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Szamotulska K, Loghi M, Weber G, Heller G, Zile-Velika I, Isakova J, Monteath K, Jané Checa M, Zhang WH, Gissler M. Setting targets for population health improvements: Trends in perinatal health in Europe over the past five years. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Euro-Peristat network documented disparities in perinatal outcomes between countries in Europe in its reports published every 5 years, but trend analyses were limited because data were not collected annually.
Methods
Using the Euro-Peristat PHIRI protocol, we estimated rates and assessed trends between 2015 and 2019 for preterm birth, stillbirth, neonatal mortality and caesarean delivery. Country-specific relative risks (RR) for year, modelled as a continuous variable, were estimated and random effects meta-analysis used to generate pooled RRs. Heterogeneity was measured with the I2 statistic (percentage of variability in estimates due to heterogeneity rather than sampling error).
Results
Stillbirth rates ≥24 weeks of gestational age (GA) varied in 2019 from <2.5 per 1000 births in Denmark, Estonia, Finland and Slovenia to over 4 per 1000 in Belgium, Cyprus, UK Wales and Lithuania. Preterm birth rates ranged from <6% in Lithuania, Finland, Latvia, Estonia and Denmark to 8% or more in Portugal, Belgium, UK Scotland and Cyprus. Fewer than 20% of births were by caesarean in Norway, the Netherlands, Finland, Estonia in comparison to one-third in Cyprus, Ireland, Italy, UK Scotland. Trends over time differed between countries and were not related to the level of the indicator: the pooled RR by year for preterm birth was 0.99 [0.99; 1.00] with five countries having significant decreases and three countries having increases. Caesarean section rates were stable overall (RR: 1.00 [0.99; 1.01]RR:1.00, 95% CI: 0.99-1.01), but with high heterogeneity (I2=99%); in six countries rates increased significantly, whereas in nine rates decreased between 2015 and 2019.
Conclusions
European countries have varying rates and trends of the principal perinatal health indicators. Investigation of policies in high-performing countries could provide guidance for improvement elsewhere.
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Affiliation(s)
- K Szamotulska
- Department of Epidemiology, Institute of Mother and Child , Warsaw, Poland
| | - M Loghi
- Directorate for Social Statistics & Welfare, Italian Statistical Institute , Rome, Italy
| | - G Weber
- Department of Epidemiology and Statistics, Directorate of Health, Ministry of Health , Luxembourg, Luxembourg
| | - G Heller
- Institute for Quality Assurance and Transparency in the Healthcare Sector , Berlin, Germany
| | - I Zile-Velika
- Center for Disease Prevention and Control , Riga, Latvia
| | - J Isakova
- Health Statistics Department, Institute of Hygiene , Vilnius, Lithuania
| | | | - M Jané Checa
- Department of Health, Public Health Agency of Catalonia , Barcelona, Spain
| | - WH Zhang
- School of Public Health, Université Libre de Bruxelles , Brussels, Belgium
| | - M Gissler
- Finnish Institute for Health and Welfare , Helsinki, Finland
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Zeitlin J, Philibert M, Rihs TA, Draušnik Ž, Gatt M, Engiom HM, Recape J, Szamotulska K, Barros H, Gissler M. Impact of the COVID-19 pandemic on perinatal health and perinatal health inequalities in Europe. Eur J Public Health 2022. [PMCID: PMC9594766 DOI: 10.1093/eurpub/ckac129.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic and lockdowns may adversely affect pregnancy outcomes due to disrupted healthcare provision and increased stress, anxiety and economic hardship. We assessed changes in perinatal outcomes in 2020 using population birth data in Europe. Methods 25 Countries in the Euro-Peristat Network implemented a federated analysis using routine national data. Countries generated anonymised aggregate data files using R scripts from individual-level data formatted to a common data model with 22 variables. We compared preterm birth, stillbirth, neonatal death and caesarean delivery rates in 2020 to 2015-2019 for 2 periods: full-year (FY) and pandemic (March-September [MS]). Data from October onward were not included in the MS period because potentially declining pandemic-related fertility may affect perinatal indicators. Country-specific relative risks (RR) for the periods, adjusted for linear trends, overall and by socio-economic (SES) group, were calculated and pooled using random effects meta-analysis. Results Preterm birth rates decreased slightly (pooled RR: 0.97FY [95% confidence interval (CI) 0.95-0.99]; 0.98MS [0.96-1.00]) in 2020. Heterogeneity was high (I2FY=85%; I2MS=70%), with 5 countries experiencing significant declines. Neonatal mortality rates were unchanged (0.97FY [0.92-1.01]) while stillbirth rates were higher (1.05FY [1.01; 1.09]; 1.10MS [1.02; 1.19]). Caesarean rates were slightly raised (1.02FY [1.00-1.03]; 1.02MS [0.99-1.04], 5 countries had significant increases). Increases for stillbirth were more pronounced in the lowest (1.08FY [0.99-1.16]) versus highest SES group (1.05 FY [0.93-1.17]). Conclusions In 2020, there was an unexpected decline in preterm birth in some countries, while increases in stillbirths and caesarean occurred in others. High country-level heterogeneity suggests that some government policies to mitigate the pandemic might have been more protective of pregnant women and newborns than others.
