Ocena morfologii i dystrybucji naczyń włosowatych w kapilaroskopii wału paznokciowego u chorych na twardzinę układową i zdrowych osób

Introduction: Systemic sclerosis (SSc) is a connective tissue disease characterized by vascular damage and immunological abnormalities leading to fibrosis that can damage multiple organs. The pathogenesis is complex and still poorly understood. However impaired angiogenesis in SSc has a major role in tissue injury and sequelae fibrosis. Nailfold capillaroscopy (NC)/nailfold videocapillaroscopy (NVC) is safe and non-invasive methods used to investigate microvascular changes in the peripheral circulation and it is a method of great diagnostic value in diagnosing and monitoring the patients with SSc. Typical microvascular alterations, called scleroderma pattern characterized by giant capillaries, haemorrhages and successive loss of capillaries, are observed at NC/NVC in a significant percentage of SSc patients, hence our interest was focused on the assessment of NVC in patient with systemic sclerosis (SSc). Material and methods: Thirty patients with SSc according to the ACR and EULAR criteria and healthy volunteers underwent NVC assessment. Nailfold capillaroscopy was performed by a videocapillaroscope and the picture of the capillaries at the hands were documented and evaluate. Results: NVC disturbed patterns were significantly prominent in SSc patients (p < 0.05) compared to the healthy control group. A normal capillaroscopic pattern was not observed in patients with SSc. The number of loops/mm was significantly lower in SSc group (p < 0.05) and was 4.28 capillaries/mm (min.1/mm; max. 10/mm). We did not notice significant difference in frequency of mega-capillaries (lcSSc/dcSSc: 41%/29%, p > 0.05) and avascular areas (lcSSc/dcSSc: 64%/57%, p > 0.05) between limited (lSSc) and diffuse (dSSc) SSc. Conclusions: Severe capillary damage is characteristic for SSc patients therefore NVC seems to be useful for selection of patients developing SSc

Rozpowszechnienie palenia tytoniu oraz palenie bierne w populacyjnych badaniach polskiego programu cindi w latach 1991–2007 – analiza porównawcza

Prevalence of tobacco use and environmental tobacco smoke in polish population research. WHO-CINDI Programme in 1991–2007This article is a report from comparison surveys, carried out in connection with WHO-CINDI Programme during the years 1991–2007. The analysis was based on random sampling tests concerning big Polish cities’ inhabitants, all in all almost 11.5 thousand respondents. Taking everything into consideration, it has been established, that:1. Regular smoking frequency becomes smaller (the effect of implemented prophylactic programmes, a so-called ‘intervention variable’).2. Still, propagation of environmental smoking is an alarming   phenomenon, however it is definitely improving. Despite the fact, that more and more respondents are living in a free-smoking zone, each 5-6 adult city inhabitant spends over 5 hours a day in a room full of smoke.3. Within time passing, as a result of quitting an addiction, a belief concerning harmful smoking consequences grows. This tendency is not yet sufficiently justified. Becoming alarmed with the concerning phenomenon is definitely not enough when making an opinion in this matter

Years of life lost as a measure of premature death among dual‑chamber pacemaker recipients from Małopolska Province

Background: Pacemakers have become the standard of care in patients with severe bradycardia and conduction abnormalities. The survival and premature mortality can be assessed using the years of life lost (YLLs). Aims: The aim of the study was to analyze mortality trends over the period from 1999 to 2015 among patients implanted with a dual‑chamber (DDD) pacemaker who were inhabitants of Małopolska Province. Methods: This was a retrospective study of records collected from consecutive patients who underwent de novo DDD pacemaker implantation at a single center between 1984 and 2014. Inclusion criteria were residence status in Małopolska Province at the latest follow‑up visit and death between 1999 and 2015. The standard expected years of life lost per death was used to calculate YLLs. Time trends were evaluated with joinpoint models and presented as an average annual percentage change (AAPC). Results: Among a total of 3932 consecutive patients implanted with a DDD pacemaker, 1211 patients met the inclusion criteria. We noted an increase in the mean age at implant from 70 years in 1999 to 75.5 years in 2015 (AAPC, 0.6%; P < 0.05), the number of years lived after DDD pacemaker implantation from 2.6 years to 8.2 years (AAPC, 7.4%; P < 0.05), and the mean age at death from 72.6 years to 83.8 years (AAPC, 0.89%; P < 0.05). Finally, we observed a reduction of the YLLs per death from 17.4 years in 1999 to 9 years in 2015 (AAPC, –4%; P < 0.05). All trends were significant for both men and women. Conclusions: In the 17‑year follow‑up, we showed significant changes in analyzed trends, in particular a reduction in the YLLs per death

