Hospitalizations of patients with herpes zoster in Poland during 2012-2021: A population-based study

INTRODUCTION

The varicella-zoster virus (VZV) is an infectious agent that causes both chickenpox and herpes zoster/shingles (HZ). This infection can take various clinical forms, result in permanent complications, and be a marker of immunosuppression, e.g. in the course of a neoplastic disease. The aim of this study is to analyze epidemiological trends in hospitalization and hospital mortality rate among HZ patients in Poland (2012-2021).

METHODS

Our study is a population-based, retrospective analysis of hospital discharge records of patients with HZ. Data were obtained from the National Institute of Public Health in Poland, and they covered the period from 2012 to 2021. All hospitalization records with primary or secondary ICD-10 B02 code diagnosis were included in the study.

RESULTS

We analyzed the total number of 23,432 hospital discharge records of HZ patients in 2012-2021. The study group consisted of 22,169 (94.6 %) hospitalization records of first-time diagnosis of HZ in hospitalized patients: 9,309 males (42 %) and 12,860 females (58 %). In this group, 70.3 % were patients over 60 years old. The mean and median age was 64 and 69 years, respectively. The mean annual first-time hospitalization rate for HZ was estimated to be 5.8 per 100,000 person-years (95 % CI: 4.8-6.7 per 100,000 person-years). The hospitalization rate for HZ was similar during 2012-2019. There was a significant decrease in hospitalizations in 2020-2021 in comparison with the previous years (R2 = 0.42, p < 0.05). Women showed a higher hospitalization rate than men (p < 0.001). Urban residents had a higher hospitalization rate than rural residents (p < 0.001). In the analyzed period, 246 deaths were recorded (1.1 % of all hospitalized HZ patients) -119 males and 127 females.

CONCLUSIONS

The HZ-related number of hospitalizations and mortality in Poland are relatively low, but HZ is still a significant health problem. Risk factors include female gender, older age and residence in urban areas.

Newborn Hospitalizations Before and During COVID-19 Pandemic in Poland: A Comparative Study Based on a National Hospital Registry

Objectives: There are limited data on the impact of the COVID-19 outbreak in Poland on newborn health. The aim of the study is to show recent information on hospitalizations of newborns in Poland in the pre-pandemic and COVID-19 pandemic era. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized in 2017-2021. Results: The data on which the study was based consisted of a substantial number of 104,450 hospitalization records. Annual hospitalization rate was estimated to be 50.3-51.9 per 1,000 in 2017-2019, 56 per 1,000 in 2020 and it rose to 77.7 per 1,000 in 2021. In comparison to the pre-pandemic period, in the COVID-19 era, we observed significantly more hospitalization cases of newborns affected by maternal renal and urinary tract diseases (p < 0.001), syndrome of infant of mother with gestational diabetes (p < 0.001), maternal complications of pregnancy (p < 0.001). In the COVID-19 era, the prevalence of COVID-19 among newborns was 4.5 cases per 1,000 newborn hospitalizations. Conclusion: The COVID-19 pandemic outbreak could significantly contribute to qualitative and quantitative changes in hospitalizations among newborns.

Hospitalizations of patients with sarcoidosis before and during the COVID-19 pandemic in Poland

INTRODUCTION

Sarcoidosis is a multisystemic granulomatous disease that mostly affects the lungs and lymphatic system. Due to its rarity and variable clinical course, analyses of factors related to sarcoidosis should be based on large databases and long observation periods.

OBJECTIVES

The aim of this study was to determine the characteristics of patients with sarcoidosis hospitalized in Poland over a long period (2016-2021).

PATIENTS AND METHODS

We conducted a retrospective study using hospital discharge records compiled by the National Institute of Public Health NIH - National Research Institute. We analyzed the records of patients with sarcoidosis from the entire Polish population at their first hospitalization.

RESULTS

We identified a total of 15 548 first-time hospitalizations for sarcoidosis. The mean annual disease incidence was 6.8 cases per 100 000. The mean (SD) age of the patients was 45.8 (13.6) years, and it was lower in men than in women (42.9 [12.5] vs 49.8 [14.2] years; P <0.001). There were significantly more hospitalizations among city dwellers (62.3% vs 37.3% for rural residents; P <0.001). At the beginning of the COVID‑19 pandemic in Poland there was a decrease in the number of hospitalizations for sarcoidosis, followed by an increase in the subsequent year. The all‑cause in‑hospital death rate was significantly higher during the COVID‑19 pandemic, as compared with the period before the pandemic (7.2 vs 2.3 per 1000; P <0.001).

CONCLUSIONS

Health care changes related to the outbreak of the COVID‑19 pandemic may have increased the health debt for inpatient sarcoidosis treatment. The occurrence of sarcoidosis in Poland may be related to demographic and territorial factors.

Time Trend Analysis of Comorbidities in Ankylosing Spondylitis: A Population-Based Study from 53,142 Hospitalizations in Poland

BACKGROUND

(1) Influence of comorbidities on life expectancy and treatment outcomes is one of the main concerns of modern rheumatology, due to their rising prevalence and increasing impact on mortality and disability. The main objective of our study was to analyze the time trends and shifts in the comorbidity profile and mortality over 10 years in the Polish population with ankylosing spondylitis (AS). (2) Data from 2011-2020 years were acquired from the General Hospital Morbidity Study in the National Institute of Public Health-National Institute of Hygiene (NIH-PIB) as ICD-10 codes. Based on ICD10 codes, we calculated the percentage shares for comorbidities, with the relative risk ratios and odds ratios. We analyzed the hospitalization rates and mortality from the overlapping conditions. Also, we analyzed age and sex related differences in the clinical manifestations of AS patients. (3) Results: From 53,142 hospitalizations of patients with AS, we found that the male population presented higher rates of cardiovascular (2.7% vs. 1.3% p < 0.001) and pulmonary conditions (1.2% vs. 0.8% p < 0.025). Inflammatory bowel diseases were more common in the female population than in males (2.3% vs. 1.7%, p < 0.001). In the years 2011-2020, we observed a decline in the number of hospitalized patients due to cardiovascular (p < 0.001) and respiratory system conditions (p < 0.001), yet the relative risk and odd ratios remained high. In the years 2011-2020, 4056 patients received biological treatment (7%). The number of initiated biological therapies correlated negatively with the number of reported hospitalizations due to ischemic heart diseases (IHD) (p < 0.031, r = -0.8). Furthermore, in the logistic regression model, we found strong collinearity between cardiovascular and pulmonary comorbidities (VIF = 14; tolerance = 0.1); also, the number of reported IHD's correlated positively with the number of pulmonary infections (p < 0.031, r = 0.7) (4).

