CHANGES IN THE INCOMES AND EXPENDITURES OF HOUSEHOLDS IN POLAND AND THEIR REGIONAL RELATIONS

The article assesses the financial situation of households in 2000-2019 in prospect of changes of incomes and expenditures in Poland. It has been assumed, as a point of reference, that dispersionof the analysed processes is dependent on geographical area– therefore regional scale was applied. To the analysis and comparison the data from the researches on households budgetsperformed by GUS were used. Adopting simultaneously an econometric approach (considering the time (years 2000-2019) as independent, explanatory variable) analytical trend functions wereestimated. A retrospective analysis of the incomes and expenditures of the population of Poland indicates the growing trends. Regional comparative analysis of households allows to drawconclusions that level of economic condition is very diversified

Comparison of fetal myocardial contractility before and after laser photocoagulation of communicating vessels in twin-to-twin transfusion syndrome

Objectives: To evaluate changes in myocardial contractility that occur after selective laser photocoagulation of communicating vessels (SLPCV) in fetuses from pregnancies complicated with twin-to-twin transfusion syndrome (TTTS). Methods: The study included 51 pregnant women between 16 and 26 weeks of gestation who underwent SLPCV due to TTTS. Ultrasonography was performed before SLPCV and on postoperative day 1, 3(4) and 7. Fetal heart contractility in both fetuses was evaluated by determining the shortening fractions of the left and right ventricles (FS LV and FS RV), and the myocardial performance index (Tei-Index). Results: There was a significant increase in postoperative FS LV and FS RV in recipients (from 35.7% to 44%, P=0.037 and from 27.6% to 32.9%, P=0.021, respectively). Pre-operative Tei-Index values for both the left (0.55) and right ventricle (0.6) were above normal. The mean postoperative Tei-Index for the left ventricle decreased significantly to 0.49 (P=0.011), while no significant change was observed in the right ventricle (0.57). No significant differences between pre- and postoperative FS and Tei-Index values were noted in the donors. Conclusions: SLPCV is reflected by a significantly increased myocardial contractility in recipients

Ambulatory blood pressure monitoring and subclinical inflammation in children with chronic kidney disease

Background. Children with chronic kidney disease (CKD) are characterized by increased risk of hypertension andchronic low-grade inflammation. The aim of the study was the analysis of relation between parameters of ambulatoryblood pressure monitoring (ABPM) and subclinical inflammation in children with CKD. Material and methods. Study group included 27 paediatric patients (age 14.23 ± 3.57 years) with CKD stage 2–5;18 children with previously recognized hypertension. In all patients we evaluated ABPM, office blood pressure,complete blood count and selected clinical and biochemical parameters. Results. In the study group, GFR was from 7.05 to 86.73, mean 40.88 ± 25.82 mL/min/1.73 m2. All 9 childrenwithout hypertension had normal blood pressure in ABPM, but ABPM detected poor blood pressure control in 7among 18 (38.9%) children with previously recognized and treated hypertension. Abnormal circadian blood pressureprofile was found in 12 (44.4%) children: 9/18 (50.0%) with hypertension and 3/9 (33.3%) with normal BP. Systolic,diastolic, mean blood pressure and diastolic blood pressure load correlated with neutrophil count, neutrophilto-lymphocyte ratio and platelet-to-lymphocyte ratio (r = 0.39–0.49, p = 0.010–0.044); diastolic and mean bloodpressure and diastolic blood pressure load with parathormone (r = 0.48–0.57, p = 0.005–0.023); diastolic bloodpressure load with phosphate and calcium-phosphorus product (r = 0.44–0.47, p = 0.021-0.030); diastolic bloodpressure dipping with phosphate (r = –0.43, p = 0.034). Conclusions. 1. Ambulatory blood pressure monitoring should be used in children with chronic kidney disease on aregular basis, especially in those with arterial hypertension. 2. Blood pressure in children with chronic kidney diseasemay be related to degree of subclinical inflammation

Outcome after supracricoid laryngectomies in the material of ENT Department, Poznan University of Medical Sciences

All patients with T1 and T2 laryngeal cancer should be treated with the intent to preserve the larynx. In T3 glottic low-volume tumors, larynx preservation is an appropriate standard treatment option. Supracricoid partial laryngectomy remains a reasonable alternative to radiotherapy for patients with T2–T3 glottic cancer. Prospective clinical study aims to evaluate the oncological results of supracricoid partial laryngectomy as a treatment for selected glottic and supraglottic carcinoma, and to determine the different prognostic factors that may influence local control and survival. In the period of 2000–2007, 145 patients were treated at the academic tertiary referral medical center: ENT Department, University of Medical Sciences, Poznán, Poland. The ages of the analyzed group of patients ranged from 23 to 79, with mean 56.5 age for men and 25 for women. All of the patients had biopsy proven squamous cell carcinoma. Of the 145 patients 82 had glottic cancer and 63 had supraglottic cancer. The patients were staged according to the 2003 edition of the TNM classification established by the AJCC. The pathological TNM classification was additionally taken into consideration. All patients were treated by means of supracricoid and transglottic partial laryngectomy. The type of supracricoid partial laryngectomy was based on tumor localization and extension. Four patients underwent cricohyoidopexy, 57 cricohyoidoepiglottopexy, 65 reconstruction modo Calearo, and 19 modo Sedlacek-Tucker. We performed 21 unilateral selective neck dissections and none bilateral. A nasogastric feeding tube was inserted in all patients, and removed in patients that regained proper swallowing. As a result, we took into consideration the oncological and functional results. Histopathological examination of the operating specimen revealed the presence of dysplasia or invasive carcinoma at the margins, or a close margin of less than 5 mm from the edge of the resection (16 cases). The metastases were found on the neck in three cases, predominantly in the level II (2 cases) and III (1 case). Metastasis was found in one patient that had undergone CHP, Sedlacek-Tucker, and Calearo, respectively. Five patients received postoperative radiotherapy. The decision to use adjuvant radiotherapy was based on the presence of invasive carcinoma at the resection margin and on the presence of multiple positive neck nodes or extracapsular spread of the disease. The Kaplan–Meier estimated 3- and 5-year overall survival rates in the group of 122 because 23 patients did not report for medical check-ups

What has changed in the prevalence of hypertension in dialyzed children during the last decade?

Background: Hypertension very often accompanies progression of chronic kidney disease (CKD) in children. A cross-sectional analysis of hypertension prevalence in dialyzed children in Poland was designed with a comparison with the data previously recorded 10 years earlier. Methods: Two cohorts of children were analyzed: 59 subjects dialyzed in 2013, and 134 children from the previous study performed in 2003 that were reevaluated according to the current methodology. The incidence of hypertension (defined by SDS of sBP or dBP >1.64), clinical data, medical history, dialysis modalities and selected biochemical parameters of dialysis adequacy were analyzed. Results: The prevalence of hypertension increased from 64% in 2003 to 78% in 2013. The efficacy of antihypertensive treatment remained unsatisfactory (61% proper BP control). Preservation of residual urine output and strict fluid balance may prevent development of hypertension in children on dialysis. Conclusions: Despite the higher awareness of hypertension and its complications in dialyzed children, the incidence of this entity has increased during the last decade, with the percentage of undertreated patients comparable to that observed 10 years ago. Thus, more attention should be paid to therapy efficacy in this population to prevent further damage to the cardiovascular system and to decrease morbidity