antibodies against antigens: A/Victoria/2570/2019 (H1N1)pdm09, A/Cambodia/e0826360/2020(H3N2), B/Washington/02/2019 (B/Victoria lineage), and B/Phuket/3073/2013 (B/Yamagata lineage) of the quadrivalent influenza vaccine for epidemic season 2021/2022. RESULTS The highest protective level, ie, the percentage of people with antibody titers ≥40 was 87.5% and was recorded for subtype A/Cambodia/e0826360/2020(H3N2), the dominant type causing infections in the epidemic season 2021/2022 confirmed by molecular biology methods. Geometric mean titer (GMT) values and protective levels for B/Washington/02/2019 (B/Victoria lineage) antigen were higher for men than women (respectively 38.4 vs 67.6; P<0.001 and 58.0% vs 74.6%; P<0.001). The protective levels of antibodies among patients vaccinated vs unvaccinated against COVID-19 were higher for B/Washington/02/2019 (B/Victoria lineage) and B/Phuket/3073/2013 (B/Yamagata lineage) antigens (64.2% vs 44.4%; P=0.023 and 78.6% vs 55.6%; P=0.004). GMT values for vaccinated against COVID-19 were also higher. There were no significant differences between younger (65-79 years) and older (≥80 years) seniors. CONCLUSIONS The analysis shows differences in the level of individual antibodies, GMT and the protective level depending on subtypes of influenza A or B virus, B/Victoria or B/Yamagata lineage, sex, and previous vaccination history against influenza and COVID-19.

Background: The number of late diagnoses of HIV remains very high in Poland, leading to a high proportion of patients developing and dying of HIV-related diseases. The main reason for this is the very low utilization of HIV testing. Our analyses aimed to investigate knowledge about the indications for HIV testing among medical university students, as well as identify their own HIV testing experiences., Material and Methods: A cross-sectional survey study was designed to collect information on the students' demographics and their experiences of HIV testing, as well as their knowledge of virus transmission and the indications for testing. Data were collected as part of the HIV&#95;week@WUM project conducted at the Medical University of Warsaw in parallel with the 18th European AIDS Conference, which took place in Warsaw between 18 and 21 October 2023., Results: In total, 545 questionnaires were collected. The median age of the study participants was 20 (interquartile range (IQR): 19-22 years). The majority of respondents were as follows: women (67.5%), born in Poland (97.8%), and were attending the medical faculty (56.7%). Only 114 (21.43%) participants had ever been tested for HIV. For all modes of HIV transmission, most of the respondents overestimated the risk of acquiring HIV, but, at the same time, they had never been tested for HIV., Conclusions: Only one in five health sciences students has ever had a test for HIV, which is less than estimates for the general population of Warsaw. There is an ongoing need to popularize testing among future health care providers in order to address both the indications for testing for individuals and the better use of HIV testing in clinical practice.

Background: The association of sarcopenia and frailty syndrome with dietary patterns is not yet well recognized., The Aim: The aim of the study was to evaluate the association among dietary patterns, suspected sarcopenia, and frailty syndrome among older people in Poland., Methods: The study was conducted in 2022 and 2023 among people aged 55 and older. The sample was chosen arbitrarily. The following questionnaires were used in the study: the KomPAN (assessment of frequency of food intake and sociodemographic characteristics), the SARC-F (assessment of risk of sarcopenia), and the EFS (diagnosis of frailty syndrome). To confirm the suspicion of sarcopenia, muscle strength was assessed using the HGS and FTSST, and physical fitness was assessed using the GST. Based on the frequency of food consumption, 11 DPs (factors) were selected using PCA analysis. SARC-F, HGS, FTSST, and GST results were used to identify homogeneous groups (clusters) using cluster analysis, a k-means method., Results: Two clusters were identified: cluster 1 (the non-sarcopenic cluster, or nSC) and cluster 2 (the sarcopenic cluster, or SC). Associations between variables were assessed using logistic regression. Suspected sarcopenia was found in 32.0% of respondents, more in men than women, and more among those either over 75 or 65 and under. EFS results showed that the risk (22.1%) or presence of frailty syndrome (23.8%) was more common in men than women and more common in those aged 75 and older than in other age groups. Male gender; older age; and unfavorable dietary patterns, i.e., consumption of white bread and bakery products, white rice and pasta, butter, and potatoes (factor 1) and cheese, cured meat, smoked sausages, and hot dogs (factor 9), increased the likelihood of sarcopenia and frailty syndrome, while the pattern associated with fruit and water consumption (factor 7) had the opposite effect., Conclusions: Confirmation of the importance of dietary patterns in the etiology and pathogenesis of sarcopenia and frailty syndrome should be documented in prospective cohort studies.

