Mental Health during the Second Wave of the COVID-19 Pandemic-Polish Studies.

The presented research aimed to identify the impacts of the second wave of the coronavirus disease 2019 (COVID-19) pandemic on respondents' mental health state and identify variables related to the respondents' symptoms of anxiety and depression; 618 subjects participated in the research. A specially prepared survey and Polish adaptations of the following methods were used: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS 10), MINI-COPE Questionnaire (Brief COPE Inventory), Alcohol Use Disorder Identification Test (AUDIT), Scale of Death Anxiety (SDA), The Fear of COVID-19 Scale (FCV-19S). Over 24% of the respondents reported having experienced suicidal thoughts since the start of the pandemic. Almost 16% drank alcohol in a risky or harmful way. The average value of perceived stress indicated its high and very high intensity. Over 20% had symptoms of anxiety disorders, and almost 19% had anxiety and depression symptoms. It means that almost 40% of the respondents probably have mental disorders. More women, younger people, and those with disorders prior to the onset of the pandemic were among those who manifested these disorders. They also used passive and avoidance stress coping strategies more frequently. In conclusion, the second wave of the pandemic negatively affected the mental health of the respondents. A high percentage of the respondents manifested anxiety and anxiety-depressive disorders and declared having of suicidal thoughts.

Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients.

Premature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing osteopenia and osteoporosis, which poses an important problem for public health. Purpose: The aim of this study was to evaluate and compare the values of bone mineral density (BMD), T-score and Z-score within the lumbar spine (L1-L4) using the dual energy X-ray absorptiometry method. The dual-energy X-ray absorptiometry (DXA) scans described in this original prospective article were performed at the time of POI diagnosis and after treatment with sequential hormone replacement therapy (HRT). Materials and methods: This study included 132 patients with a mean age of 31.86 ± 7.75 years who had been diagnosed with idiopathic POI. The control group consisted of 17 healthy women with regular menstrual cycles, with a mean age of 23.21 ± 5.86 years. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), insulin, and fasting serum glucose were measured. Lumbar spine (L1-L4) BMD was assessed by means of dual-energy X-ray absorptiometry. DXA scans were performed at the time of diagnosis and following treatment with sequential hormone replacement therapy (HRT) comprised of daily oral 2 mg 17-ß-estradiol and 10 mg dydrogesterone. The mean time of observation was 3 ± 2 years. Results: Patients in the POI group presented with characteristic hypergonadotropic hypogonadism. They had a significantly decreased mean lumbar spine BMD when compared to healthy controls (1.088 ± 0.14 g/cm2) vs. 1.150 ± 0.30 g/cm2) (p = 0.04) as well as a decreased T-score (0.75 ± 1.167 vs. -0.144 ± 0.82) (p = 003). There was a significant increase in BMD (1.088 ± 0.14 vs. 1.109 ± 0.14; p < 0.001), T-score (-0.75 ± 1.17 vs. -0.59 ± 1.22; p < 0.001), and Z-score (-0.75 ± 1.12 vs. -0.49 ± 1.11; p < 0.001) after the implementation of HRT when compared to pre-treatment results. Conclusions: In conclusion, this study has demonstrated that patients with POI often have decreased bone mineral density and that the implementation of HRT has a significant and positive influence on bone mass. The implementation of full-dose HRT and monitoring of bone status is particularly important in these patients.

Mental Health and the SARS-COV-2 Epidemic-Polish Research Study.

