Postpartum depression : bipolar or unipolar? Analysis of 434 Polish postpartum women

Objective: To assess the prevalence of soft bipolar features in a sample of women with postpartum depressive symptoms, as well as to compare the sociodemographic and obstetric characteristics of subjects with bipolar or unipolar postpartum depressive symptomatology. Methods: Four hundred and thirty-four participants were enrolled in this cross-sectional study. Postpartum depression (PPD) symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), while the Mood Disorder Questionnaire (MDQ) was used to screen for bipolarity features. Results: Of the 434 participants, 66 (15.2%) scored ≥ 13 points on the EPDS, thus fulfilling the screening criteria, and 103 scored ≥ 7 points on the MDQ. In comparison with non-depressed subjects, the women who scored positively on the EPDS were significantly more likely to exhibit symptoms of bipolar spectrum disorders (38 vs. 21%; chi-square test, p = 0.015). Women with bipolar PPD symptomatology were significantly younger than those exhibiting unipolar PPD symptoms (31.0±4.8 years vs. 28.5±4.1 years; t-test, p = 0.03). The groups did not differ in terms of obstetric characteristics. Conclusion: Our findings suggest that patients with PPD symptomatology may be more likely to exhibit soft bipolarity features as compared with non-depressed women

Tobacco smoking in Poland in the years from 2003 to 2014 : multi-centre National Population Health Examination Survey (WOBASZ)

The reduction of tobacco smoking remains a challenge for public health. The main purpose of this study was to evaluate changes in the prevalence and patterns of tobacco use in the adult population of Poles in the years from 2003 to 2014. Furthermore, changes in the smoking addiction, the declared reasons for smoking, as well as readiness and motivation to stop smoking were assessed. Based on data from the Polish studies WOBASZ and WOBASZ II, the analysis included 14 576 participants from the first study (6906 men and 7670 women) and 5696 participants from the second study (2578 men and 3118 women), aged between 20 and 74 years. According to the WOBASZ II study, 30% of men and 21% of women in Poland smoked, the rates being 9% and 4% lower for men and women, respectively, in comparison with the WOBASZ study (P <0.001). The average number of cigarettes smoked daily per smoker significantly decreased during the follow‑up period among men (from 17.9 to 15.8 cigarettes per day) and women (from 13.7 to 12.1 cigarettes per day). The percentage of men who never smoked increased from 29.8% to 36.1% (P <0.0001), while the proportion of women who never smoked did not change. However, the percentage of those expressing unwillingness to quit smoking nearly doubled in WOBASZ II in comparison with WOBASZ. Although the smoking rates in Poland have declined over the past decade, smoking remains prevalent among men and women. Therefore, it is necessary to optimize tobacco control in Poland, including fiscal policy, counseling and tobacco addiction treatment, as well as promotional and educational activities, with a special emphasis on the female population

Novel therapies of treating non-muscle invasive bladder cancer when BCG therapy turns out to be insufficient

Introduction: Bladder cancer is one of the most common cancers in the world. There are two forms of bladder cancer: non-muscle invasive bladder cancer and muscle invasive bladder cancer. A common treatment method for non- muscle invasive bladder cancer is intravesical BCG (Mycobaterium bovis) therapy after radical tumor resection. It is estimated that half of patients will have an insufficient response to BCG treatment. Patients using this type of therapy also report side effects more and more often. Aim of the study: The aim of this article is to discuss the latest discoveries in the treatment of non-muscle invasive bladder cancer when BCG therapy is insufficient. Material and Methods: The paper was created based on the PubMed and Scholar database. The literature was reviewed using the key words: „bladder cancer”; „BCG”; „treatment”; „side effects”; „novel therapies”. Results: The research shows that novel therapies are effective and safe compared to the use of BCG. In such patients, atezolizumab, metformin or intravesical magnesium sulfate infusions may be used as an alternative. An innovative solution is the use of HIVEC - heated chemotherapy administered intravesically. There are also drugs that potentiate the action of BCG, making the therapy more effective. These include: sasanlimab and rapamycin. Due to the side effects experienced by patients, the use of intravesical BCG is often replaced with intravesical infusions of chemotherapy drugs. Conclusion: The research shows that novel therapies are effective compared to the use of BCG. Unfortunately, more research is needed to standardize the treatment of non-muscle invasive bladder cancer

Trends in hypertension prevalence, awareness, treatment, and control among Polish adults 75 years and older during 2007–2014

