Local Government Initiatives: A Comprehensive Analysis of Infertility Diagnostic and Treatment Programs in Poland (2009-2020).

BACKGROUND Infertility is an increasingly significant public health problem. However, thanks to the achievements of modern medicine, it is possible to take steps to treat it. The objective of this study was to present data about programs for the diagnosis and treatment of infertility that were developed, implemented, and financed by local governments at all levels in Poland in 2009-2020. MATERIAL AND METHODS The study was conducted based on the analysis of existing data from the Minister of Health. We present data on infertility diagnostics and treatment programs, the number of programs in particular years, the number of programs implemented by individual levels of local governments, the number of people participating in the programs, and the total cost of the programs in EUR. RESULTS Programs aimed at diagnosing/treating infertility began to be implemented in 2012 (most were implemented in 2019 and 2020, 18 each). Twenty-three local governments of various levels, including 5 communes, 13 cities with poviat rights, 1 poviat, and 4 voivodeships, participated in the implementation of these programs. A total of 22 379 people were covered by infertility diagnosis and treatment programs in the years 2012-2020. The cost of all implemented programs was over EUR 10.7 million. CONCLUSIONS The legal situation in Poland caused the vast majority of infertile couples who wanted to have children to have to self-finance in vitro fertilization procedures. A small number of local governments undertook actions aimed at co-financing in vitro fertilization procedures.

Parents' Awareness of Infectious Diseases Epidemiology in Poland and Ukraine.

BACKGROUND: There has been a decline in vaccine-related confidence in Ukraine over the past few years, resulting in high rates of infectious diseases. Due to the arrival of a large number of refugees in Poland following the outbreak of war in Ukraine in February 2022, the risk of infectious diseases in Poland among children and adults has increased. The present study aimed to analyze the relationship between parents' knowledge of the epidemiological situation of infectious diseases in Poland and Ukraine and socio-demographic factors and their attitudes towards vaccination. MATERIAL AND METHODS: A cross-sectional survey study was designed. Data were collected through an online questionnaire between November 2022 and January 2023, where the inclusion criteria was having a child under 18 years of age. Study participants' stratification was based on responses to seven knowledge questions; those who answered all questions correctly were allocated to group 1, and the others to group 2 for further analysis. RESULTS: A total of 547 parents were included. Their median age was 34 years [IQR: 31-39]. There were 233 (42.60%) participants who answered all the knowledge questions correctly. Respondents from group 1 were older (p = 0.033), were more likely to be in favor of recommended vaccination (p = 0.040), to be vaccinated with four doses against SARS-CoV-2 (p = 0.014), to have their children vaccinated against SARS-CoV-2 (p < 0.001), and to believe that the influx of migrants from Ukraine would increase the incidence rate of infectious diseases in Poland in the future (p < 0.001). They also declared awareness of the impact of migration on the epidemiological situation in Poland (p < 0.001) more often. According to the logistic regression model, older parents (OR = 1.31, p = 0.029), those who were willing to receive additional vaccinations due to migration (OR = 4.29, p = 0.003), those who were aware of the impact of migration on the epidemiological situation (OR = 2.38, p < 0.001), and those who believed that migration would have affected the incidence rate of infectious diseases in Poland (OR = 2.28, p = 0.003) were significantly more likely to belong to group 1. However, parents who were willing to vaccinate their children with additional vaccinations due to migration were significantly less likely to answer all the questions correctly (OR = 0.21, p = 0.002). CONCLUSIONS: Awareness of the epidemiological situation in Poland and Ukraine among parents is related to a greater awareness of the impact of migration and the use of recommended vaccinations and those against SARS-CoV-2. Additional vaccinations should be further promoted among both Poles and migrants.

Immunological and Clinical Responses to Vaccinations among Adults Living with HIV.

People living with human immunodeficiency virus (HIV) are at higher risk of morbidity and mortality due to vaccine-preventable diseases. At the same time, they are less likely to respond to vaccinations, and might have a higher rate of vaccine adverse event and faster waning of protective effect. International and national guidelines emphasize the importance of vaccinating people living with HIV against respiratory system disease pathogens including seasonal influenza, Streptococcus pneumoniae, and COVID-19, as well as against sexually transmitted infections, i.e., Hepatitis A and B (HAV, HBV) and human papillomavirus (HPV). This narrative review aims to provide a comprehensive examination of the current knowledge regarding the immune and clinical responses elicited by vaccinations in the older adult population living with HIV.

Parents' Attitudes towards Vaccinations Regarding the Ukrainian Migration to Poland in 2022.

