The analysis of Sudden Infant Death Syndrome in Poland

Introduction: Sudden Infant Death Syndrome is defined in literature similarly as a sudden and unexpected death of an infant occurring during sleep and, at the same time, causes of which cannot be explained based on anamnesis, circumstances of death or comprehensive post-mortem examinations. Sudden Infant Death Syndrome is considered to be the most frequent cause of death among infants in the developed countries. Incidence of SIDS in the whole world ranges from about 0.1 to 6.0/1,000 live births. As much as 90% concerns deaths in the first year of life of a child, whereas 70% stands for deaths for which the cause remains unknown. In SIDS, about 90% of cases concern children under 1 year old and, in particular, at the age of between 2 and 4 months.The aim: The aim of the study was to present the most significant aspects of SIDS as well as description and analysis of risk factors for occurrence of sudden infant death syndrome based on statistical data.Materials and methods: For the purpose of the study, the secondary data analysis and desk research technique have been applied. The analysis is based on statistical data from the time period 2009-2014 released by the Central Statistical Office of Poland.Results: In 2009-2014, the highest number of deaths of infants and new-borns was reported in 2009 with the number being as high as 2,327. In the following years, the number of deaths of new-borns and infants systematically decreased. In 2010 it was 2,057 and in 2011 – 1,836, in 2012 – 1,791, in 2013 – 1,684, and in 2014 – 1,583. The highest number of deaths of boys was reported in 2009 – 1,298, while the number of deaths of girls in that year, although it was the highest in the analysed period, was lower – 1,029.Conclusions: cases of death were more frequent among boys rather than girls. The highest number of deaths was reported among infants under the age of one month and the number decreased with an increasing infants’ age. More cases of death were reported in the city area rather than in a village

Standards of analgesic treatment versus hospital practice

Introduction: Pain remedying is a fundamental patient law. Modern medicine is acknowledging the mechanism and the warp of pain, commanding more efficient therapeutic means allowing to control the pain.  Multidirectional pain therapy uses variable techniques and medicines which enables to maximize the analgesic effect during the reduction of side effects of each method.Objective: Evaluation of applying standards of analgesic treatment in hospital practice.Material and methods: There were 100 people with severe pain who underwent surgical and orthopedic treatment, as well as, the ones with chronic pain, staying in neurological ward who took part in the examination. Choice of examined patients was random and embraced hospitals patients in the Podkarpackie voivodeship with “Szpital bez Bólu” (eng.: Hospital without pain) certificate.  Examined group comprised of : 57% of women and 44% of men, living in rural (56%) and urban (44%) area. Research methods used in the examinations, were diagnostic opinion poll, records analysis and pain measurements.Results: 42 % of patients can feel the pain intermittently, 37% is not able to estimate how often do pain ailments occur, however, 21% of people suffer from chronic pain ailments. Patients have estimated their pain as follows: severe (26%), difficult to determine (20%), shooting (16%), burning (15%), radiating (10%), dull (8%), stinging (3%) and the one which appears when touched (2%). Having estimated the pain intensity, 53% of respondents claimed that they feel medium pain intensity and 33% claimed to have felt great pain. Nurses in the post-op (54%) and anesthesiologist (26%) are the one, to inform patient about possibilities and eventual methods of post-operative pain management.Conclusions: Pain limits physical functioning of patient. Five-stage scales included in the examination, were VAS and VRS which are sufficient in prophylaxis and pain alleviation but not entirely readable and understandable for all patients. Education of patient influences on the awareness and abilities of evaluating the pain

The analysis of incidence of risk factors of neoplastic diseases among patients with a diagnosed neoplastic disease