Background: The aim of this study was to assess changes in the prevalence, awareness, and treatment of hypertension and its effectiveness between 2007 (WOBASZ Senior study) and 2013–2014 (WOBASZ II) in a sample of the Polish population over the age of 75 years. Methods: Sampling had three stages, stratified according to voivodeships, type of community, and gen­der. Finally, the WOBASZ II study included 467 persons (290 women and 177 men). For a comparison of the data, 1096 persons (538 women and 554 men) examined in the WOBASZ Senior study were used. Results: Systolic and diastolic blood pressures significantly decreased from 153.0 ± 23.9 mmHg to 142.9 ± 22.3 mmHg and from 85.2 ± 11.9 mmHg to 78.4 ± 11.3 mmHg, respectively, from 2007 to 2014 (p &lt; 0.0001). Prevalence of hypertension among people included in WOBASZ studies slightly decreased from 83.8% to 77.9% (rate ratio [RR]: 0.95; 95% confidence interval [CI]: 0.78–1.16) in men, and from 75.4% to 71.8% (RR: 0.93; 95% CI: 0.8–1.09) in women. Hypertension awareness was improved from 59.2% to 72.9% (RR: 1.23; 95% CI: 0.97–1.56) in men, and from 74,8% to 93% (RR: 1.26; 95% CI: 1.01–1.58) in women. The proportion of men and women, with implemented hypertension treatment, increased from 48.4% to 61.1% (RR: 1.26; 95% CI: 1.01–1.58), and from 63.2% to 82.0% (RR: 1.3; 95% CI: 1.1–1.53), respectively. The effectiveness of the treatment was improved over two-fold, there was an increase from 10.3% to 26.8% (RR: 2.65; 95% CI: 1.81–3.89) in men, and from 13.8% to 33.5% in women (RR: 2.44; 95% CI: 1.81–3.3). Conclusions: The prevalence of hypertension in Polish seniors remains high, but has decreased slightly in the perspective of the last 7 years. Although treatment and control has improved over the last decade, it remains below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Polish seniors should be intensified

Prevalence, awareness, treatment and control of hypertension in the adult Polish population : multi-center National Population Health Examination Surveys : WOBASZ studies

Introduction: Hypertension is one of the main risk factors of cardiovascular diseases. The first aim of the study was to evaluate the prevalence, awareness and treatment of hypertension as well as treatment effectiveness (blood pressure < 140/90 mm Hg) in a representative sample of the Polish population over the age of 19, examined in the WOBASZ II program. The second aim was to assess the changes in these parameters between 2003-2005 (WOBASZ study) and 2013-2014 in adults aged 20-74. Material and methods: Sampling was performed in three stages, stratified according to voivodeship (province), type of commune, and gender. Finally, the study included 6163 persons (3406 women and 2757 men) examined in the years 2013-2014 (aged ≥ 19 years). For comparison the data from 14 755 persons (7783 women and 6452 men aged 20-74 years) examined in the years 2003-2005 were used. Results: In the years 2013-2014, the age-standardized prevalence of hypertension, awareness, treatment and control was 42.7%, 59.3%, 46.1%, and 23% respectively. In the last decade an increase in the prevalence of hypertension (relative ratio (RR) 1.12; 95% confidence interval (CI): 1.07- 1.18), treatment (RR = 1.26; 95% CI: 1.17-1.36) and control (RR = 2.16; 95% CI: 1.91-2.45) was found. In contrast, the awareness decreased nonsignificantly (RR = 0.98; 95% CI: 0.92-1.05). Conclusions: The prevalence of hypertension in Poland is high, and increased by about 12% in 10 years. Although the number of treated patients and blood pressure control improved nearly twofold over the last decade, this is still below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Poland should still be intensifie

Zalecenia dotyczące stosowania badań pozytonowej emisyjnej tomografii w onkologii

