192 results on '"Szybiński Z"'
Search Results
2. Prevalence of medullary thyroid cancer in the endemic goiter area
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Szybiński, Z., primary and Mazurek, E., additional
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- 1992
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3. Influence of iodine deficiency and iodine prophylaxis on thyroid cancer histotypes and incidence in endemic goiter area
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Huszno B, Szybiński Z, Przybylik-Mazurek E, Stachura J, Trofimiuk M, Buziak-Bereza M, Filip Gołkowski, and Pantoflinski J
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Adult ,Male ,Endemic Diseases ,Goiter ,Incidence ,Middle Aged ,Age Distribution ,Humans ,Female ,Poland ,Preventive Medicine ,Thyroid Neoplasms ,Sex Distribution ,Deficiency Diseases ,Aged ,Iodine - Abstract
The aim of the study was to evaluate the correlation between thyroid cancer histotype and incidence rate (IR) and iodine nutrition level in two endemic goiter areas: the districts of Krakow and Nowy Sacz. The suspension of iodine prophylaxis in Poland in 1980 resulted in increased goiter prevalence in schoolchildren and adults and elevated TSH levels in newborns in the early 1990s. Since 1992 a rise in thyroid cancer IR was observed. Thyroid cancer IR in the Krakow population was 2.22 in 1986; 3.62 in 1995 and 6.02 in 2001; in Nowy Sacz: 1.52; 2.59 and 3.88 respectively. In 1986 papillary/follicular cancer ratio in both areas was about 1.0--the value typical of iodine deficient areas. After restoring the obligatory iodine prophylaxis in 1997, a significant decrease in elevated TSH concentration in newborns and urinary iodine concentration increase in schoolchildren were observed. A relative rise in the incidence of papillary thyroid cancer and decrease in follicular cancer, resulting in rise in papillary/follicular thyroid cancer ratio up to 5.9 in 2001 was also observed. Since 1999 no further thyroid cancer IR increase was noted. In conclusion, a significant increase in differentiated thyroid cancer IR was observed in association with the iodine prophylaxis suspension. Changes in thyroid cancer histotypes in 1986-2001 and a significant decrease in incremental rate of differentiated thyroid cancer probably reflect the influence of effective iodine prophylaxis. The significant difference between IR of thyroid cancer incidence in the districts of Krakow and Nowy Sacz may be related to differences in the exposure to radiation after the Chernobyl accident.
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- 2003
4. Iodine-induced hyperthyroidism--an epidemiological survey several years after institution of iodine prophylaxis in Poland
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Lewiński, A., Szybiński, Z., Bandurska-Stankiewicz, E., Grzywa, M., Karwowska, A., Kinalska, I., ALDONA KOWALSKA, Makarewicz, J., Nauman, J., Słowińska-Klencka, D., Sowiński, J., Syrenicz, A., Zonenberg, A., Huszno, B., and Klencki, M.
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Adult ,Dose-Response Relationship, Drug ,Incidence ,Biopsy, Needle ,Thyroid Gland ,Middle Aged ,Health Surveys ,Hyperthyroidism ,Iodide Peroxidase ,Thyroglobulin ,Humans ,Poland ,Preventive Medicine ,Radionuclide Imaging ,Aged ,Autoantibodies ,Iodine ,Ultrasonography - Abstract
In 1997, the obligatory model of iodine prophylaxis was introduced in Poland in order to correct the existing status of mild and/or moderate iodine deficiency. In order to monitor possible side-effects of increased iodine supply, studies on iodine-induced hyperthyroidism were initiated by establishing several regional registers of hyperthyroidism. In the present paper, the results of a two-year monitoring (2000-2001) have been summarized. There are no epidemiological data on hyperthyroidism prior to starting the iodine prophylaxis, but the obtained current data are comparable to observations in other countries, made after iodine supplementation. The incidence of iodine-induced hyperthyroidism did not exceed the acceptable level, thus confirming--together with previous observations on the effectiveness of iodine prophylaxis--the adequacy of applied dose of KI (30 microg/kg NaCl), used for salt iodization in Poland.
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- 2003
5. [Pituitary function after transsphenoidal surgery for pituitary adenoma]
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Filip Gołkowski, Trofimiuk M, Huszno B, Bałdys-Waligórska A, Szybiński Z, Czepko R, and Danilewicz B
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Adenoma ,Adult ,Male ,Pituitary Gland ,Humans ,Female ,Pituitary Neoplasms ,Middle Aged ,Diabetes Insipidus ,Hypopituitarism ,Hypophysectomy - Abstract
Nowadays transsphenoidal surgery is the method of choice in most cases of pituitary adenoma treatment, both functioning and non-functioning. This method is considered to be safer than transcranial approach, as lower incidence of complications, particularly hypopituitarism, is observed. The aim of the study was to evaluate the pituitary function after transsphenoidal surgery. 20 patients (mean age 49.3 +/- 13.9 years) were included into the study. The anterior pituitary insufficiency was defined as an inadequate excretory response to metopirone, LH-RH and TRH stimulation. Diabetes insipidus was diagnosed based on clinical symptoms. Hypopituitarism was diagnosed after surgery in 7 patients, 3 cases had adrenal and gonadal insufficiency, 1 patient had insufficiency of the pituitary-thyroid and gonadal axis and 3 subjects panhypopituitarism. Diabetes insipidus was still present in 2 patients, 3 months after surgery. We conclude that transsphenoidal approach in pituitary adenoma surgery is connected with low risk of iatrogenic hypopituitarism.
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- 2002
6. Goiter incidence and urinary iodine excretion in children of age group 6-13 years living in south-eastern Poland (Kraków coordinating center)
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Rybakowa M, Tylek D, Ratajczak R, Antoń A, Skalski M, Przybylik-Mazurek E, Huszno B, Filip Gołkowski, Tarnawski A, and Szybiński Z
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Male ,Adolescent ,Incidence ,Thyroid Gland ,Humans ,Female ,Poland ,Child ,Goiter, Endemic ,Iodine ,Ultrasonography - Abstract
The study included 4103 school children attending randomly selected schools localized in towns and villages of 3 geographically distinct regions: mountainous, (Carpathian endemia), upland, lowland. The children were divided into four age-related groups. The incidence of goiter as detected by palpation was 38.1% in all the children studied, the value being similar in all three regions (38.1, 37.3 and 38.6%, respectively). Goiter incidence differs slightly among urban and rural children, amounting to 40.5 and 34.5%, respectively, in the two groups. In about 60% of children urinary iodine excretion was lower than 50 micrograms/l, while in about 30% it was normal. In about 10% of children studied urinary iodine excretion was lower than 20 micrograms/l. The results obtained indicate the occurrence among children of the studied region of goiter endemy of moderate degree. It was found that the percentage of children excreting more than 50 micrograms/l of urinary iodine was higher among those consuming iodized salt as compared to those consuming non-iodized salt. The first effects of resumption of common salt fortification with iodide in southern Poland can already be noted. There is, however, a need for optimization and steady control over this prophylactic action.
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- 1993
7. THE PREVALENCE OF THE METABOLIC SYNDROME USING THREE PROPOSED DEFINITIONS. POLISH MULTICENTER STUDY ON DIABETES EPIDEMIOLOGY (PMSDE)
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Szurkowska, M, primary, Gilis-Januszewska, A, additional, Pach, D, additional, Szafraniec, K, additional, and Szybiński, Z, additional
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- 2005
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8. Chronobiological Analysis of Changes in Circadian Rhythm of Anterior Pituitary Hormones Level During Glycemia Normalization by Means of Biostator.
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Sieradzki, J., Stanuch, H., Gołda, W., and Szybiński, Z.
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- 1987
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9. The Macrophage in the Antibody-Mediated Suppression of the Humoral Response.
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Pryjma, J., Ptak, W., Szybiński, Z., and Sarnowicz, Krystyna
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- 1972
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10. Work of the Polish Council for Control of Iodine Deficiency Disorders, and the model of iodine prophylaxis in Poland
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Szybiński Z and Polish Council for Control of Iodine Deficiency Disorders
11. Results of epidemiologic studies performed after the disaster in Czernobyl among the adult part of the population in the region of Krakow,Wyniki badań epidemiologicznych podjetych po awarii w Czarnobylu wśród dorosłej cześci populacji regionu krakowskiego
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Szybiński, Z., Korzeniowska, D., Przybyszowski, A., Przybyłowski, J., Skalski, M., Gołkowski, F., Stanuch, H., and Wiśniowski, Z.
12. [Neurological disturbances in the course of glucagonoma: a case report]
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Filip Gołkowski, Trofimiuk M, Tomaszewska R, Huszno B, and Szybiński Z
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Adult ,Male ,Pancreatic Neoplasms ,Liver Neoplasms ,Glucagonoma ,Humans ,Coma - Abstract
A case of 40-year-old patient with glucagonoma associated with neurological and consciousness disturbances is reported. The diagnosis of the tumour was based on clinical manifestations (diabetes mellitus, anaemia, weight loss, distant metastases), visualisation (USG, CT of the abdomen) and immunohistochemical staining of the biopsy of tumour metastatis to the liver. During the progress of disease paraplegia, other neurological symptoms and three episodes of coma were observed. This should be associated with the neurologic paraneoplastic syndrome and hepatic failure due to diffuse metastases to the liver, especially when no metastases to the central nervous system were found in CT. Although patient was treated with chemotherapy, disseminated neoplasmatic process was the cause of the fatal outcome.
13. Principles, main goals and methods of the nationwide program: 'investigations on iodine deficiency and model of iodine prophylaxis in Poland'
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Szybiński, Z., Nauman, J., Gembicki, M., Rybakowa, M., Huszno, B., Gołkowski, F., Ryszard Drozdz, Stanuch, H., Starkel, L., and Skalski, M.
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Male ,Adolescent ,Thyroid Gland ,Health Promotion ,Health Surveys ,Primary Prevention ,Prevalence ,Humans ,Mass Screening ,Female ,Poland ,Child ,Goiter, Endemic ,Iodine ,Ultrasonography - Abstract
The main reasons to start investigations on IDD in Poland as a nationwide project of the Ministry of Health and Welfare sponsored by the State Committee For Scientific Research and Foundation for Polish Science were: cessation of iodizing of kitchen salt in Poland in 1980, increase of the incidence of goitre in the population and hyperthyrotropinemia in newborns, results of the survey undertaken after Chernobyl disaster indicating an increase of goiter incidence (Nauman et al.) and results of the pilot study (Gutekunst, Gembicki, Kinalska and Rybakowa) indicating an increase of thyroid volume and diminishing of iodine excretion in urine of children in Kraków, Białystok ad Poznań regions. Therefore the main goals of the project were as follows: to evaluate IDD in Poland on the population basis, to map goiter incidence and iodine deficiency in geographic areas, to evaluate a voluntary model of iodine prophylaxis in Poland (20 mg of KI/kg of salt). The investigations were carried out in 19330 children (48.7% of boys and 51.3% for girls) in age group 6-13 years, attending 111 coeducational randomly selected schools from all the country. This number represents 0.35% of children subpopulation in the above age-groups. For practical purposes local coordinating centers at the relevant Departments of Endocrinology and Board of Coordinators were set up. The programme of survey included: filling the questionnaire by children's parents, thyroid palpation and classification according to WHO and ICCIDD criteria, thyroid volume determination by means of ultrasonograph Kontron Sigma 1 L with linear transducer 7.5 MHz, determination of iodine in casual morning urine sample using Sandell and Kalthoff method. Determination of iodine concentration in urine was performed in each case of goiter and in the same number of children without goiter. The results were segregated according to coordinating centers and according to 6 geographical areas of the country. The results were calculated according to the descriptive statistics using Student's test, Chi-square test F-test and Leven's test. The results segregated according to geographic areas were tested by means of analysis of variance using the linear model. The final results of the programme are presented in the next papers.
14. Study on consequences of radioactive iodine pollution and iodine prophylaxis after the Czernobyl accident in the Krakow region,Badania nad skutkami skazenia jodem radioaktywnym i profilaktyki jodowej podjetej w wyniku awarii w Czarnobylu w regionie krakowskim
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Szybiński, Z., Rybakowa, M., Stanuch, H., Wiśniowski, Z., and Korzeniowska, D.
15. Ultrasound measurement of thyroid volume in the nation-wide epidemiological survey on iodine deficiency in Poland
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Filip Gołkowski, Szybiński Z, Huszno B, Stanuch H, and Zarnecki A
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Male ,Palpation ,Adolescent ,Incidence ,Thyroid Gland ,Health Surveys ,Cross-Sectional Studies ,Humans ,Mass Screening ,Female ,Poland ,Child ,Goiter, Endemic ,Iodine ,Ultrasonography - Abstract
Thyroid size was evaluated by ultrasonography and palpation during a study performed in 1992 and 1993 by PCCIDD. Statistical analysis was carried out in 15774 cases with thyroid volume measured by trained teams of doctors. The results were evaluated in 5 age group: 6-8, 9-10, 11-12, and 13 years. The upper limit of the thyroid volume in each age group was defined as mean for stage 0 (WHO) + 1 SD. Our upper limits of thyroid volume in age groups were: 6.1, 7.2, 8.4 and 9.1 ml, respectively. The highest frequency of goitre (according to ultrasound criteria) were in the Sudeten endemia region (53.1%), the lowest in the Seaside area (14.3%). Significant influence of age, sex, height, weight, place of living, and thyroid hormone containing drugs on thyroid size was proved. The influence of iodine prophylaxis on thyroid volume was not significant.