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Affiliation(s)
- J Zeitlin
- Obstetrical Perinatal and Pediatric Epidemiology, Université Paris Cité , Inserm, Paris, France
| | - M Philibert
- Obstetrical Perinatal and Pediatric Epidemiology, Université Paris Cité , Inserm, Paris, France
| | - TA Rihs
- Federal Statistical Office , Neuchâtel, Switzerland
| | - Ž Draušnik
- Division of Public Health, Croatian Institute of Public Health , Zagreb, Croatia
| | - M Gatt
- Directorate for Health Information and Research , Pieta, Malta
| | - HM Engiom
- Norwegian Institute of Public Health , Bergen, Norway
| | - J Recape
- Université Libre de Bruxelles , Brussels, Belgium
| | - K Szamotulska
- National Research Institute of Mother and Child , Warsaw, Poland
| | - H Barros
- EPIUnit, University of Porto , Porto, Portugal
| | - M Gissler
- Finnish Institute for Health and Welfare , Helsinki, Finland
- Karolinska Institutet , Stockholm, Sweden
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Pankiewicz K, Szczerba E, Fijalkowska A, Szamotulska K, Szewczyk G, Issat T, Maciejewski TM. The association between serum galectin-3 level and its placental production in patients with preeclampsia. J Physiol Pharmacol 2021; 71. [PMID: 33727431 DOI: 10.26402/jpp.2020.6.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/30/2020] [Indexed: 11/03/2022]
Abstract
Galectin-3 is β-galactoside-binding lectin, used in cardiology as a biomarker of heart failure. Available research suggest galectin-3 may play a role in the development of preeclampsia. Seventy seven women were included in the study: 39 with preeclampsia and 38 with uncomplicated pregnancy. Patients underwent blood sample analysis (galectin-3, N-terminal pro-brain natriuretic peptide (NT-proBNP), soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), cystatin C, creatinine) and echocardiographic examination. After delivery, placental tissue samples were obtained for immunohistochemistry evaluation. In patients with preeclampsia, serum galectin-3 levels (11.8 versus 9.5 ng/ml; p = 0.004) and galectin-3 expression in placental tissue (immunoreactive score (IRS) in extravillous trophoblasts: 9 versus 5; p = 0.002; in syncytiotrophoblasts: 6 versus 2, p < 0.001) were significantly higher than in the control group. Serum NT-proBNP and sFlt-1 levels, sFlt-1/PlGF ratio, serum creatinine and cystatin C levels were significantly higher, whereas serum PlGF levels and estimated glomerular filtration rate (eGFR) were significantly lower in preeclamptic patients than in uncomplicated pregnancy. On echocardiography, preeclamptic women had significantly greater thickness of interventricular septum (IVS) and left ventricle posterior wall (PW) and significantly worse left ventricle diastolic function (higher E/e' values). Serum galectin-3 level did not correlate with any other biochemical parameters, as well as the vast majority of echocardiographic parameters. Significant correlation between serum galectin-3 and its placental expression in syncytiotrophoblasts (STB) was revealed. Renal function parameters and NT-proBNP correlated with antiangiogenic state. This study demonstrated increased serum galectin-3 levels and placental galectin-3 production in preeclamptic patients, in comparison to women with uncomplicated pregnancy. Myocardial dysfunction and worse renal function parameters in patients with preeclampsia were not related to galectin-3. The main source of galectin-3 in maternal blood was its placental production. In the development of preeclampsia, galectin-3 may act as a compensatory mechanism to impaired placentation in early pregnancy.
