Breast Cancer and Spirituality Among Women in Poland: A Case-Control Study.

In this case-control study, we assessed differences in daily spiritual experiences between patients with breast cancer diagnoses and healthy controls in relation to other breast cancer risk factors. The participants were 201 newly diagnosed Polish patients with breast cancer (58 ± 6 years) and 201 age-matched healthy controls. Spiritual experiences were assessed using the Daily Spiritual Experiences Scale (DSES). Adjusted odds ratios (OR) and 95% confidence intervals (CI) of the DSES score for breast cancer diagnosis were calculated with logistic regression. The DSES score was significantly higher in the healthy controls than in the cases. After controlling for alcohol use, education, BMI, and rural residence, higher spirituality was associated with a lower risk of breast cancer (OR 0.98, 95% CI 0.97-1.00). Two DSES item scores differed significantly between cases and controls, being lower in breast cancer cases: "I am spiritually touched by the beauty of creation" (p = 0.01) and "I feel selfless caring for others" (p = 0.049). After controlling for other variables (i.e., hormone replacement therapy, family history, breastfeeding, and diet quality), the DSES score was statistically non-significant (OR 0.99, 95% CI 0.97-1.006). Therefore, the original relationship DSES score and breast cancer was quite weak. Although the study found little relationship between the analyzed variables, presented differences in spirituality may differentiate the patterns of spiritual well-being among breast cancer patients; however, more data are needed from longitudinal study designs to establish causal inferences.

Selected dietary factors and breast cancer risk

While breast cancer is the most common cancer in women around the world, it is necessary to know the nutritional factors that can have both protective and negative effects on the risk of breast cancer. Unfortunately, the results of the research still do not give a definite answer to the question: which food products or food ingredients reduce, and which increase the risk of breast cancer. At a time when the main source of knowledge of health for the majority of society is the internet, myths about this disease are still being replicated. Only on the basis of clear scientific evidence can we build an effective prevention program that can save millions of women from breast cancer. In this review, we decided to present nutritional risk factors whose impact on the risk of breast cancer was examined, however, the results are not conclusive, like: fibre, milk products

Internet searches for "suicide", its association with epidemiological data and insights for prevention programs.

BACKGROUND: Literature demonstrates that analysis of internet search data is a useful tool in predicting the occurrence of illnesses and health-related behaviors. The aim of the study was to quantitatively present the trends in Google searches for the keyword "suicide" and to analyze its correlation with the number of suicides in Poland. SUBJECTS AND METHODS: We used the Google Trends tool to compile data for years 2004-2016. Statistical analysis was performed for annual, monthly, daily and hourly data. Official data on suicide in Poland were obtained from the Central Statistical Office and the General Police Headquarters of Poland. RESULTS: A gradual decrease in Google Relative Search Volume of the keyword "suicide" was observed in years 2004-2014, despite the significant increase of suicide rate in Poland (R=-0.24). Reverse correlation was also found between regional suicide coefficients and search volume (R=-0.22). The highest search volumes were recorded in winter months, first days of the week and at night hours (p<0.001). CONCLUSIONS: Presented results may contribute to more effective suicide prevention programs. By specifying the time intervals in which searching suicide information is the highest, it will become easier get to individuals at risk.

Indoor Exposure to Volatile Organic Compounds in Children: Health Risk Assessment in the Context of Physiological Development.

Indoor air quality is strongly affected by the contamination of ambient air and that related to building and finishing materials and to human activity. Poor ventilation of closed spaces facilitates retention of greater quantity of pollutants. Infants and children are at particular risk of exposure to indoor air pollutants as they undergo rapid physiological and biochemical changes and demonstrate activity patterns unlike those in adults. Health risk assessment in children should be carried out with regard to children-specific factors, since these factors may constitute a source of errors. In this article we weigh up two different: Scenario 1 in which risk assessment was carried out in five age-groups (0-1, 2-3, 4-6, 7-11, and 12-16 years of age) and Scenario 2 encompassing only two age-groups (0-6 and 7-16 years of age). The findings indicate that data on carcinogenic and non-carcinogenic effects obtained by applying the second scenario were overestimated or averaged; either giving much reduced information that may lead to a false judgment on actual risk. This kind of fallacy is avoided when applying the age stratification into a greater number of groups for the health risk assessment in children.