16. [An oligosymptomatic case of pheochromocytoma]
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Filip Gołkowski, Trofimiuk M, Huszno B, Szybiński Z, Nowak K, and Popiela T
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Adult ,Diagnosis, Differential ,Catecholamines ,Adrenal Gland Neoplasms ,Humans ,Female ,Pheochromocytoma ,Glucagon - Abstract
A case of 34-year old female with incidentally diagnosed adrenal tumour is discussed. The patient complained only of mild headaches and heart palpitations and was not previously treated for hypertension. A diagnosis of pheochromocytoma was made. The diagnostic controversies arose because of subclinical course of the disease, slightly elevated biochemical markers of pheochromocytoma (catecholemines urinary excretion) and non-characteristic result of glucagon stimulation test results. The diagnosis was confirmed by histologic examination of tumour tissue. Presented case indicates the need for thorough clinical and hormonal evaluation of patients with incidentaloma (particularly, when adrenal tumour diameter is larger than 3 cm) to avoid serious complication of surgery treatment in case of misdiagnosis.
17. [Co-occurrence of diabetic gastropathy and cardiovascular vegetative neuropathy in patients with diabetes type 1. ]
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Huszno B, Trofimiuk M, Płaczkiewicz E, Pach D, Szurkowska M, Szybiński Z, and Filip Gołkowski
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Adult ,Male ,Diabetes Mellitus, Type 1 ,Gastroparesis ,Diabetic Neuropathies ,Gastric Emptying ,Cardiovascular Diseases ,Humans ,Female ,Diabetic Angiopathies - Abstract
The occurrence of autonomic neuropathy in patients with diabetes is associated with increased incidence of cardio-vascular events and increased mortality. The character of such process is not clear yet and the question if the damage to autonomic nerves equally involves particular organs and systems is open. The aim of the study was to assess the concordance of cardio-vascular neuropathy with diabetic gastropathy in type 1 diabetic patients. The study involved 42 subjects with type 1 diabetes mellitus (age 36.7 +/- 8.3 years; duration of the disease 14.8 +/- 33 years). Gastric emptying of solid food was assessed scintigraphically. T1/2 max and residual isotope activity (expressed as the percentage of initial value) at 45th minute of the study were estimated. Autonomic cardio-vascular neuropathy was assessed based on the Ewing battery tests results.11 of all subjects (group A) showed normal or increased gastric emptying of solid foods (T1/2 max 36.6 +/- 9.3 min, residual activity 39.6 +/- 12.1%) and 31 remaining subjects (group B) demonstrated delayed gastric emptying (T1/2 max 89.2 +/- 11.4 min, residual activity 74.6 +/- 5.2%), which was regarded as diabetic gastropathy symptom. 31 (74%) of all subjects were diagnosed with cardio-vascular neuropathy, 18 of them (43%) showed early autonomic neuropathy and remaining 13 (31%) presented decided cardio-vascular neuropathy. In group A2 (18%) subjects were diagnosed with early and 5 subjects (45%) with decided neuropathy. In group B early and decided autonomic neuropathy was present in 16 (51%) and 8 (26%) subjects. No statistically important difference between both groups was found.The results of the study support the thesis of a disseminated nature of the diabetic autonomic neuropathy and of not concomitant involvement of autonomic nervous system in particular organs and systems of the human body.
18. [Results of epidemiologic studies performed after the disaster in Czernobyl among the adult part of the population in the region of Krakow]
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Szybiński Z, Korzeniowska D, Przybyszowski A, Przybyłowski J, Skalski M, Filip Gołkowski, Stanuch H, and Wiśniowski Z
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Adult ,Male ,Adolescent ,Incidence ,Urban Health ,Rural Health ,Iodides ,Middle Aged ,Humans ,Female ,Poland ,Radioactive Hazard Release ,Ukraine ,Goiter, Endemic ,Iodine ,Power Plants - Abstract
Epidemiologic studies following the Czernobyl accident were performed in region Kraków, including Kraków, Nowy Sacz and Kielce district. 1426 males and 2495 females were selected according to the random sample on the whole population of Kraków and Nowy Sacz, as well as in some selected areas in Swietokrzyski Mountains, and in Kielcecity. The aim of the study was to assess the results of the prophylaxis with Kalium iodine after the radiation and the incidence of the goiter in the population. It was stated, that 19.2% of the population in Kraków district, 16.9% in Nowy Sacz and 20% in Kielce received the prophylactic dosis of K.J. 80% took mainly the Lugol solution, between May, the 1st and 5th, 1986. Among 18 of person showing side effects like gastrointestinal disturbances, 16 were of female sex. Goiter incidence according to WHO classification was 50.7%, 67.3% and 49.9% in Kraków, Nowy Sacz and Kielce respectively. The difference between the incidence of goiter in males and females was 1:3. In women it was rather Ist and IInd degree of goiter, in men OB and Ist. Nodules of thyroid gland in the rural region of Kraków, Nowy Sacz and Kielce were seen in women in 10.8%, 1.7%, add 12.3% consecutively. Hormonal studies i.e T3, T4, TSH serum concentration showed normal results in all groups studied. TSH concentration was the highest in the group OB. The microsomal and antithyroglobulin antibodies level was the same independently on the prophylactic dosis of Lugol solution. The high incidence of thyroid diseases not related to the accident was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
19. Polish multicenter study on diabetes type 1 incidence in the age group 0-14 between 1998 and 1999,Wieloośrodkowe badania nad zapadalnościa̧ na cukrzycȩ typu 1 w grupie wiekowej 0-14 lat w Polsce w latach 1998-1999
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Szybiński, Z., Dziatkowiak, H., Wa̧sikowa, R., Kinalska, I., Korman, E., Grzywa, M., Korniszewski, L., Trippenbach, H., Bandurska-Stankiewicz, E., Pach, D., Płaczkiewicz, E., Ciechanowska, M., Bieniarz, J., Irina Kowalska, Stankiewicz, W., Sobel-Maruniak, A., Orłowska-Florek, R., Staniszewski, A., Symonides-Ławecka, A., Dziubińska-Kolender, E., Kiełtyka, A., and Walczycka, L.
20. Effect of Medical Vagotomy on Acid and Pepsin Responses to Histamine and Pentagastrin in Man
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Konturek, S. J., primary, Szybiński, Z., additional, and Horzela, T., additional
- Published
- 1967
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21. Effect of myocardial revascularization on global and regional right and left ventricular function
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Bacior, B, Grodecki, J, Hubalewska-Hola, A, Królikowski, T, Szot, W.M, Kubinyi, A, Szybiński, Z, and Kawecka-Jaszcz, K
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- 1999
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22. 40(th) EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004
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S. Artigas, A V Dreval, Mark I. McCarthy, C Watson, Peter H. Bennett, M Quint, Y Ikeda, E Alpert, F Schiele, H Sekihara, Erik Gylfe, P Lowe, J Kuhlmann, Alain Golay, V Longo, Shahidul Alam Khan Akm., L G Mantovani, M Zawodniak-Szalapska, G Winkler, T Harrity, L Virág, U Johne, Kuo S-W., Linda C Tapsell, J Rodriguez, Michel Komajda, K Kankova, Carole A. Cull, M Sporna, E Estilles, U Ribel, M C Spruce, E Buzzigoli, T Prazak, J K McLaughlin, M K Lingohr, M Lim, F Calara, A Siebenhofer, G Meregalli, Roberto Anichini, A D Baron, R Kurashvili, P C Butler, G I Fantus, T. E. De Gooyer, Park Y-M., R. Walther, S Heinrich, Agnieszka Zawiejska, S Mukherjee, Nikolaos Papanas, G Wong, Ian D. Caterson, David M. Maahs, Shuichi Kaneko, Alexandra E. Butler, Francisco Javier Ampudia-Blasco, O N Kong, Attali J-R., C A Hedman, K Oshinyemi, Nicolle Müller, I C Cranston, N Okumus, M V Vlaiculescu, Balasubramanian Ravikumar, W W Cheatham, K Mukasa, K B Biswas, Annunziata Lapolla, Phil McEwan, G Mader, Gilles Chassot, Dragi Anevski, Werner A. Scherbaum, M Donath, C Hesselmann, R A Gandhi, David E. Moller, Ezio Bonifacio, C Garcia, V Ifandi, P Hornnes, Nieuwenhoven Fav., C Puech, S Pérez-Del-Pulgar, Kim S-R., G Hines, C Rubio Terrés, Michael Gaster, N. Hosszufalusi, A Scholze, Andrew A. Young, Stavros Liatis, F Hariri, S Tan, Paul Valensi, Allan E. Karlsen, J Kim, E. Moberg, J Kaiser, L Berman, G Nelson, A Altkrüger, P Kothare, D B Cook, S Doran, G. van Dijk, Shahnaz Shahinfar, Kim C-S., P Stahl, M Manousaki, S Sigrist, S K Lim, M. P. Stern, A Guberti, C Rezzani, J McKenney, Karl Thomaseth, Sofia Carlsson, M Julia, R Brillante, I Rubesova, T Darkow, E Matsumoto, Wendy M. Macfarlane, M Di Martino, G Bardini, Rossella Menghini, D Duhot, E Farcasiu, Annalisa Natalicchio, I Lindner, J Buvat, Christian L. Brand, Harry Dorchy, Iwona Pietrzak, Z T Luo, P Home, M Ekelund, Jesper Gromada, Kristine Færch, F Piarulli, H Kim, R Mentel, Zsuzsanna K. Zsengellér, Dullaart Rpf., Anton Luger, Thomas A. Pearson, V Manicardi, P Rösen, Feng Y-M., R Morganti, Lars Hansen, Demuth H-U., Haruo Kasai, A Shostak, Rudi Steffensen, G Taylor, Markolf Hanefeld, C Santini, E Hamaguchi, Roberto Miccoli, F Storms, M Cooper, Y Lee, Allison E. Aiello, P Smith, T Suehiro, K Treece, M Waluś, Timothy A Welborn, Simone Baltrusch, E Kontela, S Chai, J Crean, H Yokoyama, Johan G. Eriksson, Rafael Hernández Hernández, J Rodríguez-Saldaña, M P Tornero, G Formoso, D. Lovell, E Bingham, A Mylonakis, M Manteghetti, D Fedele, Antonio Martín-Duce, Ralph A. DeFronzo, D Salcedo, Kurt Højlund, Antonio Petrone, Sheu Whh., C Gutierrez, Flavia Pricci, S Kurita, Z G Abbas, M M Benedetti, Philippe A. Halban, Daniel J. Cox, O Ljungkvist, Justine Davies, J Palsgaard, Lars Sjöström, E Bosi, L Janin-Manificat, W. F. Kelly, M. Fernandez, E Colak, O V Mulyarchik, B Kronshage, F Lang, M Erfurth, Takashi Kadowaki, N Jendrike, U Walter, J Wishart, Y. Neye, D Kim, N Furuhashi, M Barsotti, D Florow, L Ke, L Borgquist, N C Jackson, Ffolliott M. Fisher, V Baskar, K Yoshioka, Bryan A. Wolf, G Chabrier, R Skoumal, Livio Luzi, H Kose, I Pharisien, B. Klein, H Winiarska, M C Johnson, L Griffiths, Nonna Kravchun, C Combe, Baptist Gallwitz, J Zdychova, L Skorda, Jorma Ilonen, W Gao, I N Steen, A Terrinoni, P D Ambery, W Kern, C M Kusminski, Cho M-H., Paolo Pozzilli, Louise G. Grunnet, E Schönle, David R Matthews, Robert W. Taylor, Y Cohen, Kim H-S., M P Eccles, N B Tutuncu, D McDowell, Richard M. Bergenstal, K Takamatsu, T Steiner, Jaan Palgi, Valdemar Grill, N Niculescu, G Federici, S Lehto, P. M. McKeigue, M Barone, Michael E. Trautmann, S