Introduction: Risk of neoplastic diseases in the whole world’s population has been increasing regularly. Thanks to the GLOBACAN data base operating under the auspices of the International Union Against Cancer it has been reported that up to 2002 10,900,000 of new cases of cancer were diagnosed and 6,700 deaths were reported. According to the World Health Organization, in 2020 we may expect about 10 million deaths, including 7-8 millions in the developing countries, while this number in the developed countries will not change and will be 2-3 million. The world’s most frequently occurring tumour is lung cancer. It accounts for 12.4% of all tumours diagnosed. According to the epidemiological research, the basic factors responsible for cancer development among people are those environmental factors that result from humans’ behaviour.Objective: The objective is to analyze the occurrence of risk factors of a neoplastic disease among patients with a diagnosed oncological disease.Material and methods: The research involved 500 patients of the oncology department. Women accounted for more than a half of all patients, namely 58%, while men 42%. In order to obtain the research material, a standardized questionnaire has been applied, including interview and physical examination, enabling assessment and analysis of occurrence of cancer risk factors.Results: The most frequently diagnosed tumour among women is breast cancer (20%), while among men the most frequently occurring is prostate cancer (10%). 20% of women and 10% of men lived near high-voltage line. 11% of women were active smokers while 6% passive smokers. When it comes to men, 18% were active smokers, while 5% passive smokers.Conclusions: The most frequent cancer among women is breast cancer, while among men prostate cancer. Smoking does not have a significant influence on cancer development in women, however, it has a significant influence on cancer development in men. Overweight and obesity have a significant influence on cancer development in women, while they have insignificant influence on cancer development in men

Zatrudnienie w Polsce 2006: Produktywnosc dla pracy

This book constitutes a follow-up and extension of Employment in Poland 2005. In this issue we analyse the influence of demand-side factors on Polish labour market and especially so from the macroeconomic and regional perspectives. We begin with macroeconomic look at the labour markets in eight – out of ten – states which joined the EU in 2004. We focus on identifying aggregate disturbances which had a crucial influence on the economic fluctuations within the CEE region in the period 1994-2005, and we assess to what extent these disturbances are responsible for different dynamics of unemployment and employment trends in the examined countries and to what extent different fiscal and monetary approaches adopted at that time contributed to remedy these disturbances. The key finding resulting is that the relatively most significant decrease in employment and increase in unemployment levels in Europe, which came about in Poland after the year 2000, are due to the idiosyncratic decrease in return on capital and total factor productivity [TFP] dynamics. We also find that, although the policy-mix adopted in the above period was not the direct cause for the slowdown, its role in accommodating the shock was probably moderately negative. Then we study regional differences in the labour market in Poland in the period 2000-2005. We analyse aggregate data and identify microeconomic factors affecting trends in job creation and destruction. We group the NUTS4 regions in Poland in six homogenous clusters and find that in the period 2000-2005 no significant changes in the labour market indicators occurred either between clusters or between voivodeships (NUTS2 regions). This is so because the direction and depth of fluctuations on the regional scale were generally shaped by aggregate shocks which affected the economy as a whole. Moreover, the above period saw a greater differentiation in terms of productivity and thus, in most parts of Poland, increasing employment and unemployment rates are due to the development of labour-intensive manufacturing. We argue that only the largest urban conglomerations in Poland have adopted the development model which supports high economic growth in medium and long term. In third part of the study we focus on spatial mobility of Polish workers. In case of both internal and international migrations we demonstrate that economic factors determine significantly decisions about changing place of residence and that the key incentive to migrate is higher wages in the destination location and a relatively worse situation in the labour market in the region of origin. We also estimate the scale of international migration from Poland, which indicate that the number of people who stayed abroad for more than two months in the year 2005 was higher by approximately 165,000-379,000 people than before EU accession, due to one-time increase in migration flows. Moreover, we point out that international migration is mostly seasonal and that emigrants retain strong ties with their homeland. As for internal migration, we argue that its aggregate intensity is relatively modest and we emphasise that although in general the population moves from smaller to larger conglomerates, the limited scale of these movements makes the progress in urbanisation being slow and agglomerations less numerous than in other EU member states. In the long run, this may constitute an obstacle for real convergence to the most developed EU countries. Finally we scrutinize work in the non-observed economy (NOE) in Poland. According to various methodologies we asses the NOE output at 15-30 per cent of the GDP, and we find that the main reasons behind the existence of the grey economy in Poland are overly burdensome fiscal policy and excessively restrictive economic regulations. We close the report with demonstrating links between areas we studied and implications for labour market and economic policy in Poland.Poland; unemployment; employment; transition countries; labour market shocks; unemployment persistance; regional disparities; labour migration; informal employment