Background: The aim of this study was to assess the mental state of Poles in the first weeks of the SARS-COV-2 epidemic. Methods: In the study, the General Health Questionnaire-28 (GHQ-18), The Perceived Stress Scale (PSS-10), and Mini-Cope were used. Results: The study was conducted on a group of 443 individuals, including 348 women (78.6%) and 95 men (21.4%). There were more women (χ2 = 6.42, p = 0.02) in the group of people with high results in the GHQ-28 questionnaire and the differentiating factors between those with sten scores above 7 (significantly deteriorated mental health) and those with average or low results (sten score below 7) turned out to be: treatment for mental disorders before the pandemic (χ2 = 19.57, p < 0.001) and the use of psychotherapy during the pandemic (χ2 = 4.21, p = 0.04) and psychiatric pharmacotherapy (χ2 = 8.31, p = 0.01). The presence of suicidal thoughts since the appearance of the pandemic-related restraints and limitations significantly differentiates the compared groups (χ2 = 38.48, p < 0.001). Conclusions: Every fourth person in the examined group (over 26% of the respondents) recorded results that indicate a high probability of mental functioning disorders. Approximately 10% of the respondents signalled the occurrence of suicidal thoughts since the beginning of the pandemic. The respondents complain mainly about problems in everyday life, lack of satisfaction from one's own activities, tension, trouble sleeping, and feelings of exhaustion. Individuals with significantly reduced mental well-being use non-adaptive coping strategies, such as denying problems, emotional discharge, taking substances, discontinuation of action, and blaming themselves for the situation. The risk factors for the deterioration of the mental state of the respondents during the pandemic include psychiatric treatment before the beginning of the pandemic, the presence of suicidal thoughts during forced isolation, and the use of non-adaptive coping strategies (denial of the existence of problems, emotional discharge, use of psychoactive substances, discontinuation of action, and blaming oneself for the situation).

Bone Metabolism in Patients Treated for Depression.

BACKGROUND: Depression and osteoporosis are severe public health problems. There are conflicting findings regarding the influence of depression on bone metabolism. The aim of the presented study was to compare bone turnover markers and vitamin D levels between patients treated for depression and healthy controls. PATIENTS AND METHODS: We determined a concentration of osteocalcin, carboxy-terminal telopeptide of type I collagen (ß-CTX), 25-hydroxyvitamin D (25OHD) and 1,25(OH)2D3 in 99 patients, aged 46.9 ± 11 years, treated for depression, as well as in 45 healthy subjects. Depressive status was determined with the Hamilton Depression Scale (HDRS). RESULTS: In patients treated for depression, we demonstrated significantly lower osteocalcin concentrations (p < 0.03) and higher concentration of ß-CTX (result on the border of significance; p = 0.08). Those relationship were stronger in women. The level of 25OHD and 1,25(OH)2D3 did not differ significantly between the examined groups. We observed a negative correlation between the 25OHD and HDRS score after treatment in all patients treated for depression and in subgroups of women and subjects with recurrent depression. CONCLUSIONS: Our results indicate that depression is related to disturbances in bone metabolism, especially in women and patients with recurrent depression, suggesting its role in context of osteoporosis development.

Alcohol Consumption Reported during the COVID-19 Pandemic: The Initial Stage.

Physical health is not the only area affected by the outbreak of the SARS-CoV-2 virus pandemic. There are also other consequences that have globally affected many millions at other levels, namely: Societal, political, economic, and cultural. This study aims to survey alcohol drinking throughout the pandemic so as to investigate those factors considered most relevant; i.e., sociodemographic and clinical. A longitudinal study was designed. The first (or initial) stage was completed between April 10-20 2020 on 443 subjects during the enforcement of the "Lockdown" in Poland. The second stage will be due in June 2020. As well as an in-house questionnaire, the study used: The Alcohol Use Disorder Identification Test (AUDIT), General Health Questionnaire (GHQ-28), Perceived Stress Scale (PSS-10), and the Brief COPE Inventory (Mini COPE). Alcohol was the most commonly used psychoactive substance (73%) identified. More than 30% changed their drinking habits because of the pandemic, with 16% actually drinking less, whilst 14% did so more. The former group was significantly younger than the latter. Amongst the stress-related coping strategies, it was found that current alcohol drinkers were significantly less able to find anything positive about the pandemic situation (positive reframing) and were mentally less able to cope. Those drinking more now were found to have been drinking more intensively before the pandemic started.

Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland.