Smirnov, J Mannion, M Eto, C Rousseau, M Conti, C S Ernest, Antonio Ceriello, D H Schweitzer, Jung E-D., Andreas Festa, Avijit Lahiri, A Shepelkevich, A Murro, A Kollmann, Jonathan R.S. Arch, R Landgraf, Son H-Y., I Engelsberger, E Agardh, S Rodríguez-Mulero, P J Kraml, K Lee, D. F. Du Toit, E Kim, G Fadini, Williams Ajk., Philip Home, M B Antcieferov, C Perlemoine, D Perrea, Song X-L., D Ruggieri, Krister Bokvist, Heidi Sørensen, Bilbao, G Yoshino, J P Taylor, Shen H-M., S M Furier, R Urquhart, J Wohlgelernter, Jianping Weng, T. Baba, Q Hong, C Silva, Castaigne J-P., M Felaco, X X Zhang, M Jaroň, Milla Rosengård-Bärlund, J G Papp, Toshio Miyata, Lervang H-H., Park M-K., I Kinalska, A Long, Oomen Phn., N Kogawa, Ippolita Patrizia Patera, S. Karadeniz, Dinesh Selvarajah, D S Chung, A Wensaas, Richard Imrich, M Recasens, J Ruxer, O Buchea, E Wilpart, S P Stepanenko, Le Ttd., H Ohgawara, Mariaconsuelo Valentini, A Mondok, M Peltonen, Marianne O. Larsen, K Chatzianagnostou, Agneta Ståhle, A L Ferrari, L Bordier, F Maingrette, A Matsuda, G Vukomanovic, Jakob D. Wikstrom, T Yamakita, E Gorostiaga, J Jin, B Gopalan, Heinz Drexel, S Hewitt, Rury R. Holman, C Dieterle, T L Ruchti, N Asatiani, M Sidira, A Iezzi, A J Sommerfield, D Châtenet, M L Olsen, R Bergemann, C Koehler, T L Kuraeva, B Balas, Christian Berne, E Santos-Mazo, G Smith, A Siejka, R Kožnarová, A Mattina, S Sheikh, A Adomeit, M Rasmussen, J. Fagerudd, N Busciantella Ricci, Nuria Vilarrasa, E Hammar, T L Thoms, L Aydın, Ron G. Rosenfeld, A Nikolajuk, R Gos, C L Morgan, H L Yu, D Dheelchand, S Ramrath, N Boudriga, Jerome I. Rotter, C Jahannault, W M Weston, Folke Lindgärde, M Hertlova, D Knight, A Monroy-Mayorga, E Pardini, A Chamson-Reig, B Franke, Janie McCluskey, Joseph Bryan, C Nikolopoulou, Christie M. Ballantyne, Fausto Santeusanio, L Pegoraro, M Lee, A Klimenko, S Jaiveer, K. Pettersson-Fernholm, Michael A. Nauck, A Ekbom-Schnell, G Deferrari, Riccardo Schiaffini, S. Pampanelli, Khan Aka., David Hopkins, Maija Wessman, M Kamarinos, Noh J-H., O Ebisui, K McCarroll, Jeppe Sturis, Peter Nowotny, N Gorbenko, Åke Sjöholm, David G. Maggs, A E Halseth, B Cresci, A A Ortiz-Gress, A Korakovouni, O Matejkova, C E Mogensen, C J Lin, Ramon Gomis, H Seaman, C Granier, Yang C-H., F Assah, O Sanchez, Fausto Machicao, Peter G. Morris, Alberto Ortiz, A Giardinelli, D Bracaglia, A Gonzalo, S Pavlatos, Andreas Lechner, F Canovic, L Sjolind, Allan Vaag, Birgitte Bruun Nielsen, David A. Ziegler, Vito Lampasona, R Gershoni-Baruch, A. Dei Cas, H Renz, E Mena, Matthew Waltham, Kim D-M., H Levanen, D D Mick, Valentina Alexandrovna Peterkova, E Meskhishvili, Sarah Nutland, R Bustani, John R. 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Chipchase, S, Treece, K, Pound, N, Hill, N, Cyganek, K, Mirkiewicz sieradzka, B, Malecki, M, Wolkow, P, Skupien, J, Naskalska, A, Sieradzki, J, Tapp, R, Tonkin, A, Harper, A, Mccarty, D, Söderberg, S, Taylor, H, Chitson, P, Alberti, G, Sheetz, M, Aiello, L, Davis, M, Milton, R, Arora, V, Hu, K, Girach, A, Vignati, L, Tyrberg, M, Melander, A, Lindblad, U, Giannarelli, R, Coppelli, A, Sartini, M, Aragona, M, Fletcher, E, Ninkovic, S, Foster, L, Jones, D, De Gooyer, T, Stitt, A, Vingrys, A, Wilkinson berka, J, Lewandowska, A, Randeva, H, Komorowski, J, Lewandowski, K, Jurowski, P, Sankar, S, Gos, R, Kowluru, R, Odenbach, S, Shinn, S, Agardh, C, Hultberg, B, Segura, R, Fonollosa, A, Berrone, E, Beltramo, E, Solimine, C, Ubertalli, A, Islam, N, Esteve, E, Fernandez, M, Recas, I, Mauri, S, Biarnes, F, Junca, E, Fernádez real, J, Rössner, S, Stenlof, K, Levy, B, Perry, B, Fitchet, M, Chrysos, G, Kamaratos, A, Lepeniotis, G, Kokkoris, S, Varytimiadis, K, Stasini, F, Mikros, S, Gianneli, D, Tryfinopoulou, K, Melidonis, A, Nikolopoulou, C, Harley, K, Ryder, R, De, P, Vannieuwenhoven, F, Rossing, K, Oliver, N, Goldschmeding, R, Jacobsen, P, Tan, F, Liew, S, Mukherjee, J, Lim, P, Fröjdö, S, Sjölind, L, Parkkonen, M, Mäkinen, V, Tikellis, C, Nieuwenhoven, F, Macisaac, R, Tsalamandris, C, Mcneil, K, Panaiotopoulos, S, Smith, T, Ho, M, Matthews, P, Jerums, G, Hut, H, Van Den Meiracker, A, Nakhjavani, M, Behjati, J, Esteghamati, A, Esfahanian, F, Aghamohamadzadeh, N, Abbasi, M, Kohnert, K, Zander, E, Krabbe, S, Stehouwer, C, Schalkwijk, C, Krarup Hansen, T, Teppo, A, Ebeling, P, Abdella, N, Mojiminiyi, O, Al Dahi, W, Al Mohammedi, H, Al Jebely, S, Neugebauer baba, S, Baba, T, Ohashi, H, Nakajima, S, Hesselmann, C, Watanabe, T, Nargis, M, Zaid, R, Voronko, O, Tchugunova, L, Vikulova, O, Nosikov, V, Liu, L, Zheng, T, Li, M, Zhang, R, Xiang, K, Hadjadj, S, Jeunemaitre, X, Vervoort, G, Veldman, B, Berden, J, Wetzels, J, Singh, B, Holland, M, Baskar, V, Oh, J, Seo, J, Choi, K, Baik, S, Choi, D, Kim, N, Matsumoto, S, Suetsugu, M, Matsutomo, R, Pisarczyk wiza, D, Banaszak, A, Wysocki, H, Usui, H, Shikata, K, Okada, S, Ogawa, D, Yozai, K, Kido, Y, Nagase, R, Ohga, S, Tone, A, Sasaki, M, Wada, J, Unno, Y, Horiuchi, S, Mclennan, S, Kamarinos, M, Waltham, M, Dy, V, Yue, D, Zdychova, J, Komers, R, Cresci, B, Giannini, S, Manuelli, C, Giunti, S, Pinach, S, Ianni Palarchio, A, Arnaldi, L, Vittone, F, Camussi, G, Cavallo Perin, P, Gruden, G, Marshall, S, Jones, S, White, K, Brizzi, M, Dentelli, P, Rosso, A, Calvi, C, Gambino, R, Cassader, M, Salvidio, G, Deferrari, G, Pegoraro, L, Pagano, G, Cavallo perin, P, Oates, R, Ellery, C, Beebe, D, Coutcher, J, Qian, Y, Lowe, V, Appleton, T, Raunig, D, O'Neil, S, Mylari, B, Amazonas, R, Fujita, A, Doi, A, Matsuno, S, Okamoto, K, Matsumoto, E, Furuta, H, Nishi, M, Tsuno, T, Taniguchi, H, Bessho, H, Wasén, E, Isoaho, R, Mattila, K, Vahlberg, T, Kivelä, S, Irjala, K, Rigalleau, V, Lasseur, C, Perlemoine, C, Barthes, N, Raffaitin, C, 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Thornalley, P, Babaei jadidi, R, Karachalias, N, Kupich, C, Ahmed, N, Fowler, A, Baker, A, Starczynski, J, O'Hare, P, Szepietowska, B, Szelachowska, M, Puch, U, Glebocka, A, Quinn, D, Mcternan, C, Bonser, R, Idzior walus, B, Woźniakiewicz, E, Dimitriou, K, Apostolou, O, Kontela, E, Devangelio, E, Gould, E, Serri, O, Roussin, A, Buithieu, J, Mamputu, J, Renier, G, Giordanetti, S, De Amici, E, Poggi, G, Turpini, C, Fratino, P, Garzaniti, A, Banu, I, Paries, J, Roman, G, Negrean, M, Bala, C, Nita, C, Kistorp, C, Gustafsson, F, Chong, A, Lip, G, Galatius, S, Ari, N, Sahilli, M, Ceylan isık, A, Ozansoy, G, Karasu yilmaz, C, Matteucci, E, Rosada, J, Pallini, M, Evangelista, I, Cassetti, G, Giusti, C, Giampietro, O, Capaldo, B, Galderisi, M, Cicala, S, Turco, A, Imbroinise, A, Nosso, G, D'Errico, A, De Divitiis, O, Klimontov, V, Korolyova, E, Jeltova, L, Bondar, I, Tarkun, I, Arslan, B, Canturk, Z, Tarkun, P, Agacdiken, A, Komsuoglu, B, Méneveau, N, Pierre justin, E, Alsayed, M, Sabbah, R, Paulin, S, Marcu, S, Tauveron, I, Zimmermann, C, Schiele, F, Seronde, M, Vautrin, P, Lusson, J, Thieblot, P, Bernard, Y, Mistry, A, Pye, M, Peovska, I, Maksimovic Pavlovic, J, Vavlukis, M, Pop Gorceva, D, Bosevski, M, Scognamiglio, R, Negut, C, De Kreutzenberg, S, Madonna, R, De Caterina, R, Willerson, J, Geng, Y, Vahsen, S, Ledwig, D, Ramrath, S, Frantz, S, Schmidt, I, Calvillo, L, Dienesch, C, Elbing, I, Bischoff, H, Ertl, G, Bauersachs, J, Davydov, A, Mkrtum'Yan, A, Baranova, L, Ikeda, Y, Suehiro, T, Osaki, F, Ota, K, Arii, K, Kumon, Y, Hashimoto, K, Doney, A, Morris, A, Palmer, C, Byun, S, Doo, H, Pagnin, E, Calo, L, Fadini, G, Kubaszek, A, Chai, S, Chai, Q, Rasmussen, L, Ledet, T, Wogensen, L, Lengyel, C, Varró, A, Virág, L, Magyar, J, Bíró, T, Jost, N, Skoumal, R, Nánási, P, Tóth, M, Horkay, F, Papp, J, Zacharopoulou, O, Athanaselis, S, Tsokos, N, Doupis, J, Psallas, M, Cokkinos, D, Pavlatos, S, Liatis, S, Akhobadze, T, Dzneladze, L, Samarguliani, I, Taskiran, M, Rasmussen, V, Jensen, G, Fisher, A, Petrovsky, N, Srikusalanukul, W, Budge, M, Trifunovic zamaklar, D, Zivkovic, M, Jelic, V, Vukomanovic, G, Ristic, A, Seferovic, P, Costa, J, Duarte, S, Manley, S, Sailesh, S, Venkataraman, A, Haider, Y, Groza, I, Oprean, M, Ardelean, A, Morosanu, A, Darkow, T, Vanderplas, A, Mamas, M, Mcelduff, P, Burns, J, Edwards, R, Fitchet, A, Young, R, Gibson, J, Lichiardopol, R, Niculescu, N, Totora, A, Pencea, C, Tomescu, I, Cinteza, M, Manicardi, V, Coscelli, C, Navazio, A, Catellani, E, Michelini, M, Dall'Asta, D, Guberti, A, Piazza, A, Gasparini, E, Pantaleoni, M, Guiducci, U, Manari, A, Sejil, S, Janand delenne, B, Avierinos, J, Habib, G, Labastie, N, Vague, P, Lassmann vague, V, Luźniak, P, Tatoń, J, Wojciechowska Luźniak, A, Zairis, M, Lyras, A, Patsourakos, N, Tsirimbis, V, Foussas, S, Lupón, J, Urrutia, A, Herreros, J, González, B, Coll, R, Altimir, S, Prats, M, Valle, V, Abreu padí, C, Rábago, G, Ivanova, L, Brasacchio, D, Harno, E, Keenan, A, Li, H, Lu, Z, Ke, L, Liu, H, Jeong, I, Chae, M, Choi, M, Yoo, H, Kim, C, Yun, M, Na, M, Kang, Y, Kong, O, Son, S, Kim, I, Tanaka, N, Hosoi, M, Matsuyama, Y, Fukumoto, M, Yamakita, T, Yoshioka, K, Ishii, T, Sato, T, Fujii, S, Aoki, T, Shibata, T, Mizutani, N, Suzuki, J, Fowelin, J, Samuelsson, P, Brandrup wogsen, G, Okumura, K, Tokmakova, A, Staroverova, D, Antcieferov, M, Shutichina, I, Kuntchevich, G, Vriesendorp, T, Morélis, Q, Legemate, D, Schaper, F, Mainas, E, Gkioulmpasanis, I, Panagiotou, I, Vassilikos, G, Skorda, L, Sidira, M, Christoforidou, M, Alaveras, A, Artikis, V, Evdemon, E, Lechleitner, M, Koch, T, Ebenbichler, C, Sturm, W, Moretti, L, Moruzzo, D, Boldrini, E, Pandolfo, C, Kameyama, M, Iwasa, R, Cho, M, Nam, J, Huh, K, Kaplar, M, Paragh, G, Erdei, A, Csongradi, E, Garai, I, Varga, J, Galuska, L, Udvardy, M, Higa, M, Kaneko, Y, Hiroi, N, Koziarska, D, Nowacki, P, Majkowska, L, Luzniak, P, Wojciechowska luźniak, A, Tushuizen, M, Nieuwland, R, Snoeck, D, Sturk, A, Diamant, M, Aguiar, L, Bahia, L, Villela, N, Laflor, C, Conde, C, Bottino, D, Dorigo, D, Bouskela, E, Pu, S, Luo, Z, Lam, K, Dan, Q, Xu, A, Shen, J, Cheng, K, Xu, J, Thamer, C, Stefan, N, Haap, M, Heller, E, Tschritter, O, De Prado, A, Ortiz, A, Ybarra, J, Gich, I, Pou, J, Ehren, M, Roggenland, D, Reinsen, B, Klein, H, Rittig, K, Stock, J, Kocher, B, Balletshofer, B, Shon, H, Chung, D, Nakatani, Y, Matsuhisa, M, Kaneto, H, Hatazaki, M, Yoshiuchi, K, Katakami, N, Kawamori, D, Ohtoshi, K, Sakamoto, K, Matsuoka, T, Ozawa, K, Ogawa, S, Hori, M, Yamasaki, Y, Zitouni, K, Harry, D, Nourooz zadeh, J, Earle, K, Olesen, P, Franco, L, Corvaja, C, Semplicini, A, Ceylan işık, A, Arı, N, Rösen, P, Lee, I, Park, K, Jung, E, Shin, D, Jo, S, Obuobie, K, Prakash, P, Hanna, F, Lazarus, J, Varadhan, L, Gurushankar, J, James, D, Sheikh, S, Gaede, P, Zou, D, Vilarrasa, N, Perez maraver, M, Mena, E, Perez, D, Setti, G, Buckingham, R, Urbančič, V, Stefanovska, A, Bernjak, A, Ažman juvan, K, Kocijančič, A, Glowania, A, Filters, T, Fosmark, D, Torjesen, P, Kilhovd, B, Berg, T, Sandvik, L, Hanssen, K, Mentink, C, Donchenko, G, Stepanenko, S, Maingrette, F, Deng, H, Lindenmair, A, Freudenthaler, A, Baumgartner parzer, S, Nizheradze, K, Khoruzhenko, A, Tronko, N, Sheu, W, Ou, H, Shen, H, Lin, T, Wu, H, Yang, C, Mogylnytska, L, Schmoelzer, I, Davies, J, Band, M, Struthers, A, Prázný, M, Škrha, J, Kasalová, Z, Neelotpol, S, Jahan, P, Kauschke, S, Harrop, C, Schäfer, A, Widder, J, Eigenthaler, M, Walter, U, Uchimura, I, Ikebukuro, M, Kaibara, M, Hirata, M, Helal, R, Pervin, F, Yang, X, Jansson, P, Nagaev, I, Jack, M, Carvalho, E, Sunnerhagen, K, Cam, M, Cushman, S, Smith, U, Creely, S, Farmer, J, Gustafson, B, Kusminski, C, Krusinova, E, Wohl, P, Klementova, M, Lanska, V, Mcdougall, C, Kelly, I, Abbas, Z, Lutale, J, Archibald, L, Karunajeewa, H, Stingemore, N, Stuccio, G, Mcgechie, D, Muller, L, Hak, E, Goudzwaard, W, Montorsi, F, Homering, M, Sprenger, K, Goldstein, I, Asnaghi, V, Ferrari, G, Rastaldi, M, Gabellini, D, Dell'Antonio, G, Maestroni, A, Ruggieri, D, Luzi, L, Piemonti, L, Zerbini, G, Anafaroglu, I, Tutuncu, N, Sultana, M, Siddiqua, N, Iwasaki, T, Nakajima, A, Yoneda, M, Mukasa, K, Tanaka, S, and Sekihara, H
