Impact of Serum Vitamin D, B6, and B12 and Cognitive Functions on Quality of Life in Peri- and Postmenopausal Polish Women.

BACKGROUND Menopause initiates or accelerates health problems in a woman’s life, and affects cognitive processes and quality of life. We aimed to assess the quality of life, cognitive functions, and serum vitamin D, B6, and B12 concentrations in perimenopausal and postmenopausal Polish women. Also, we correlated the assessment of the quality of life with these vitamin concentrations and cognitive functions. MATERIAL AND METHODS The study was conducted in 287 perimenopausal and postmenopausal women. Serum levels of vitamin D, B6, and B12, cognitive functions using CNS Vital Signs software, and quality of life using WHO Quality of Life Brief were tested. RESULTS Almost all of the perimenopausal and postmenopausal women had normal concentrations of serum vitamin B12 (96%), 80% of them had normal B6 concentration, while only 9% had optimal serum vitamin D concentration. Postmenopausal women had lower Neurocognitive Index, psychomotor speed, motor speed, reaction time, and lower assessment of overall quality of life, physical health, and social relationships compared to perimenopausal women. In comparison to postmenopausal women, perimenopausal women had a lower serum vitamin B6 concentration, and the lower the concentration of this vitamin in serum they had, the lower they assessed their environment. Perimenopausal women assessed their social relationships the better, the better the visual memory, and the lower the processing speed they had. Postmenopausal women assessed the environment the better, the higher their Neurocognition Index was, and the better the reaction time they had. CONCLUSIONS Assessment of quality of life was associated with some cognitive functions in both perimenopausal and postmenopausal women.

Workplace Interventions for Type 2 Diabetes Mellitus Prevention-an Umbrella Review.

PURPOSE OF REVIEW: Type 2 diabetes mellitus (T2DM) is a chronic disease that may lead to severe complications. The main methods of preventing or delaying the onset of T2DM include lifestyle changes. The purpose of this study is to identify and evaluate the effectiveness of workplace interventions aimed at preventing type 2 diabetes. An umbrella review was conducted in accordance with the Cochrane Collaboration guidelines. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. The quality assessment of the included studies was performed using the AMSTAR2 tool. RECENT FINDINGS: The final analysis included 7 studies. The majority (4 of 7) of the studies included in the review focused on workplace interventions based on the guidelines of the US Diabetes Prevention Program (DPP) or other similar programs. The method of decreasing the risk of type 2 diabetes among employees are programs consisting of multiple approaches aimed at improving parameters associated with diabetes, i.e., body weight, and therefore BMI, reduction, and reducing blood glucose levels, as well as HbA1c levels through educational approach and lifestyle changes. The results of those studies point to multicomponent interventions as more effective than single-component interventions. An effective workplace intervention aimed to reduce the risk of type 2 diabetes among employees is a multicomponent program consisting of elements such as educational activities, interventions targeting dietary changes and increased physical activity.

The long-term efficacy of tick-borne encephalitis vaccines available in Europe - a systematic review.

BACKGROUND: Despite the availability of vaccination, TBE (tick-borne encephalitis) remains a global public health problem. Therefore, the aim of our study was to assess the long-term efficacy of vaccinations against tick-borne encephalitis using vaccines available on the European market. METHODS: The analysis was conducted on the results of a systematic review conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The search was performed in three databases, namely Medline (via PubMed), EMBASE (via Ovid), and the Cochrane Library database. The authors followed the PRISMA method and the selection of the articles was performed with two independent researchers. RESULTS: From a total of 199 citations, 9 studies were included in this review. According to the primary studies identified in the search, the efficacy of available anti-TBE vaccines ranges from 90.1% to 98.9%; however, in individuals above the age of 60, the protection wanes as early as one year after vaccination. Administration of a booster dose 3 years after completion of the basic vaccination schedule significantly extended the period of protection against TBE. CONCLUSIONS: Anti-TBE vaccines available in Europe have a high level of efficacy. However, the level of protection against TBE is decreasing after vaccination. Therefore, in addition to the conventional schedule, booster vaccines should be administered every 5 years in individuals before the age of 60 and more frequently, e.g. every 3 years, in individuals aged 60 and beyond.