The HIV (Human Immunodeficiency Virus) epidemic remains a significant public health issue, requiring ongoing access to preventive methods. This study aimed to analyze the evolution of the HIV epidemic in Lower Silesia from 2010 to 2020, focusing on the key populations. A retrospective analysis of the medical records from newly diagnosed HIV patients at a major HIV clinic in Wroclaw was conducted, examining demographic data, infection routes, and laboratory results. An 84% increase in newly diagnosed HIV cases was observed over the decade, with the most common route of infection being sex between men (70% among those with a known infection route). These patients were generally in better clinical condition compared to their heterosexual counterparts, as indicated by a higher median CD4+ T cell count (465/μL vs. 250/μL). The changes in clinical status and infection routes were statistically significant. The HIV epidemic in Lower Silesia has shifted, with a notable rise in new infections among men who have sex with men. Heterosexual patients were often diagnosed at more advanced stages. Prevention strategies should adapt to these changing trends, with education and testing accessibility remaining priorities nationwide.

Objectives: The aim of this work is to initiate or revive a scientific discussion on the impact of professional life on the parameters of human lifespan., Material and Methods: Presented analysis is based on 8578 Polish elite or well-known person who died in 2001-2021., Results: The results of the conducted analysis indicate that in the case of men the highest values of the median age at death were characteristic of freelancers (median [Me] ± quartile deviation [QD] 85.5±8.5 years), followed by scientists and academic teachers of the biological and medical specialty (Me±QD 84.0±7.5 years) and officers of power structures (Me±QD 83.5±8.5 years). Subsequently, the highest value of the median age at death was recorded for social activists (Me±QD 83.0±9.5 years), clergy (Me±QD 82.0±7.5 years) and scientists and academic teachers of specialties other than biological and medical (Me±QD 82.0±8.0 years). Significantly, at the very end of this list are athletes (Me±QD 77.0±9.0 years). Nevertheless, the results of the analysis confirm that professional athletes are characterized by higher median age at death compared to the general population. Analysis made only within athletes group demonstrated that the parameters of lifespan of athletes of endurance disciplines (Me±QD 78.0±8.0 years) are the most favorable compared to athletes of other disciplines, in particular in compare to team sports athletes (Me±QD 75.0±10.0 years) or combat sports athletes (Me±QD 75.0±7.1 years)., Conclusions: What is new and innovative in this paper is comparing the lifespan characteristics of athletes in comparison to widely represented group of other professions with higher socio-economic status. Unexpectedly, the lifespan of athletes occurred to be lower than for fast all other analyzed occupational groups, except mainly of entertainment musicians. Finally, the results presented in this paper emphasize the need to analyze the lifespan characteristics of athletes in a broader scope than only in relation to the general population. Int J Occup Med Environ Health 2024;37(3):335-50., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objectives: Monitoring tobacco use is one of the most important tobacco control interventions recommended by the World Health Organization. This study aimed to assess the prevalence of cigarette smoking, e-cigarette use, and heated tobacco use in a nationwide sample of adults in Poland, as well as to identify factors associated with smoking, e-cigarette use, and heated tobacco use., Material and Methods: This nationwide crosssectional survey was carried out in February 2-4, 2024 using the computer-assisted web interviewing method. The study questionnaire included 17 closed questions on smoking, e-cigarette use, and heated tobacco use. A sample of 1080 adults was selected using a non-probability quota sampling method., Results: Data were collected from 1080 adults, age M±SD 48.4±15.5 years, 53% females. Past 30-day smoking was declared by 30.4% of adults in Poland, including 24.5% of daily smokers. Ever e-cigarette use was declared by 33% of respondents, and 20.6% had ever tried heated tobacco. Past 30-day e-cigarette use was declared by 15.2% of adults, wherein 5.9% were daily e-cigarette users. Past 30-day heated tobacco use was declared by 10.9% of respondents, wherein 4.9% were daily heated tobacco users. One-tenth of adults were dual users (cigarette and e-cigarette or heated tobacco), and 6.5% were past 30-day triple users. Age 40-59 years, having less than higher education, and bad economic status were significantly associated with daily smoking (p < 0.05). Age 18-39 years, having less than higher education, and active occupational status (employment/ self-employment) were associated with daily e-cigarette use (p < 0.05). Age 18-39 years and active occupational status were associated with daily heated tobacco use (p < 0.05)., Conclusions: This study provides comprehensive epidemiological data on the current prevalence of smoking, e-cigarette use, and heated tobacco use. The introduction of e-cigarettes and heated tobacco products evoked changes in social behaviors related to nicotine use. Int J Occup Med Environ Health. 2024;37(3):271-86., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