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0303 health sciences ,medicine.medical_specialty ,business.industry ,EASD ,Endocrinology, Diabetes and Metabolism ,Human physiology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Family medicine ,Internal Medicine ,Medicine ,business ,030217 neurology & neurosurgery ,030304 developmental biology - Published
- 2004
23. Predictors of long term weight loss maintenance in patients at high risk of type 2 diabetes participating in a lifestyle intervention program in primary health care: The DE-PLAN study.
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Gilis-Januszewska A, Barengo NC, Lindström J, Wójtowicz E, Acosta T, Tuomilehto J, Schwarz PEH, Piwońska-Solska B, Szybiński Z, Windak A, and Hubalewska-Dydejczyk A
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- Aged, Body Mass Index, Counseling methods, Diabetes Mellitus, Type 2 etiology, Dietary Fats adverse effects, Female, Humans, Life Style, Male, Middle Aged, Program Evaluation, Time Factors, Diabetes Mellitus, Type 2 prevention & control, Obesity therapy, Primary Health Care methods, Weight Loss, Weight Reduction Programs methods
- Abstract
Lifestyle interventions in type 2 diabetes (DM2) prevention implementation studies can be effective and lasting. Long-term weight loss maintenance enhances the intervention effect through a significant decrease in diabetes incidence over time. Our objective was to identify factors predicting long-term successful weight reduction maintenance achieved during a DM2 prevention program in patients with high DM2 risk in primary health care. Study participants (n = 263), middle-aged, slightly obese with baseline increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC)>14), but no diabetes were invited to receive 11 lifestyle counselling sessions, guided physical activity sessions and motivational support during 10-months. The study participants had three clinical examinations during the study (baseline, one and three years). Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of weight reduction maintenance two years after the discontinuation of the intervention. Out of 105 patients who completed all three examinations (baseline age 56.6 (standard deviation (SD) = 10.7), body mass index 31.1 kg/m2 (SD = 4.9), FINDRISC 18.6 (SD = 3.1)), 73 patients (70%) showed weight loss during the intervention (mean weight loss 4.2 kg, SD = 5.1). The total weight loss achieved in the maintainers (27 of 73 study participants) two years after the intervention had finished was 6.54 kg (4.47 kg+2.0 kg). The non-maintainers, on the other hand, returned to their initial weight at the start of the intervention (+0.21 kg). In multivariable analysis baseline history of increased glucose (odds ratio (OR) = 3.7; 95% confidence interval (CI) 1.0-13.6) and reduction of total fat in diet during follow-up (OR = 4.3; 95% CI 1.5-12.2) were independent predictors of successful weight loss. Further studies exploring predictors of weight loss maintenance in diabetes prevention are needed to help health care providers to redesign interventions and improve long-term outcomes of real life interventions.
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- 2018
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24. Predictors of completing a primary health care diabetes prevention intervention programme in people at high risk of type 2 diabetes: Experiences of the DE-PLAN project.
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Gilis-Januszewska A, Lindström J, Barengo NC, Tuomilehto J, Schwarz PE, Wójtowicz E, Piwońska-Solska B, Szybiński Z, Windak A, and Hubalewska-Dydejczyk A
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- Adult, Aged, Exercise, Female, Humans, Male, Middle Aged, Poland, Risk Reduction Behavior, Counseling, Diabetes Mellitus, Type 2 prevention & control, Health Behavior, Life Style, Primary Health Care
- Abstract
It has been shown that real-life implementation studies for the prevention of type 2 diabetes (DM2) performed in different settings and populations can be effective. However, not enough information is available on factors influencing the reach of DM2 prevention programmes. This study examines the predictors of completing an intervention programme targeted at people at high risk of DM2 in Krakow, Poland as part of the DE-PLAN project.A total of 262 middle-aged people, everyday patients of 9 general practitioners' (GP) practices, at high risk of DM2 (Finnish Diabetes Risk Score (FINDRISK) >14) agreed to participate in the lifestyle intervention to prevent DM2. Intervention consisted of 11 lifestyle counseling sessions, organized physical activity sessions followed by motivational phone calls and letters. Measurements were performed at baseline and 1 year after the initiation of the intervention.Seventy percent of the study participants enrolled completed the core curriculum (n = 184), 22% were men. When compared to noncompleters, completers had a healthier baseline diabetes risk profile (P <.05). People who completed the intervention were less frequently employed versus noncompleters (P = .037), less often had hypertension (P = .043), and more frequently consumed vegetables and fruit daily (P = .055).In multiple logistic regression model, employment reduced the likelihood of completing the intervention 2 times (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.25-0.81). Higher glucose 2 hours after glucose load and hypertension were the independent factors decreasing the chance to participate in the intervention (OR 0.79, 95% 0.69-0.92 and OR 0.52, 95% CI 0.27-0.99, respectively). Daily consumption of vegetables and fruits increased the likelihood of completing the intervention (OR 1.86, 95% 1.01-3.41).In conclusion, people with healthier behavior and risk profile are more predisposed to complete diabetes prevention interventions. Male, those who work and those with a worse health profile, are less likely to participate and complete interventions. Targeted strategies are needed in real-life diabetes prevention interventions to improve male participation and to reach those who are working as well as people with a higher risk profile.
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- 2018
- Full Text
- View/download PDF
25. Determinants of weight outcomes in type 2 diabetes prevention intervention in primary health care setting (the DE-PLAN project).
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Gilis-Januszewska A, Piwońska-Solska B, Lindström J, Wójtowicz E, Tuomilehto J, Schwarz PEH, Kissimova-Skarbek K, Szybiński Z, Windak A, and Hubalewska-Dydejczyk A
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- Adult, Aged, Female, Humans, Male, Middle Aged, Treatment Outcome, Diabetes Mellitus, Type 2 prevention & control, Life Style, Primary Health Care, Weight Loss
- Abstract
Background: Real life implementation studies performed in different settings have proved that lifestyle interventions in the prevention of type 2 diabetes (DM2) can be effective, although the weight reduction results are typically modest compared to randomized control trials. Our objective was to identify the factors that predict successful weight loss in a less intensive, lower budget, real life setting lifestyle diabetes prevention intervention., Methods: Study participants (n = 175) with increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC) > 14) but no diabetes at baseline received ten group lifestyle counselling sessions, physical activity and motivation sessions during a ten-month intervention. Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of successful weight reduction defined as a reduction of ≥5% of the initial body weight., Results: At 12 months following the initiation of the intervention, 23.4% of study participants lost ≥5% weight (mean loss of 7.9 kg, SD = 5.8). Increased physical activity (44% vs 25%, p = 0.03), decreased total fat consumption (88% vs 65%, p = 0.006) and adherence to four-five lifestyle goals (71% vs 46%, p = 0.007) were more often reported among those who managed to lose ≥5% weight versus those who did not. In a multivariate analysis, meeting the ≥5% weight loss goal was most effective in individuals with a higher baseline BMI (OR 1.1, 95%CI 1.0-1.2), baseline and medium versus higher education (OR 5.4, 95% CI 1.2-24.7) and a history of increased glucose (OR 2.6, 95%CI 1.1-1.3). A reduction of total fat in the diet was an independent lifestyle predictor, increasing the probability of successful weight loss by 3.8 times (OR 3.8, 95% CI 1.2-11.4)., Conclusion: Baseline higher BMI, lower education and a history of increased glucose predicted the successful weight loss among individuals with a high risk for the DM2 following lifestyle intervention in a real life primary health care setting. People who manage to lose weight more often adhere to lifestyle changes, while the reduction of total fat in diet independently predicts successful weight loss. Further studies exploring the predictors of success in implementation studies in DM2 prevention should help health care providers redesign interventions to improve their effectiveness and outcomes., Trial Registration: ISRCTN, ID ISRCTN96692060 , registered 03.08.2016 retrospectively.
- Published
- 2018
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26. Sustained diabetes risk reduction after real life and primary health care setting implementation of the diabetes in Europe prevention using lifestyle, physical activity and nutritional intervention (DE-PLAN) project.