CONCLUSIONS

Cardiopulmonary comorbidities are a main factor associated with increased mortality in patients with AS, especially in hospitalized patients. The mortality rates among patients with AS admitted to hospital due to other conditions other than movement disorders exceed the populational risk. The number of biologically treated patients correlated negatively with hospital admissions due to IHD.

Colonization with drug-resistant pathogens among patients in long-term care facilities and under home hospice care - a cross-sectional study

INTRODUCTION AND OBJECTIVE

The spread of drug-resistant bacteria is deemed a worldwide threat. Patients in long-term care, including those under palliative care, are exposed to a high risk of colonization and infection with drug-resistant pathogens. This refers primarily to long-term care facilities as opposed to home care. A cross-sectional study was carried out between 1 January 2018 - 30 June 2019. The study was approved by the Bioethics Committee at the Medical University of Warsaw (KB/222/2017).

OBJECTIVE

The aim of the study was to assess the frequency and type of colonization with drug-resistant pathogens among patients in long-term care facilities and those under home hospice care. An additional aim was evaluation the risk of pathogen transmission according to the type of provided long-term care.

MATERIAL AND METHODS

The study included 129 participants: 68 patients under the care of 3 long-term care facilities in Warsaw, Poland, 42 patients under home hospice care, and 19 household members of hospice patients. All included participants provided written informed consent. Oropharyngeal and rectal swabs were obtained from all participants for microbiological assessment.

RESULTS

Colonization with pathogens was more common in long-term care facilities residents (82.4%) than in at-home hospice patients (42.9%). Risk of colonization was significantly lower in patients staying at home than in long-term care facilities patients (OR 0.16; 95% CI 0.06-0.38).

CONCLUSIONS

Conclusions. Risk of colonization with drug-resistant pathogens depends on the type of care and is significantly higher in patients staying at long-term care facilities. Systemic measures, such as microbiological screening, are necessary to provide optimal patient care and to ensure epidemiological safety, both to patients and their caregivers.

Ukrainian migrants' and war refugees' admissions to hospital: evidence from the Polish Nationwide General Hospital Morbidity Study, 2014-2022

BACKGROUND

Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning. The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland.

METHODS

The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022.

RESULTS

In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) - 26.1%, pregnancy, childbirth and the puerperium (O00-O99) - 18.4%, and factors influencing health status and contact with health services (Z00-Z99) - 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common - 14.9%, followed by abnormal clinical and lab findings (R00-R99) - 11.9%, and infectious and parasitic diseases (A00-B99) - 11.0%.

CONCLUSIONS

Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.

Trends in Hospitalization Duration for Rare Diseases: A Retrospective Analysis of Sarcoidosis, Still's Disease, and Systemic Sclerosis in Poland (2009-2018)

BACKGROUND A rare disease is a health condition that rarely occurs in the population. It is estimated that up to 400 million people around the world suffer from a rare disease. This retrospective study aimed to investigate factors associated with length of hospitalization in 78 626 patients with sarcoidosis, 3294 patients with adults-onset Still's disease, and 35 549 patients with systemic sclerosis between 2009 and 2018 using data from the National Institute of Public Health in Poland. MATERIAL AND METHODS In this population-based study, we analyzed hospital discharge records of first-time and subsequent hospitalizations. To perform the statistical analyses, R software was used. RESULTS The average length of hospitalization over the selected period in the diseases was 5.39 days for sarcoidosis, 6.22 days for scleroderma, and 7.44 days for Still's disease, and was shorter for each of the diseases analyzed compared with the length of hospitalization for second and subsequent stays. There were no substantial differences in length of hospitalization between males and females. The average length of hospitalization increased with each additional comorbidity. CONCLUSIONS The study showed that hospitalizations for selected rare diseases do not cause a significant burden on the healthcare system. The results also showed that advanced age and comorbidities are important factors determining the length of hospitalization. The average length of hospital stay for selected rare diseases in Poland is not longer than the European Union (EU) average, so it can be assumed that the process of inpatient treatment in Poland is optimal.

Congenital toxoplasmosis among hospitalized infants in Poland in the years 2007-2021: study based on the national hospital registry

Congenital toxoplasmosis (CT) is a rare entity and it may pose a life-threatening risk for the newborns. The aim of the study was to evaluate the incidence and other selected factors of CT in Poland. Our study is a population-based study on CT patients in 2007-2021. The study was based on 1504 hospitalization records of first-time diagnosis of CT in newborns. In the study group, we observed 763 males (50.7%) and 741 females (49.3%). The mean and median age was 31 days and 10 days, respectively. Based on the hospital registry, the mean annual CT incidence was estimated to be 2.6 per 10,000 live births (95% CI 2.0-3.2 per 10,000 live births). The incidence of CT cases fluctuated over the years 2007-2021, with the highest incidence in 2010 and the lowest one in 2014. There were no statistically significant differences between the incidence of CT in relation to sex or place of residence. The periodic fluctuations in the number of cases of congenital toxoplasmosis indicates the need to develop effective prevention programs to effectively counteract the disease and its consequences.

Knowledge about the COVID-19 and ways of its prevention among Medical University of Warsaw students

BACKGROUND

The aim of the study was to assess the state of knowledge of Medical University of Warsaw (MUW) students on COVID-19, modes of transmission and preventive measures.

MATERIAL AND METHODS

The study was conducted in October 2020. The participants were all the students attending classes at MUW - 8922 persons. All had completed the online training "Work safety and hygiene during COVID-19." To assess their state of knowledge an online questionnaire was made available on the MUW e-learning platform. The questionnaire comprised 4 parts: (1) awareness of rules of hand hygiene, (2) medical aspects of COVID-19, (3) preventing SARS-CoV-2 infection transmission in health care facilities, and (4) preventing infection transmissions in the society.

RESULTS

The majority of students (93.9%) demonstrated a sufficient level of knowledge. The highest passing threshold was found on the medical programme (96.7% of students with satisfactory level of knowledge), dentistry (96.2%) and pharmacy (95.5%). The statistically significant factors that differentiated student results proved to be faculty (p < 0.001), study programme (p < 0.001), year of studies (p = 0.001), form of studies (p < 0.001). The participants most often showed full knowledge (100% correct answers in sub-area) of preventing infection transmissions in the society (93.3%) and medical aspects of COVID-19 (91.8%), less complete in terms of ways of preventing infection transmission in health care facilities (85.4%), and in particular hand hygiene rules (78.3%). All the variables characterizing academic status (study programme, faculty, year and form of studies) were statistically significant differentiating factors for students' full knowledge in all of the 4 analyzed sub-areas, while students' sex only in the sub-area of COVID-19 medical aspects.