Employment in Poland 2007: Security on flexible labour market

This Report is a third in the series Employment in Poland. It consists of four Parts, devoted to empirical analysis of the impact of macroeconomic shocks on EU New Member States labour markets‘ in 1996-2006; utilization of flexible forms of employment on Polish labor market, determinants of wages and wage inequalities in Poland; effectiveness of ALMP in Poland, respectively. In Part I, we present how the cyclical upturn propagated on Polish labour market in 2003-2007 and how the performance of that market evolved relatively to other EU countries. Then we apply a panel SVECM to study propagation of macroeconomic shocks in eight CEE countries which joined the EU in 2004. We show that demand side shocks (foreign demand and labour demand shocks) were of foremost importance to unemployment and employment fluctuations in the region. At the same time, we argue that the wage shocks, thought of as wage rigidities, were important internal disturbances affecting the developments on the labour markets in the region. Part II is devoted to atypical forms of labour employment. We show that in all CEE countries the incidence of nonstandard employment arrangements is much lower than in Western Europe. Although Poland stands out in the whole EU with its dynamic spread of temporary employment and integration of temporary work agencies in the functioning of the labour market, in general the potential of atypical employment in Poland and other CEE is largely unfulfilled when it comes to work- life balance or supporting the economic activity of people who find it difficult to work full-time due to age or health reasons. In case of Poland, we study in more detailed way the legal, infrastructural and tax-related factors affecting the utilisation of nonstandard forms of employment. In Part III, we study wage developments in Poland from macro- and micro-perspective alike. We argue that wage growth in Poland exhibited a significant inertia during the transition period. We find that the concurrent rise of wage inequalities in Poland was due to the fact that rapid technological progress favoured some professional and social groups more than others. The increasing return on formal education and rising premiums on work in managerial positions as well as increasingly diverse individual and market characteristics of Polish workers seem to play the key role. The public sector stands out with higher wage compression than private sector. We show also that, in international comparison, the gender wage gap in Poland is relatively small. Notwithstanding the above, even if differences in individual and employer characteristics as well as working time are taken into consideration, women still earn about ten percent less than men. Part IV focuses active labour market policies (ALMP). We assess the ALMP spending and structure in Poland and we use the survey, conducted for the purposes of this Report, to study to effectiveness of ALMP. To our knowledge, it is the first attempt at producing a rigorous and comprehensive evaluation of ALMP effectiveness in Poland in the recent years. Applying Propensity Score Matching, we find that intervention and public works turn out to be completely inefficient when it comes to enhancing employment chances of the unemployed. At the same time, even for those programs that are characterised by positive net efficiency, such as internships and traineeships, the deadweight loss is also high, i.e. support is extended to groups whose situation is relatively good, whereas more difficult cases are neglected. Thus, the placement of ALMP participants in Poland is sub-optimal, which partly reflects very poor job broking and counseling done by PES. We complete the report with policy implications

Selection pressure phenomenon during treatment of chronic myeloid leukemia patients with BCR-ABL1 tyrosine kinase inhibitors: problem analysis on the basis of case report