- Author
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Gilis-Januszewska A, Lindström J, Tuomilehto J, Piwońska-Solska B, Topór-Mądry R, Szybiński Z, Peltonen M, Schwarz PE, Windak A, and Hubalewska-Dydejczyk A
- Subjects
- Aged, Body Mass Index, Counseling, Europe, Female, Glucose Intolerance, Humans, Male, Middle Aged, Poland, Risk Factors, Risk Reduction Behavior, Diabetes Mellitus, Type 2 prevention & control, Diet, Exercise, Life Style, Primary Health Care organization & administration
- Abstract
Background: Real life implementation studies performed in different settings and populations proved that lifestyle interventions in prevention of type 2 diabetes can be effective. However, little is known about long term results of these translational studies. Therefore, the purpose of this study was to examine the maintenance of diabetes type 2 risk factor reduction achieved 1 year after intervention and during 3 year follow-up in primary health care setting in Poland., Methods: Study participants (n = 262), middle aged, slightly obese, with increased type 2 diabetes risk ((age 55.5 (SD = 11.3), BMI 32 (SD = 4.8), Finnish Diabetes Risk Score FINDRISC 18.4 (SD = 2.9)) but no diabetes at baseline, were invited for 1 individual and 10 group lifestyle counselling sessions as well as received 6 motivational phone calls and 2 letters followed by organized physical activity sessions combined with counselling to increase physical activity. Measurements were performed at baseline and then repeated 1 and 3 years after the initiation of the intervention., Results: One hundred five participants completed all 3 examinations (baseline age 56.6 (SD = 10.7)), BMI 31.1 (SD = 4.9)), FINDRISC 18.57 (SD = 3.09)). Males comprised 13% of the group, 10% of the patients presented impaired fasting glucose (IFG) and 14% impaired glucose tolerance (IGT). Mean weight of participants decreased by 2.27 kg (SD = 5.25) after 1 year (p = <0.001). After 3 years a weight gain by 1.13 kg (SD = 4.6) (p = 0.04) was observed. In comparison with baseline however, the mean total weight loss at the end of the study was maintained by 1.14 kg (SD = 5.8) (ns). Diabetes risk (FINDRISC) declined after one year by 2.8 (SD = 3.6) (p = 0.001) and the decrease by 2.26 (SD = 4.27) was maintained after 3 years (p = 0.001). Body mass reduction by >5% was achieved after 1 and 3 years by 27 and 19% of the participants, respectively. Repeated measures analysis revealed significant changes observed from baseline to year 1 and year 3 in: weight (p = 0.048), BMI (p = 0.001), total cholesterol (p = 0.013), TG (p = 0.061), fasting glucose level (p = 0.037) and FINDRISC (p = 0.001) parameters. The conversion rate to diabetes was 2% after 1 year and 7% after 3 years., Conclusions: Type 2 diabetes prevention in real life primary health care setting through lifestyle intervention delivered by trained nurses leads to modest weight reduction, favorable cardiovascular risk factors changes and decrease of diabetes risk. These beneficial outcomes can be maintained at a 3-year follow-up., Trial Registration: ISRCTN, ID ISRCTN96692060 , registered 03.08.2016 retrospectively.
- Published
- 2017
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27. The effects of iodised salt licks and teat dipping on the iodine content of cow's milk and blood plasma.
- Author
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Śliwiński B, Brzóska F, Węglarzy K, Szybiński Z, and Kłopotek E
- Subjects
- Animals, Cattle, Female, Mammary Glands, Animal, Animal Nutrition Sciences, Disinfectants, Iodine analysis, Milk chemistry, Plasma chemistry
- Abstract
Introduction: Milk has been identified as the ideal carrier of iodine in the human diet. The iodine concentration in cow's milk depends on the iodine intake in the animal's daily rations., Materials and Methods: The first experiment, which lasted for 90 days, investigated the effectiveness of salt licks containing 0 (control group), 150, and 300 mg I/kg (experimental groups) and the effect on the iodine content of cow's milk and blood plasma. The second experiment determined the effect of udder disinfection and iodine teat dipping with iodine disinfectant (experimental group) compared to chlorine dip (control group) on the iodine content of milk and blood plasma. Milk iodine and blood plasma concentrations were meas- ured using the Sandell-Kolthoff method modified by the Bobek and Kołczak procedure., Result: Salt licks containing 150 and 300 mg I/kg increased iodine intake by 7.5 and 15.0 mg I/day, respectively. Average iodine intake in the control group was 6.23 mg I/day, and 13.68 and 21.10 mg I/day in the experimental groups, respectively. There were no significant differences in the average cows' milk yield, which averaged 21.0 ± 1.1 kg/day. Average milk iodine content was 53.8 μg/1000 mL (control group), 65.0 and 84.7 μg/1000 mL (experimental groups). Average plasma iodine content tended to increase in the experimental groups, but the differences between the groups were not significant. In the second experiment iodine udder disinfection and teat dipping increased average milk iodine content from 44.0 ± 1.6 to 59.3 ± 2.3 μg/1000 mL. Average plasma iodine content increased only slightly, with a non- significant difference between the control and experimental groups., Conclusion: The iodine content of salt licks at 150 and 300 mg I/kg makes it possible to obtain from 65 to 85 μg I/1000 mL of cow's milk. Pre-milking udder hygiene and post-milking iodine teat dipping additionally increase the iodine content of milk by around 15 μg I/1000 mL milk, i.e. an increase of 35% in relation to cows from the control group.
- Published
- 2015
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28. The memory on Prof. Aldo Pinchera M.D., Ph.D.
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Szybiński Z and Nauman J
- Subjects
- Europe, Goiter history, Goiter prevention & control, History, 20th Century, History, 21st Century, Humans, Iodine deficiency, Endocrinology history
- Published
- 2013
29. Reference values for thyroid volume established by ultrasound in Polish schoolchildren.
- Author
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Szybiński Z, Trofimiuk-Müldner M, Buziak-Bereza M, Walczycka L, and Hubalewska-Dydejczyk A
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- Child, Female, Goiter epidemiology, Humans, Male, Organ Size, Poland epidemiology, Reference Values, Sodium Chloride, Dietary, Ultrasonography, Goiter diagnostic imaging, Iodine deficiency, Thyroid Gland diagnostic imaging
- Abstract
Introduction: A frequency in excess of 5% of goitre in children is an approved WHO marker of iodine deficiency. As thyroid ultrasound remains the main method of thyroid volume (TV) assessment, the choice of adequate normative values is important for the proper interpretation of epidemiologic data. There is disagreement as to whether local or international normative values should be used. The aim of this study was to establish Polish local TV normative values in children aged 6-12 years., Material and Methods: The study was carried out in a group of 642 children aged 6-12 years (312 girls and 330 boys) living in the Polish seaside area with a proven history of best iodine supply. Inclusion criteria were: iodine concentration in casual morning urine samples above 100 μg/L, no goitre on palpation, no pathological findings on thyroid US, no history of thyroid disorders, no treatment affecting thyroid function, and written informed consent from the child's parents. TV was measured ultrasonographically with a 7.5 MHz linear transducer. Urinary iodine concentration (UIC) was measured in urine spot samples using the Sandell-Kolthoff method., Results: Median UIC ranged according to age from 126.6 to 155.1 μg/L in girls, and from 132.23 to 157.62 μg/L in boys. TVs at P97 were: 3.96, 4.23, 4.33, 5.44, 6.07, 9.5, and 10.9 for girls and 3.99, 4.2, 4.79, 6.61, 7.38, 7.89, and 9.35 for boys. They were lower than the 1997 WHO normative values but higher than the 2004 reference currently adopted by the WHO., Conclusions: The obtained results may be adopted as normative TV values for Polish children.
- Published
- 2012
30. Work of the Polish Council for Control of Iodine Deficiency Disorders, and the model of iodine prophylaxis in Poland.
- Author
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Szybiński Z
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Dietary Supplements, Female, Food, Fortified, Goiter epidemiology, Goiter prevention & control, Goiter, Endemic epidemiology, Humans, Infant, Infant, Newborn, Iodine administration & dosage, Male, Middle Aged, National Health Programs, Poland epidemiology, Pregnancy, Sodium Chloride, Dietary, World Health Organization, Young Adult, Goiter, Endemic prevention & control, Iodine deficiency
- Abstract
The Polish Council for Control of Iodine Deficiency Disorders (PCCIDD) was established in 1991 in Krakow at the Chair and Dept. of Endocrinology, Jagiellonian University, Collegium Medicum, following the example of the International Council for Control of Iodine Deficiency Disorders (ICCIDD) in Charlottesville, USA. The PCCIDD co-operates with the European Co-ordinating Centre in Pisa, Italy. The PCCIDD comprises a group of experts in endocrinology, iodine prophylaxis, the technology of salt and food iodisation, and Polish representatives of several organisations: WHO, UNICEF, the Polish Consumers Federation, and the Spokesman for Children's Rights. The strategic goal of the Polish Council is to solve the problem of iodine deficiency in Poland realising the Programme for Elimination of Iodine Deficiency financed by the Ministry of Health. The Polish model of iodine prophylaxis contains obligatory iodisation of household salt (20-40 mg KI/1 kg) and neonates' formula (10 μg/100 mL of milk), and additional supplementation for pregnant and breastfeeding women with 150-200 μg of iodine as pharmacotherapy. The model is very effective: endemic goitre in schoolchildren has been eradicated, the prevalence of goitre in pregnant women has fallen from 80% to 19%, the frequency of transient hypothyroidism in neonates has dropped from 2.0% to 0.16%, and the observed increase of incidence rate of thyroid cancer in women over 40 years old has diminished markedly. In 2008, a WHO Collaborating Centre (WHOCC) for Nutrition was designated at the Department of Endocrinology, UJCM in Krakow. The main goal of the WHOCC is to sustain effective iodine prophylaxis in Poland in the light of the latest WHO recommendations on the necessary reduction of daily salt intake as a risk factor for hypertension and arteriosclerosis. Therefore, additional standardised carriers of iodine (milk, mineral water) have been introduced into the food market.
- Published
- 2012
31. [Assessement of the usefulness of whole body scintigraphy after administration of 6 MBq of 131I in the diagnostic of breast cancer].
- Author
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Gołkowski F, Sokołowski G, Gil J, Kostecka-Matyja M, Basta P, Sowa-Staszczak A, Szybiński Z, and Hubalewska-Dydejczyk A
- Subjects
- Adult, Aged, Breast Neoplasms chemistry, Female, Humans, Middle Aged, Radionuclide Imaging, Symporters analysis, Breast Neoplasms diagnostic imaging, Iodine Radioisotopes, Whole-Body Counting
- Abstract
Introduction: Sodium-iodine symporter (NIS) belongs to a large family of natrium dependent ion transporters found in normal thyroid cells located on the basilar membrane of tyreocytes. Under physiologic conditions, the NIS is also present in other tissues: salivary glands, gastric mucosa, mammary glands during lactation, and vascular plexus of the fourth ventricle. NIS expression has also been found in many tumors, including breast cancer., Aim: The aim of this study was to evaluate the usefulness of whole body scintigraphy after administration of relatively low activity of 131I (6 MBq)in the diagnostics of breast cancer., Material and Methods: The study included nine women with breast cancer, aged 38-73 years (mean 55.6 +/- 11.7 years) and a control group of 14 women aged 29-84 years (mean 48.8 +/- 16.7 years). The uptake of radioiodine in whole body scintigraphy 24 hours after administration of 131I radioiodine (6 MBq) was compared between the control group and breast cancer patients. No pharmaceuticals reducing thyroid iodine uptake or increasing NIS expression were used., Results: Whole body scans using 6 MBq 131I activity revealed no focal radioiodine uptake outside the thyroid tissue in patients with breast cancer as well as volunteers from the control group., Conclusions: Whole body scintigraphy using 131I, dosed at 6 MBq, with no additional treatment increasing extrathyroidal uptake of radioiodine, appears to be ineffective in the imaging of breast cancer.
- Published
- 2011
32. Summary from the European Meeting of WHO Collaborating Centres for Nutrition, Kraków, 23-24 June 2010.
- Author
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Szybiński Z and Breda J
- Subjects
- Diet, Europe, Humans, Iodine deficiency, Sodium Chloride, Dietary adverse effects, Deficiency Diseases prevention & control, Diabetes Mellitus, Type 2 prevention & control, Health Promotion, Nutritional Sciences education, Obesity prevention & control, Public Health education
- Abstract
In June 2010, the WHO Regional Office for Europe, in co-operation with the WHO Collaborating Centre for Nutrition at the Department of Endocrinology, Jagiellonian University, Collegium Medicum, organized in Krakow the 1st Conference of the WHO European Collaborating Centres for Nutrition. Taking part were representatives of the WHO Regional Office for Europe Nutrition, Dr Joao Breda (Programme Manager - Nutrition, Physical Activity and Obesity Programme) and representatives of the WHO Collaborating Centres for Nutrition from Denmark, Greece, Holland, the UK and Poland, as well as representatives of co-operating institutes from Portugal, Switzerland and the UK. The main objective of the meeting was to discuss the ongoing work of each Collaborating Centre and the development of a strategic plan for the coming years in the most important areas of interest: the prevention of obesity, type 2 diabetes and other NCD, nutrition and inequalities, capacity building in nutrition as well as micronutrient deficiencies (namely iodine deficiency). A final report summarising the Network Meeting is being prepared and will be released in due course.
- Published
- 2011
33. Iodine, selenium, and other trace elements in urine of pregnant women.
- Author
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Szybiński Z, Walas S, Zagrodzki P, Sokołowski G, Gołkowski F, and Mrowiec H
- Subjects
- Adult, Female, Humans, Pregnancy, Iodine urine, Selenium urine, Trace Elements urine
- Abstract
The purpose of this work was to determine trace element levels in urine and evaluate possible associations between urinary iodine concentration (UIC), other trace elements (Cr, Cu, Fe, Mn, Na, Se, Zn), toxic elements (Cd, Pb), anthropometrical measures (body weight and height), glycemic indices (serum insulin and glucose), and several parameters related to thyroid function (thyroid stimulating hormone, free thyroxine, antithyroid peroxidase antibodies, thyroid volume, and thyroid echogenicity) in pregnant women. One hundred sixty-nine participants were recruited. The whole study group, originating from Krakow region, comprised three subgroups belonging to three trimesters: I trimester (n = 28), II trimester (n = 83), and III trimester (n = 58). Trace elements were determined using inductively coupled plasma mass/(atomic emission) spectrometry. Partial least square model was used to reveal correlation structure between parameters investigated, as well as a possible causal relationship between dependent parameters and potentially explanatory parameters. Results obtained for trace and toxic elements in urine were comparable with results of other authors, although the study group was not homogenous. We confirmed (1) low iodine excretion in pregnant women, (2) the existence of statistically significant correlation between UIC and urinary selenium, and (3) lack of correlation between latter parameter and typical indices of thyroid function. Urinary selenium correlated with other urinary trace elements, but physiological significance of this finding remains uncertain. The fact that a large number of pregnant women fail to meet dietary recommendations for iodine is the major reason for concern.