One Year On: Poland's Public Health Initiatives and National Response to Millions of Refugees from Ukraine.

The Russian military invasion of Ukraine on February 24, 2022, resulted in the largest refugee crisis in Europe since World War II. As a neighboring country to Ukraine, Poland was the main country to initially receive refugees. Between February 24, 2022, and February 24, 2023, 10.056 million refugees from Ukraine, mainly women and children, crossed the Polish-Ukrainian border. Up to 2 million of these refugees from Ukraine found shelter in private homes throughout Poland. More than 90% of the resident refugees in Poland were women and children, and approximately 900 000 refugees from Ukraine have sought employment, mainly in the services sector. Since February 2022, there has been rapid development of a national legal framework to ensure access to healthcare, including providing refugees who are healthcare workers with job opportunities. Epidemiological surveillance and prevention programs for infectious diseases and mental health support systems have been implemented. These initiatives have required the use of language translators to ensure that there are no barriers to understanding and implementing public health measures. Hopefully, the lessons learned from Poland and neighboring countries that have hosted millions of Ukrainian refugees can help future preparedness for supporting refugees. This review aims to summarize the lessons learned by the Polish public health services during the past year and outlines the public health initiatives that have been implemented and are still ongoing.

The Effects of Offering Freedom to Comply by Pediatricians and Nurses, Using the But-You-Are-Free (BYAF) Technique, on Vaccination Compliance on 185 Parents of Newborn Babies Conducted in Outpatient Clinics in Poland Between January 2022 and July 2022.

BACKGROUND This study aimed to evaluate, in outpatient clinics in Poland between January 2022 and July 2022, the effectiveness of the But-You-Are-Free (BYAF) social influence technique by healthcare professionals during interaction with 185 parents deciding about vaccinating (eg, Hexacima, Prevenor 13, Synflorix, Rotateq, Act Hib, Boostrix, Pentaxim, DTP, Imovax, Priorix, MMR, Tetracim, Adacel, Euvax B, Fuvax, FSME, Varilix, Nimenrix, Bexero vaccines) their babies. MATERIAL AND METHODS During an interaction with pediatricians or nurses, the parents were encouraged to vaccinate their babies. In experimental condition (111 interactions), the BYAF technique was employed, and the phrase "But you are free" was added at the end of the conversation. In the control condition (74 interactions), it was not employed. RESULTS In the experimental condition, 71 (64%) participants declared intention to vaccinate their children. In the control condition, it 61 (84%) participants declared intention to vaccinate (the difference in percentages was significant: P=0.006). The number of parents who actually vaccinated their babies in the experimental condition was 92 (83%) and in the control condition it was 70 (95%; P=0.018). CONCLUSIONS The findings showed that participants who were exposed to the BYAF technique declared lower intentions to vaccinate their babies, and vaccinated them less often than those in the control condition. This result critically highlights that this technique should not be employed in the medical settings of pediatric vaccination.

Assessment of Hospital Volume in the Surgical Management of Endometrial and Ovarian Cancer: A Polish Population-Based Study.

BACKGROUND Surgery is a cornerstone in management of ovarian and endometrial cancer. The European Society of Gynecological Oncology introduced quality indicators to improve management of these cancers. The optimal annual number of surgeries per unit was established for high-quality surgical treatment. MATERIAL AND METHODS The database of the National Health Fund on surgical management of endometrial and ovarian cancer was analyzed. Patients treated between 2017 and 2020 were included. Departments where patients underwent surgery were divided according to number of surgeries performed per year in endometrial cancer: ≥80, 79-50, 49-20, 19-0; and ovarian cancer: ≥100, 99-50, 49-20, 19-0. Optimal number of surgeries per center was defined as at least 100 and 80 surgeries per year in ovarian and endometrial cancer, respectively. RESULTS Totally, there were 22 325 surgeries in 316 units and 10 381 surgeries in 251 units due to endometrial and ovarian cancer, respectively. Most surgeries in endometrial cancer (n=15 077; 67.5%) and ovarian cancer (n=9642; 92.88%) were performed in departments that did not meet optimal criteria in number of surgeries. Between 2017 and 2019, an increasing trend in number of surgeries per year in endometrial and ovarian cancer was found. In 2020, there was a decrease in the number of surgeries by 7.8% (n=453) and 8.6% (n=234) in endometrial and ovarian cancer, respectively. CONCLUSIONS In Poland, surgical treatment of ovarian and endometrial cancer is decentralized. Most cancer patients underwent surgery in low-volume general gynecologic departments. The COVID-19 pandemic impaired cancer management, leading to a decreased number of surgeries.