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Affiliation(s)
- K Pankiewicz
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland.
| | - E Szczerba
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - A Fijalkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - K Szamotulska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland
| | - G Szewczyk
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
| | - T Issat
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
| | - T M Maciejewski
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
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Zeitlin J, Alexander S, Barros H, Blondel B, Delnord M, Durox M, Gissler M, Hindori-Mohangoo AD, Hocquette A, Szamotulska K, Macfarlane A. Perinatal health monitoring through a European lens: eight lessons from the Euro-Peristat report on 2015 births. BJOG 2019; 126:1518-1522. [PMID: 31260601 DOI: 10.1111/1471-0528.15857] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2019] [Indexed: 12/01/2022]
Affiliation(s)
- J Zeitlin
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and Statistics (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - S Alexander
- Perinatal Epidemiology and Reproductive Health Unit, CR2, School of Public Health, ULB, Brussels, Belgium
| | - H Barros
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal
| | - B Blondel
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and Statistics (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - M Delnord
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and Statistics (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France.,Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - M Durox
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and Statistics (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - M Gissler
- THL National Institute for Health and Welfare, Helsinki, Finland.,Karolinska Institute, Stockholm, Sweden
| | - A D Hindori-Mohangoo
- Department Child Health, Netherlands Organisation for Applied Scientific Research, TNO Healthy Living, Leiden, the Netherlands.,Perinatal Interventions Suriname, Perisur Foundation, Paramaribo, Suriname.,School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - A Hocquette
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and Statistics (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - K Szamotulska
- Department of Epidemiology and Biostatistics, National Research Institute of Mother and Child, Warsaw, Poland
| | - A Macfarlane
- Centre for Maternal and Child Health Research, City, University of London, London, UK
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Rutkowski P, Lugowska I, Klepacka T, Szumera-Cieckiewicz A, Michalak E, Lenarcik M, Pienkowski A, Teterycz P, Szamotulska K. NY-ESO expression in osteosarcoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx675.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lugowska I, Cybulska-Stopa B, Jagodzinska-Mucha P, Teterycz P, Koseła-Paterczyk H, Kozak K, Szamotulska K, Roman K, Switaj T, Ziobro M, Rutkowski P. Baseline neutrophil-to-lymphocyte ratio and its values monitored over time is associated with outcome of metastatic melanoma patients treated with immunotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Delnord M, Hindori-Mohangoo AD, Smith LK, Szamotulska K, Richards JL, Deb-Rinker P, Rouleau J, Velebil P, Zile I, Sakkeus L, Gissler M, Morisaki N, Dolan SM, Kramer MR, Kramer MS, Zeitlin J. Variations in very preterm birth rates in 30 high-income countries: are valid international comparisons possible using routine data? BJOG 2016; 124:785-794. [PMID: 27613083 DOI: 10.1111/1471-0528.14273] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Concerns about differences in registration practices across countries have limited the use of routine data for international very preterm birth (VPT) rate comparisons. DESIGN Population-based study. SETTING Twenty-seven European countries, the United States, Canada and Japan in 2010. POPULATION A total of 9 376 252 singleton births. METHOD We requested aggregated gestational age data on live births, stillbirths and terminations of pregnancy (TOP) before 32 weeks of gestation, and information on registration practices for these births. We compared VPT rates and assessed the impact of births at 22-23 weeks of gestation, and different criteria for inclusion of stillbirths and TOP on country rates and rankings. MAIN OUTCOME MEASURES Singleton very preterm birth rate, defined as singleton stillbirths and live births before 32 completed weeks of gestation per 1000 total births, excluding TOP if identifiable in the data source. RESULTS Rates varied from 5.7 to 15.7 per 1000 total births and 4.0 to 11.9 per 1000 live births. Country registration practices were related to percentage of births at 22-23 weeks of gestation (between 1% and 23% of very preterm births) and stillbirths (between 6% and 40% of very preterm births). After excluding births at 22-23 weeks, rate variations remained high and with a few exceptions, country rankings were unchanged. CONCLUSIONS International comparisons of very preterm birth rates using routine data should exclude births at 22-23 weeks of gestation and terminations of pregnancy. The persistent large rate variations after these exclusions warrant continued surveillance of VPT rates at 24 weeks and over in high-income countries. TWEETABLE ABSTRACT International comparisons of VPT rates should exclude births at 22-23 weeks of gestation and terminations of pregnancy.