- Published
- 2010
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34. [Iodine-deficiency prophylaxis and the restriction of salt consumption--a 21st century challenge].
- Author
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Szybiński Z, Jarosz M, Hubalewska-Dydejczyk A, Stolarz-Skrzypek K, Kawecka-Jaszcz K, Traczyk I, and Stoś K
- Subjects
- Humans, Hypertension prevention & control, Iodine administration & dosage, Iodine adverse effects, Nutrition Policy trends, Poland epidemiology, Societies, Medical, Sodium Chloride, Dietary adverse effects, World Health Organization, Food, Fortified adverse effects, Iodine deficiency, Sodium Chloride, Dietary administration & dosage, Thyroid Diseases prevention & control
- Abstract
The World Health Organization (WHO) issued a recommendation (Technical Consultation: Paris 2006, Luxembourg 2007) that salt consumption, as a risk factor for hypertension, atherosclerosis, myocardial infarction, stroke, and select cancers, should be restricted. The European Commission looked to adhere to this recommendation by creating the High Level Group on Nutrition and Physical Activity. According to WHO recommendations, a daily allowance of 5 g NaCl (i.e., 2 g Na) for individual salt consumption should not be exceeded. At present, mean individual salt consumption in Poland totals 13.5 g, of which salt used in household constitutes 8.8 g. In some regions of Poland, this number reaches upwards of 15.0 g/person. The Position Paper on Initiatives Aimed at Decreasing Salt Consumption in Poland, developed by an expert group at the National Food and Nutrition Institute, set the course for intervention, including changing recipes for mass-produced food products and large-scale catering, improving oversight by food control agencies, and continuing legislative changes. These interventions should also include education directed towards consumers, food producers, public health professionals, healthcare workers, and media representatives. The Position Paper of the Polish Hypertension Society also sets the course for promoting restricted salt consumption and controlling hypertension on a population level. However, household salt is the main carrier of iodine in the Polish model of iodine prophylaxis. Thus, any interventions also require synchronized action with the Polish Council for Control of Iodine Deficiency Disorders. Current efforts aimed at preventing iodine-deficiency look to increase consumption of other iodine-rich products (e.g., milk, mineral water) with standardized levels of iodine. Once they achieve an iodine concentration of 0.1-0.2 mg, these products can easily supplement any decrease in physiological iodine levels resulting from reduced salt consumption. Also required are wide-ranging educational campaigns which will be coordinated by the new designated WHO Collaborating Centre for Nutrition at the Chair of Endocrinology at Jagiellonian University, Collegium Medicum in Kraków.
- Published
- 2010
35. Iodine concentration in Polish milk - variations due to season and region.
- Author
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Brzóska F, Szybiński Z, and Sliwiński B
- Subjects
- Animals, Cattle, Environmental Monitoring statistics & numerical data, Poland, Seasons, Urban Population, Food Analysis statistics & numerical data, Iodine analysis, Milk chemistry
- Abstract
Introduction: Iodine concentration was studied in Polish consumer milk., Material and Methods: The milk originated from 13 provincial cities and 65 dairy cooperatives located in Poland., Results: Milk iodine concentration in the winter season of 2007-2008 was 146.8 mg/L, with a standard deviation for the provinces of 27.9 mg/L and variation coefficient of 19.0% (n = 66 samples). Iodine concentration for provincial cities ranged from 76.3 to 192.0 mg/L. It was highest in the milk samples from the Lubelskie province (191.9 mg/L) and lowest in the milk samples from Podlasie (113.8 mg/L). In the summer season, milk iodine concentration averaged 100.4 mg/L, with a standard deviation of 38.9 ìg/L and variation coefficient of 38.8% (n = 27 samples)., Conclusions: Iodine concentration for provincial cities ranged from 63.8 to 173.7 mg/L. Compared to the winter season, milk iodine concentration in the summer season was lower by an average of 25.2%, with a standard deviation of 4.3% (Kielce) to 52.2% (Wrocław).
- Published
- 2009
36. [Iodine prophylaxis in Poland in light of the WHO recommendation on reduction of the daily salt intake].
- Author
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Szybiński Z
- Subjects
- Adult, Causality, Comorbidity, Female, Humans, Infant, Newborn, Poland epidemiology, Pregnancy, Prevalence, World Health Organization, Dietary Supplements, Disease Outbreaks prevention & control, Goiter epidemiology, Iodine administration & dosage, Iodine deficiency, Sodium, Dietary standards
- Abstract
Iodine prophylaxis started in Poland in 1935, was suspended in periods of time 1939-1945 and 1980-1988. In 1991 Polish Council for Control of Iodine Deficiency Disorders (PCCIDD) was established and epidemiological survey performed in 1992-1993, defined Poland as an area with moderated - at seaside part as light - severity of iodine deficiency. In 1996 the Minister of Health introduced disposition on obligatory iodization of household salt with 30+/-10 mg KJ/kg and neonates formula with 10 ug/100 ml. Additionally supplementation the pregnant and breast feeding women with daily dose of iodides 100-150 ug was recommended. This very effective model resulted with eradication of endemic goiter in schoolchildren 6-12-years-old, decrease of prevalence of goiter in adults and pregnant women decrease of frequency of the elevated TSH concentration in neonates blood and decrease of dynamic of increasing an incidence rate of differentiated thyroid cancer and its follicular fraction. Poland has been defined by WHO and ICCIDD as a country with sufficient iodine prophylaxis and WHO collaborating Centre for Nutrition has been established at the Department of Endocrinology CMUJ in Krakow. WHO in 2006 and 2007 formulated recommendation on reduction of daily salt intake and additional new carriers of iodine are recommended: milk and natural mineral water containing known concentration of iodide (100-200 ug/l). The coordinating organization for iodine prophylaxis in Poland is PCCIDD as executive body of the National Program for Elimination of Iodine Deficiency financed by the Ministry of Health.
- Published
- 2009
37. Iodine prophylaxis--the protective factor against stomach cancer in iodine deficient areas.
- Author
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Gołkowski F, Szybiński Z, Rachtan J, Sokołowski A, Buziak-Bereza M, Trofimiuk M, Hubalewska-Dydejczyk A, Przybylik-Mazurek E, and Huszno B
- Subjects
- Child, Female, Goiter epidemiology, Goiter prevention & control, Humans, Incidence, Iodine urine, Male, Poland epidemiology, Sodium Chloride, Dietary, Stomach Neoplasms etiology, Stomach Neoplasms mortality, Thyroid Diseases epidemiology, Thyroid Diseases prevention & control, Goiter complications, Iodine administration & dosage, Iodine deficiency, Stomach Neoplasms epidemiology, Thyroid Diseases complications
- Abstract
Background: Poland has one of the highest death rates for stomach cancer in Europe. Moderate iodine deficiency and in consequence high goitre prevalence led to the implementation in 1996 of a very efficient mandatory model of iodine prophylaxis, based on household salt iodisation (30 +/- 10 mg KI/1 kg of salt)., Aim of the Study: The aim of the study was evaluation of incidence rate of stomach cancer and its possible relation to increased iodine consumption in the years 1992-2004., Methods: Iodine supply and effectiveness of iodine prophylaxis were evaluated on the basis of comparative analysis of goitre prevalence and ioduria in schoolchildren. To allow comparison between time periods with varying population age structures, the incidence rates of stomach cancer were standardized for age, using the "world standard population". The direct standardization method has been applied. For each sex, the time-trend of incidence rates was shown in graphs over the years 1991-2004., Results: Evident increase in iodine consumption in this period of time was proved by rise in percentage of schoolchildren (6-8 years old) with ioduria above 100 microg/l from 11.4% in 1992-1993 to 52.9.1% in 2003. It was correlated with the decrease in goitre prevalence from 18.8% to 3.2% respectively. The 24-h thyroid uptake of (131)I in investigated population fell from 45.5% in 1986 to 26.8% in 1998. In Krakow the standardized incidence ratio of stomach cancer for men decreased from 19.1 per 100,000 to 15.7 per 100,000, and for women from 8.3 per 100,000 to 5.9 per 100,000 in the years 1992-2004. A significant decline of average rate of decrease was observed in men and women (2.3% and 4.0% per year respectively)., Conclusion: Observed association between improved iodine supply and decrease of incidence of stomach cancer could indicate the protective role against stomach cancer of iodine prophylaxis in iodine deficient areas--further studies are necessary.
- Published
- 2007
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38. Increased prevalence of hyperthyroidism as an early and transient side-effect of implementing iodine prophylaxis.
- Author
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Gołkowski F, Buziak-Bereza M, Trofimiuk M, Bałdys-Waligórska A, Szybiński Z, and Huszno B
- Subjects
- Adolescent, Adult, Female, Humans, Hyperthyroidism blood, Hyperthyroidism epidemiology, Hypothyroidism blood, Iodine administration & dosage, Iodine blood, Iodine deficiency, Male, Middle Aged, Poland, Prevalence, Thyrotropin blood, Trace Elements administration & dosage, Trace Elements blood, Treatment Outcome, Hyperthyroidism chemically induced, Hypothyroidism prevention & control, Iodine adverse effects, Sodium Chloride, Dietary, Trace Elements adverse effects
- Abstract
Objective: To assess the prevalence of hyperthyroidism just after implementation of iodine prophylaxis among adults from an area with iodine deficiency., Study Design and Subjects: A total of 1648 adults (age 16 years and older) were sampled from an area of southern Poland during two nationwide epidemiological surveys. Of these, 1424 adults with negative medical history for thyroid disorders qualified for final analysis. The authors compared thyroid dysfunction in participants prior to (1989-1990) and after implementation of iodine prophylaxis (1997-1999)., Setting: The southern part of Poland., Results: We found an increase in the serum concentration of anti-thyroid microsomal antibodies from 4.9% in the years 1989-1990 to 12.1% after introduction of iodised household salt (P < 0.0001). The prevalence of hyperthyroidism (defined as thyroid-stimulating hormone < 0.4 microU ml- 1) significantly increased in the equivalent period from 4.8 to 6.5% (P = 0.009)., Conclusions: We concluded that a sudden rise in iodine intake after implementation of iodine prophylaxis among adults from the area with iodine deficiency may lead to an increase in thyroid autoimmunity and prevalence of hyperthyroidism. Those possible early side-effects appear to be only temporary and are acceptable when compared with the evident benefits of adequate iodine intake.
- Published
- 2007
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39. [Alcohol consumption and the risk of insulin resistance--population based study].
- Author
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Szurkowska M, Szafraniec K, Pach D, Targosz D, Piwońska-Solska B, Hubalewska-Dydejczyk A, Szybiński Z, and Huszno B
- Subjects
- Adult, Body Mass Index, Comorbidity, Cross-Sectional Studies, Diabetes Mellitus, Type 2 drug therapy, Dose-Response Relationship, Drug, Female, Glucose Intolerance blood, Glucose Tolerance Test, Humans, Insulin, Male, Mass Screening, Middle Aged, Odds Ratio, Poland epidemiology, Retrospective Studies, Risk Factors, Sex Distribution, Surveys and Questionnaires, Alcohol Drinking epidemiology, Diabetes Mellitus, Type 2 epidemiology, Insulin Resistance
- Abstract
Unlabelled: The aim of the study was to assess the relationship between alcohol consumption and insulin resistance in the adult Kraków's inhabitants., Materials and Methods: 6000 subjects at age 35-75, participants of the Polish Multicenter Study on Diabetes Epidemiology, were randomized and invited to the study. Finally in 2838 participants the standardized questionnaire examination of the life style especially alcohol consumption was performed. In all persons anthropometric and blood pressure examination was performed. Fasting lipids, fasting and after glucose load glucose and insulin were determined. Glucose tolerance was determined in all study participants according WHO 1999 criteria. Insulin-resistance was defined as the highest quartile of the distribution of the HOMA-IR index assessed for population with normal glucose tolerance (NGT)., Results: In examined group 472 (29.2%) women and 150 (12.2%) men were abstainers. Alcohol consumption below 10 glday declared 68.4% of women and 54.9% of men, between 10 and 30 g/day--2.0% of women and 24.7% of men, above 30 g/day--8.2% of men and 0.4% of women. In men with normal glucose tolerance the lowest HOMA-IR we observed in the group drinking daily above 30 g of alcohol (2.05 +/- 1.3). In men with impaired glucose tolerance the lowest HOMA-IR was observed in the group drinking daily below 10 g of alcohol, the highest in the group of abstainers (2.81 +/- 2.04 vs. 3.23 +/- 1.72; ns). For men drinking between 10 and 30 g of alcohol daily decreased the risk of insulin resistance at 40% (OR = 0.6; 95% CI: 0.37-0.96), drinking above 30 g daily decreased the risk at 49% (OR = 0.51; 95% CI: 0.27-0.96). We didn't observed this relationship in the group of women., Conclusion: Our results confirm positive impact of daily alcohol intake above 10 g for the risk of insulin resistance in the group of men.