The impact of smoking tobacco and drinking alcohol on mortality risk in people of working age – Results of an 8-year study in a large urban center

Background: The aim of the study was to assess the effects of smoking and drinking alcohol on death rates in working-age urban inhabitants in Poland. Material and Methods: In 2001 randomly selected inhabitants of Łódź, aged 18-64 years, were included in the WHO Program Countrywide Integrated Noncommunicable Diseases Intervention (CINDI). The study sample comprised 1828 people (1002 men, 826 women). In 2009 for all participants of the 2001 study, information was obtained whether they were living or deceased, or moved out of Łódź. The Cox proportional hazard model was used for the evaluation of hazard ratios (HR). Results: The analysis revealed the increased risk of death among Łódź inhabitants of working age. An 8-year follow-up yielded the following values: for active smokers compared with people slightly addicted to nicotine, HR = 2.582 (95% CI: 1.381-4.825, p < 0.003); for people heavily addicted to nicotine, HR = 3.656 (95% CI: 1.544-8.654, p < 0.004); and for passive smokers (risk for persons staying in smoky rooms up to 5 h a day, compared to those not living in smoke-filled rooms), HR = 2.021 (95% CI: 1.111-3.672, p < 0.03). The variable that had a protective effect on the mortality risk of working-age population turned out to be a "reasonable" use of alcohol (HR = 0.411, 95% CI: 0.227-0.744, p < 0.004), compared to non-drinking alcohol at all. Conclusions: Addiction to smoking significantly increases the risk of premature death, and therefore appropriate prevention programs aimed at the reduction of smoking can contribute to closing the gap in the population health status. Med Pr 2014;65(2):251–26

THE IMPACT OF SMOKING TOBACCO AND DRINKING ALCOHOL ON MORTALITY RISK IN PEOPLE OF WORKING AGE - RESULTS OF AN 8-YEAR STUDY IN A LARGE URBAN CENTER

Background: The aim of the study was to assess the effects of smoking and drinking alcohol on death rates in working-age urban inhabitants in Poland. Material and Methods: In 2001 randomly selected inhabitants of Łódź, aged 18-64 years, were included in the WHO Program Countrywide Integrated Noncommunicable Diseases Intervention (CINDI). The study sample comprised 1828 people (1002 men, 826 women). In 2009 for all participants of the 2001 study, information was obtained whether they were living or deceased, or moved out of Łódź. The Cox proportional hazard model was used for the evaluation of hazard ratios (HR). Results: The analysis revealed the increased risk of death among Łódź inhabitants of working age. An 8-year follow-up yielded the following values: for active smokers compared with people slightly addicted to nicotine, HR = 2.582 (95% CI: 1.381-4.825, p < 0.003); for people heavily addicted to nicotine, HR = 3.656 (95% CI: 1.544-8.654, p < 0.004); and for passive smokers (risk for persons staying in smoky rooms up to 5 h a day, compared to those not living in smoke-filled rooms), HR = 2.021 (95% CI: 1.111-3.672, p < 0.03). The variable that had a protective effect on the mortality risk of working-age population turned out to be a "reasonable" use of alcohol (HR = 0.411, 95% CI: 0.227-0.744, p < 0.004), compared to non-drinking alcohol at all. Conclusions: Addiction to smoking significantly increases the risk of premature death, and therefore appropriate prevention programs aimed at the reduction of smoking can contribute to closing the gap in the population health status. Med Pr 2014;65(2):251–26

Determinants of premature mortality in a city population: An eight-year observational study concerning subjects aged 18–64

Background: Premature deaths constitute 31.1% of all deaths in Łódź. Analysis of the causes of premature deaths may be helpful in the evaluation of health risk factors. Moreover, findings of this study may enhance prophylactic measures. Material and Methods: In 2001, 1857 randomly selected citizens, aged 18-64, were included in the Countrywide Integrated Noncommunicable Diseases Intervention (CINDI) Programme. In 2009, a follow-up study was conducted and information on the subjects of the study was collected concerning their health status and if they continued to live in Łódź. The Cox proportional hazards model was used for evaluation of hazard coefficients. We adjusted our calculations for age and sex. The analysis revealed statistically significant associations between the number of premature deaths of the citizens of Łódź and the following variables: a negative self-evaluation of health - HR = 3.096 (95% CI: 1.729-5.543), poor financial situation - HR = 2.811 (95% CI: 1.183‑6.672), occurring in the year preceding the study: coronary pain - HR = 2.754 (95% CI: 1.167-6.494), depression - HR = 2.001 (95% CI: 1.222-3.277) and insomnia - HR = 1.660 (95% CI: 1.029-2.678). Our research study also found a negative influence of smoking on the health status - HR = 2.782 (95% CI: 1.581-4.891). Moreover, we conducted survival analyses according to sex and age with Kaplan-Meier curves. Conclusions: The risk factors leading to premature deaths were found to be highly significant but possible to reduce by modifying lifestyle-related health behaviours. The confirmed determinants of premature mortality indicate a need to spread and intensify prophylactic activities in Poland, which is a post-communist country, in particular, in the field of cardiovascular diseases