Mimo ogromnego postępu związanego z wprowadzeniem do terapii chorych na przewlekłą białaczkę szpikową (CML) inhibitorów kinazy tyrozynowej (TKI) u około 15% pacjentów stwierdza się oporność na leczenie I linii za pomocą imatynibu (IM). Jest ona w około 40% przypadków związana z obecnością mutacji w obrębie domeny kinazowej BCR-ABL1 (KD BCR-ABL1). Część defektów jest oporna na IM, a jego stosowanie prowadzi do selekcji klonów opornych niewrażliwych także na TKI II generacji (dazatynib, nilotynib). W pracy przedstawiono przebieg choroby u pacjentki z CML w fazie przewlekłej, u której z powodu oporności na IM podjęto leczenie nilotynibem. Stosowanie leku doprowadziło do uzyskania większej odpowiedzi cytogenetycznej, a następnie jej utraty, w wyniku obecności mutacji Y253H KD BCR- -ABL1. Zmiana inhibitora II generacji na dazatynib pozwoliła uzyskać całkowitą odpowiedź hematologiczną po 3 miesiącach terapii. Niestety, wkrótce potem rozpoznano fazę akceleracji choroby i potwierdzono obecność innej mutacji F317L KD BCR-ABL1. Przebieg choroby u wspomnianej chorej był podstawą do podjęcia dyskusji dotyczącej zjawiska presji selekcyjnej związanego ze stosowaniem TKI u chorych z CML. Hematologia 2010; 1, 3: 261-266Despite a great progress related to the introduction of tyrosine kinase inhibitors (TKI) to the therapy of patients with chronic myeloid leukemia (CML), resistance to the first-line treatment with imatinib (IM) is diagnosed in about 15% of patients. In about 40% of cases it is related to the presence of mutations affecting kinase domain of BCR-ABL1 (KD BCR-ABL1). Some defects are IM-resistant and its further administration leads to the selection of resistant clones, insensitive also to the 2nd generation TKIs (dasatinib, nilotinib). This paper focuses on medical history of patient diagnosed with CML in the chronic phase in whom nilotinib treatment was started due to the appearance of IM-resistance. Administration of nilotinib allowed to obtain major cytogenetic response and, subsequently, its loss due to the emergence of Y253H mutation within KD BCR-ABL1. Substitution of the 2nd generation drug to dasatinib allowed to obtain complete hematological response after 3 months of treatment. Unfortunately, the acceleration phase of the disease and the presence of another F317L mutation of KD BCR-ABL1 were documented thereafter. Disease outcome in the presented case was the reason for undertaking a discussion about selection pressure phenomenon related to TKI administration in patients with CML. Hematologia 2010; 1, 3: 261-26

Diagnosing and management of iatrogenic moderate and severe ovarian hyperstymulation syndrome (OHSS) in clinical material.

Severe ovarian hyperstymulation syndrome is a rare but potentially life-threatening complication in patients undergoing assisted reproductive techniques (ART). The pathogenesis of this condition is likely to be multifactorial. The aim of the retrospective study was to present management in moderate and severe iatrogenic ovarian hyperstymulation syndrome (OHSS) in clinical material. The study group was 19 women, admitted to the Department of Obstetrics and Gynecology in Central Clinical Hospital of Ministry of Interior and Administration in Warsaw from large outpatient infertility center "Novum" in Warsaw with moderate and severe OHSS between 14.07.2004 and 8.11.2005. Laboratory tests and ultrasound examination of the ovarian size and ascites were performed, abdominal circumference was measured. Patients were treated with rehydration with intravenous crystalloids and colloids, diuretics, antibiotics, anticoagulants and ultrasound-guided paracentesis if symptoms of ascites become severe (ascites causes pain and compromised pulmonary function). Oral intake of water was restricted, monitoring of fluid intake and output, and daily monitoring of body weight was performed. During treatment controlled laboratory tests were done. In one patient occurred intra-abdominal hemorrhage from ovarian rupture and laparotomy with oophorectomy was performed. The ovarian hyperstimulation syndrome is still a difficult diagnostic and therapeutic problem and more studies are required to elucidate pathophysiology of OHSS. Because of still unknown etiology treatment is empirical and in most of cases bases on experience of medical team. Thus, the management in individual patients varies according to the severity of ovarian hyperstymulation syndrome and its complications

Periphyton in urban freshwater facilitates transformation of trace organic compounds: A case study on iodinated contrast media