- Published
- 2007
40. Nontraditional atherosclerotic risk factors and extent of coronary atherosclerosis in patients with combined impaired fasting glucose and impaired glucose tolerance.
- Author
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Surdacki A, Stochmal E, Szurkowska M, Bode-Böger SM, Martens-Lobenhoffer J, Stochmal A, Klecha A, Kawecka-Jaszcz K, Dubiel JS, Huszno B, and Szybiński Z
- Subjects
- Adult, Aged, Arginine analogs & derivatives, Arginine blood, C-Reactive Protein metabolism, Cholesterol blood, Discriminant Analysis, Female, Glucose Clamp Technique, Homocysteine blood, Humans, Male, Middle Aged, Risk Factors, Triglycerides blood, Blood Glucose metabolism, Coronary Artery Disease blood, Insulin Resistance physiology
- Abstract
Partially inconsistent data exist on mutual relations between nontraditional atherosclerotic risk factors, including the magnitude of insulin resistance (IR), as well as on their relevance for atherogenesis in the metabolic syndrome. Subjects exhibiting combined impaired fasting glucose and impaired glucose tolerance (IFG/IGT) are exposed to an exceptionally high risk for atherogenesis and development of type 2 diabetes mellitus. Because of islet Beta-cell dysfunction, the usefulness of commonly used indices of IR is limited in IFG/IGT. Our aim was to assess the relationship between extent of angiographic coronary artery disease (CAD) and nontraditional atherosclerotic risk factors (including IR by a clamp-based golden standard method) in IFG/IGT. Fifty-three subjects (32 men, 21 women; mean age, 55 +/- 11 years) with stable angina, preserved left ventricular systolic function, and IFG/IGT were divided into 3 groups: group A (no coronary stenoses >50%, n = 22), group B (1-vessel CAD, n = 15), and group C (2/3-vessel CAD, n = 16). Insulin sensitivity was quantified by a hyperinsulinemic euglycemic clamp technique and expressed as M. M value, plasma homocysteine (Hcy) level, and asymmetric dimethyl-L-arginine (ADMA)/L-arginine ratio were independent determinants of CAD extent as shown by forward stepwise discriminant function analysis. Compared with group A (M = 32.7 +/- 9.3 micromol/kg fat-free mass [FFM] per minute; Hcy, 8.1 +/- 1.4 micromol/L), lower M and higher Hcy levels were found in group B (M = 16.9 +/- 8.2 micromol/kg FFM per minute, P < .001; Hcy, 11.2 +/- 2.9 micromol/L, P = .003) and C (M = 16.4 +/- 7.8 micromol/kg FFM per minute, P < .001; Hcy, 12.8 +/- 3.9 micromol/L, P < .001). The ADMA/L-arginine ratio was increased in group C (0.0078 +/- 0.0011) compared with group A (0.0063 +/- 0.0013, P = .03) and B (0.0058 +/- 0.0012, P = .01). Multivariate correlates (P < .05) of plasma Hcy concentrations were M (beta = -.34 +/- .12, P = .008), creatinine clearance (beta = -.23 +/- .10, P = .03) and fasting insulin (beta = .25 +/- .12, P = .04). This indicates an additive contribution of IR, plasma Hcy, and elevated ADMA/L-arginine ratio to the extent of angiographic CAD in combined IFG/IGT.
- Published
- 2007
- Full Text
- View/download PDF
41. [Environmental factors in the development of type 1 diabetes -- a new insight].
- Author
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Płaczkiewicz-Jankowska E, Szybiński Z, and Huszno B
- Subjects
- Autoimmune Diseases immunology, Bacterial Infections epidemiology, Causality, Comorbidity, Diabetes Mellitus, Type 1 immunology, Diabetes Mellitus, Type 1 virology, Diet, Environment, Female, Human Development, Humans, Infant, Islets of Langerhans immunology, Male, Nitrites toxicity, Prediabetic State immunology, Prevalence, Risk Factors, Seasons, Socioeconomic Factors, Virus Diseases epidemiology, Autoimmune Diseases epidemiology, Diabetes Mellitus, Type 1 epidemiology, Environmental Exposure, Insulin-Secreting Cells immunology
- Abstract
According to the traditional model of pathogenesis of type 1 diabetes - it develops in genetically susceptible individuals in whom environmental factors trigger an autoimmune process of beta-cell destruction. Although susceptibility may be inherited, there is a growing body of evidence showing the role of environmental factors that might not only trigger but also perpetuate the chronic autoimmune process. These factors may exert their action long before the disease manifests itself clinically, which significantly hampers their identification. Three groups of environmental factors that were most widely studied include of viral infections, feeding patterns in infancy and toxic compounds (especially nitrites). Other factors possibly playing a role in modifying the development of the disease are vaccinations, psychological stress and climatological factors. The authors summarize the data supporting the role of environmental factors in the development of the disease and show a more recent model of type 1 diabetes pathogenesis. It may partly explain why the disease incidence increased has so much in the last three decades despite markedly improved hygiene and health care standards.
- Published
- 2007
42. [Prevalence of the metabolic syndrome and its components in adult inhabitants of Krakow].
- Author
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Szurkowska M, Szafraniec K, Gilis-Januszewska A, Pach D, Krzentowska A, Szybiński Z, and Huszno B
- Subjects
- Adult, Aged, Aged, 80 and over, Cholesterol, HDL blood, Comorbidity, Female, Humans, Hypertension epidemiology, Incidence, Male, Mass Screening statistics & numerical data, Middle Aged, Poland epidemiology, Prevalence, Sex Distribution, Triglycerides blood, Body Constitution, Body Mass Index, Metabolic Syndrome diagnosis, Metabolic Syndrome epidemiology
- Abstract
Objectives: There are only few studies on the prevalence of the metabolic syndrome in Polish population. The aim of the study was to assess the prevalence of the metabolic syndrome according to NCEP definition in adult inhabitants of Krakow., Material and Method: The study was conducted in 2004-2005 in 42 Krakow's primary health care units in patients aged over 25, not treated due to the diabetes type 2 and/or coronary artery disease, with no history of myocardial infarction or stroke. In all study participants anthropometric examination, blood pressure, fasting total cholesterol and fasting glucose were measured. In those with total cholesterol > 5.2 mmol/l additional triglicerides and HDL-cholesterol were measured., Results: 40989 people (67.2% women and 32.8% men) aged 25 to 97 (54.1 +/- 14.1 years) were examined. In 19,4% of the examined population the MS was diagnosed (20.9% women and 16.2% men). In age group below 55 years the MS was more frequent in men than in women. Impaired glucose tolerance was found in 5394 study participants (3239 women and 2155 men). Mean systolic blood pressure was higher in men than in women (131.5 +/- 16,1 vs 127.0 +/- 17.5, p < 0.0001), the same was found for diastolic blood pressure (81.5 +/- 0.3 vs 78.6 +/- 9.6 p < 0.0001). 33.5% of women and 34.9% of men (p < 0.01) were treated from hypertension. In age group below 55 years men were more frequently treated due to hypertension than women (p < 0.001). In 8.7% of women and 14.1% of men (p < 0.001) newly diagnosed hypertension was found. In all age groups untreated hypertension was more frequent among men than in women. In 26.1% women and 33.5% men hypertriglicrdymia was found. In age group below hypertiglicerydemia was more frequent in men than in women (p < 0.001). Low HDL-cholesterol was found in 20.9% of women and 10.1% of men (p < 0.001). Visceral fat distribution was found in 19.9% of men and 33.3% of women., Conclusions: The MS was found in 20% of examined inhabitants of Krakow. Special attention should be paid to high prevalence of the MS among men younger than 45 years, as well as high prevalence of hypertriglicerydemia and newly diagnosed hypertension present in this group of men. The study results confirm the necessity of implementation of screening and early prevention of cardiovascular disease programs especially focused on younger men.
- Published
- 2006
43. [Prevalence of the glucose metabolism disturbances in screening of adult inhabitants of Krakow].
- Author
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Szurkowska M, Szafraniec K, Gilis-Januszewska A, Pach D, Krzentowska A, Szybiński Z, and Huszno B
- Subjects
- Adult, Aged, Aged, 80 and over, Carbohydrate Metabolism physiology, Comorbidity, Cross-Sectional Studies, Female, Glucose Tolerance Test methods, Humans, Male, Middle Aged, Obesity epidemiology, Overweight physiology, Poland epidemiology, Prevalence, Sex Distribution, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 prevention & control, Glucose Intolerance epidemiology, Mass Screening statistics & numerical data
- Abstract
Objectives: In Poland, similarly like in the other European countries type 2 diabetes screening and prevention projects have been run. In Krakow, Krakow's Municipality had undertaken a decision of financing a prevention program directed to adult inhabitants of the city. The aim of the study was to assess the prevalence of the glucose metabolism disturbances in adult inhabitants of Krakow city., Material and Method: The study was conducted in 2004-2005 in 42 Krakow's primary health care units in patients aged over 25, not treated due to the diabetes type 2 and/or coronary artery disease, with no history of myocardial infarction or stroke. In all study participants anthropometric examination, blood pressure and fasting glucose were measured. Diabetes risk score (DRS) and fasting glyceamia were used to classify patients to receive oral glucose tolerance test (OGTT)., Results: 40989 people (67.2% women and 32.8% men) aged 25 to 97 were examined. 12495 people received OGTT, in 1858 fasting glycaemia measurement was repeated. In 15.1% of men and 12.7% of women impaired glucose metabolism was found (p < 0.01). IFG was found in 5.9% men and 4.7% women (p < 0.01). The prevalence of IGT was the same in men and women (3.7% vs 3.8%, ns). Newly diagnosed diabetes type was found in 5.5% men and 4.2 % of women (p < 0.01). The prevalence of impaired glucose metabolism was increasing with age in men and women, in all categories of glucose disturbances, age related trends were statistically significant. Overweight was more frequent in men than in women (50.3% vs 36.8%, p < 0.0001), while obesity was more frequent in women compared to men (20.7% vs 19.5%, p < 0.02). Obesity was statistically more frequent in people with impaired glucose metabolism compared to those with normal glucose tolerance. Overweight was more frequent in women with impaired glucose metabolism compared to women with normal glucose metabolism, no relation with overweight was observed in men., Conclusions: The prevalence of newly diagnosed type 2 diabetes is increased in people aged over 55, what confirms the necessity of screening in this group of age. Due to more prevalent newly diagnosed type 2 diabetes and IFG in men, in all age groups implementation of routine screening for impaired glucose metabolism in men aged over 35 should be considered. Results of the study confirm the importance of the implementation of early prevention programs focused on lifestyle modification, especially addressed to men.
- Published
- 2006
44. Association of coronary atherosclerosis with insulin resistance in patients with impaired glucose tolerance.
- Author
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Stochmal E, Szurkowska M, Czarnecka D, Stochmal A, Klecha A, Kawecka-Jaszcz K, and Szybiński Z
- Subjects
- Adult, Comorbidity, Coronary Artery Disease epidemiology, Disease Progression, Female, Glucose Intolerance epidemiology, Glucose Tolerance Test, Humans, Male, Middle Aged, Myocardial Infarction epidemiology, ROC Curve, Regression Analysis, Coronary Artery Disease physiopathology, Glucose Intolerance physiopathology, Insulin Resistance
- Abstract
Objectives: The purpose of the study was to evaluate the role of insulin resistance (IR) in the development of coronary atherosclerosis in patients with impaired glucose tolerance., Methods and Results: The study group consisted of 42 patients with impaired glucose tolerance. Based upon coronary angiography the patients were divided into group A--with prior myocardial infarction and critical coronary stenosis (n=20) and group B--without prior myocardial infarction and without critical coronary stenosis (n=22). In each patient glucose disposal rate (GDR) during metabolic clamp, insulinaemia in the fasting state and during the clamp, glycaemia during oral glucose tolerance test (OGTT), BMI and body mass composition were measured. The groups did not differ in age, BMI, percent fat content and distribution, and blood pressure. Fasting insulinaemia (56.7 microU/ml) was higher in group A than in group B (22.3 microU/ml). GDR in group A (2.96 mg/kg b.m./min) was lower than in group B (5.36 mg/kg b.m./min). There was a negative correlation between the number of critically narrowed coronary vessels and GDR in group A. GDR below 3.97 mg/kg b.m./min was found, based on regression analysis, to be a powerful risk factor for myocardial infarction., Conclusions: The relationship between IR and severity of coronary atherosclerosis implies its unfavourable role in the development of atherosclerosis. The present findings indicate a negative role of IR in the development of myocardial infarction and suggest that it is an independent risk factor, which identifies high-risk patients requiring treatment that would increase tissue insulin sensitivity.
- Published
- 2005
- Full Text
- View/download PDF
45. [Disturbances of thyroid function in adult population of the city of Cracow followed up for ten years observation].
