Aetiology, diagnosis and management of halitosis – a narrative review

Objectives The present study aimed to present an overview of the aetiology of oral malodour and the diagnostic and treatment procedures. Design A comprehensive review of scientific literature (up to December 2021) was conducted using Medline and PubMed databases and Google Scholar, including checking reference lists of journal articles by hand-searching. Results are presented descriptively for halitosis's aetiology, diagnosis and clinical management. Results The origin of the foul odour problem is mainly due to intra-oral causes, while only a proportion of cases result from additional systemic problems. In some cases, the problem can be caused by co-existing oral and extraoral problems. Evidence suggests that the leading cause of intra-oral halitosis is the anaerobic microorganisms present in the tongue plaque. Less commonly, the foul odour is due to poor oral hygiene and periodontitis. Conclusion The origin of the foul odour problem is mainly due to intra-oral causes, while only a proportion of cases result from additional systemic problems. Dentists need to analyse and treat the oral problems that may be responsible for the patient's malodour, as well as inform the patient about the causes of the foul odour and oral hygiene procedures (flossing, tongue cleaning, selection and use of appropriate mouthwash and toothpaste). If the problem persists, they should know whom to refer the patient to for further diagnosis. It is reasonable to organise consultations on halitosis in a multidisciplinary setting - periodontists, otolaryngologists (ENT specialists), internal medicine specialists, gastroenterologists, psychiatrists, psychologists and others

Can we expect re-emergence of infectious diseases in the near future?

Ever since Hippocrates expressed the view that environmental factors can influence disease incidence, attempts have been made to link the emergence of disease, especially outbreaks of infectious diseases, with the various factors that contribute to their occurrence. Among the possible causes favoring the spread of pathogens and the increase in the incidence of infectious diseases, environmental and social conditions are mentioned. An unprecedented set of new conditions has made the human population more vulnerable and more susceptible to infectious diseases than ever before. It is possible that the observed contemporary patterns of development and spread of infectious diseases may be seen as heralds of a new stage of epidemiological transformation characterized by an increased risk of infectious disease epidemics. In past centuries, one of the hallmarks of infectious disease plagues has been their unpredictability. Currently, warning forecasts prepared by scientists do not always translate into preventive measures

Interdisciplinarity and multidisciplinarity of the medical profession. Opportunity or threat?

This article aims to describe the actual scope of requirements for physicians and analyse it as an opportunity for, or threat to, the development of the profession. The article will be subdivided into two parts. In the first, concerning the interdisciplinarity of the medical profession, we shall provide constructive criticism of the specialisation system within the medical profession. This part will be subdivided into two segments: the first will list the opportunities for physicians which result from often far-reaching specialisation, while the second will enumerate the threats. The second part, dealing with the multidisciplinarity of the medical profession will define the scope of actual competences required from physicians so as to judge whether such a large amount of additional knowledge is helpful for physicians in fulfilling their professional requirements, or if it overwhelms them

Internal and external factors determining effective implementation of the National Health Programme

This article explores various factors that affect implementation of the Polish health strategy, namely National Health Programme (NHP). On the basis of the concept of the Health Policy Triangle, the authors identify several factors of effective implementation of the NHP for the years 2016–2020 under the current legislation and organisational conditions. Those factors are divided into two groups: internal (dependant on NHP policy document) and external ones (related to legal and organisational context of programme’s implementation). Next, each factor is briefly characterised to provide some general guidance for the NHP for the next period. The final part of the article contain a list of proposed actions and decisions to be taken in order to ensure higher effectiveness of the next NHP

Increasing the effectiveness of health care by paying for results - specifics, examples and conditions for effective application

W artykule dokonano przeglądu najnowszej literatury zagranicznej (głównie amerykańskiej), przedstawiającej koncepcje oraz sposób wdrożenia systemów wynagradzania za wyniki (P4P) i kupowania w oparciu o wartość (V-BP) w opiece zdrowotnej. Ich celem jest wzrost efektywności, rozumianej jako udzielanie wysokiej jakości świadczeń zdrowotnych po uzasadnionym koszcie. Do podstawowych warunków ich zastosowania autorki zaliczyły opracowanie standardów medycznych oraz funkcjonowanie systemów informatycznych, rejestrujących wykonane procedury i osiągnięte efekty zdrowotne. Przedstawione doświadczenia zagraniczne pokazują, że sukces systemów typu P4P i V-BP zależy od dobrania właściwych kryteriów oceny (m.in. działania o udowodnionej skuteczności klinicznej, zależne od świadczeniodawców, różnorodne), a także od odpowiedniego powiązania wynagradzania z poziomem i dynamiką wartości tych kryteriów u usługodawców. Specyfika opieki zdrowotnej wymaga zatem ścisłej współpracy specjalistów ds. zarządzania z profesjonalistami medycznymi zarówno na etapie konstrukcji systemów, jak i wdrażania oraz zmian.A review of the recent literature (mainly American) on the concept and implementation of pay-for-performance (P4P) and value-based purchasing (V-BP) systems in health care has been elaborated in the article. The aim of these systems is to increase effectiveness - provision of high quality health care services at a reasonable cost. Development of medical standards and information systems, recording medical procedures and achieved health effects are among the basic conditions for implementation of P4P or V-BP like systems. The experience from abroad shows that the success of these systems depends on a proper selection of assessment criteria (evidencebased actions, fully controlled by providers, various) as well as a proper relationship between payments and the level and dynamics of the providers' implementation of the criteria. Therefore, health care requires a tight collaboration between management specialists and medical professionals at the construction stage as well as during the implementation and changes of the systems