Positron emission tomography (PET) is a modern functional imaging method with proven value in diagnosing, staging, evaluating of response to anticancer therapy and detecting of relapses in numerous neoplasms. Utility, sensitivity and specificity of PET has increased by its use in combination with computed tomography (CT) or magnetic resonance in form of fusion PET-CT or PET-MR and the introduction of new radiotracers. This paper, prepared based on scientific evidence by a multidisciplinary group of authors, presents the utility and clinical recommendations for the application of PET-CT in oncology. PET-CT is particularly useful for: — appropriate diagnosis and initial staging of patients with head and neck, lung, pancreatic and esophageal cancers as well as lymphomas, advanced melanomas and tumors of unknown primary site; — detection of relapses inpatients with colorectal, thyroid, ovarian, head and neck, and breast cancers, as well as lymphomas; — monitoring of response to therapy in patients with testicular and lung cancers, lymphomas and some types of sarcomas. PET-MR is particulary useful in pediatrics.  Pozytonowa emisyjna tomografia (PET) jest nowoczesną metodą czynnościowego obrazowania o potwierdzonej wartości w rozpoznawaniu i określaniu stopnia zaawansowania, ustalaniu kategorii odpowiedzi na leczenie przeciwnowotworowe oraz wykrywaniu nawrotów wielu nowotworów. Użyteczność, czułość i swoistość PET znacznie zwiększyły się po połączeniu z badaniem za pomocą komputerowej tomografii (KT) lub magnetycznego rezonansu (MR) oraz wprowadzeniu nowych radiofarmaceutyków. Obecne opracowanie, przygotowane na podstawie dowodów naukowych przez wielodyscyplinarny zespół autorów, przedstawia użyteczność i zalecenia kliniczne stosowania badania PET-KT w onkologii. Badanie PET-KT jest szczególnie przydatne w: — rozpoznawaniu i określaniu wyjściowego zaawansowania u chorych na nowotwory głowy i szyi, płuca, trzustki, przełyku oraz chłoniaki, zaawansowane czerniaki i nowotwory o nieznanym punkcie wyjścia; — wykrywaniu nawrotów u chorych na nowotwory jelita grubego, tarczycy, jajnika, głowy i szyi, piersi oraz chłoniaki; — określaniu odpowiedzi na leczenie u chorych na nowotwory jądra, płuca oraz chłoniaki i niektóre mięsaki. Badanie PET-MR jest szczególnie istotne w zastosowaniach pediatrycznych

Morphometry of the heart orifices and morphometry and topography of the coronary ostia in the goat

Background: The coronary vessels have been described in various species of domestic and wild ruminants. However, no studies on the detailed morphology and morphometry of heart orifices and coronary ostia in the Polish goat are available. Materials and methods: The study was carried out on 112 female, adult dairy goats belonging to Polish Fawn Improved and Polish White Improved breed, closely related to French Alpine and Saanen, respectively. Results: In all examined individuals, all heart orifices and heart valves were of normal structure. There was no significant diametrical difference between the aortic and pulmonary orifice. The right atrioventricular opening was significantly wider than the left atrioventricular opening. The dimension of the left coronary ostium ranged from 1.0 to 5.5 mm with the arithmetic mean (±standard deviation [SD]) of 4.3 ± 0.8 mm. The dimension of the right coronary ostium ranged from 0.5 to 5.0 mm with the arithmetic mean (±SD) of 2.8 ± 0.7 mm. Both coronary artery ostia were located under the sinotubular junction. 39/112 examined goats (34.8%) had variations in the structure of the coronary ostia such as the lack of main trunk or the presence of additional coronary ostia. They were observed in one (in 34/39 goats) or both coronary arteries (5/39 goats). Conclusions:  In goats, the dimensions of aortic and pulmonary orifices are similar while the right atrioventricular opening outsizes the left one. On the other hand, the left coronary ostium is wider than the right one. Morphological variations in the coronary ostia occur in approximately one third of goats, more often in the right than in the left ostium

Systems for grading the strength of recommendations in clinical practice guidelines in oncology

Introduction. In order to improve the applicability of clinical practice guidelines, their authors assign recommendations with grades denoting the degree of conviction regarding their practical application. Nevertheless even within one branch of medicine, significant differences between the grading systems arise. Material and methods. To identify these systems, websites of societies and institutions publishing oncology guidelines were searched. Only high-quality, regularly updated guidelines were included. Results. Five systems were analysed – all incorporate quality of evidence and strength of recommendation, but vary in the methods of their assessment and structure of the scales. Discussion. The described systems depend on the review of data, the quality of which supports the ascribed strength. Systems differ with regard to the methods of assessing the quality, quantity and consistency of evidence, potentially leading to assigning different grades of strength to recommendations based on the same studies. Conclusions. The introduction of unified grading systems across each branch of medicine could aid the development of unambiguous recommendations that are easy to introduce within the healthcare system