CONCLUSIONS

There is a clear need for conducting systematic educational activities among students of all medical study programmes and assessing their level of knowledge in those areas that were identified as least frequently controlled, namely, hand hygiene and infection transmission in health care facilities. Med Pr. 2022;73(5):369-81.

Hospitalizations of Ukrainian Migrants and Refugees in Poland in the Time of the Russia-Ukraine Conflict

BACKGROUND

In the face of a sudden influx of several million migrants and war refugees from Ukraine to other European countries, knowledge about the health of Ukrainian citizens becomes increasingly important. The aim of the study is to identify the main health problems of hospitalized Ukrainian citizens residing in Poland in the period from 2014 to June 2022.

METHODS

This study is based on hospitalization data of Ukrainian patients in Poland taken from the Nationwide General Hospital Morbidity Study.

RESULTS

The study group covered 8591 hospitalization records. We observed two hospitalization peaks, one in patients aged 0-5 and the other one in those aged 20-35. After the official outbreak of the war, 2231 Ukrainian citizens were hospitalized in Poland. At this time, the most often reported principal reasons for the hospitalizations of adult women were diseases related to pregnancy, childbirth and the puerperium, whereas in groups of adult men diseases were related to injury, poisoning and certain other consequences of external causes, and in children and adolescents diseases were infectious and parasitic diseases.

CONCLUSIONS

Our findings may have implications for healthcare policies and service provision to newly arrived migrants and war refugees in target European countries.

Congenital herpes simplex virus infection among hospitalized infants in Poland

INTRODUCTION AND OBJECTIVE

Congenital herpes simplex virus infection (cHSV) is a rare entity and may pose a life-threatening disease for the newborns. Due to the public health and clinical importance of cHSV infection in infants, the recent data on this disease in Poland should be investigated. The aim of the study was to evaluate the incidence and other factors related to cHSV.

MATERIAL AND METHODS

The study is retrospective, population-based that utilised the hospital discharge records of cHSV patients. Data were obtained from National Institute of Public Health NIH - National Research Institute in Warsaw, Poland, covering the period 2014-2019.

RESULTS

The study group consisted of 1,573 cHSV newborns (841 males and 732 females). Among this group, 70.1% were infants up to 90 days of age and 3.6% were neonates up to 28 days of age. The mean and median age was 98 days (95% CI: 94.5-101.8, SD 74) and 70 days (IQR: 53-104), respectively. Based on the hospital registry the overall average cHSV incidence over the study period was estimated to be 69 per 100,000 live births. The number of cHSV infection fluctuated over the years 2014-2019 with a significant decreasing trend from 2015-2019 (P<0.01). A significantly higher cHSV incidence was observed among patients from urban than rural areas of Poland (88 vs 40/100,000 live births; P<0.001).

CONCLUSIONS

CHSV incidence may be related to multifactorial conditions for the occurrence of this disease. Further studies on changes in the incidence of cHSV are needed.

Adult-onset Still's disease in Poland - a nationwide population-based study

INTRODUCTION

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology, which affects young adults and is associated with multiple organ involvement and life-threatening complications. The aim of the study was to establish the incidence and prevalence of AOSD in Poland, and factors related to this disease among hospitalized patients.

MATERIAL AND METHODS

A retrospective, population-based study was conducted, using data from hospital discharge records compiled by the National Institute of Public Health in 2009-2018.

RESULTS

Based on hospitalization records and census data in a group of the 1,050 patients included in the study, women were predominant (60%) and patients' mean and median ages at hospitalization were 42 (95% CI: 40.8-42.8) and 38 years, respectively. The average annual incidence rate of AOSD during the 10-year period was established at the level of 0.32/100,000 (95% CI: 0.30-0.34), and the point prevalence at the end of 2018 was 2.7/100,000. The most common comorbidities were: cardiovascular diseases (14%), diseases of the musculoskeletal system and connective tissue (14%), endocrine, nutritional and metabolic diseases (9%).

CONCLUSIONS

AOSD is a rare disease Poland with gender and territorial differences in incidence ratek, and predominance of cardiovascular diseases among comorbidities. The presented data may be useful for comparisons of the Polish population with other geographical regions. Predominance of patients from urban regions and predominance of women may suggest environmental and personal factors in AOSD development; however, further research seems to be necessary.

Effects of Soy Isoflavones on Biochemical Markers of Bone Metabolism in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This systematic review and meta-analysis of randomized controlled trials was performed to more completely assess potential changes in bone turnover marker levels in postmenopausal women during the intake of soy isoflavones. PubMed (Medline) and EMBASE were searched for relevant studies, and their quality was evaluated according to Cochrane criteria. The levels of markers were evaluated in a total of 1114 women who ingested mean daily doses of 98.2 mg (30.9 to 300) of soy isoflavones for 3 to 24 months, in comparison to those of 1081 subjects who used a placebo. Ten, eighteen, eight, and fourteen comparison studies were finally selected for an estimation of the effects on osteocalcin (OC), bone alkaline phosphatase (BAP), pyridinoline (PYD), and deoxypyridinoline (DPD), respectively. A summary of the results of intervention was as follows: 4.16%, 95% CI: -7.72-16.04, p = 0.49 for OC; 5.50%, 95% CI: -3.81-14.82, p = 0.25 for BAP; -12.09%, 95% CI: -25.37-1.20, p = 0.07 for PYD; and -7.48%, 95% CI: -15.37-0.41, p = 0.06 for DPD. The meta-analysis of the included studies revealed some statistically insignificant observations that soy isoflavones intake is associated with a trend in increased levels of OC and BAP, as well as a trend in reduced levels of PYD and DPD. Soy isoflavones may have a beneficial effect on bone formation markers, but this requires extensive multi-center research.