Study of 52 Pediatric Patients Who Required 78 Hospital Admissions for Cerebral Venous Sinus Thrombosis from 2013 to 2020 Using Data from the Polish National Health Fund Registry.

BACKGROUND Cerebral venous sinus thrombosis (CVST) in children is a rare disease with a complex, multifactorial etiopathogenesis. The Polish National Health Fund (NHF) Registry [Narodowy Fundusz Zdrowia (NFZ)], contains health insurance data from all 16 national provinces, or voivodeships. This study used data from the Polish NHF Registry to evaluate 52 pediatric patients who required 78 hospital admissions for CVST from 2013 to 2020. MATERIAL AND METHODS The data in the Polish NHF Registry were acquired based on the disease code I67.6 from the International Classification of Diseases, Tenth Revision (ICD-10), and the patients' age (up to 18 years old). RESULTS We identified 78 hospitalizations of 52 pediatric patients due to CVST in Poland from 2013 to 2020 (63.5% boys and 36.5% girls, mean age 9.7±5.8 years old). The mean duration of hospitalization was 10.5±11.7 days, the mean cost of hospitalization was 3273±2191 Polish zloty (PLN). The most common age subgroup was adolescents (27%). Ten percent of patients were hospitalized in a region other than their region of residence. The duration and cost of hospitalization were positively correlated with each other (r=0.512, P<0.001). The most common type of admission was an emergency (51%), and the most common discharge was referral for further outpatient treatment (50%). CONCLUSIONS Polish registry data showed that from 2013 to 2020, CVST was more commonly diagnosed in male adolescents from 15 to 18 years of age who presented as emergency hospital admissions. There were regional differences in incidence and duration of hospital stay and healthcare costs between patients.

Efficiency and Effectiveness of Patient Care Provided by Physicians in Rural and Urban Areas in Poland.

BACKGROUND The health sector in Poland is currently facing challenges such as limited financial resources, poor infrastructure, and insufficient human resources. To address these issues, increasing cost-effectiveness at the individual physician level has become essential. This study aimed to evaluate the efficiency and effectiveness of patient care at the level of individual primary health care physicians and to compare the performance of physicians working in urban and rural areas. MATERIAL AND METHODS Thirteen original effectiveness indicators were developed based on a literature review, expert consultations, and a pilot study at the Medical and Diagnostic Center in Siedlce. The indicators were used to evaluate the effectiveness of physicians and compare physicians' characteristics working in rural and urban areas. The study extracted data on physicians' characteristics and used the indicators to evaluate their effectiveness. RESULTS Physicians working in rural areas treated more patients due to staff shortages. However, physicians working in urban areas demonstrated greater effectiveness in performing routine and advanced health checks and mammograms. Despite this advantage, the average life expectancy of patients was higher among patients of physicians working in rural areas. CONCLUSIONS Five indicators developed in the study formed a scale, which is a step toward developing a uniform effectiveness indicator. Further research on consistently measuring effectiveness could significantly impact the development of sociometric research methodology. This study highlights the differences in efficiency and effectiveness of physicians working in rural vs urban areas and underscores the need for healthcare policymakers to consider these differences in addressing healthcare resource allocation.

Fertility-Sparing Treatment in Gestational Choriocarcinoma: Evaluating Oncological and Obstetrical Outcomes in Young Patients.