Small Bowel Bacterial Overgrowth Associated with Persistence of Abdominal Symptoms in Children Treated with a Proton Pump Inhibitor.

Small bowel bacterial overgrowth (SBBO) was diagnosed in 22.5% of 40 children treated for 3 months with a proton pump inhibitor (PPI). Compared with those without SBBO, children with SBBO had higher frequency of abdominal pain, bloating, eructation, and flatulence. Patients with gastrointestinal symptoms after PPI treatment should be evaluated for SBBO rather than empirically prolonging PPI therapy.

Air Pollution Increases Risk of Occurrence of Intracerebral Haemorrhage but Not of Subarachnoid Haemorrhage: Time-Series Cross-Sectional Study.

(1) Background: Haemorrhagic strokes (HS), including intracerebral (ICH) and subarachnoid haemorrhages (SAH), account for approximately 10-15% of strokes worldwide but are associated with worse functional outcomes and higher rates of mortality, and financial burden than ischemic stroke. There is evidence that confirmed poor air quality may increase the incidence of haemorrhagic strokes. The aim of our study was to evaluate the association between individual ambient air pollutants and the risk of haemorrhagic stroke in an urban environment without high levels of air pollution. (2) Methods: A time-series cross-sectional study design was used. A daily air pollution concentration (Agency of Regional Air Quality Monitoring in the Gdansk Metropolitan Area) and incidence of haemorrhagic strokes (National Health Fund) were obtained and covered the time period from 1 January 2014 to 31 December 2018. A generalised additive model with Poisson regression was used to estimate the associations between 24-h mean concentrations of SO2, NO, NO2, NOx, CO, PM10, PM2.5, and O3 and a daily number of haemorrhagic strokes. (3) Results: The single-day lag model results showed that NO2, NO and NOx exposure was associated with increased risk of ICH (88% events) with RR of 1.059 (95% CI: 1.015-1.105 for lag0), 1.033 (95% CI: 1.007-1.060 for lag0) and 1.031 (95% CI: 1.005-1.056 for lag0), but not for SAH (12% events). Exposure to CO was related to a substantial and statistically significant increase in incidence for 1.031 (95% CI: 1.002-1.061 for lag0) but not for SAH. Higher SO2, PM10, PM2.5, and O3 exposures were not significantly related to both ISC and SAH. (4) Conclusions: In this time-series cross-sectional study, we found strong evidence that supports the hypothesis that transient elevations in ambient NO2, NO and CO are associated with a higher relative risk of intracerebral but not subarachnoid haemorrhage.

[Age and duration of employment of health care workers with occupational viral hepatitis B and C]. / Wiek i staz zawodowy pracowników ochrony zdrowia z zawodowym wirusowym zapaleniem watroby typu B i C.

BACKGROUND: In this paper we present the study of the incidence of hepatitis B and C among health care workers in the Pomorskie voivodeship in the years 1999-2009. The aim of the study was to analyze the relationship between the certified occupational HCV and HBV infections and the age and duration of employment of infected health care workers. MATERIAL AND METHODS: To analyze the epidemiological situation of occupational hepatitis among health care workers in the Pomorskie voivodeship, the data 338 occupational disease certificates were obtained. RESULTS: Of the 338 certified cases of occupational viral hepatitis during this period 222 (65.7%) cases were diagnosed with hepatitis B, and 116 (34.3%) with hepatitis C. The total number of health care workers included 301 (89%) women, and 37 (11%) men. The majority of occupational hepatitis cases occurred in the following age groups 45-49, 40-44, 50-54 and 35-39 years. The mean age for the whole population was 46.20 years. The average duration of employment was 18.34 years, and it was lower for women than for men by 1.71 years (18.15 vs. 19.86). The cases of hepatitis mostly occurred during the periods of 15-19, 20-24 and 25-29 years of employment (50% of cases). CONCLUSIONS: These data suggest that the employees used to postpone the procedure of occupational disease certification. Short work experience confirms a higher risk of infection among employees of analytical laboratories and dental offices. The relationship between a higher risk of infection in workers and a shorter duration of employment (little work experience) was evidenced.