The COVID-19 pandemic compromised the principles underlying the functioning of public health, which is understood as the prevention of diseases and care for the health of entire communities. During the pandemic period, the efforts of the health system focused on patients with suspected infection and those infected with the SARS-CoV-2 virus, which led to changes in the provision of health services and the characteristics of patients receiving medical services at the pre-hospital stage. The objective of this study was to investigate the effects of the COVID-19 pandemic on potential health emergencies in paediatric patients based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The data used in the study were derived from interventions carried out by Emergency Medical Teams (EMT) in central and eastern Poland, involving patients who were under 18 years of age ( n  = 12,619). The data were collected from 1 January 2017 to 31 December 2022. The study used descriptive statistics, the Mann-Whitney U Test, and the Chi-square test. The study reveals that fewer paediatric patients (5.28%) were provided medical services by EMTs during the COVID-19 pandemic compared to the pre-pandemic period (5.86%). There was a decrease in the number of injuries in paediatric patients (from 42.0 to 32.7%; p  < 0.001), and more patients were left at the location from which the call was made (18.9 vs. 23.9%; p  < 0.001). Moreover, during the pandemic, as compared to the pre-pandemic period, there was an increase in the number of cases of pre-hospital assistance provided to paediatric patients with fever, irrespective of gender, area (village, city) or patient age. During the pandemic, paediatric patients consumed alcohol more frequently. The age of patients who were provided with assistance by EMTs decreased (median of 10.0 vs. 9.0; p  < 0.001). The COVID-19 pandemic brought about changes in the prevalence of potential health emergencies in children. The incidence of injuries decreased, while the number of interventions due to fever and alcohol consumption increased. There was a reduction in the number of patients transported to the hospital. In addition, the age of patients who received medical assistance decreased. The study shows health problems that were faced by paediatric patients during the COVID-19 pandemic and, therefore, can be helpful in preparing the healthcare system for emergency situations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mitura, Celiński, Snarska and Szajda.)