Introduction: Due to urbanization and demographic change trace organic compounds (TrOCs), synthetic chemicals such as pharmaceuticals, personal care products or biocides are an increasing problem in waterbodies affected by treated sewage. This contamination is particularly relevant when surface water is used for drinking water production, either directly or by bank filtration. Removal and transformation of TrOCs are affected by a variety of processes, and we hypothesize that periphyton, the mixture of photo- and heterotrophic biota attached to submerged surfaces of aquatic ecosystems, can facilitate TrOC transformation. Here we experimentally tested the influence of periphyton on different substrates on the transformation of iodinated contrast media (ICM). These hydrophilic compounds are problematic due to their poor removal by conventional wastewater treatment and high persistence of the triiodinated benzoic acid within aquatic environments. Methods: We added 100 μg L-1 of three ICM, iopromide (IOP), iopamidol (IOM) and diatrizoate (DIA) to batch experiments containing periphyton on artificial substrates or on invasive quagga mussels and to a column experiment with periphyton, quagga mussels and sediment from a bank filtration site in a lake. Results: IOP concentrations were reduced by up to 93% after 30 days in batch experiments with periphyton on artificial substrates and completely in treatments with mussels and periphyton. In contrast, no concentration decrease was observed for IOM and DIA. IOP reduction was positively correlated with periphyton biomass ranging from 0.7 to 9.2 g dry weight m-2 and negatively correlated with oxygen saturation. 9 of 12 known aerobic IOP transformation products frequently occurring in treated wastewater were found. Discussion: We suggest that periphyton facilitated IOP transformation by providing substrate for bacterial growth and enhanced bacterial growth rates due to algal photosynthesis, a co-oxidation catalyzed by ammonia oxidizing bacteria and by a stimulatory influence of labile carbon produced by periphytic algae on the microbially mediated decomposition of IOP. Periphyton is facilitated by increased nutrient supply of dense mussel stands or by an increased surface area provided in dense macrophyte stands. Consequently, changes in the abundance of these littoral communities by invasion or management can affect TrOC transformation and thus water quality for drinking water production from urban freshwaters.Peer Reviewe

Employment in Poland 2007: Security on flexible labour market

This Report is a third in the series Employment in Poland. It consists of four Parts, devoted to empirical analysis of the impact of macroeconomic shocks on EU New Member States labour markets‘ in 1996-2006; utilization of flexible forms of employment on Polish labor market, determinants of wages and wage inequalities in Poland; effectiveness of ALMP in Poland, respectively. In Part I, we present how the cyclical upturn propagated on Polish labour market in 2003-2007 and how the performance of that market evolved relatively to other EU countries. Then we apply a panel SVECM to study propagation of macroeconomic shocks in eight CEE countries which joined the EU in 2004. We show that demand side shocks (foreign demand and labour demand shocks) were of foremost importance to unemployment and employment fluctuations in the region. At the same time, we argue that the wage shocks, thought of as wage rigidities, were important internal disturbances affecting the developments on the labour markets in the region. Part II is devoted to atypical forms of labour employment. We show that in all CEE countries the incidence of nonstandard employment arrangements is much lower than in Western Europe. Although Poland stands out in the whole EU with its dynamic spread of temporary employment and integration of temporary work agencies in the functioning of the labour market, in general the potential of atypical employment in Poland and other CEE is largely unfulfilled when it comes to work- life balance or supporting the economic activity of people who find it difficult to work full-time due to age or health reasons. In case of Poland, we study in more detailed way the legal, infrastructural and tax-related factors affecting the utilisation of nonstandard forms of employment. In Part III, we study wage developments in Poland from macro- and micro-perspective alike. We argue that wage growth in Poland exhibited a significant inertia during the transition period. We find that the concurrent rise of wage inequalities in Poland was due to the fact that rapid technological progress favoured some professional and social groups more than others. The increasing return on formal education and rising premiums on work in managerial positions as well as increasingly diverse individual and market characteristics of Polish workers seem to play the key role. The public sector stands out with higher wage compression than private sector. We show also that, in international comparison, the gender wage gap in Poland is relatively small. Notwithstanding the above, even if differences in individual and employer characteristics as well as working time are taken into consideration, women still earn about ten percent less than men. Part IV focuses active labour market policies (ALMP). We assess the ALMP spending and structure in Poland and we use the survey, conducted for the purposes of this Report, to study to effectiveness of ALMP. To our knowledge, it is the first attempt at producing a rigorous and comprehensive evaluation of ALMP effectiveness in Poland in the recent years. Applying Propensity Score Matching, we find that intervention and public works turn out to be completely inefficient when it comes to enhancing employment chances of the unemployed. At the same time, even for those programs that are characterised by positive net efficiency, such as internships and traineeships, the deadweight loss is also high, i.e. support is extended to groups whose situation is relatively good, whereas more difficult cases are neglected. Thus, the placement of ALMP participants in Poland is sub-optimal, which partly reflects very poor job broking and counseling done by PES. We complete the report with policy implications.Poland; unemployment; employment; transition countries; labour market shocks; SVECM; wage rigidities; flexible forms of employment, wage inequalities, wage determinants, active labour market policy, ALMP effectiveness