Assessment of Low-Level Air Pollution and Cardiovascular Incidence in Gdansk, Poland: Time-Series Cross-Sectional Analysis.

(1) Background: More than 1.8 million people in the European Union die every year as a result of CVD, accounting for 36% of all deaths with a large proportion being premature (before the age of 65). There are more than 300 different risk factors of CVD, known and air pollution is one of them. The aim of this study was to investigate whether daily cardiovascular mortality was associated with air pollutants and meteorological conditions in an urban environment with a low level of air pollution. (2) Methods: Data on daily incidence of strokes and myocardial infarctions in the city of Gdansk were obtained from the National Health Fund (NHF) and covered the period from 1 January 2014 to 31 December 2018. Data on the level of pollution, i.e., SO2, NO, NO2, NOx, CO, PM10, PM2.5, CO2, O3 and meteorological conditions came from the foundation: Agency of Regional Air Quality Monitoring in the Gdansk metropolitan area (ARMAG). Using these data, we calculated mean values with standard deviation (SD) and derived the minimum and maximum values and interquartile range (IQR). Time series regression with Poisson distribution was used in statistical analysis. (4) Results: Stroke incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.019 (95%CI: 1.001-1.036), 1.036 (95%CI: 1.008-1.064) and 1.017 (95%CI: 1.000-1.034) for every increase in IQR by 14.12, 14.62 and 22.62 µg/m3, respectively. Similarly, myocardial infarction incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.030 (95%CI: 1.011-1.048), 1.053 (95%CI: 1.024-1.082) and 1.027 (95%CI: 1.010-1.045) for every increase in IQR by 14.12, 14.62 and 22.62 µg/m3, respectively. Both PM10 and PM2.5 were positively associated with myocardial infarction incidence. (5) Conclusions: In this time-series cross-sectional study, we found strong evidence that support the hypothesis that transient elevations in ambient PM2.5, PM10, NO2, SO2 and CO are associated with higher relative risk of ischemic stroke and myocardial infarction incidents.

[Religiosity and health in epidemiological studies]. / Zwiqzek miedzy religia a zdrowiem w badaniach epidemiologicznych.

The relationship between religion and health has been the subject of growing interest in epidemiological research. The aim of this paper is to review the data on relationship between health-related behaviors associated with religiosity and reduced mortality and morbidity. In this review beneficial effects of religiosity on specific physical and mental health diseases, focusing on coronary heart disease, cancer, depression, suicide, psychosis, and substance abuse are described. Religious beliefs and practices can represent powerful sources of comfort, hope, and meaning and they are associated with protective dietary habits and reduced risk of substance abuse. Religiosity can be also harmful as it is often entangled with neurotic and psychotic disorders. The current published data suggests that religiosity has a favorable effect on survival, although the methodological controversies including presence of biases typical for observational research indicate that results should be interpreted with caution.

Increased risk of death compared to other antipsychotics in elderly clozapine users in Poland.

Clozapine can cause severe adverse effects. Few epidemiologic studies have considered the effect of clozapine use in elderly patients. The aim of this study was to assess mortality in elderly patients treated with clozapine in comparison to patients treated with first- or second-generation antipsychotics. We conducted a retrospective cohort study involving 26 639 patients who were 65 years of age or older and were receiving antipsychotic medication between 2008 and 2012. Cox proportional-hazards models were used to compare the risk of death between different groups of antipsychotics after controlling for age, sex, concomitant treatment with cardiovascular or metabolic medications. The use of antipsychotic medications other than clozapine was associated with a lower adjusted risk of death [hazard ratio, 0.89; 95% confidence interval (95% CI), 0.79-0.99]. The use of cardiac and antilipemic but not antidiabetic drugs was associated with a significantly lower risk of death in this population (hazard ratio, 0.88; 95% CI, 0.83-0.93; hazard ratio, 0.66; 95% CI, 0.58-0.75 and hazarad ratio, 1.09; 95% CI, 0.96-1.24, respectively). These results suggest that clozapine is associated with an increased risk of death in the elderly. Although the study was based on administrative records linkage, its results suggest that attention should be paid to patients taking antipsychotics.