Hospitalizations for COVID-19 in Poland: a study based on data from a national hospital register

INTRODUCTION COVID‑19 has been identified by the World Health Organization as a pandemic. Poland introduced extensive antiepidemic measures relatively early in order to slow down the spread of the disease. OBJECTIVES The study aims to present recent data on COVID‑19 hospitalizations during the first months of the disease outbreak in Poland. PATIENTS AND METHODS This is a retrospective, population‑based study conducted using hospital discharge records that included a diagnosis of COVID-19. Data were obtained from the National Institute of Public Health, where they had been originally collected for a Polish hospital morbidity study. They included 8840 hospitalization records from the period between February and September 2020. RESULTS Overall, there were 8252 records of patients hospitalized for COVID‑19 for the first time, which accounted for 93% of all hospitalizations. The study group consisted of 4161 men (50.4%) and 4091 women (49.6%). Significantly more patients from urban than rural areas were hospitalized (21.8 per 100 000 vs 20.5 per 100 000; P <0.02). In the period subject to analysis, 1073 in‑hospital deaths were observed (13% of all patients), 965 of which occurred during first‑time hospitalizations (11.7% of all patients). In the study group, patients who died during hospitalization compared with those who survived hospitalization were significantly older, more frequently lived in urban areas, and had more comorbidities. CONCLUSIONS The findings of our study, especially the differences between survivors and nonsurvivors with COVID-19, may be helpful in recognizing patients requiring special medical care and preventive measures during hospitalization.

Evaluation of Clinical Meaningfulness of Red Clover (Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The meta-analysis presented in this article covered the efficacy of red clover isoflavones in relieving hot flushes and menopausal symptoms in perimenopausal and postmenopausal women. Studies were identified by MEDLINE (PubMed), Embase, and the Cochrane Library searches. The quality of the studies was evaluated according to Cochrane criteria. A meta-analysis of eight trials (ten comparisons) demonstrated a statistically significant reduction in the daily incidence of hot flushes in women receiving red clover compared to those receiving placebo: weighted mean difference (WMD—weighted mean difference) −1.73 hot flushes per day, 95% CI (confidence interval) −3.28 to −0.18; p = 0.0292. Due to 87.34% homogeneity, the performed analysis showed substantive difference in comparisons of postmenopausal women with ≥5 hot flushes per day, when the follow-up period was 12 weeks, with an isoflavone dose of ≥80 mg/day, and when the formulations contained a higher proportion of biochanin A. The meta-analysis of included studies assessing the effect of red clover isoflavone extract on menopausal symptoms showed a statistically moderate relationship with the reduction in the daily frequency of hot flushes. However, further well-designed studies are required to confirm the present findings and to finally determine the effects of red clover on the relief of flushing episodes.

Congenital cytomegalovirus infections in Poland - a national hospital register-based study

INTRODUCTION AND OBJECTIVE

Congenital cytomegalovirus (cCMV) infections are common worldwide. CCMV infected newborns are mostly asymptomatic at birth. However, cCMV remains the major infectious cause of congenital abnormalities in the developing foetus and newborns. The aim of the study was to provide recent data on cCMV in Poland.

MATERIAL AND METHODS

Aretrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized from 2009-2018. CCMV incidence rates were estimated on the basis of data taken from a Polish hospital morbidity study, carried out by the National Institute of Public Health.

RESULTS

The study group consisted of 1,916 hospitalized patients with the first-time diagnosis of cCMV. Among them, 52% were patients up to 30 days of age. The median age was 28 days. The average annual incidence of cCMV was 48 per 100,000 live births (95% CI 23.5-73.4). A significantly higher cCMV incidence rate was observed in patients from more urban than rural regions of Poland (55 per 100,000 vs 39 per 100,000; P<0.001). In the study period, 9 hospital deaths (0.5 % of all patients) were reported. The coexistence of nervous system diseases was observed in 26% of cases and hearing loss in 6% of cases.

CONCLUSIONS

The significantly more cCMV cases were observed in patients from more urban than rural regions of Poland may suggest the presence of territorial factors related to the cCMV incidence in Poland. The relatively high percentage of newborns with hearing loss or neurologic diseases may require activities aimed at reducing the cCMV incidence. The epidemiological data presented may be useful for comparisons with other geographical regions.

The impact of selected educational and information interventions on the coverage rate and attitudes to influenza vaccination in nursing staff

BACKGROUND

Influenza vaccinations are recommended for medical staff as an effective and safe form of preventing influenza and its complications. The aim of the study was to assess the impact of selected educational and information interventions on the influenza vaccination coverage (IVC) in nursing personnel and their attitude towards this procedure.

MATERIAL AND METHODS

The study participants (N = 320) were randomly divided into 4 groups. Group 1 participated in stationary training, whereas group 2 participated in distance learning. Additionally, 2 subgroups were established in each of the groups above: 1 subgroup received a reminder about the vaccination in the form of a short text message, and the other group did not receive any such reminder. The IVC rate in each group was determined; the attitude towards influenza vaccination was measured using the health belief model.

RESULTS

The highest IVC was obtained after stationary training followed by a reminder in the form of a short test message (36%). The reminder significantly affected IVC in the group attending stationary training (p < 0.05, OR = 2.5, 95% CI: 1.16-5.58); however, it had no impact on the IVC in the group participating in distance learning (p > 0.05, OR = 1.2, 95% CI: 0.51-2.83). Both stationary training and distance learning positively influenced the attitude towards influenza vaccinations. A major change in attitudes towards influenza vaccinations was observed only in the case of stationary training followed by a reminder in the form of a short text message (positive changes in perceived susceptibility and severity took place, perceived vaccination benefits increased, and perceived barriers were reduced).

CONCLUSIONS

Stationary training followed by a reminder in the form of a short text message is more effective in increasing the IVC rate compared to distance learning. It also promotes positive changes in attitudes to this prophylactic procedure, which is why it should be recommended for wider implementation. Med Pr. 2020;71(6):665-85.