BACKGROUND Gestational choriocarcinoma (GC) is an uncommon neoplasia that occurs in women who may not have completed a procreation plan. The aim of this study was to evaluate oncological and obstetrical outcomes in young patients with GC after fertility-sparing treatment. MATERIAL AND METHODS The eligibility criteria for the study were histopathological diagnosis of GC, age ≤40 years, and treatment with systemic chemotherapy. Patients who underwent upfront hysterectomy were excluded. The response to treatment was assessed according to beta-human chorionic gonadotropin (beta-hCG) serum measurement. Complete response and progression were considered if the beta-hCG dropped to a normal range and increased (or reached a plateau), respectively. The birth rate was calculated as the number of women who gave birth after treatment divided by the total number of patients. RESULTS A total of 18 patients fulfilled the study's eligibility criteria. A complete response and progression to first-line chemotherapy were found in 13 (72.22%) and 5 (27.78%) patients, respectively. Salvage treatment was administered to patients with progression. Overall, 16 (88.88%) patients achieved complete response after treatment and 2 (11.12%) died. GC relapse was diagnosed in 1 patient 62 months after treatment. The birth rate was 22.22%, and a total of 6 children were born. All pregnancies ended in term delivery. No congenital abnormalities were detected in the newborns. CONCLUSIONS GC is a life-threatening form of gestational trophoblastic neoplasia, mainly due to its rapid course and resistance to chemotherapy. Most patients with GC will not be able to bear children after treatment.

Prognostic Factors for Uterine Sarcoma and Carcinosarcoma: Insights from a 10-Year Follow-Up Study.

BACKGROUND Uterine sarcomas and carcinomas are rare tumors and treatment outcomes are far from expected. We investigated the prognostic significance of selected serum biomarkers and the impact of some clinical and tissue factors on overall survival (OS) at 10-year follow-up. MATERIAL AND METHODS The material for analysis was a group of 34 patients with uterine sarcomas and 18 with carcinomas. Immunohistochemistry was performed to determine Ki 67, p53 and ER and PR. Concentrations: CA 125, IL8, VEGF, SFTL1, VEGF R2, sTNFRI and MMP-9 were determined in the serum of patients before treatment and in the control group. RESULTS The most frequently elevated levels observed of sTNF RI in 94% and VEGF in 62%. On the ROC curve analysis, sTNF RI and VEGF concentrations showed the highest sensitivity. Patients with striated cell sarcoma, smooth cell sarcoma and high-grade rhabdomyosarcoma had the worst prognosis. Patient age, FIGO stage and expression of Ki67, p53, ER and PR, CA 125 (p<0.038) and IL-8 (p<0.024) were statistical prognostic factors for OS. However, in multivariate analysis, serum levels of: CA 125 concentration (p<0.045), age (p<0.010) and p53 expression (p<0.014) were found to be significant independent prognostic factors. CONCLUSIONS A 10-year follow-up of patients with uterine sarcoma indicates that age above 60 years at diagnosis and high p53 expression and elevated CA125 levels before treatment can be independent prognostic factors. The high diagnostic sensitivity of sTNF RI and VEGF suggests the possibility of using these biomarkers in the early diagnosis of uterine sarcomas.

Evaluation of the effectiveness of prophylactic sealing of pits and fissures of permanent teeth with fissure sealants - umbrella review.

BACKGROUND: Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue destruction. In addition to proper oral hygiene, prophylactic sealing of fissures and cavities with a sealant is a method of preventing the development of caries. The aim of this study is to summarise the effectiveness of fissure sealing of permanent teeth with fissure sealants compared to other preventive methods or no intervention. METHOD: An umbrella review was carried out to achieve the purpose of our study. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. Quality assessment of the included studies was performed using the AMSTAR2 tool. In addition, a manual search for recommendations/clinical practice guidelines on dental prophylaxis was performed. RESULTS: 204 publications were identified, of which 15 met the inclusion criteria. Based on the results of 3 systematic reviews, there was a statistically significant reduced odds of caries occurrence or development with prophylactic sealing of permanent teeth compared with no intervention - depending on the review and follow-up period odds ratio (OR) ranged from 0.06 [95%CI: (0.01-0.32)] to 0.28 [95%CI: (0.20-0.38)]. In the eight systematic reviews that analysed different sealants, there were no statistically significant differences between the types of materials used for prophylactic tooth sealing. For systematic reviews comparing the efficacy of fissure sealants with fluoride varnish, three reported no statistically significant difference in the efficacy of caries incidence, with only one systematic review based on 1 RCT finding a statistically significant difference in favour of fissure sealants. CONCLUSION: Compared to the no intervention, dental sealing is an effective method for the prevention of dental caries. However, it is not possible to conclude conclusively which type of sealant and which of the available prophylactic methods is more effective in preventing caries.