Health status and its socio-economic covariates in the older population in Poland - the assumptions and methods of the nationwide, cross-sectional PolSenior2 survey.

INTRODUCTION: Population ageing constitutes an increasing medical, social, and economic burden worldwide. Optimal senior policy should be based on well-assessed knowledge on the prevalence and control of age-related diseases, multimorbidity, disabilities, and their social determinants. The objective of this paper is to describe the assumptions, methods, and sampling procedures of the PolSenior2 survey, which was aimed at characterising the health status of old and very-old adults in Poland. MATERIAL AND METHODS: The project was conducted in the period 2018-2019 as a cross-sectional survey of a representative sample of people aged 60 years and over. Subjects were selected using three-stage stratified and proportional random sampling in seven equally sized (n = 850) age groups. The study protocol consisted of face-to-face interviews, specific geriatric scales and tests, and anthropometric and blood pressure measurements performed by well-trained nurses at participants homes as well as blood and urine sample laboratory tests. RESULTS: In the Polsenior2 study a group of 5987 subjects underwent the questionnaire parts of the survey, and almost all (n = 5823) agreed to blood or urine sample collection. CONCLUSIONS: In recent decades several studies focused on various aspects of elderly health and life conditions had been carried out in Poland and Central and Eastern Europe. However, none of them is so complex and has covered so many issues as PolSenior2, which is the largest study devoted to the health status of older persons in Poland and one of the largest and the most comprehensive in Europe. The results of the study will help to improve health policy targeted at the elderly population in Poland.

Relationship between P-wave duration and atrial electromechanical delay assessed by tissue Doppler echocardiography.

BACKGROUND: The aim of the study was to assess the relationship between P-wave duration on the surface electrocardiogram (ECG) and echocardiographic parameters of atrial electromechanical delay (EMD), as well as contraction synchrony during different atrial pacing modalities. METHODS: In 57 patients with sinus node disease and prolonged sinus P-wave duration treated with multisite atrial pacing (MSAp), the EMD was measured by tissue Doppler in several left and right atrial sites during sinus rhythm, MSAp, and single-site pacing at right atrial appendage (RAAp), Bachmann's bundle (BBp) region, and coronary sinus (CSp) ostium. Regional atrial synchrony was calculated on the basis of EMD. RESULTS: P-wave duration was 141 ± 16, 120 ± 17, 138 ± 17, 144 ± 16, and 160 ± 19 ms during sinus rhythm, MSAp, BBp, CSp, and RAAp, respectively (P < 0.001 RAAp and MSAp vs other). P-wave duration correlated with all atrial EMDs as well as interatrial and intraleft atrial parameters of dyssynchrony. In multivariate analysis, the EMD in lateral left atrial wall was the strongest predictor of P-wave duration (ß 0.41; P < 0.001). The relationship between P-wave duration and the atrial EMDs was most prominent during RAAp (all left atrial walls r > 0.51; P < 0.01) and BBp (all atrial walls r > 0.42; P < 0.05), while during sinus rhythm and CSp, only weak correlation between echo and ECG was found. Neither of the tissue Doppler parameters correlated with P-wave duration during MSAp. Interatrial dyssynchrony correlated with P-wave duration during sinus rhythm and RAAp and intraleft atrial dyssynchrony only during sinus rhythm. CONCLUSIONS: P-wave duration of the surface ECG is highly correlated with the atrial EMD, the relationship is specific for each pacing modality.

Cause-specific mortality and risk factors of death among inpatients of a psychiatric hospital. / Umieralnosc szczególowa i czynniki ryzyka zgonu wsród pacjentów szpitala psychiatrycznego.