The aim of this study was to evaluate the knowledge regarding a healthy lifestyle and prophylaxis during pregnancy among women from rural and urban areas and how this changed within a 5-year period. Analyses of the population of pregnant women in Poland were made using a questionnaire survey. The survey was conducted in the years 2010-2012 and 2017. Questionnaires from 6128 pregnant women were collected. The statistical analyses were conducted using IBM SPSS. The examined population was comprised of 41% women from rural areas and 59% women from urban areas. Alcohol consumption was lower among women from rural areas than among urban inhabitants in 2010-2012; in 2017 a trend of even lower consumption was observed. Folic acid supplementation was more broadly developed in the urban population; however, in 2017, higher percentage rates of both populations admitted taking folates before pregnancy. More women in urban than in rural areas performed physical activity during pregnancy, but the differences decreased in 2017. Knowledge of a healthy lifestyle and prophylaxis during pregnancy increased regardless of place of residence; however, the most evident change could be observed among women from rural areas.

Comparison of American guidelines for field triage and Polish criteria as qualification to a trauma center.

INTRODUCTION: Trauma is the third cause of death among the general population in Poland, and the first in people aged 1-44 years. Trauma centers are hospitals dedicated to treating patients with multiple organ injuries, in a complex way that endeavours to ensure a lower mortality rate, shorter hospital stay and better outcomes if the patients are transferred to such a center. Worldwide, there are many models on how to treat a trauma patient, but them to be qualified for the procedure, the selection of potential patients is crucial. OBJECTIVE: The aim of the study was to compare the Polish model for qualification to a trauma center and American Guidelines for Field Triage. MATERIAL AND METHODS: Retrospective analysis of medical documentation recorded between 1 January 2014 - 31 December 2014 was undertaken. The study concerned trauma patients admitted to the Emergency Department of the Regional Trauma Center at the Copernicus Memorial Hospital in Lódz, Poland. Inclusion criterion was initial diagnosis 'multiple-organ injury' among patients transported by the Emergency Medical Service (EMS). RESULTS: In the period indicated, 3,173 patients were admitted to the Emergency Department at the Copernicus Memorial Hospital. From among them, 159 patients were included in the study. Only 13.2% of the patients fulfilled the Polish Qualification Criteria to Trauma Center in comparison to 87.4% who fulfilled the American Guidelines for Field Triage. CONCLUSIONS: Polish qualification criteria do not consider the large group of patients with severe injuries (ISS>15), but indicate patients with minimal chance of survival. Polish criteria do not consider the mechanism of injury, which is a relevant predictive indicator of severe or extremely severe injuries (ISS>15). Further studies should be undertaken to improve the qualification and treatment of trauma patients in Poland.

The awareness of caregivers about their children's exposure to ionizing radiation accompanying medical procedures: the assessment study.

OBJECTIVES: The aim of the study was a survey-based assessment concerning parents of children undergoing CT examinations and their knowledge of detailed information about procedures involved in imaging diagnostics. MATERIAL AND METHODS: A statistical analysis of 108 surveys of parents of children undergoing CT studies in the Department of Pediatric Radiology in Poznan, Poland was done, with the use of Statistica software. RESULTS: In result of the evaluation of all subsections of the substantive question number, the majority of answers were incorrect (68-98%). No correlation between the number of CT examinations conducted for a child and the number of correct answers to substantive questions was observed. No correlation between the number of CT examinations conducted for a child and the fact of noting the examination with the use of ionizing radiation down in a child's health certificate was stated. The statistical analysis showed that children of parents who declared that the aim of the CT examination had been explained to them better underwent more of them. CONCLUSIONS: Parents are poorly informed about a radiation dose and risk related to a CT examination procedure. Int J Occup Med Environ Health. 2019;32(1):65-73.

Correlation between the single, high dose of ingested baclofen and clinical symptoms.