Editorial: The Public Health Implications for the Refugee Population, Particularly in Poland, Due to the War in Ukraine.

On February 24, 2022, the Russian Federation initiated a military invasion of Ukraine, resulting in a significant armed conflict in Europe. Large numbers of refugees and asylum-seekers have left Ukraine. As of March 29, more than 4 million refugees, including over 1.5 million children, have left Ukraine, while about 7 million individuals have become displaced within Ukraine. Most refugees have gone to bordering countries, with 76% coming to Poland. This large number of refugees in such a short time requires urgent public health measures to ensure their health and safety. Refugees to Poland must receive access to healthcare, social care, and education. Those who have chronic disease and malignancy must continue to receive treatment. Medical students' continued education and training in their host countries should be prioritized to provide needed healthcare resources. Epidemiological disease surveillance and disease prevention are required at this time. The continuation of the current conflict in Ukraine also poses a potentially severe risk to the global environment and long-term food security. This editorial aims to highlight the public health implications for the refugee population, particularly in Poland, due to the current war in Ukraine.

Use of Mobile Apps and Wearables to Monitor Diet, Weight, and Physical Activity: A Cross-Sectional Survey of Adults in Poland.

BACKGROUND Mobile health technologies (mHealth) such as mobile applications (mobile apps), and wearables are gaining popularity. Regular monitoring of public attitudes toward the use of mHealth is crucial to effectively implementing mHealth in healthcare. Therefore, this study aimed to assess the level of use of mobile apps and wearables to monitor diet, weight, and physical activity among adults in Poland and to identify factors associated with the willingness to use new technologies for health monitoring. MATERIAL AND METHODS This cross-sectional survey was carried out on a representative sample of 1070 adult inhabitants of Poland, between 1 and 4 July, 2022. A computer-assisted web interview (CAWI) technique was used. The study questionnaire included 20 closed questions on eating habits, lifestyle, and the use of eHealth mobile apps and wearables. RESULTS Almost one-quarter of respondents (23.2%) used wearables (a band or a watch) to monitor physical activity and 14.4% had a smart bathroom scale at home. Among adults in Poland, 16.3% used mobile apps to monitor physical activity and 13.3% used mobile apps to control their diet. Out of 19 different socioeconomic and lifestyle factors analyzed in this study, younger age, healthy diet, regular physical activity, and participation in organized sports activities were significantly associated (P<0.05) with the use of mobile apps and wearables. CONCLUSIONS A lack of socioeconomic barriers to accessing mobile apps and wearables presented in this study suggests that mHealth technology can be used to promote a healthy lifestyle in different socioeconomic groups and can reduce health inequalities.

Screening for SARS-CoV-2 Infection in Students at the Medical University of Warsaw, Poland Between November 15 and December 10, 2021 Using a Single Lateral Flow Test, the Panbio™ COVID-19 Ag Rapid Test.

BACKGROUND Education was significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus. Online learning affects the quality of learning as well as the mental health status of students. Regular screening for COVID-19 may be crucial to provide practical classes during the pandemic. The present study aimed to analyze the usefulness of rapid antigen tests for on-campus COVID-19 screening in real-life conditions at a medical university in Poland. MATERIAL AND METHODS This screening study was carried out among students attending practical classes at the Medical University of Warsaw, Poland between November 15 and December 10, 2021, during which a series of rapid antigen tests (Panbio™ COVID-19 Ag Rapid Test Device, nasal) were performed by healthcare professionals (nurses). Out of 104 student groups selected for the study (n=1847 students), 423 individuals from 63 student groups were tested at least once (22.9% response rate). A total of 2295 samples were collected. RESULTS Among the participants, 3.4% (n=15) had positive test results. Out of 15 COVID-19 cases, 14 were vaccinated. At least 1 positive COVID-19 case was detected in 8 student groups. In 3 student groups, we observed ≥2 infections that occurred at intervals, which may suggest student-to-student SARS-CoV-2 transmission. CONCLUSIONS This study produced real-world data from a COVID-19 screening study and confirmed the usefulness of the rapid antigen test (Panbio™ COVID-19 Ag Rapid Test Device nasal) for on-campus COVID-19 screening prior to practical classes. Maintaining a high percentage of participants is crucial to ensuring the effectiveness of on-campus COVID-19 screening.