Coping strategies observed in women with rheumatoid arthritis

When faced with a chronic disease such as rheumatoid arthritis, the patient attempts to cope with the stressful situation by applying coping strategies. The main aim of rheumatoid treatment is not only improving health but also increasing the quality of life. The research objective was to determine the relationship among socio demographic factors, duration of the disease and its associated ailments, attitude to the disease, self-assessment of one's knowledge of RA, and the application of coping strategies in stressful situations by women with rheumatoid arthritis. The study involved 193 patients of the Clinic of Rheumatology and Systemic Connective Tissue Diseases, and the Rheumatology Unit of the Specialist Outpatient Clinic of the Independent Public Teaching Hospital No. 4 in Lublin, from November 2016 - June 2017. The Coping Orientations to Problems Experienced Inventory (COPE) Questionnaire and an author's Original Questionnaire were used in the study. Analysis of variance (ANOVA) and Tukey's range test were applied for statistical analysis. A p-value<0.05 defined the statistical differences. Analysis was performed using the commercial SPSS Statistics 19 software (IBM Corp., Armonk, NY, USA). The respondents usually use instrumental social support (11.5±1.7), focus on and vent emotions (11.4±1.9), use emotional social support (11.4±1.8), employ active coping (11.4±2.1) and positive reinterpretation and growth (11.2±1.8), and least often rely on their sense of humour (5.5±1.4) or use alcohol or drugs (5±1.1). The factors which determine the types of strategy used are age, education, the duration of the disease, ailments experienced, and attitude towards the disease. Those respondents who declared a greater knowledge of RA more often applied positive reinterpretation and growth, and more rarely used alcohol or drugs. In the treatment and rehabilitation processes it is important to reinforce in the patient positive expectations for the treatment, seek advantages and benefits in one's present health status, and educate patients about the disease, its therapy and appropriate coping strategies.

No-Touch Automated Room Disinfection after Autopsies of Exhumed Corpses

Autopsies of exhumed bodies pose a risk of infections with environmental bacteria or fungi, which may be life-threatening. Thus, it is important to use effective methods of disinfection in forensic pathology facilities. In this study, we investigated the effectiveness of no-touch automated disinfection (NTD) system after autopsies of exhumed bodies. Directly after 11 autopsies of exhumed bodies, we used an NTD system based on a peroxone vapor to disinfect the air and surfaces. We measured microbial burden in the air and on surfaces before and after NTD. The NTD system reduced the mean bacterial burden in the air from 171 colony forming units (CFU)/m³ to 3CFU/m³. The mean fungal burden in the air decreased from 221 CFU/m³ to 9CFU/m³. The mean all-surface microbial burden was 79 CFU/100 cm² after all autopsies, and it decreased to 2 CFU/100 cm² after NTD. In conclusion, the peroxone-based NTD system was effective for decontamination of the air and surfaces in a dissecting room after autopsies of exhumed bodies.

Asbestosis hospitalizations in Poland (2006-2016): results from the National Hospital Discharge Registry

INTRODUCTION AND OBJECTIVE

Occupational asbestos exposure is one of the major public health issues. Although asbestos use in Poland has decreased, asbestosis continues to remain an important health concern in the area of occupational medicine. The aim of the study is to perform a descriptive analysis of hospitalization cases in patients suffering from asbestosis in Poland.

MATERIAL AND METHODS

The authors used hospital discharge records to conduct a retrospective, population-based study. To estimate the asbestosis hospitalization rate, data from the Nationwide General Hospital Morbidity Study conducted by the National Institute of Public Health were used. Events were defined as in-patient hospital discharges during 2006-2016. 1,101 hospitalization records of 764 patients were included in the study.

RESULTS

In the study group of first-time hospitalized patients, the mean and median ages were 68.1 and 69 years, respectively; CI: 67.3-68.9; SD: 11.1, min-max:16-99 years. In this group, significant gender differences were observed (560 males vs. 204 female; P<0.001). No statistical differences were observed regarding the place of residence. During the observation period, 61 in-hospital deaths were reported (8% of all patients), 40 of whom (5.2 % of all patients) took place during the first-time hospitalizations. Asbestosis hospitalizations were mainly clustered in the south-western region, whereas the highest hospitalization rates were clustered in several areas of Poland.

CONCLUSIONS

The authors believe this study to be the first evaluation of asbestosis in Poland made on the basis of the hospital morbidity database. The data presented may be helpful in comparative studies on the epidemiology of asbestosis across European countries.

Sarcoidosis among hospitalized patients in Poland: a study based on a national hospital registry

INTRODUCTION

Sarcoidosis is a systemic granulomatous disease mainly affecting the lungs, although granulomas can also involve any other organ.

OBJECTIVES

We sought to describe patients during their first hospitalization for sarcoidosis in Poland from 2008 to 2015. To our knowledge, this is the first evaluation of the disease in Poland based on a hospital morbidity database.

PATIENTS AND METHODS

We conducted a retrospective, population‑based study, using hospital discharge records compiled by the National Institute of Public Health in the years 2008 to 2015.

RESULTS

Among the 23 097 patients included in the study, men were predominant (54.7%). The mean and median ages at hospitalization were 44.7 years (95% CI, 44.5-44.9) and 42 years, respectively. Most patients (65%) resided in urban areas. The average annual incidence rate of sarcoidosis was 7.5 per 100 000 (95% CI, 7.1-7.9). The lungs were the most commonly affected organ (57.9%), while the remaining cases included sarcoidosis of lymph nodes and no lung involvement (18%), the skin (1.4%), and other or unspecified sites (22.7%). Skin sarcoidosis occurred significantly more frequently in women, while sarcoidosis of the lungs with coexisting sarcoidosis of lymph nodes was significantly more prevalent in men. Seasonal variability in sarcoidosis incidence was observed.

CONCLUSIONS

Sex and age may have a significant impact on the occurrence of sarcoidosis in Poland. Changes in seasonality may suggest the role of environmental factors. These data on sarcoidosis in Poland may be helpful in comparative analyses with other European countries.

Polyarteritis nodosa: decreasing incidence in Poland

INTRODUCTION

There are many studies on the epidemiology of the orphan disease polyarteritis nodosa (PAN) in European countries. The use of a hospital morbidity database is an important element of epidemiological analysis. The study is the first such analysis in Poland and may provide an opportunity to compare the data in a European context.

MATERIAL AND METHODS

We conducted a retrospective, population-based study using hospital discharge records with a PAN diagnosis. PAN incidence was estimated based on data from a Polish hospital morbidity study carried out by the National Institute of Public Health. Data on all inpatients discharged from non-psychiatric hospitals in Poland were collected between 2008 and 2013. We identified 557 patients with first-time hospitalizations for PAN.

RESULTS

The sample consisted of 202 (36.3%) males and 355 (63.7%) females. The median and mean age was 53 and 50 years, respectively. The average annual incidence of PAN in Poland was estimated to be 2.4 per million. PAN incidence decreased significantly over time in Poland between 2008 and 2013 (3.3 per million vs 1.9 per million, p < 0.001) and it may be associated with a decrease in hepatitis B incidence observed in Poland.