OBJECTIVES: The aim of the study was to determine general and specific in-hospital mortality rates, and to identify mortality risk factors. METHODS: The study included 15,997 medical records of subjects who have been hospitalized at the Hospital for Patients with Neurotic and Psychiatric Diseases in Starogard Gdanski in 2005-2012. The study was designed as aretrospective cohort study with Cox proportional model for survival analysis. Standardized mortality ratio (SMR) and its 95% confidence intervals were calculated (95% CI). RESULTS: Independent risk factors for death were: male sex, older age, hypertension, atherosclerosis, history of myocardial infarction, heart failure, cirrhosis, tuberculosis, history of cancer, anemia, and inflammation. Delirium not induced by alcohol or other psychoactive substances was associated with the highest mortality risk of all psychiatric diagnoses. Unemployment was associated with doubled risk of in-hospital death. SMR for the whole population of hospitalized patients amounted to 17.88 (95% CI: 15.99-20.00). CONCLUSIONS: Medical comorbidities have a significant and clinically important impact on in-hospital mortality in psychiatric patients in Poland. Clinicians' awareness and active management of medical conditions amongst such patients is needed to reduce the risk of inhospital mortality in psychiatric facilities.

Early Alcohol Use Initiation, Obesity, Not Breastfeeding, and Residence in a Rural Area as Risk Factors for Breast Cancer: A Case-Control Study.

The aim of this study was to determine the risk factors for breast cancer in the Polish population. In total, 201 Polish women newly diagnosed with breast cancer and 201 one-to-one age-matched healthy controls participated in this case-control study. Data on sociodemographic characteristics, reproductive and menstrual history, medical history, lifestyle factors, and anthropometric measurements were collected by the interviewers. Odds ratios and 95% confidence intervals were obtained using multivariate unconditional logistic regression models controlling for potential confounders. Significant relationships were observed between BMI, alcohol use initiation, breastfeeding, education, and place of residence. Obese women had a higher risk of breast cancer than women with a BMI < 30 (OR = 1.9; 95% CI: 1.16 to 3.04). Early alcohol use initiation (≤15 years) was associated with an almost two-fold higher risk of breast cancer (OR = 1.98, 95% CI: 1.06 to 3.69). Breastfeeding for less than 3 months (OR = 2.3, 95% CI: 1.52 to 3.5), receiving a basic and vocational education (OR = 2.5, 95% CI: 1.49 to 4.19), and living in a rural area (OR = 1.7, 95% CI: 1.05 to 2.9) increased the risk of breast cancer. Prevention activities for breast cancer are already needed in adolescents and young women. A much greater emphasis should also be placed on breast cancer prevention campaigns in rural areas in Poland.

Incidence of spinal muscular atrophy in Poland--more frequent than predicted?

BACKGROUND: The application of molecular methods has enhanced and enlarged the diagnostics of spinal muscular atrophy (SMA) and its carriership. It allows for reliable epidemiological studies which are of importance to demography and genetic counseling. METHODS: This study sought to evaluate the incidence of SMA in Poland, on the basis of the prevalence of the SMN1 gene deletion carrier state in the general population, as well as an analysis of all cases of SMA diagnosed in the years 1998-2005. RESULTS: The prevalence of the SMN1 gene deletion carrier state was estimated at 1 per 35 persons (17/600), yielding an incidence of SMA equal to 1 per 4,900. By contrast, the incidence of SMA based on the results of the meta-analysis was an estimated 1 per 7,127 in Warsaw and 1 per 9,320 persons across Poland, suggesting that some cases of SMA remain undiagnosed. SMA1 predominated among the diagnoses, accounting for 69% of all cases. CONCLUSION: A high prevalence of the SMN1 deletion carrier state in the general population indicates that SMA could be a more frequent disease than is predicted by the epidemiological data regarding diagnosed cases.

Total Dietary Fats, Fatty Acids, and Omega-3/Omega-6 Ratio as Risk Factors of Breast Cancer in the Polish Population - a Case-Control Study.