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Affiliation(s)
- M Delnord
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - A D Hindori-Mohangoo
- Department Child Health, TNO, The Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands.,Department Public Health, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - L K Smith
- The Infant Mortality and Morbidity Studies Group (TIMMS), Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - K Szamotulska
- Department of Epidemiology and Biostatistics, National Research Institute of Mother and Child, Warsaw, Poland
| | - J L Richards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - P Deb-Rinker
- Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, ON, Canada
| | - J Rouleau
- Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, ON, Canada
| | - P Velebil
- Institute for the Care of Mother and Child, Prague, Czech Republic
| | - I Zile
- Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - L Sakkeus
- Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - M Gissler
- THL National Institute for Health and Welfare, Helsinki, Finland.,Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Stockholm, Sweden
| | - N Morisaki
- Department of Lifecourse Epidemiology, Department of Social Medicine, National Centre for Child Health and Development, Setagayaku, Tokyo, Japan
| | - S M Dolan
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - M R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - M S Kramer
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - J Zeitlin
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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Delnord M, Szamotulska K, Hindori-Mohangoo AD, Blondel B, Macfarlane AJ, Dattani N, Barona C, Berrut S, Zile I, Wood R, Sakkeus L, Gissler M, Zeitlin J. Linking databases on perinatal health: a review of the literature and current practices in Europe. Eur J Public Health 2016; 26:422-30. [PMID: 26891058 PMCID: PMC4884328 DOI: 10.1093/eurpub/ckv231] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: International comparisons of perinatal health indicators are complicated by the heterogeneity of data sources on pregnancy, maternal and neonatal outcomes. Record linkage can extend the range of data items available and thus can improve the validity and quality of routine data. We sought to assess the extent to which data are linked routinely for perinatal health research and reporting. Methods: We conducted a systematic review of the literature by searching PubMed for perinatal health studies from 2001 to 2011 based on linkage of routine data (data collected continuously at various time intervals). We also surveyed European health monitoring professionals about use of linkage for national perinatal health surveillance. Results: 516 studies fit our inclusion criteria. Denmark, Finland, Norway and Sweden, the US and the UK contributed 76% of the publications; a further 29 countries contributed at least one publication. Most studies linked vital statistics, hospital records, medical birth registries and cohort data. Other sources were specific registers for: cancer (70), congenital anomalies (56), ART (19), census (19), health professionals (37), insurance (22) prescription (31), and level of education (18). Eighteen of 29 countries (62%) reported linking data for routine perinatal health monitoring. Conclusion: Research using linkage is concentrated in a few countries and is not widely practiced in Europe. Broader adoption of data linkage could yield substantial gains for perinatal health research and surveillance.
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Affiliation(s)
- M Delnord
- INSERM, UMR 1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris-Descartes University, Paris, France
| | - K Szamotulska
- Department of Epidemiology and Biostatistics, National Research Institute of Mother and Child, Warsaw, Poland
| | - A D Hindori-Mohangoo
- Netherlands Organization for Applied Scientific Research, TNO Healthy Living, Department Child Health, Leiden, The Netherlands Anton de Kom University of Suriname, Faculty of Medical Sciences, Department Public Health, Paramaribo, Suriname
| | - B Blondel
- INSERM, UMR 1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris-Descartes University, Paris, France
| | - A J Macfarlane
- Centre for Maternal and Child Health Research, City University London, London, UK
| | - N Dattani
- Centre for Maternal and Child Health Research, City University London, London, UK
| | - C Barona
- General Directorate of Public Health, Generalitat Valenciana, Valencia, Spain
| | - S Berrut
- Swiss Federal Statistical Office, Section Health, Neuchâtel, Switzerland
| | - I Zile
- Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - R Wood
- Information Services Division, NHS National Services Scotland, Edinburgh, Scotland, UK
| | - L Sakkeus
- Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
| | - M Gissler
- Information Services Department, THL National Institute for Health and Welfare, Helsinki, Finland
| | - J Zeitlin
- INSERM, UMR 1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris-Descartes University, Paris, France
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Delnord M, Mohangoo AD, Szamotulska K, Gissler M, Zeitlin J. The availability of data on maternal and newborn health in routine systems in 29 European countries. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv173.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Delnord
- INSERM, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153), Paris-Descartes University, Paris, France
| | - AD Mohangoo
- Netherlands Organization for Applied Scientific Research, TNO Healthy Living, Department Child Health, Leiden,The Netherlands
| | - K Szamotulska
- Department of Epidemiology, National Research Institute of Mother and Child, Warsaw, Poland
| | - M Gissler
- THL National Institute for Health and Welfare, Information Services Department, Helsinki, Finland