INTRODUCTION AND OBJECTIVES: Baclofen is a drug used mainly to treat muscle spasticity. Its overdose can lead to life-threatening clinical symptoms, including acute respiratory failure requiring mechanical ventilation. The aim of this study was to assess the prevalence of selected clinical symptoms associated with baclofen poisoning comparing to an ingested dose. MATERIAL AND METHODS: 60 cases of oral baclofen poisoning were analyzed. Gender, age distribution, and correlation between the dose of ingested baclofen were studied, as well as and following clinical parameters: degree of altered consciousness, heart rate, blood pressure, presence of acute respiratory failure, duration of mechanical ventilation, and presence of psychotic symptoms. RESULTS: The study found statistically significant correlations between dosage of ingested baclofen and presence of acute respiratory failure, as well as duration of mechanical ventilation. No statistically significant correlations were found between the dose of ingested baclofen and presence of hypertension, bradycardia, acute psychotic symptoms, or level of consciousness disturbance. However, it was found that patients who suffered from hypertension, bradycardia, and altered mental status ingested a larger dose of baclofen. CONCLUSIONS: There is a statistically significant correlation between the dose of ingested baclofen and the presence of acute respiratory failure, and duration of mechanical ventilation. Patients who have taken a single dose of baclofen of 200 mg, or higher, should be managed in centres able to provide continuous monitoring of life functions. Those with a higher level of a single dose of baclofen ingestion (>500 mg), should be hospitalized in a Toxicology Unit or Intensive Care Unit able to provide airway support and mechanical ventilation.

Treatment of elderly patients with acute myeloid leukemia adjusted for performance status and presence of comorbidities: a Polish Adult Leukemia Group study.

This prospective study estimated outcomes in 509 elderly patients with acute myeloid leukemia (AML) with different treatment approaches depending on Eastern Cooperative Oncology Group (ECOG) performance status and Charlson Comorbidity Index (CCI). Patients were stratified into fit (ECOG 0-2 and CCI 0-2) or frail (ECOG>2 and/or CCI>2) groups. Fit patients with CCI 0 received intensive chemotherapy whilst reduced-intensive chemotherapy (R-IC) was given to those with CCI 1-2. Frail patients received best supportive therapy. Fit patients presented a longer overall survival (OS) than frail subjects, but 8-week mortality rates were similar. The complete response (CR) rate between fit CCI 0 and CCI 1-2 subgroups was significantly different. Both of the fit subgroups showed similar 8-week mortality rates and OS probabilities. Allocating fit patients with CCI 1-2 to R-IC enabled an increase in the group of elderly patients who could be treated with the intention of inducing remission.

A clinical utility of a strip test for influenza A/B and comparison with detection by RT PCR.

INTRODUCTION AND OBJECTIVE: In June 2009 the World Health Organization announced influenza pandemic caused by A/H1N1/v virus. It became crucial to recognize new cases of A/H1N1/v infection. An effective screening diagnostic procedure was needed for patients suffering from influenza-like symptoms for making an initial diagnosis and analyzing epidemiological pattern of infection. We used a strip test for influenza A/B as a screening diagnostic procedure for patients suffering from influenza-like symptoms for making an initial diagnosis. For comparison, RT PCR for detecting A/H1N1/v was performed. The aim of this study was to assess the efficacy and sensitivity of the strip test and its value for making initial diagnosis of influenza A/H1N1/v. MATERIAL AND METHODS: Strip testing for the influenza A/B infection was performed on 1123 patients with influenza-like symptoms in the Admission Unit of the Regional Infectious Diseases Hospital in Warsaw. Strip test results were analyzed according to the age of patients and season of the year. For 97 patients strip test results for detecting A/H1N1 infection were compared with those obtained by RT PCR. RESULTS: There were no statistically significant differences found between the methods and strip testing demonstrated sensitivity of 61% and specificity of 71%. CONCLUSIONS: No statistically significant differences were found between the two methods, however, strip test had low sensitivity and specificity.

Pretreatment levels of vascular endothelial growth factor in plasma predict a complete remission rate and time to relapse or progression in patients with diffuse large B-cell lymphoma.