- Author
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Buziak-Bereza M, Gołkowski F, and Szybiński Z
- Subjects
- Adult, Aged, Female, Follow-Up Studies, Humans, Hyperthyroidism prevention & control, Hyperthyroidism urine, Hypothyroidism prevention & control, Hypothyroidism urine, Male, Middle Aged, Poland epidemiology, Thyroid Function Tests, Hyperthyroidism epidemiology, Hypothyroidism epidemiology, Iodine deficiency, Iodine therapeutic use, Iodine urine, Urban Population statistics & numerical data
- Abstract
Unlabelled: The aim of the study was to define disturbances of thyroid function in adult population of the city of Cracow followed up for ten years. The analysis included the results obtained from 891 individuals, 571 females and 320 males aged 18-78 years examined prior to and after implementation of the obligatory model of iodine prophylaxis (years 1989-1990 and 1998-1999). After the exclusion of patients diagnosed earlier as having hyperthyroidism or hypothyroidism, the mean TSH level in the years 1998-1999 was significantly higher as compared to data obtained between 1989 and 1990 (1.44 microj/ml vs. 1.30 microj/ml) in the examined population. Our 10 years observation revealed an insignificant increase in frequency of hyperthyroidism only among females (1.6% vs. 0.9%) which did not indicate a clear, endemic in character increase at the population level. In the present investigations, hypothyroidism was demonstrated to occur more frequently as compared to the 1989-90 study (2.1% vs. 1.4% among females and 0.3% vs. 0% in males). Both differences were not statistically significant. As seen from the present results, over the investigated 10-year period, in the Cracow population, there occurred a clear, statistically significant (p<0.001) increase of the percentage of individuals with an elevated TPO antibody titter (3.8% vs. 11.8%). In our investigation no correlation was observed between anti-TPO antibodies and ioduria levels., Conclusions: The results reveal no statistically significant increase in incidence of hyperthyroidism and hypothyroidism after implementation of the obligatory model of iodine prophylaxis. The future studies are needed to clarify the mechanisms involved in increase of anti-TPO autoantibodies and verify its possible temporary nature.
- Published
- 2005
46. [Iodine deficiency in pregnancy--a continuing public health problem].
- Author
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Szybiński Z
- Subjects
- Adult, Female, Goiter epidemiology, Humans, Infant, Newborn, Iodine therapeutic use, National Health Programs standards, Poland epidemiology, Pregnancy, Pregnancy Complications epidemiology, Sodium Chloride, Dietary administration & dosage, Goiter prevention & control, Iodine deficiency, Maternal Nutritional Physiological Phenomena, Maternal Welfare, Pregnancy Complications prevention & control, Primary Prevention standards
- Abstract
Iodine prophylaxis in Poland started in 1997 and is based on mandatory iodzation of household salt with 20-40 mg KI/ 1 kg, supplementation of bottle fed infants with iodized formulas with 10,0 microg KI/100 ml, and a voluntary supplementation of pregnant and breast feeding women with additional 100-150 microg of iodine/ day. Last evaluation of efficacy of the iodine prophylaxis performed in 2003 by WHO and International Council for the Control of Iodine Deficiency Disorders allocated Poland within the group of the European countries with sufficient iodine supplementation on the population level. However according to data of the Institute of Mather and Chield in Poland, around 50 % of pregnant women only is additionally supplemented with iodine. Iodine deficiency during pregnancy even as a moderate iodine deficiency, creates a risk of mental retardation, perinatal complication like low and very low births weigt of neonates with increased perinatal mortality rate and late consequences in adult life: metabolic syndrom and type 2 diabetes. Another limitation of the actual model of iodine prophylaxis in Poland, it is too high consumption of natrum chloride (over 5,0 g of household salt/day/ capita). It is around 50% over WHO recommendation. Intensive preventive program against hypertension, type 2 diabetes, atherosclerosis, osteoporosis and some neoplasmatic diseases includes limitation of natrum chloride consumption- as one of the risk factors. Therefore new scope of the National Programme for Elimination of Iodine Deficiency will include: a special prorgramme for the iodization of animal food according to european standard, increased rate of pregnant women additionally supplemented with iodine, strengthening public awarness on necessary increase of milk consumption especially in pregnancy and in children and continouse monitoring system of biologic effects and technologic quality of the model of iodine prophylaxis.
- Published
- 2005
47. [Insulin resistance indices in population-based study and their predictive value in defining metabolic syndrome].
- Author
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Szurkowska M, Szafraniec K, Gilis-Januszewska A, Szybiński Z, and Huszno B
- Subjects
- Adult, Blood Glucose metabolism, Comorbidity, Female, Glucose Intolerance epidemiology, Glucose Tolerance Test statistics & numerical data, Humans, Incidence, Male, Middle Aged, Poland epidemiology, Predictive Value of Tests, Prevalence, Glucose Intolerance diagnosis, Insulin Resistance, Mass Screening statistics & numerical data, Metabolic Syndrome diagnosis, Metabolic Syndrome epidemiology
- Abstract
Unlabelled: In clinical studies insulin resistance, the main factor of the Metabolic Syndrome (MS), is determined directly by metabolic clamp technique, while in epidemiological studies is estimated on the basis of indices calculated from oral glucose tolerance test glycemia and insulinemia. The aim of the study was to find out which insulin resistance indicator best predicts the risk of the MS., Material and Methods: The study population consisted of 2673 inhabitants of Kraków, aged 35-75 years, who participated in the "Polish Multicenter Study on Diabetes Epidemiology". Fasting insulin, HOMA-IR, QUICKI and Matsuda's index were determined for all subjects. Insulin resistance was defined as the cutoff values for the population with normal glucose tolerance and with BMI < 25 kg/m2., Results: All insulin resistance indices were closely correlated (r=0.78-0.98), and the frequency of insulin resistance in the general population was similar (47%-54%), however the highest prevalence of insulin resistance was observed when Matsuda index was used. The risk of insulin resistance, increased with the category of glucose tolerance, and was the highest when Matsuda index was used. The MSWHO was observed in 42% to 45% of the studied population and the predictive value of insulin resistance indices were similar when using WHO criteria. The highest sensitivity in the MSNCEP identification was observed when Matsuda index was used. Matsuda index had also the highest sensitivity to diagnose MSNCEP as compared with the remaining insulin resistance indices., Conclusions: The study insulin resistance indices have a similar value in predicting the MSWHO while Matsuda index predicts best the MSNCEP. Matsuda index as well predicts best the risk of insulin resistance. This argues in favor of using oral glucose tolerance test to estimate risk for diabetes mellitus and cardiovascular disease.
- Published
- 2005
48. [Studies on iodine deficiency in adult population of Cracow].
- Author
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Buziak-Bereza M, Gołkowski F, and Szybiński Z
- Subjects
- Adult, Female, Goiter diagnosis, Goiter, Endemic epidemiology, Goiter, Endemic prevention & control, Goiter, Nodular epidemiology, Goiter, Nodular prevention & control, Humans, Incidence, Male, Middle Aged, Poland epidemiology, Prevalence, Retrospective Studies, Time Factors, Goiter epidemiology, Goiter prevention & control, Iodine deficiency, Iodine therapeutic use, Iodine urine, Urban Population statistics & numerical data
- Abstract
The aim of the study carried out in 1989-90 and 1998-99 was to define the iodine deficiency state and goiter prevalence in adult population of Cracow. The analysis included data obtained from 230 individuals (143 females and 87 males). The mean age was 36 +/- 15 years. The thyroid size and morphology was determined by ultrasound method using Aloka unit equipped with 7.5 MHz linear transducer. The concentration of iodine in casual morning urine sample was measured using Sandell-Kolthoff's method. The 10- year observation revealed an insignificant decrease in prevalence of goiter from 26.2% to 21.8%. We observed statistically significant (p = 0.001) decrease in the parenchymal goiter prevalence from 22.7% to 11.7 in the same period of time. The significant increase in incidence of nodular goiter was found (6.5% vs 20.8%, p < 0.001). In all groups investigated through 1989-99, there was an increase in medians of ioduria over the 10-year period. The level of urinary iodine excretion was not essential element for risk of nodular goitre. Thus, the results indicate the beneficial effect of iodine prophylaxis which reflects in decrease of prevalence of parenchymal goiter. No clear effect of iodine prophylaxis was noticed regarding rise in nodular goiter incidence.
- Published
- 2005
49. [Analytical problems of iodine defficiency examination in Polish Nation-wide deficit control program].
- Author
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Naskalski JW, Drozdz R, Solnica B, Rostworowski W, Szybiński Z, Huszno B, Trofimiuk M, and Buziak-Bereza M
- Subjects
- Adolescent, Child, Goiter, Endemic epidemiology, Health Services, Humans, Incidence, Mass Screening methods, Poland epidemiology, Goiter, Endemic diagnosis, Iodine deficiency
- Abstract
The environmental iodine deficiency has been a serious problem in the Polish health care system for many years. In many European countries the prevention of iodine deficiency-related health deficits in population scale is based on edible salt supplementation with KI. In the decade of the 80-ties the iodine supplementation program in Poland was stopped, which has caused a subsequent increase in prevalence of goiter and iodine deficiency-related hypothyreosis. These diseases were observed in many regions of Poland, including the areas beyond regions of formerly known iodine deficiency endemias. In order to control the whole Polish population, iodine consumption deficit in1991 the "Polish Program of Iodine Deficiency Control and Prevention of Iodine Deficiency-related Disorders" has been established in the year 1991. In 1992--1996 a common iodine supplementation of salt used for general consumption was 20 mg KI/kg of NaCl, and in 1997 the mandatory supplementation of salt was 30 (+10) per kg of salt which has been introduced for the whole country. This paper reports the results of iodine excretion assays in school children 6-12 years old, in the years 1993--94, 1996--97 and 1999--2002 respectively. The obtained collections of iodine urine concentrations have shown distributions with a remarkable rightward skewness. Normalization of distributions required logarythmic transformation. The quartile values obtained for data collections from years 1992--94, 1996--97 and 1999--2002 have shown that in 5-7 years of iodine deficiency prevention program yielded increase in iodine excretion in morning urine samples by about 37.8 microg, while the iodine excretion median values increased from 63.5 mg/L in years 1992--1994 to 94.0 mg/L in years 1999--2001, respectively. The lower limits of iodine excretion ranges calculated as the mean value minus 2SD of transformed data for the years 1992--1994 amounted to: 7.74 mg/L and for the years 1999--2001 amounted to 14.1 microg/l, respectively. Assessing percent of children obtaining low iodine suplementation then recommended (below 50 mg/L in urine sample) amounted to 35.8% in years 1992--1994 and 15.4% in years 1999--2001 respectively.
- Published
- 2004
50. [Assessment of early immunosuppressive therapy in the prevention of complications of Graves' disease].
- Author
-
Huszno B, Trofimiuk M, Gołkowski F, Plinta T, and Szybiński Z
- Subjects
- Adult, Antithyroid Agents therapeutic use, Drug Therapy, Combination, Female, Graves Disease immunology, Humans, Male, Thyrotoxicosis immunology, Thyrotoxicosis prevention & control, Treatment Outcome, Adrenergic beta-Antagonists therapeutic use, Azathioprine therapeutic use, Graves Disease drug therapy, Graves Disease prevention & control, Immunosuppressive Agents therapeutic use, Methimazole therapeutic use
- Abstract
Unlabelled: Regardless the autoimmune origin of Graves' disease, the preferred method of its treatment remains antithyroid drug administration. Use of immunosuppressive agents (mostly steroids) is still limited to the therapy of disease complications, such as proliferative ophthalmopathy. The aim of the study was to assess the influence of early immunosuppressive treatment of autoimmune thyrotoxicosis with azathioprine on the course of the disease and the incidence of its complications. The study comprised 64 patients (47 females and 17 males aged 20-43 years) for the first time diagnosed with Graves' disease. The subjects were randomised into two groups. Group I consisted of 28 patients treated only with antithyroid drugs, the remaining 36 subjects additionally receiving azathioprine were included into group II. The dose of both drugs was adjusted during the treatment according to metabolic status of each patients. The treatment was continued for 8-14 months, the follow-up duration after therapy withdrawal was 5 years. Euthyreosis was achieved in all patients 2-8 weeks after treatment initiation. No drug intolerance symptoms were observed in group I. In four patients additionally treated with azathioprine, gastrointestinal side effects or leucopenia were present. The disease relapse was observed during the follow-up period in 15 (53.5%) patients of group I and in 3 (8.3%) of group II, the difference was statistically significant (p<0.01). Only one patient receiving additionally azathioprine presented ophthalmic symptoms compared with seven subjects (25%) treated only with antithyroid drugs (p<0.001). The patients of group I were also more frequently referred to surgical treatment due to rapid goitre growth (accordingly 5 (17.8%) and 1 (2.7%) patients, p=0.07), the difference between both groups not being statistically significant., Conclusions: Additional early immunosuppressive treatment significantly decreased frequency of Graves' disease complications and thyrotoxicosis recurrence. The use of azathioprine may be advised in patients with contraindications to the radical Graves' disease treatment and in prophylaxis of its complications.
- Published
- 2004
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