Background: The available data on the relationship between diet/folic acid and congenital heart disease (CHD) are not consistent. This study aimed to investigate the relationship between the intake and supplementation of folic acid and other selected factors in mothers and the risk of congenital heart defects in fetuses., Methods: A case-control study was conducted. The study group included pregnant women with fetuses from singleton pregnancies with prenatally diagnosed heart defects in the fetus ( n = 79) and pregnant women whose course of pregnancy was normal with no heart defects or other developmental anomalies diagnosed in the fetus ( n = 121). The patients were diagnosed at a reference center in Poland. The women completed a lifestyle questionnaire and FFQ and precisely described their use of dietary supplements. A univariate logistic regression model was used to evaluate the association between folic acid and selected risk factors and CHD. The association was significant and included such risk factors such as nutritional status, medications taken, smoking, and alcohol consumption. Additionally, the time of starting folic acid supplementation turned out to be statistically significant. The reference period of supplementation was the period before pregnancy., Results: Lack of supplementation increases the risk of heart defects in children by more than four times compared to supplementation before pregnancy (OR = 4.19; p = 0.0117), whereas supplementation beyond the eighth week of gestation increases the risk almost threefold (OR = 2.90; p = 0.0474). The presence of congenital defects in the family is also an important factor., Conclusions: A history of congenital heart defects or other defects, lack of periconceptional folic acid supplementation, and lack of dietary supplementation before pregnancy were associated with congenital heart defects in the fetus. Place of residence, parents' education, lifestyle habits such as smoking and alcohol consumption, nutritional status before pregnancy, and mother's diseases did not show a significant relationship with congenital heart defects in the children. There is an urgent need to develop preventive strategies and conduct extensive public education.

Melanoma is a malignant tumor with the highest growth rate in the incidence and is the leading cause of death due to skin cancers. In Poland, approximately 1500 cases of melanoma are detected annually in advanced or metastatic stages. Intensive preventive measures can contribute to its early-stage diagnosis, consequently reducing the number of fatalities. The aim of the study was to assess the occurrence of melanoma risk factors among the residents of Silesia region and their knowledge about the diagnosis and prevention of this cancer. An original questionnaire was used in the study, and its completion was anonymous. The study was conducted among the residents of the Silesian Voivodeship. A total of 400 (100%) individuals were examined. Among them were 243 women and 157 men. The participants' ages ranged from 16 to 84 years (mean age = 34.38 ± 18.39). The participants were burdened with melanoma development risk factors such as fair skin complexion (235; 58.75%), having more than 50 pigmented lesions (158; 39.50%) and sunburns (105; 26.25%). Over 40% (166; 41.50%) of the participants had never examined their pigmented lesions. A staggering 78% (311; 77.75%) of the respondents had never undergone dermatoscopic examination, and over 50% (215; 53.75%) did not know what this examination entailed. Just under 16% (63; 15.75%) of the participants stated that their family doctor had examined their pigmented lesions, and almost % (154; 97.47%) of those with numerous pigmented lesions had never been referred to a dermatologist for dermatoscopy. The surveyed residents of the Silesian Voivodeship were burdened with numerous risk factors for melanoma development, with the most common being fair skin complexion, having more than 50 pigmented lesions, and sunburns. The knowledge of the participants regarding the diagnosis and prevention of melanoma development was insufficient, thus highlighting the necessity for conducting systematic educational initiatives in the mentioned field. These initiatives should ultimately lead to the preservation of health and life, as well as the maintenance of its high quality., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Obesity is a complex disease with numerous health complications, influenced by factors such as genetics, lifestyle, mental health, societal impact, economic status, comorbidities, and treatments. This multicenter study included adults aged ≥35 years referred to a CVD prevention program, where sociodemographic data, anthropometric examinations, laboratory tests, and HLPCQ responses were collected. The study analyzed 1044 patients with a mean age of 47.9 years. Among them, 22.2% (232 patients) were diagnosed with obesity. These patients exhibited higher blood pressure, non-HDL cholesterol, triglycerides, and glucose levels (all p < 0.001). A comparative analysis showed that obese patients had significantly lower scores in healthy dietary choices, dietary harm avoidance, daily routine, organized physical exercise, and overall HLPCQ scores. These results indicate that individuals considered healthy were actually living with obesity and its associated complications. Consequently, family physicians should proactively identify patients at risk of obesity using existing programs. The Polish healthcare system urgently needs systemic solutions, including effective health promotion and the creation of obesity prevention programs at an early stage of adult life. These measures are essential to address the growing obesity epidemic and improve public health outcomes.