BACKGROUND/AIM: Breast cancer is the most common type of cancer among women around the world and the leading cause of cancer-related death among women. The knowledge about modifiable risk factors, such as diet, can be an acceptable, cheap and non-pharmacological prevention tool. The aim of this study was to investigate the association between dietary fat, dietary fatty acids, fish intake, and breast cancer in women. PATIENTS AND METHODS: A case-control study was designed. A total of 201 consecutive, newly diagnosed, polish female cancer patients (mean age: 58 years) and 201 one-to-one age-matched controls were enrolled. A standardised questionnaire assessing various socio-demographic, clinical, lifestyle, and dietary characteristics was applied via face-to-face interviews. Detailed dietary intake information was assessed using a validated Food Frequency Questionnaire. Odds ratios (OR) and 95% confidence intervals (95%CI) were obtained using multiple unconditional logistic regression models controlling for non-dietary and dietary potential confounders. RESULTS: Consumption of polyunsaturated fats (PUFA) over 10% of total energy intake was associated with a significantly lower risk of breast cancer compared to low intake of PUFA (OR=0.4, 95%CI=0.19-0.85). Low (<0.2) omega-3/ omega-6 ratio (OR=2.04, 95%CI=0.996-4.17), fish consumption less than once every six months (OR=3.37, 95%CI=1.57-7.23) and being overweight (OR=2.07, 95%CI=1.3-3.3) were associated with increased risk of breast cancer. Residents of rural areas had a significantly higher risk compared to women from urban areas (OR=1.8, 95%CI=1.06-3.03). CONCLUSION: High intake of PUFA can decrease the risk of breast cancer, while the low omega-3/omega-6 ratio increases the risk. In addition, overweight state, eliminating fish from the diet and living in rural areas can also increase the risk of breast cancer.

Socioeconomic correlates and biochemical profiles of smokers in Poland: a cross-sectional study.

INTRODUCTION: Epidemiological studies have shown a fairly constant association between the socioeconomic status and smoking. However, associations between smoking and the biological indicators of health status have not been well described yet. OBJECTIVES: This study aimed to determine the relationship among smoking, biochemical risk factors, and sociodemographic characteristics in the Polish population. PATIENTS AND METHODS: A survey was carried out in a representative sample of Polish residents aged 18 to 79 years. A total of 2413 randomly selected subjects participated in the survey. Logistic regression analysis as well as parametrical and nonparametrical tests were performed. RESULTS: Significantly higher cholesterol, apolipoprotein B, and potassium levels were observed in smoking women and men compared with the nonsmoking population. Significantly lower bilirubin levels were noted in smoking individuals. Higher C­reactive protein and lower creatinine levels were reported only in the smoking male population compared with nonsmokers. There was a significant inverse gradient in the relationship between income and smoking. Single women and men were at greater risk of being smokers (odds ratio [OR], 1.9 and 2.39, respectively). Individuals from small towns (less than 50 000 inhabitants) were at significantly greater risk of smoking compared with those living in rural areas (OR, 1.45 and 1.64 in women and men, respectively). CONCLUSIONS: We found differences regarding socioeconomic characteristics and major biochemical parameters between smokers and nonsmokers in Poland. However, it is difficult to establish which associations are causal for cardiovascular risk owing to the cross­sectional design of this study.

Survival analysis in patients with preserved left ventricular function and standard indications for permanent cardiac pacing randomized to right ventricular apical or septal outflow tract pacing.

BACKGROUND: Optimal right ventricular (RV) pacing site in patients referred for permanent cardiac pacing remains controversial. A prospective randomized trial was done to compare long-term effect of permanent RV apex (RVA) vs RV outflow tract (RVOT) pacing on the all-cause and cardiovascular mortality. METHODS AND RESULTS: A total of 122 consecutive patients (70 men, 69 +/-11 years), with standard pacing indications were randomized to RVA (66 patients) or RVOT (56 patients) ventricular lead placement. After the 10-year follow-up period the mortality data were summarized on the basis of an intention-to-treat analysis. During the long-term follow-up, 31 patients from the RVA group died vs 24 patients in the RVOT group (hazard ratio (HR), 0.96; 95% confidence interval (CI), 0.57-1.65; P=0.89). There were 10 cardiovascular deaths in the RVA and 12 in the RVOT group (HR, 1.04; 95%CI, 0.45-2.41; P=0.93). There were no differences in the all-cause or cardiovascular mortality between the pacing sites after adjustment for age, gender, arterial hypertension, atrial fibrillation, New York Heart Association class and left ventricular end-diastolic diameter. CONCLUSIONS: The RVOT provides no additional benefit in terms of long-term survival over RVA pacing.