The aim of this study was to verify whether pretreatment plasma levels of vascular endothelial growth factor (VEGF) correlate with prognosis and survival of patients with diffuse large B-cell lymphoma (DLBCL). Plasma VEGF levels were assessed at the time of diagnosis in 157 DLBCL patients treated with anthracycline-based chemotherapy. Plasma VEGF levels greater than or equal to the highest quartile (high VEGF levels) were associated with lower probability of a complete remission achievement (odds ratio 0.3; 95% confidence interval [CI]: 0.1-0.6; p = 0.002) in univariate as well as in multivariate analysis (p = 0.04). The estimated 3-year progression-free survival (PFS) rate of patients with high VEGF levels was 31.7% (95% CI 17-51) compared to the 62.5% 3-year PFS rate (95% CI 53-71; p = 0.0004) in the patients with lower values. The former group of patients demonstrated an estimated 3-year overall survival (OS) rate of 47.1% (95% CI 30-65) in contrast to the 3-year OS rate of 64.3% (95% CI 54-73; p = 0.02) in the latter. In multivariate analysis, the high VEGF level retained its independent impact on shorter PFS (p = 0.02). Our results suggest that VEGF plays an important role in the clinical course of DLBCL. VEGF may be a useful marker for selecting the patients for whom new treatment approaches, especially those based on VEGF inhibitors, could be recommended.

Epigenetic regulation in drug addiction.

The interaction between environmental signals and genes has now taken on a clear molecular form as demonstrated by stable changes in chromatin structure. These changes occur through activation or repression of specific gene programmes by a combination of chromatin remodelling, activation and enzymatic modification of DNA and histones as well as nucleosomal subunit exchange. Recent research investigating the molecular mechanisms controlling drug-induced transcriptional, behavioural and synaptic activity has shown a direct role for chromatin remodelling--termed as epigenetic regulation--of neuronal gene programmes and subsequent addictive behaviour arising from it. Recent data suggest that repeated exposure to certain drugs promotes changes in levels of histone acetylation, phosphorylation and methylation, together with alterations in DNA methylation levels in the neurons of the brain reward centre, localised in the Nucleus Accumbens (NAc) region of the limbic system. The combination of acetylating, phosphorylating and methylating H3 and H4 histone tails alter chromatin compaction thereby promoting altered levels of cellular gene expression. Histone modifications, which weaken histone interaction with DNA or that promote recruitment of transcriptional activating complexes, correlate with permissive gene expression. Histone deacetylation, (which strengthen histone: DNA contacts), or histone methylation, (which recruits repressive complexes to chromatin), promote a state of transcriptional repression. Using animal models, acute cocaine treatment increases H4 acetylation at acutely regulated gene promoters, whereas H3 acetylation appears to predominate at chronically induced promoters. Chronic cocaine and alcohol treatment activate and repress many genes such as FosB, Cdk5, and Bdnf, where their dysregulation, at the chromatin level, contribute to the development and maintenance of addiction. Following drug exposure, it is still unknown, howver, how long these changes in chromatin structure persist in affecting neuronal function, but some do so for life.

Determining the scale of designer drugs (DD) abuse and risk to public health in Poland through an epidemiological study in adolescents.

Since 2008, it has been recognised by most health authorities worldwide that the abuse of newly-emerging psychoactive drugs, ('designer drugs'/'legal highs'; DD), in youth is a rapidly increasing problem, especially in the EU, threatening to offset gains made in tackling established and illegal drugs which they are intended to mimic; DD diversity is continually increasing to circumvent laws. The aim of the study was to determine the scale of DD abuse/availability amongst Polish youth. The surveyed test population was randomly selected from a representative group of adolescents attending high schools, secondary schools and universities throughout Poland. Questionnaires were completed by 14,511 subjects (10,083 school pupils and 4,428 students). Few persons from each group admitted using DDs; 453 school pupils (4.49%) vs. 81 students (1.83%). More males (4.74%) took DDs than females (2.77%). The tendency to take DDs in the company of friends was high in both DD-taking groups (>80%). DDs were consumed mostly in open spaces (34.15%), discos/pubs (21.13%) and boarding school/friend's house (20.57). Most frequently, DDs came from shops (57.68%), friends (31.46%) or dealers (10.11%). Ensuing symptoms included; happy/euphoric mood (58.80%), talkativeness (42.51%) and hallucinations (22.85%). Over 74% of DD-takers in both groups experienced adverse reactions, and those requiring help sought it from: friends/colleagues (6.74%), doctors (5.06%), and hospitals (4.87%), but most rarely from parents/guardians (2.62%). Urgent action is being taken, especially in youth education, to prevent DDs becoming the serious menace seen with conventional drugs.