| | - J Zeitlin
- INSERM, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153), Paris-Descartes University, Paris, France
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Lugowska I, Szamotulska K, Klepacka T, Ambroszkiewicz J, Grygalewicz B, Michalak E, Gajewska J, Lenarcik M, Koch I, Pieńkowska-Grela B, Mierzejewska E, Rutkowski P. 3425 The prognostic value of changes over time of HER-2/ECD concentration in osteosarcoma patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31898-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Delnord M, Szamotulska K, Monhangoo A, Gissler M, Barona C, Barros H, Berrut S, Chalmers J, Dattani N, Sakkeus L, Zile I, Zeitlin J. Linking databases on perinatal health: a review of the literature and current practices in Europe. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku164.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Koseła-Paterczyk H, Szacht M, Morysiński T, Ługowska I, Dziewirski W, Falkowski S, Zdzienicki M, Pieńkowski A, Szamotulska K, Switaj T, Rutkowski P. Preoperative hypofractionated radiotherapy in the treatment of localized soft tissue sarcomas. Eur J Surg Oncol 2014; 40:1641-7. [PMID: 25282099 DOI: 10.1016/j.ejso.2014.05.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/26/2014] [Accepted: 05/29/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The primary treatment of soft tissue sarcomas (STS) is a radical resection of the tumor with adjuvant radiotherapy. Conventional fractionation of preoperative radiotherapy is 50 Gy in fraction of 2 Gy a day. The purpose of the conducted study was to assess the efficacy and safety of hypofractionated radiotherapy in preoperative setting in STS patients. METHODS 272 patients participated in this prospective study conducted from 2006 till 2011. Tumors were localized on the extremities or trunk wall. Median tumor size was 8.5 cm, 42% of the patients had tumor larger than 10 cm, whereas 170 patients (64.6%) had high grade (G3) tumors. 167 patients (61.4%) had primary tumors. Patients were treated with preoperative radiotherapy for five consecutive days in 5 Gy per fraction, with an immediate surgery. Median follow up is 35 months. RESULTS 79 patients died at the time of the analysis, the 3-year overall survival was 72%. Local recurrences were observed in 19.1 % of the patients. Factors that had a significant adverse impact on local recurrence were tumor size of 10 cm or more and G3 grade. 114 patients (42%) had any kind of treatment toxicity, vast majority with tumors located on lower limbs. 7% (21) of the patients required surgery for treatment of the complications. CONCLUSION In this non-selected group of locally advanced STS use of hypofractionated preoperative radiotherapy was associated with similar local control (81%) when compared to previously published studies. The early toxicity is tolerable, with small rate of late complications. Presented results warrant further evaluation.
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Affiliation(s)
- H Koseła-Paterczyk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - M Szacht
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - T Morysiński
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - I Ługowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland; Department of Epidemiology, Institute of Mother and Child, Warsaw, Poland
| | - W Dziewirski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - S Falkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - M Zdzienicki
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - A Pieńkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - K Szamotulska
- Department of Epidemiology, Institute of Mother and Child, Warsaw, Poland
| | - T Switaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland.
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Gajewska J, Weker H, Ambroszkiewicz J, Szamotulska K, Chełchowska M, Franek E, Laskowska-Klita T. Alterations in markers of bone metabolism and adipokines following a 3-month lifestyle intervention induced weight loss in obese prepubertal children. Exp Clin Endocrinol Diabetes 2013; 121:498-504. [PMID: 23771796 DOI: 10.1055/s-0033-1347198] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Adipokines may influence bone metabolism in children, but this phenomenon is not well understood. Therefore, we studied the relationships between bone markers and adipokines during weight loss in obese children. MATERIALS AND METHODS We determined serum leptin, soluble leptin receptor (sOB-R), adiponectin, BALP (bone alkaline phosphatase), CTX-I (C-terminal telopeptide of type I collagen), body composition and bone mineral density (by dual-energy X-ray absorptiometry) in 100 obese prepubertal children before and after 3 months of lifestyle intervention (low-energy diet, physical activity). The control group consisted of 70 non-obese children. RESULTS Obese children had higher BALP activity by about 20% (p<0.001) and similar value of CTX-I compared with non-obese children. After weight loss (-0.96 BMI-SDS mean change), the BALP value in obese patients decreased (p<0.001), whereas CTX-I concentration was unchanged. Changes in BALP were positively correlated with changes in BMI (Body Mass Index) (r=0.352, p<0.001), but not associated with adipokine levels. Trend analysis using SDS-BMI subgroups showed that greater reduction of body mass was associated with a greater decrease of BALP (p=0.035) and leptin values (p<0.001), as well as a greater increase of sOB-R (p<0.003). CONCLUSIONS Obesity during the prepubertal period is associated with an alteration in the adipokines profile and greater whole-body bone mass as a result of increased bone formation rather than reduced bone resorption. Changes in bone metabolism during lifestyle intervention seem to be related to weight loss but not to changes in adipokines. Further studies should elucidate the influence of long-term therapy on bone mass in childhood.