Background: Russia's aggression against Ukraine in early 2022 resulted in a large migration of refugees to many countries, including Poland. Vaccination coverage for some infectious diseases in Ukraine is lower than in Poland; consequently, the incidence of infectious diseases-including measles, poliomyelitis, tuberculosis, and COVID-19-is higher. We aimed to investigate whether the migration of Ukrainians had influenced decisions of Polish parents on having their children vaccinated and to examine their attitudes towards vaccinations. Material and methods: A cross-sectional online survey study was designed. Data on parents' demographics, attitudes toward vaccination, and knowledge of the current epidemiological situation in Poland were collected. Parents participating in the study were divided into two subgroups for further analysis according to their decisions to have their children vaccinated. Results: A total of 568 questionnaires were collected, of which 21 did not meet the inclusion criteria for the analysis (respondents were not parents). The Ukrainian immigrants' influx affected 54 (9.87%) participants in their decision of having their children vaccinated. Respondents in this group were more likely to have a positive attitude toward recommended vaccinations (p = 0.0428); in addition, they more often had their children vaccinated with recommended vaccinations (p = 0.0063), believed the vaccination coverage with mandatory vaccinations was higher in Poland than in Ukraine (p = 0.0014), and believed the incidence of diseases covered by mandatory (p = 0.0472) and recommended (p = 0.0097) vaccinations was higher in Ukraine. In addition, parents who declared that the migration had affected their decision regarding their children's vaccinations had more often been vaccinated due to the influx of Ukrainian immigrants (p < 0.00001) and were more likely to be aware of how migration had impacted the current epidemiological situation in Poland (p = 0.0021). Moreover, the survey more often made these participants think about getting additional vaccinations for themselves (p < 0.0001) and their children (p < 0.0001). Conclusions: The Ukrainian immigrants' influx affected nearly one tenth of surveyed parents in their decision of having their children vaccinated. This group was more aware of the differences between infectious diseases' epidemiology in Poland and Ukraine. In addition, they also had a more positive attitude toward vaccinations.

The COVID-19 Crisis and the Incidence of Alcohol-Related Deaths in Poland.

BACKGROUND Identifying risk and protective factors for excessive alcohol consumption can inform targeted health policies, reducing the impact of potential mental health crises. This study examined the validity and reliability of COVID-19-related death data and explored the correlations among age, sex, residential status, alcohol abuse, and healthcare access. MATERIAL AND METHODS This analysis of Polish residents' mortality relies on individual data from the register of deaths maintained by Statistics Poland. This study examined deviations in the number of deaths between 2020 and 2021 by analyzing specific causes of death. RESULTS Alcohol abusers had increased COVID-19 risk factors compared to the general population. F10 values were 22% higher than expected in 2020, aligning with predictions for 2021. Higher mortality rates were observed in the first year of the pandemic. In 2020, women and rural residents were more affected (31% and 25% higher than expected, respectively), while men and urban residents were less affected (21% and 20% higher than expected, respectively). In 2021, the trend reversed, with men 2% higher than predicted and women 4% lower. Urban area residents had a 77% lower than expected value, while rural area residents were similar (8% higher). Overall mortality exceeded expectations in both 2020 (13% higher) and 2021 (23% higher). In 2021, alcohol-related non-mental health problems increased by more than 40% in standardized death rates (SDRs). CONCLUSIONS Alcohol-related deaths reflect the hidden effects of the pandemic. Measuring the pandemic's impact on global excess mortality is hindered by inconsistencies in COVID-19 death reporting.

Comparison of the prevalence of risk factors for Toxoplasma Gondii infection among pregnant women in rural and urban areas in Poland.

Introduction: Toxoplasma gondii is a protozoan parasite. While this infection typically exhibits no symptoms in humans, it poses a potential threat to the developing fetus in pregnant women. Several risk factors contribute to toxoplasmosis infection. Adherence to hygiene protocols and avoiding the consumption of raw meat, unwashed vegetables, and fruits may mitigate the risk of this disease. Objective: This study aimed to compare the prevalence of toxoplasmosis risk factors among pregnant women suspected of toxoplasmosis living in rural areas with those residing in urban areas. Materials and methods: A retrospective observational study was conducted by analyzing data from the medical records of pregnant women suspected of toxoplasmosis. These women were consulted at the Provincial Infectious Diseases Hospital between September 2019 and March 2020. The analysis encompassed patients' demographic data and information concerning toxoplasmosis risk factors. A total of 273 women's data were included in the analysis. Diagnosis relied on serological verification using the VIDAS® analyzer (bioMérieux, Lyon, France). Results: Women residing in rural areas were less likely to report a good socio-economic status (p=0.0064), and toxoplasmosis infection was less frequently ruled out (p=0.0023). In comparison to women living in urban areas, pregnant women from rural regions were more likely to have confirmed primary toxoplasmosis (p=0.0164). Additionally, they were more prone to working in gardens without gloves (p<0.0001), consuming unwashed vegetables (p=0.0025), eating raw meat during pregnancy (p=0.0008), and cats caregiving during pregnancy (p=0.0002). This exposure included both care for domestic cats before and during pregnancy (p=0.0069) and interactions with wild cats (p<0.0001). Conclusions: Pregnant women living in rural areas exhibited significantly higher exposure to toxoplasmosis risk factors. They also displayed a higher incidence of primary infections during pregnancy and a lower rate of excluded infections.