Managing water safety in healthcare. Part 1--Strategies and approaches for waterborne pathogen control.

Summaries in 2 parts are presented from a conference held in London at the Royal Society for Public Health on 16-17 May 2012, on the latest developments in dealing with waterborne hospital-acquired infections (nosocomial), from the UK perspective. Also included were some views from continental Europe. The first part, focuses on management strategies and plans that are either in use or recommended by domestic/international guidelines, such as the WHO, for prevention, control and risk assessment of disease outbreaks resulting from the presence of these pathogenic microorganisms in water appliances/supplies. Various solutions are discussed, some more effective than others, but all require a comprehensive strategy and technical expertise run by properly trained and dedicated professionals.

Serum tumor necrosis factor-α and interleukin-10 levels as markers to predict outcome of patients with chronic lymphocytic leukemia in different risk groups defined by the IGHV mutation status.

Tumor necrosis factor (TNF)-α and interleukin (IL)-10 are cytokines involved in the balance between cell-mediated and humoral immunity. We investigated whether serum TNF-α and IL-10 levels have any impact on clinical outcome of patients with chronic lymphocytic leukemia (CLL). TNF-α and IL-10 levels were determined in the serum of 160 CLL patients at the time of diagnosis. The cytokine low-risk group consisted of patients with either TNF-α and IL-10 levels below their medians or those with only one elevated parameter. Both TNF-α and IL-10 levels greater than or equal to their medians defined the cytokine high-risk group. The high-risk patients presented a shorter 3-year treatment-free survival (TFS) than low-risk subjects (15 vs. 69.6 %; p < 0.0001). The high-risk group (p = 0.0002) along with high leukocyte count (p < 0.0001) and unmutated immunoglobulin heavy-chain variable region genes (p < 0.0001) independently predict the risk of progression in patients with Rai stage 0-II. Furthermore, the high-risk group had an independent prognostic impact on shorter TFS both in patients with mutated (24.3 vs. 78.2 %; p < 0.0001) and unmutated (8.2 vs. 49 %; p = 0.004) immunoglobulin heavy-chain variable region genes (IGHV) as compared to the low-risk group. The estimated 5-year overall survival (OS) of high-risk patients was shorter than those in the low-risk group (83.3 vs. 97.1 %; p = 0.003). Multivariate analysis demonstrated the cytokine high-risk group (p = 0.02) followed by Rai stage III-IV (p = 0.048) to be independent factors predicting shorter OS. At diagnosis, TNF-α and IL-10 may predict the outcome of patients with CLL.

Dietary habits and body image perception among Polish adolescents and young adults - a population based study.

Patterns of nutritional behaviours shaped in childhood and during the period of adolescents are mostly continued in adult life, and on these patterns, to a great degree, depends the risk of development of many chronic diseases. The aim of this study was to assess the relationship between dietary habits and body image perception among Polish adolescents and young adults. The study group covered 14,511 adolescents/young adults: 10,081 children attending high schools and secondary schools, and 4,428 university students. More than 87% of schoolchildren and students admitted that that they snacked between meals everyday, and 1/3 of them mentioned that they consumed meals at night. As many as 41.40% of schoolchildren, and 46.70% of students experienced the feeling of overeating at least several times a week. Analysis of the respondents BMI showed that in the group of students there were considerably more respondents obese or overweight, compared to the group of schoolchildren. Fear of gaining weight was mentioned by 9.90% of respondents, including 6.90% of those with normal body structure, 1.40% with underweight or overweight, and 0.40% of those obese. As many as 54.60% of the total number of respondents described their body structure as remaining within the normal, 23.7% - as slim, 13.9% reported that they were overweight, 6% - thin, while 1.7% considered themselves as obese. A comprehensive analysis of the data available, including attempts at dieting or gaining weight, indicated that approximately ¾ of obese respondents had undertaken attempts in the past to reduce their body weight. The importance of physical activity and healthy eating habits should be given due attention not only to prevent obesity but also other eating disorder.

Analysis of psychoactive and intoxicating substances in legal highs.