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Affiliation(s)
- J Gajewska
- Screening Department, Institute of Mother and Child, Warsaw
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14
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Zeitlin J, Szamotulska K, Drewniak N, Mohangoo AD, Chalmers J, Sakkeus L, Irgens L, Gatt M, Gissler M, Blondel B. Preterm birth time trends in Europe: a study of 19 countries. BJOG 2013; 120:1356-65. [PMID: 23700966 PMCID: PMC4285908 DOI: 10.1111/1471-0528.12281] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2013] [Indexed: 12/02/2022]
Abstract
Objective To investigate time trends in preterm birth in Europe by multiplicity, gestational age, and onset of delivery. Design Analysis of aggregate data from routine sources. Setting Nineteen European countries. Population Live births in 1996, 2000, 2004, and 2008. Methods Annual risk ratios of preterm birth in each country were estimated with year as a continuous variable for all births and by subgroup using log-binomial regression models. Main outcome measures Overall preterm birth rate and rate by multiplicity, gestational age group, and spontaneous versus non-spontaneous (induced or prelabour caesarean section) onset of labour. Results Preterm birth rates rose in most countries, but the magnitude of these increases varied. Rises in the multiple birth rate as well as in the preterm birth rate for multiple births contributed to increases in the overall preterm birth rate. About half of countries experienced no change or decreases in the rates of singleton preterm birth. Where preterm birth rates rose, increases were no more prominent at 35–36 weeks of gestation than at 32–34 weeks of gestation. Variable trends were observed for spontaneous and non-spontaneous preterm births in the 13 countries with mode of onset data; increases were not solely attributed to non-spontaneous preterm births. Conclusions There was a wide variation in preterm birth trends in European countries. Many countries maintained or reduced rates of singleton preterm birth over the past 15 years, challenging a widespread belief that rising rates are the norm. Understanding these cross-country differences could inform strategies for the prevention of preterm birth.
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Affiliation(s)
- J Zeitlin
- INSERM, UMRS 953, Epidemiological Research Unit on Perinatal and Women's and Children's Health, Paris, France; UPMC, Paris, France
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15
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Bouvier-Colle MH, Mohangoo AD, Gissler M, Novak-Antolic Z, Vutuc C, Szamotulska K, Zeitlin J. What about the mothers? An analysis of maternal mortality and morbidity in perinatal health surveillance systems in Europe. BJOG 2012; 119:880-9; discussion 890. [PMID: 22571748 PMCID: PMC3472023 DOI: 10.1111/j.1471-0528.2012.03330.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess capacity to develop routine monitoring of maternal health in the European Union using indicators of maternal mortality and severe morbidity. DESIGN Analysis of aggregate data from routine statistical systems compiled by the EURO-PERISTAT project and comparison with data from national enquiries. SETTING Twenty-five countries in the European Union and Norway. POPULATION Women giving birth in participating countries in 2003 and 2004. METHODS Application of a common collection of data by selecting specific International Classification of Disease codes from the 'Pregnancy, childbirth and the puerperium' chapter. External validity was assessed by reviewing the results of national confidential enquiries and linkage studies. MAIN OUTCOME MEASURES Maternal mortality ratio, with distribution of specific obstetric causes, and severe acute maternal morbidity, which included: eclampsia, surgery and blood transfusion for obstetric haemorrhage, and intensive-care unit admission. RESULTS In 22 countries that provided data, the maternal mortality ratio was 6.3 per 100,000 live births overall and ranged from 0 to 29.6. Under-ascertainment was evident from comparisons with studies that use enhanced identification of deaths. Furthermore, routine cause of death registration systems in countries with specific systems for audit reported higher maternal mortality ratio than those in countries without audits. For severe acute maternal morbidity, 16 countries provided data about at least one category of morbidity, and only three provided data for all categories. Reported values ranged widely (from 0.2 to 1.6 women with eclampsia per 1000 women giving birth and from 0.2 to 1.0 hysterectomies per 1000 women). CONCLUSIONS Currently available data on maternal mortality and morbidity are insufficient for monitoring trends over time in Europe and for comparison between countries. Confidential enquiries into maternal deaths are recommended.
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Affiliation(s)
- M-H Bouvier-Colle
- Institut National de la Santé et de la Recherche médicale-Unité Recherche épidémiologique en santé périnatale et santé des femmes et des enfants, UMR S Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, UPMC University Paris, France.