The impact of face masks on acne-prone skin in Polish young adults during COVID-19 pandemic.

COVID-19 pandemic raised many problems for patients with acne-prone skin: a limited access to health care services, the necessity of developing telemedical consultations also in dermatology, and the usage of face masks. The aim of the study was to investigate the influence of respiratory protective measures (type of masks, wearing time during the day) on declared skin condition in patients already diagnosed with acne or reporting acne for the first time. The study was conducted in Poland among 1420 responders using the original authors' questionnaire, of which 1274 responders were included in the final sample. Acne exacerbations were reported as being more frequent and more severe in women than in men. Changing cosmetic products, facial skin decontamination before or after applying masks, the number of days per week that a mask was worn were related to acne exacerbation. The type of mask had no significant impact on the occurrence of acne lesions. Respondents noted that masks contribute significantly to skin condition worsening by exacerbating existing and causing new acne lesions. This phenomenon was particularly observable in women, in whom, according to the research results, new lesions appeared much more frequently. Therefore, there is a need to develop new ways of limiting acne exacerbation during COVID-19 pandemic.

[Multifocal oscillatory potentials (mfOPs) in patients with central retinal vein occlusion]. / Wieloogniskowe potencjaly oscylacyjne (mOPs) u chorych z zakrzepem zyly srodkowej siatkówki.

PURPOSE: To evaluate usefulness of multifocal oscillatory potentials (mfOPs) in diagnostics in patients with retinal vein occlusions. MATERIAL AND METHODS: The Visual Evoked Imaging System (VERIS, version 4.9) was used to stimulate the visual system to elicit mfOPs from 103 areas subtending the central 70-80 degrees of the retina in three patients with central or branch retinal vein occlusions. Two stimulating conditions were used. For each subject, the mean first- and second-order kernel responses from occlusion area, were analyzed and compared with the fellow eye and control subjects results. RESULTS: In retinal areas without circulatory disturbances in fluorescein angiography all mfOPs components were present. In a patient with branch retinal vein occlusion in the area without capillary perfusion mfOPs responses were not detectable. CONCLUSIONS: The mfOPs are in a large extent dependent on a proper retinal circulation. The recording of mfOPs may be useful in clinical diagnosis, to asses circulatory disturbances in internal layers of the retina and in differentiation of ischemic from non ischemic retinal vein occlusions.

[Multifocal electroretinogram]. / Elektroretinogram wieloogniskowy

The paper presents current state of knowledge regarding multifocal electroretinography (mfERG). The theoretical basis of this technique, procedure, methods and examples of use in clinical diagnostics are presented.

Cone selective adaptation influences L- and M-cone driven signals in electroretinography and psychophysics.

To assess the influence of selective adaptation of long (L) and middle (M) wavelength sensitive cones with electroretinography (ERG) and psychophysics, a novel adaptation procedure was developed, which comprises a selective and quantifiable change in the state of adaptation in the different cone types. One adaptation condition was used as a reference. In four additional conditions, the M-cones or the L-cones were selectively adapted, so that they absorbed either more or less photons. At each of these five states of adaptation, the ERG response amplitudes to 30Hz L- and to M-cone selective stimuli were measured. Furthermore, the psychophysical sensitivities to L- and M-cone selective stimuli were measured at different temporal frequencies. In subjects with normal color vision, adaptation can have a strong influence on the L- and M-cone driven response amplitudes in the ERG and on both the L- and the M-cone sensitivities in the psychophysical luminance channel. As a result, the L- to M-cone ERG and psychophysical ratios can change dramatically at the different states of adaptation. The cone sensitivity thresholds and the L- to M-cone sensitivity ratio in the psychophysical chromatic channel are about unity at all states of adaptation, suggesting the presence of a compensatory mechanism. In dichromats, the responses and sensitivities to stimulation of the absent cone type were generally small at all states of adaptation. But, with reddish backgrounds residual ERG responses and residual psychophysical sensitivities were observed, indicating the presence of either a robust rod driven signal or an additional adaptation mechanisms that are not cone driven and that have not been described before.