CONCLUSIONS

Incidence of PAN in Poland was estimated to be 2.4 per million and was comparable to the incidence found in other European countries. PAN incidence decreased during 2008-2013. The decrease in PAN incidence may be related to environmental, infectious (hepatitis B) or other unknown factors. Future research is needed to identify the cause of the decrease and potential triggers of the disease.

Dietary macronutrients and fluid intakes in a sample of pregnant women with either gestational diabetes or type 1 diabetes mellitus, assessed in comparison with Polish nutritional guidelines

OBJECTIVES

Pregnancy is a critical period during which environmental factors such as nutrition can affect development. Maintaining proper nutrition becomes even more significant when pregnant women have diabetes. The aim of this study was to measure changes in energy and macronutrient intakes among pregnant women and patients diagnosed either with gestational diabetes mellitus (GDM) during pregnancy, or, type 1 diabetes mellitus (T1DM) before pregnancy, and to assess the pregnant women's dietary intakes in comparison with Polish Institute of Food and Nutrition nutritional guidelines.

MATERIAL AND METHODS

The analysis was conducted among 83 pregnant women (29 GDM patients, 26 T1DM patients and 28 normal pregnancy patients - the control group) from whom we gathered nutritional data during the second part of their pregnancies. Data on each woman's diet during pregnancy was collected is self-completed dietary records during seven consecutive 24-hour periods.

RESULTS

The mean macronutrient intake of the GDM patients was 32.1% fat, 19.5% protein, and 48.3% carbohydrates; in the T1DM group the results were 34.2%, 19.4% and 46.4% respectively; and in control group they were 31.8%, 17.6% and 50.5% respectively. This study showed that many of the pregnant women did not reach the recommended level of energy intake during pregnancy. Moreover, most of the women exceeded their fat requirements, and fat intake as a proportion of energy intakes also exceeded the guidelines in more than 60% of the women across all groups.

CONCLUSIONS

The implications and possible causes of excessive fat intake during pregnancy and pregnancies complicated by diabetes are underestimated and undertreated by obstetricians and warrant further investigation, especially in association with gestational weight gain, maternal and fetal perinatal complications, and post-gestational diabetes.

Evaluation of the Bactericidal Activity of Didecyl Dimethyl Ammonium Chloride in 2-Propanol against Pseudomonas aeruginosa Strains with Adaptive Resistance to this Active Substance According to European Standards

This study evaluated the bactericidal activity of the cationic surface active compound didecyldimethylammonium chloride in 2-propanol against the two reference strains Pseudomonas aeruginosa and Pseudomonas aeruginosa (tetracycline-resistant) as well as their isolates adapted to this active substance. Individual phases and stages of European Standards which are intended to determine the bactericidal activity of disinfectants in medical areas were used. Disinfection parameters of the tested substance as determined by suspension methods were not sufficient to achieve the required bactericidal reduction in the carrier method for Pseudomonas aeruginosa and all its adapted isolates. Pseudomonas aeruginosa (tetracycline-resistant) and its adapted isolates were more sensitive to the tested active substance when the contact time was extended from 5 to 10/15 min. Adaptive resistance of Pseudomonas aeruginosa strains can be abolished by using increased concentrations of the tested substance and/or extended contact time.

Assessment of the incidence rate of end-stage renal disease in patients with and without diabetes in Poland

INTRODUCTION

Several studies have suggested, that diabetes is very important factor of the risk of the chronic a renal disease. The paper aims to present a retrospective analysis of incidence of end-stage renal disease in subgroups of patients with and without diabetes in Poland.

MATERIAL AND METHODS

For assessing this problem an electronic search was performed using Polish National Health Fund data base from 01.01.2011 until 31.12.2013 in general population and from 01.01.2012 until 31.12.2012 in 2 populations: with diabetes and without diabetes mellitus.

RESULTS

The 43.70 % patients with end-stage renal disease was diabetic. The incidence rate in 2012 was: 292.48 ± 90.97 diabetic men / 100,000 diabetic population; 203.10 ± 90.97 diabetic women / 100,000 diabetic population; 23.44 ± 6.34 non-diabetic men / 100,000 non-diabetic population; 17.88 ± 6.33 non-diabetic women / 100,000 non-diabetic population.

CONCLUSIONS

The incidence rate of end-stage renal failure in diabetics was multiple times higher than the incidence rate in non-diabetics. The incidence rate of new ESRD cases in Poland estimated to be 36.17 per 100,000 of general populations in 2011, 35.28% in 2012 and 30.46 per 100,000 of general populations in 2013. In 2012, the incidence rate of new ESRD cases in male diabetics was 292.48 ± 90.97 per 100,000 of diabetes men population, and in women diabetics 203.10 ± 66.06 per 100,000 of diabetes women population. In the same 2012 year, the incidence of new ESRD cases in men non-diabetics was 3.44 ± 6.34 per 100,000 of non-diabetes, and in women non-diabetes 17.58 ± 6.33 per 100,000 of non-diabetes women population.

Takayasu's arteritis: a rare disease in Poland

INTRODUCTION

Takayasu's arteritis (TA) is a rare and potentially life-threatening granulomatous large-vessel vasculitis that involves mostly in the aorta and its proximal branches, and occurs most commonly in young females. This study measures the incidence and prevalence of TA, and assesses the gender distribution and territorial differences in the occurrences of this disease in Poland over a five-year period. To the best of our knowledge, this is the first evaluation of this rare disease in Poland based on a hospital morbidity database.

MATERIAL AND METHODS

Analyses were performed with population-based administrative data obtained from a national hospital morbidity study carried out between January 2011 - December 2015 by the Polish National Institute of Public Health. Yearly incidence rates and prevalence of TA were calculated using the number of TA patients and corresponding census data for the overall Polish population.

RESULTS

Data included 660 hospitalization records. The final study sample comprised 177 patients: 154 female (87%) and 23 male (13%) with first-time hospitalization for TA. The mean age was 45.4years (95% CI: 42.9-47.8; SD 16.8; range 4-81 years), median 47. The incidence rate of TA was estimated at 0.92 per million per year (95% CI: 0.68-1.16). Five-year TA prevalence was estimated to be 4,6 per million. Incidence rates of TA did not vary significantly between more urban and more rural regions.

CONCLUSIONS

The incidence of TA in Poland was similar or lower to data reported by other European countries. The study provides epidemiological data on TA in Poland that may be useful while comparing it with other geographical regions.

Proliferation and apoptosis of human placental cells exposed to aromatic hydrocarbons

OBJECTIVES

The objective of this study is to assess the effect of elevated urinary levels of aromatic hydrocarbons (AH) on the proliferation and apoptosis of human placental trophoblast cells obtained in the course of normal pregnancy in an AH-polluted region.