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16
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Simoes-Silva L, Moreira-Rodrigues M, Quelhas-Santos J, Fernandes-Cerqueira C, Pestana M, Soares-Silva I, Sampaio-Maia B, Bankir L, Leopold F, Nadine B, Roussel R, Balkau B, Michel M, Daniel B, Kurnatowska I, Grzelak P, Kaczmarska M, Masajtis-Zagajewska A, Stefanczyk L, Nowicki M, Niemczyk S, Niemczyk L, Szamotulska K, Bartoszewicz Z, Dubchak I, Syta U, Matuszkiewicz-Rowinska J, Niemczyk S, Dudek M, Bartoszewicz Z, Szamotulska K, Brodowska D, Wozniacki L, Niemczyk L, Gomolka M, Syta U, Rymarz A, Lacquaniti A, Donato V, Fazio MR, Lucisano S, Cernaro V, Lupica R, Buemi M. Hormones. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rutkowski P, Luqowska I, Brzeskwiniewicz M, Wasilewski K, Mierzejewska E, Szamotulska K, Klimczak A, Bylina E, Limon J. 9425 POSTER The Prognostic Value of Genetic Variations of VEGF-a and VEGFR2 Genes in GIST Patients Treated With Sunitinib. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Szamotulska K, Mierzejewska E. P1-528 Statistical models in longitudinal evaluation of changes in health behaviours. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976h.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Lugowska I, Wozniak W, Ambroszkiewicz J, Gajewska J, Szamotulska K. 4117 The extracellular domain of HER-2 as a potential marker for treatment monitoring in osteosarcoma. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70770-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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20
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Wozniak W, Chybicka A, Kowalczyk J, Wysocki M, Korzon M, Krawczuk-Rybak M, Rychlowska-Pruszynska M, Szamotulska K, Lugowska I. 4113 A prospective, multicentre trial of high-dose methotrexate/doxorubicin or cisplatin/doxorubicin for children and young adults with osteosarcoma – decision making analysisb. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70766-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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21
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Szostak-Wegierek D, Klosiewicz-Latoszek L, Maj A, Szamotulska K. RELATIONSHIP BETWEEN CAROTID INTIMA MEDIA THICKNESS AND ATHEROSCLEROSIS RISK FACTORS AND BIRTHWEIGHT IN YOUNG MALES. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70725-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Norek A, Sands D, Chmielewski D, Szamotulska K, Bal J. 13 Genetic markers of musculoskeletal changes in cystic fibrosis. J Cyst Fibros 2007. [DOI: 10.1016/s1569-1993(07)60013-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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23
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Szamotulska K. [Epidemiological studies in evaluation of effectiveness of health promotion programmes]. Med Wieku Rozwoj 2002; 4:67-74. [PMID: 11490060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Basic characteristics of modern epidemiology and basic characteristics of epidemiological study are presented. First of all, the description of the model of randomised controlled trial is taken into account, because of its importance for evaluation of effectiveness of treatment. Consequences of main elements of randomised controlled trial for scientific inference is explained and the possibility of application of these elements to evaluation of health promotion programmes is discussed. The main points in the discussion on the possibility of application of epidemiological methods to evaluation of health promotion programmes are mentioned.
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Affiliation(s)
- K Szamotulska
- Zaklad Epidemiologii, Instytut Matki i Dziecka, Kasprzaka 17a, 01-211 Warszawa, Poland.
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24
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Borysewicz G, Wawrzyniak M, Bulawa E, Szamotulska K, Siwinska-Golebiowska H. [Relation between specific IgE antibodies to grass pollens and to wheat, rye, soya in children with allergic disease]. Med Wieku Rozwoj 2001; 5:359-66. [PMID: 12004143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The aim of this study was to investigate the relationship between the hypersensitivity to grass pollens (gxl) and to wheat (f4), rye ff5) and soya (fl 4) in children with allergic disease. Specific IgE was determined by the FEIA CAP- System. Hypersensitivity was expressed in classes from 1 to 6. Specific IgE antibodies against grass (gxl) in 944 children with allergic disease, aged from 6 months to 18 years were detected. At the same time in 532 of these children - specific IgE to wheat and rye and in 122 children specific IgE to soya were also estimated. We detected very high correlation between the hypersensitivity to grass and the presence of specific IgE to wheat, rye (r=0.96, p<0.01) and soya (r=0.90, p<0.05).
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Affiliation(s)
- G Borysewicz
- Zaklad Immunologii, Instytut Matki i Dziecka, Kasprzaka 17a, 01-211 Warszawa, Poland.
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25
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Pakszys M, Rusek G, Kuszczak B, Szamotulska K, Mazur J. [Preliminary assessment of felbamate effect on the cerebral bioelectrical activity in children with refractory epilepsy]. Neurol Neurochir Pol 2000; 34 Suppl 1:203-14. [PMID: 10768160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Influence Felbamate on the cerebral bioelectric activity (EEG) in the group of 31 children (18 with syndrome Lennox-Gastaut, 13 with partial epilepsy) with refractory epilepsy was investigated. In the waking EEG was visually analysed: 1. Abnormalities distribution and morphology with special consideration of slow waves, sharp elements and paroxysmal character of discharges. 2. Influence of Felbamate on the duration time of discharges. 3. Range dominant frequency and length of segments (with non-disturbed topographic differentiation) of background activity EEG. During therapy the results showed more often EEG improvement among children with syndrome Lennox-Gastaut (near 70%) than in children with partial refractory epilepsy (near 30%). The EEG results correlated positively with the clinical improvement. In the both group of epilepsy background activity improvement had a statistical significance. In sleep EEG any influence of Felbamate on the sleep spindles was observed. No observation about increase beta activity in waking and sleep EEG records was noted.