Atrial electromechanical sequence and contraction synchrony during single- and multisite atrial pacing in patients with brady-tachycardia syndrome.

OBJECTIVES: Investigation of which atrial pacing modality provides atrial synchrony and the most physiological atrial contraction pattern in patients with brady-tachycardia syndrome. METHODS: Fifteen healthy subjects and 57 patients with sinus node dysfunction, atrial fibrillation recurrences, and prolonged P-wave on the electrocardiogram treated with multisite atrial (MSA) pacing were studied. One atrial lead was implanted in the coronary sinus (CS) ostium area, the other at the right atrial appendage (RAA): RAA+CS group (28 patients), or Bachmann's bundle (BB) region: BB+CS group (29). Sinus rhythm (SR) and CS, RAA, BB, RAA+CS, and BB+CS pacing modalities were evaluated. Electromechanical delay (EMD) in atrial walls was assessed by tissue Doppler echocardiography. Interatrial (DeltainterA), intra-right (DeltaRA), and intra-left (DeltaLA) atrial dyssynchrony were calculated. RESULTS: During SR, in the study group versus controls, important DeltainterA: 55 +/- 23 versus 22 +/- 11 ms (P < 0.01) and DeltaLA: 47 +/- 21 versus 21 +/- 6 ms (P < 0.001) were present. Single-site BB and both MSA pacing modes restored DeltainterA and DeltaLA (DeltainterA: 24 +/- 16, 20 +/- 13 and 14 +/- 9 ms, DeltaLA: 28 +/- 18, 28 +/- 13 and 20 +/- 10 ms during BB, RAA+CS and BB+CS pacing, respectively). CS pacing prolonged lateral RA EMD, while RAA pacing LA walls EMD, which resulted in DeltainterA persistence. CS pacing induced DeltaRA (50 +/- 23 vs 16 +/- 8 ms, P < 0.0001 vs controls). Atrial contraction sequence during BB pacing resembled that observed in controls. CONCLUSIONS: (1) Single-site BB and both MSA pacing modes restored atrial synchrony. (2) Single-site RAA and CS ostium pacing retained interatrial dyssynchrony; moreover, CS pacing created RA dyssynchrony. (3) Single-site BB pacing provided physiological atrial contraction sequence.

Survival and cause-specific mortality among unemployed individuals in Poland during economic transition.

BACKGROUND: There were few reports about the relationship between unemployment and mortality in Central Eastern European countries experiencing economic transition. METHODS: This study measures overall and cause-specific mortality rates in 47,247 subjects registered as unemployed in Danzig City and Danzig County for the period of 1999 and 2004 and compares them with the age-matched general population. RESULTS: In unemployed male subjects, the age-standardized all-cause mortality rate was significantly higher than in men from the general population: 8.36 per 1000, 95% confidence interval (95% CI) 7.71-9.0 compared with 5.1 per 1000, 95% CI 4.94-5.21. The age-standardized mortality in unemployed women was also higher than in the reference population data: 5.55 per 1000, 95% CI 4.77-6.34 and 1.89 per 1000, 95% CI 1.81-1.97, respectively. External causes, suicides, alcohol and smoking-related causes explain the excess mortality among both men and women. Unemployment status was associated with a greater risk of death in men than in women: hazard ratio (HR) 2.02, 95% CI 1.33-3.08 and HR 0.74, 95% CI 0.37-1.5, respectively. CONCLUSIONS: Possible explanations for this disparity may be the current regulations and sociocultural context in Poland. More research is needed to understand the differences in mortality risk associated with unemployment observed between men and women in Poland.