Determinants of heavy smoking: Results from the global adult tobacco survey in Poland (2009–2010)

Objective: The aim of current analysis was to identify socio-demographic correlates of heavy smoking. Materials and Methods: Global Adult Tobacco Survey (GATS), a nationally representative household study was implemented in Poland between 2009 and 2010. We used data on representative sample of 1915 adults, age 25 years and older. The Odds Ratios (OR) and 95% Confidence Intervals (CI) for heavy smoking to the broad number of variables including age, age at smoking onset, education, occupational classification, living conditions, place of residence, place of residence at age about 14 years, awareness of smoking health consequences were tested in logistic regression model. Results: Among daily smokers the rate of heavy smokers was 63% in males and 45% in females (p < 0.001). The present study indicated that three characteristics: age, early age at smoking onset and lack of awareness of smoking health consequences were significantly associated with heavy smoking among both genders. Significantly higher risk of heavy smoking was observed among the 50–59 years of age population compared to the youngest group. The heavy smoking rate was highest among males who started smoking under age 14 years (OR = 3.1; 95% CI: 1.4–6.7; p < 0.001) and females that started smoking at age 14–17 years (OR = 2.3; 95% CI: 1.5–3.5; p < 0.0001) compared to those who started smoking at age 21 years or older. Heavy smoking was significantly correlated to lack of awareness of adverse health consequences of smoking (OR = 1.5; 95% CI: 1.1–2.03; p < 0.01 and OR = 1.5; 95% CI: 1.0–2.2; p < 0.01 for men and women, respectively) compared to aware respondents. Conclusions: These outcomes should be taken into account while developing tobacco control measures. Among other things, educational interventions to increase knowledge of adverse tobacco health effects should be widely implemented

Mortality Trends Due to Skin Melanoma in Poland in the Years 2000&ndash;2020

The aim of this article is to assess mortality trends due to skin melanoma in Poland between the years 2000 and 2020, taking into account gender and place of residence (urban, rural). The subject of the analyses was data on 25,061 deaths that occurred between 2000 and 2020 due to skin melanoma (C43 according to ICD-10). Mortality rates due to this cancer, both crude (CDR) and standardised (SDR), were calculated. Trends on the calculated rates were analysed using the annual percentage change (APC) and average annual percentage change (AAPC), obtained from joinpoint regression models. Over the study period, the standardised death rate (SDR) due to skin melanoma in Poland increased from 3.60 to 4.03 per 100,000 population (AAPC = 1.1; p &lt; 0.05), for urban residents it increased from 3.56 to 3.91 (APC = 1.2; p &lt; 0.05) and for rural residents it increased from 3.00 to 4.24 (APC = 2.2; p &lt; 0.05). A higher growth rate in terms of the SDR value between the years 2000 and 2020 was recorded in men compared to women and in rural when compared to urban residents. In Poland, mortality due to skin melanoma is on the rise. The early diagnosis of this cancer should become common practice in the Polish population

Rozpowszechnienie palenia tytoniu oraz palenie bierne w populacyjnych badaniach polskiego programu cindi w latach 1991–2007 – analiza porównawcza

Prevalence of tobacco use and environmental tobacco smoke in polish population research. WHO-CINDI Programme in 1991–2007This article is a report from comparison surveys, carried out in connection with WHO-CINDI Programme during the years 1991–2007. The analysis was based on random sampling tests concerning big Polish cities’ inhabitants, all in all almost 11.5 thousand respondents. Taking everything into consideration, it has been established, that:1. Regular smoking frequency becomes smaller (the effect of implemented prophylactic programmes, a so-called ‘intervention variable’).2. Still, propagation of environmental smoking is an alarming   phenomenon, however it is definitely improving. Despite the fact, that more and more respondents are living in a free-smoking zone, each 5-6 adult city inhabitant spends over 5 hours a day in a room full of smoke.3. Within time passing, as a result of quitting an addiction, a belief concerning harmful smoking consequences grows. This tendency is not yet sufficiently justified. Becoming alarmed with the concerning phenomenon is definitely not enough when making an opinion in this matter