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Affiliation(s)
- M Pakszys
- Zakład Elektrofizjologii Dzieci i Młodziezy, Instytutu Matki i Dziecka
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26
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Szkultecka-Debek M, Szamotulska K, Kułaga Z. [Comparison of cost-effectiveness and efficacy of selected inhaled steroids in asthma treatment from budget perspective]. Pol Merkur Lekarski 2000; 7:7-8. [PMID: 10765643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Due to limited resources, when choosing among available treatment opportunities, it is necessary to include results of pharmaco-economic assessments. The aim of this study was to compare cost-effectiveness of Pulmicort Turbuhaler and Flixotide Rotadisc in asthma treatment. Result of randomised clinical study reported in Great Britain was used as a source of efficacy data. Costs of compared treatment options were calculated using the difference between full pharmacy price and patient's co-payment of consumed pharmaceuticals, as recorded in Warsaw open pharmacy shop in May 1999. It has been shown, statistically significant difference of cost-effectiveness in favour of Pulmicort Turbuhaler.
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27
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Lech M, Szamotulska K, Mielniczuk H. [Non-clinical factors in decision making about cesarean section]. Ginekol Pol 1997; 68:22-9. [PMID: 9296939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Increasing cesarean-section rates have focused attention on variation in the use of this procedure that appear to be not only dependent of medical indication. This suggestion has been checked on the basis of newly implemented special forms in hospitals located in some areas of Poland in 1990. Documentation of 11.813 live births (almost 100% of live births in described area) has been analysed. It has been found 13.2% cesarean-section rate and 2.0% rate of other operative deliveries. Majority of cesarean sections have been medically indicated. But it has been also found that highest level of mothers education has been directly linked with higher rates of cesarean section. This linkage has been stronger than any other association (with age, parity etc.). Poland as a country, is divided for several regions subordinated to particular hospitals. It has been found that some of the patients have been admitted not to regional hospitals. We conclude that cesarean section rate among these patients was higher than this same ratio among all other patients admitted for deliveries in these hospitals. This association cannot be accounted for by differences in maternal age, parity, birth weight etc.
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Affiliation(s)
- M Lech
- Zakładu Epidemiologii Instytutu Matki i Dziecka w Warszawie
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28
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Mazurczak T, Bocian E, Milewski M, Obersztyn E, Stańczak H, Bal J, Szamotulska K, Karwacki MW. Frequency of Fra X syndrome among institutionalized mentally retarded males in Poland. Am J Med Genet 1996; 64:184-6. [PMID: 8826472 DOI: 10.1002/(sici)1096-8628(19960712)64:1<184::aid-ajmg32>3.0.co;2-h] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Results of cytogenetic studies, performed in a group of 201 institutionalized mentally retarded males, are presented. At least two cytogenetic methods for eliciting the Xq27.3 fragile site, recommended by the Fourth International Workshop on the Fra X Syndrome were used. A subgroup of 67 out of 201 studied males was also examined using molecular methods. In 6 (2.9%) males fra X syndrome was diagnosed. All cytogenetic positive results were confirmed by molecular analysis. Five patients had full expansion CGG repeats and one had both premutation and full mutation. Postulated frequency of fra X syndrome in Polish population being 0.2-0.4/1,000 males seems to be lower than it could be expected on the basis of previous literature data.
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Affiliation(s)
- T Mazurczak
- Departments of Genetics, National Research Institute of Mother and Child, Warsaw, Poland
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Abstract
An attempt was made to identify the reasons for the increase in low birthweight (LBW) rates in Poland from 8.1% in 1985 to 8.4% in 1990. It was found that there was a differential increase in the LBW rates among the social groups. The highest increase was observed among the least educated mothers, especially in large cities. The LBW rate among the newborns of mothers who had finished their education at primary school level increased from 10.6% (in large cities from 14.7%) in 1985 to 12.5% (in large cities to 16.2%) in 1990. Controlling for maternal age, parity, education and place of residence did not change the significance of the increase in the LBW rate. The decline in birthweight was probably largely related to negative changes in socially differentiated levels of consumption of basic nutrients in Poland.
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Affiliation(s)
- Z J Brzezinski
- National Research Institute for Mother and Child, Department of Epidemiology and Programming, Warsaw, Poland
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