"Legal highs" known also as "smarts", "legal drugs" or "boosters" contain in their composition psychoactive substances the production, sale and possession of which are not prohibited in legislation. They are offered for sale under the cover of collectors' items, a salt bath, aroma sticks, or plant fertilizer. Marketing was the reason for such high sales of these "highs" in Poland. The phenomenon became of concern when information became available about the first cases of tragic health consequences. Raising the awareness of youth about the level of imminent danger and serious consequences associated with the use of legal highs may be a very effective way to develop appropriate attitudes of young people, and in the light of their own health can help them take proper life decisions."Legal highs" are substances of natural or synthetic origin having psychostimulating properties. These compounds may differ in chemical structure, potency, half-life, metabolism and severity of side effects. Their pharmacological activity is associated with changes in the neurotransmitter system. After higher doses of "legal highs" psychotic symptoms may occur: visual and auditory hallucinations resembling schizophrenic endogenous psychoses. An alarming fact is the underestimation of the adverse effect of these substances on human health. Any actions aimed at improving this situation are extremely important; therefore, in one of the key projects undertaken at the Institute of Rural Health in Lublin, in cooperation with other scientific institutes, concerned the analysis of a selected series of "legal highs". This research was meant top serve as a source of information for science and medicine, and for popularizing knowledge about legal highs.

Epidemiological studies in Poland on effect of physical activity of pregnant women on the health of offspring and future generations - adaptation of the hypothesis development origin of health and diseases.

It is recognized that the levels of women's physical activity during pregnancy has a direct bearing on the method of delivery and health of the newborn. The main objective of the study was investigation of the level of physical activity of women during pregnancy according to the Pregnancy Physical Activity Questionnaire (PPAQ). The subjects of this study were n=2852 post-partum women surveyed together with their newborns, representing all obstetric hospital departments throughout Poland. The questionnaires were completed on a single day during the second week of November 2011. The women were also asked about the amount, range and type of physical activity they performed before becoming pregnant. The Pregnancy Physical Activity Questionnaire was used for precisely measuring physical activity according to the standard metabolically equivalent (MET). In addition, comparisons were made between the weight of the infant and newborn status using the APGAR scale with the amount of physical activity performed by the mothers. There were decidedly low physical activity levels observed in pregnant women compared to those before becoming pregnant. Appropriate interventions can therefore now be targeted through remedial action in Poland. It is important to perform intervention studies intended to test this hypothesis and attempt to identify the most appropriate levels for intensity, duration and frequency of physical exercise during pregnancy. The studies should consider the four domains of daily physical activity and utilize tools that reliably measure exposure variables. Such studies would provide valuable information for recommendations about physical activity during pregnancy.

Public health hazards in Poland posed by foodstuffs contaminated with E. coli O104:H4 bacterium from the recent European outbreak.

Shiga toxin producing Escherichia coli (STEC) are the most virulent diarrhoeagenic E. coli known to date. They can spread with alarming ease via the food chain, as recently demonstrated by the large outbreak of STEC O104:H4 borne by sprouted seeds in 2011, clustered in northern Germany, and subsequently affecting other countries. Indeed, a significant number of infections to verocytotoxin producing Escherichia coli O104:H4 have been reported from the WHO European Region resulting in many cases of bloody diarrhoea and haemolytic uraemic syndrome in Germany, 15 other European countries and North America. Eventually, the European Food Standards Agency, (EFSA), identified the likely source to a single consignment of fenugreek seeds from an Egyptian exporter as being linked to the two outbreaks in Germany and France. The situation was closely monitored by the Chief Sanitary Inspectorate public health authority in Poland where actions undertaken ensured that the public was well informed about the dangers of STEC contamination of food, how to avoid infection, and what to do if infected. Tracing the fenugreek distributors also enabled the identification of suspected batches and their isolation. As a result, there were very few reported cases of STEC infection in Poland. Effective control over such outbreaks is therefore a vital public health task. This should include early detection and rapid identification of the contagion mode, followed by removing the foodstuff(s) from the market, providing consumer advice, and preventing secondary spreading. As a mitigation measure, screening/monitoring those involved in food handling is also warranted to exclude carriers who can be asymptomatic.