MATERIAL AND METHODS

Tissue material was obtained for study purposes from 50 afterbirths from Płock as the study group and 50 afterbirths from Kutno as the control group. The extent and intensity of reactions were analyzed. The levels of phenol and 1-hydroxypyrene in the excreted urine of pregnant (in labor) patients were determined by gas chromatography and colorimetry. The proliferative activity of trophoblast cells was assessed using MPM-2 antibodies against phosphoprotein synthesized upon mitotic induction and Ki-67 antigen while the intensity of apoptosis in trophoblast cells was assessed using p53 and bcl-2 oncoproteins involved in apoptosis-regulating mechanisms. The immunohistochemical reactions were assessed for their extent and intensity.

RESULTS

The levels of phenol and 1-hydroxypyrene excreted in the urine were statistically significantly higher in patients from Płock region. The proliferative activity of trophoblast cells was statistically significantly higher in the study group (p < 0.05). The activity of oncoprotein bcl-2 was significantly higher in the study group while the activity of p53 was sig¬nificantly higher in the control group. Pregnancy in an aromatic hydrocarbon-polluted environment has a significantly negative impact on placental tissue. Ad¬aptation mechanisms are induced as manifested by increased proliferative activity within the trophoblast and extensive inhibition of apoptosis in the study group.

Paget disease of bone among hospitalized patients in Poland

INTRODUCTION

Paget's disease (PDB) is a focal disorder of bone remodeling that occurs commonly in older people with decreasing prevalence reported in European countries. This disease is most often asymptomatic, but it can cause a variety of medical complications resulting in considerable morbidity and reduced quality of life. There is little information regarding the epidemiology of PDB in Poland. To the best of the authors' knowledge, this is the first large epidemiological analysis of this disease in Poland.

OBJECTIVE

The aim of this study was to analyze factors that may be related to the PDB epidemiology among hospitalized patients in Poland.

MATERIAL AND METHODS

The analysis was conducted on the basis of population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 - December 2014.

RESULTS

Analyzed data covered 662 hospitalization records. The final study sample comprised 94 (41.8%) male and 131 (58.2%) female patients with first-time hospitalizations for PDB, with a significant predominance of females (P<0.02), and the predominance of patients living in urban (73%) than in rural areas (27%), P<0.001. The average age of the sample was 56.8 years (CI: 54.3-59.3; SD 18.8; range 1-93 years). The number of PDB cases hospitalized in Poland significantly decreased during the analyzed period of time.

CONCLUSIONS

PDB is a rare disease with decreasing trends observed among hospitalized patients in Poland. The study results may suggest the existence of environmental risk factors for the development of PDB.

Satisfaction with Life and Adaptive Reactions in People Treated for Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common illness. An individualized approach to changes caused by a chronic disease includes specific activity resulting from cognitive-emotional predispositions. The purpose of this study was to determine the influence of selected factors such as satisfaction with life, health self-assessment, duration of the illness, and the way of coping with disease on adaptive reactions in COPD patients. The study involved 109 COPD patients. The Adaptive Responses Inventory and the Satisfaction with Life Scale were used for the assessment of variables. We found that the majority of patients had low or very low satisfaction with life (63.3% and 22.0%, respectively). There was an inverse association between anxiety and satisfaction with life (r = -0.279; p < 0.003). Patients who assessed their health as good or very good showed a significantly greater satisfaction with life (p < 0.001). In the main, attitudes demonstrating a greater satisfaction with life and motivation to cope with COPD did not predominate among the patients. A poor state of mind, and stress inversely affected satisfaction. We conclude that although positive stress can mobilize to fight for better health, anxiety caused by illness has a negative connotation as it may demotivate to protect and maintain better health and consequently may reduce satisfaction with life.

Behçet disease: a rare systemic vasculitis in Poland

INTRODUCTION    Behçet disease (BD) is an immune‑mediated small‑vessel systemic vasculitis, which is rarely seen in Poland. OBJECTIVES    The aim of this study was to evaluate the incidence and prevalence of BD, as well as to assess the sex and geographical distribution of BD in Poland during a 7‑year follow-up. To our knowledge, this is the first evaluation of this rare disease in Poland, based on a hospital morbidity database. PATIENTS AND METHODS    We analyzed population‑based administrative data obtained from a national hospital morbidity study conducted between January 2008 and December 2014 by the National Institute of Public Health in Poland. The annual incidence rates and point prevalence of BD were calculated using the number of patients with BD and corresponding census data for the overall Polish population.  RESULTS    Data included 316 hospitalization records. The final study sample comprised 130 patients (54 men [42%] and 76 women [58%]) with first‑time hospitalizations for BD. The mean (SD) age was 41.6 (18.7) years (95% confidence interval [CI], 38.3-44.8; range, 5-85 years). The incidence rate of BD was estimated at 0.5 per million persons per year (95% CI, 0.35-0.61). The point prevalence at the end of 2014 was 3.4 per million persons. The incidence rate of BD did not vary significantly between more urban and more rural regions, and BD was observed more often in women than in men. CONCLUSIONS    BD is endemic in Eastern and Central Asian countries, but is also seen in Poland. However, its incidence and prevalence rates are lower in Poland than in other European countries.

Incidence and prevalence of Systemic Sclerosis (SSc) in Poland - differences between rural and urban regions

[b] Abstract Introduction.[/b] Systemic sclerosis (SSc) is a rare and potentially severe connective tissue disease, characterized by skin fibrosis and involvement of internal organs. Because of its rarity and heterogeneous clinical presentation, reliable epidemiological studies on SSc have been particularly difficult to carry out. [b]Objectives[/b]. The purpose of this study was to present SSc epidemiology among hospitalized patients in Poland.

MATERIALS AND METHOD

The analysis was based on population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 - December 2012. [b]Results[/b]. Analyzed data covered 9,049 hospitalization records. The final sample comprised 3,653 patients with first-time hospitalizations for SSc. The average age of the sample was 53 years (SD 16.2; range 0-91 years); 84% of patients were female and 16% male. Based on hospitalization registers, the average SSc incidence was estimated to be 1.9/100,000 per year and peak age of incidence was 55 years. The point prevalence was estimated to be 9.4/100,000 at the end of 2012. SSc was more common in females, with F:M ratio ranging from 6.2:1-4.6:1 depending on the year. Analysis of hospitalization trends revealed that overall numbers of SSc hospitalizations increased, while first-time hospitalizations decreased between 2008-2012. Clusters of higher incidence were observed in more rural regions vs. urban regions. [b]Conclusion[/b]. Estimated incidence of SSc in Poland was comparable to reported incidence in other European countries. Analysis of demographic factors and reports of clusters of higher incidence may suggest the existence of environmental risk factors for the development of SSc. These observations may require further research.