Healthcare Utilization and Adherence to Treatment Recommendations among Children with Type 1 Diabetes in Poland during the COVID-19 Pandemic

Type 1 diabetes mellitus (T1D) is, next to obesity and asthma, the most common chronic disease in children in Poland. The results of T1D treatment strongly depend on the patient’s compliance with therapeutic recommendations, which entails the use of necessary health services. Based on a retrospective analysis of the data on health services provided in 2016–2020 to over 15.5 thousand patients with T1D in Poland, we assessed the compliance of the actual model of treatment of T1D in children with the current guidelines. It was found that only about 50% of patients received the number of diabetes consultations corresponding to the recognized standards, with about 15% of children with T1D remaining outside the public healthcare system. In the case of many outpatient services (ophthalmological, neurological, mental health), the number of consultations was extremely low—one order of magnitude lower than in general population and dropped even lower in 2020. This shows that the health needs of children with T1D are not being met within the public healthcare system. The COVID-19 pandemic caused significant limitations in access to healthcare in Poland. Compared to the pre-pandemic period there was a significant decrease (−27% compared to 2019) in the number of hospitalizations, and a substantial increase (+22% compared to 2019) in the number of diabetic ketoacidoses (DKA) cases. The proportion of hospitalizations caused by DKA rose to 8.9% compared to 7.3% in 2019

Preferred sources of information on diabetes prevention programmes: a population-based cross-sectional study in Poland

Objective This study aimed to analyse preferred sources of information on diabetes prevention programmes and to identify sociodemographic determinants influencing these preferences among adults in Poland.Design A cross-sectional survey was carried out between 15 and 18 September 2023 using a computer-assisted web interview. A self-prepared questionnaire included 10 questions on sources of information on type 2 diabetes prevention.Participants Data were obtained from 1046 adults (18–82 years); 53.4% were females.Results Most respondents preferred email communication (46.4%), followed by a doctor or nurse (33.5%), and a letter or leaflet directly delivered to the mailbox (25.8%) for type 2 diabetes mellitus (DM2) prevention information. Younger respondents were more likely to indicate mass media (OR=1.81, 95% CI=1.12 to 2.95, p=0.01) and digital media (OR=1.65, 95% CI=1.02 to 2.67, p=0.04) as a source of information on DM2 prevention. Those who had higher education (OR=1.51, 95% CI=1.16 to 1.96, p=0.002), as well as those with chronic diseases (OR=1.50, 95% CI=1.14 to 1.97, p=0.004), were more likely to indicate digital media. Out of 10 different variables analysed in this study, passive occupational status (OR=1.43, 95% CI=1.04 to 1.96, p=0.03) as well as having chronic diseases (OR=1.51, 95% CI=1.16 to 1.96, p=0.002) were associated with higher odds of indicating healthcare workers as a preferred source of information. Marital status, having children, place of residence, household characteristics and financial status do not significantly decide communication preferences.Conclusion Communication on DM2 prevention should be adjusted to public preferences and expectations. Tailoring interventions to different demographic groups can enhance outreach and engagement. Email emerged as a popular choice, suggesting the potential of digital communication in preventive health programmes

National HPV Vaccination Program in Poland—Public Awareness, Sources of Knowledge, and Willingness to Vaccinate Children against HPV

Since 1 June 2023, a nationwide HPV vaccination program was implemented in Poland. This study aimed to identify factors associated with public awareness of the national HPV vaccination program among adults in Poland and willingness to vaccinate children against HPV. This cross-sectional study was carried out between 14 and 17 July 2023 among 1056 adults in Poland. A self-prepared questionnaire was used. Among the respondents, 51.3% had heard about the free HPV vaccination program. The major source of knowledge on the national HPV vaccination program was TV (62%). Only 31.9% of respondents correctly indicated girls and boys aged 12 and 13 as the HPV-vaccination-eligible population. Willingness to vaccinate children against HPV was declared by 63.3% of respondents. Female gender (OR: 1.42; 95% CI: 1.11–1.81; p p p p p p p p < 0.05) were significantly associated with willingness to vaccinate children against HPV