Neutralization efficiency of alcohol based products used for rapid hand disinfection

BACKGROUND

Alcohols are the most commonly used active substances in preparations for quick hand disinfection. They should be bactericidal in very short contact time. PN-EN 13727 + A2: 2015-12 standard, for testing hygienic and surgical handrub disinfection preparations, provides mandatory test conditions of disinfectants in contact times with the range of 30 s to 60 s (hygienic handrub disinfection) and 60 s to 5 min (surgical handrub disinfection). A short contact times for hand hygiene products require a short time of neutralization process. For contact times less than or equal to 10 minutes, the estimated neutralization time is 10 s ± 1 s. Neutralization is a process that abolishes the action of disinfectants. Correct application of this process allows for proper use of disinfectants in practice and its biocidal effect. Objectives. Verification of the effectiveness of 10-second neutralization time of alcohol based preparations for hygienic handrub disinfection

MATERIALS AND METHOD

Neutralization of two products with different ethanol content (89% and 70%) for hygienic handrub disinfection according to PN-EN 13727 + A2: 2015-12 was investigated. The effectiveness of the neutralizer was assessed by determining toxicity of neutralizer, activity of residual effects of the tested products and their derivatives produced during neutralization (10 s) for test organisms (Staphylococcus aureus ATCC 6538; Pseudomonas aeruginosa ATCC 15442; Enterococcus hirae ATCC 10541; Escherichia coli K12 NCTC 10538)

RESULTS

The 10-second neutralization time was sufficient to eliminate the residual activity of products for hygienic handrub disinfection with differentiated ethanol concentration. The neutralizer used did not show toxicity to bacteria and did not produce toxic products with tested preparations after neutralization

CONCLUSIONS

Conclusions. The use of 10-second neutralization time allows in a precise way designate the contact times for hygienic handrub disinfection products

Clinical and health care aspects of respiratory tract disorders in Poland

INTRODUCTION

Respiratory diseases constitute a public health priority worldwide. This is related to the increasing exposure to microorganisms, toxic factors, allergens, drugs and smoking, as the most important factors. Increasing costs of health promotion, prevention, diagnosis and treatment of respiratory tract diseases forces the search for effective strategies in the reduction of costs without making a significant impact of these activities on health results. Chronic obstructive pulmonary disease (COPD) is an example of these diseases with increasing incidence, which has few known modifiable factors and absorbs large medical and social costs.

OBJECTIVES

The aim of this study is to present the conception of cost driver analysis that could be useful in constructing a good combination of the EBM-based treatment with cost reduction decisions.

MATERIAL AND METHODS

Analysis of cost drivers was based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines and Polish recommendations of COPD diagnosis and treatment. The proposition of cost reduction strategy in COPD treatment was based on identification of cost drivers in value chain conception.

RESULTS AND CONCLUSIONS

An increasing incidence and treatment costs of COPD force the search for methods of costs reduction in health care. Identifying, evaluating and modifying the cost drivers with use of the value chain conception could be an effective method in achieving these objectives.

Serum leptin concentration in women of reproductive age with euthyroid autoimmune thyroiditis

INTRODUCTION

Autoimmune thyroid disease (AITD) with elevated anti-thyroid peroxidase antibody (aTPO) levels appears in 12-25% of all women, apart from thyroid dysfunction. High titers of aTPO are more common in women with polycystic ovary syndrome and endometriosis. Elevated aTPO has been associated with infertility and poorer quality of life among euthyroid women, and may be related to other factors.

OBJECTIVES

The aim of the study was to measure differences in serum leptin concentration between AITD+ and AITD- patients. Setting, patients and main outcome measures: The sample was comprised of 74 women who were hospitalized in the Department of Gynecological Endocrinology, Medical University of Warsaw. Data collected included age, body mass index (BMI), and serum aTPO, serum thyroid stimulating hormone (TSH), serum fT4, serum follitropin (FSH), serum estradiol and serum leptin. AITD positive status was defined as serum aTPO greater than 5.6 mIU/ml.

RESULTS

Serum leptin concentrations were significantly higher in AITD+ patients compared to AITD- patients (17.13 ng/ml [SD 7.66] versus 12.78 ng/ml [SD 7.28]; p < 0.05). No differences by AITD status were found in age, BMI, TSH, FSH, estradiol and fT4.

CONCLUSIONS

Serum leptin concentrations were higher in patients with AITD than in patients without AITD.

Preliminary report on a study of health-related quality of life in patients with rheumatoid arthritis

There are studies about health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA), but few studies prospectively assessed HRQoL. The main purpose of this study was to analyze HRQoL in patients hospitalized due to RA exacerbation and observed over a planned 2-year follow-up in an outpatient setting. The study involved 42 women and 9 men, at mean age of 62.5 years (SD ± 12.6). The mean duration of the study was 22-23 months. The HRQoL analysis was performed using the SF-36 survey. At the beginning of the study, basic data on age, sex, selected biochemical (ESR, CRP, GFR, hemoglobin, plasma albumin, plasma protein), and clinical parameters (the duration of RA, VAS, DAS28, BMI, the presence of cardiovascular disease, diabetes, osteoporosis, osteoporotic fractures, osteoarthritis, neoplasm) were collected. Questionnaires were completed at the beginning and end of the study. Statistically significant reductions in HRQoL scores were observed in social functioning (SF; 0.42 vs 0.32, P < 0.05), whereas role-emotional health (RE; 0.48 vs 0.59, P < 0.05) and mental health (MH; 0.47 vs 0.54, P < 0.05) scores were increased. A decrease in the SF was positively correlated with the lack of osteoporosis at baseline (r = 0.35, P > 0.02). An increase in the MH was inversely correlated with BMI (r = -0.31, P < 0.05), and the level of hemoglobin (r = -0.32, P < 0.028) and positively correlated with the presence of osteoarthritis at baseline (r = 0.29, P < 0.05). In RA patients, dimensions of HRQoL as SF, RE, and MH could change within 2 years and these changes could be related to comorbidities. Although preliminary findings are promising, further studies are needed.