Multiple Cytokine Analysis of Th1/Th2/Th9/Th17/Th22/Treg Cytokine Pathway for Individual Immune Profile Assessment in Patients with Psoriasis.

BACKGROUND Psoriasis is an autoimmune and autoinflammatory disorder that has a significant impact on patient quality of life. The aim of the study was to assess the immune profiles of patients with psoriasis with multiple cytokine analysis. MATERIAL AND METHODS Fifty-two male psoriatic patients and 24 healthy male volunteers were recruited. Granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon gamma (IFN-gamma), interleukin (IL)-1 beta, IL-2, Il-4, IL-5, IL-6, IL-9, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, IL-22, IL-23, IL-27, and tumor necrosis factor (TNF)-alpha were measured in patients' serum with a Th1/Th2/Th9/Th17/Th22/Treg Cytokine 18-Plex Human ProcartaPlex Panel, based on Luminex xMAP technology. RESULTS The median fluorescence intensities of serum GM-CSF, IL-2, IL-5, IL-10, IL-13, IL-17A, IL-21, and IL-22 were not intensive enough to calculate the cytokine concentration. We observed elevated levels of IL-6 (P=0.001) and IL-9 (P=0.003) in patients, compared with the control group. The levels of IL-1beta (P=0.008) and IL-27 (P=0.006) were decreased. In patients with psoriatic arthritis, we noticed a decreased level of IL-9 compared with that in patients without arthritis (P=0.034). The levels of IL-12 (P<0.05) and IL-18 (P<0.05) correlated positively with the Psoriasis Area and Severity Index. We found negative correlations of IL-9 (P<0.05), IL-12 (P<0.05), and IL-23 (P<0.05) with the age of psoriatic patients; IL-12 (P<0.05) and IL-23 (P<0.05) with psoriasis duration; and IL-6 (P<0.05) and IL-9 (P<0.05) with the Nail Psoriasis Severity Index. CONCLUSIONS Multiple cytokine analysis seems to be an important form of individual immune profile assessment before treatment selection.

Global Changes of 5-mC/5h-mC Ratio and Methylation of Adiponectin and Leptin Gene in Placenta Depending on Mode of Delivery.

It was suggested that the epigenetic alterations of the placenta are associated with obesity, as well as the delivery mode. This study aimed to assess the effect of maternal outcome and delivery procedure on global placental DNA methylation status, as well as selected 5'-Cytosine-phosphate-Guanine-3' (CpG) sites in ADIPOQ and LEP genes. Global DNA methylation profile in the placenta was assessed using the 5-methylcytosine (5-mC) and 5-hydroxymethylcytosine (5-hmC) ratio evaluated with the ELISA, followed by target gene methylation patterns at selected gene regions which were determined using methylation-specific qPCR in 70 placentas from healthy, pregnant women with single pregnancy. We found no statistically significant differences in 5-mC/5-hmC ratio between intrapartum cesarean sections (CS) and vaginal deliveries (p = 0.214), as well as between elective cesarean sections and vaginal deliveries (p = 0.221). In intrapartum cesarean sections, the ADIPOQ demethylation index was significantly higher (the average: 1.75) compared to elective cesarean section (the average: 1.23, p = 0.010) and vaginal deliveries (the average: 1.23, p = 0.011). The LEP demethylation index did not significantly differ among elective CS, intrapartum CS, and vaginal delivery groups. The demethylation index of ADIPOQ correlated negatively with LEP in the placenta in the vaginal delivery group (r = -0.456, p = 0.017), but not with the global methylation. The methylation of a singular locus might be different depending on the mode of delivery and uterine contractions. Further studies should be conducted with locus-specific analysis of the whole genome to detect the methylation index of specific genes involved in metabolism.

Current State of Knowledge About SARS-CoV-2 and COVID-19 Disease in Pregnant Women.

During any epidemic of infectious diseases, pregnant women constitute an extremely sensitive group due to altered physiology and immune functions, and thus altered susceptibility to infection. With regard to the management of pregnant COVID-19 patients, in addition to the treatment of the infection itself, which is not that different from generally accepted principles, it is interesting to consider which obstetric procedures should be used to minimize the adverse effects on mother and child. Questions arise concerning the continuation of pregnancy, how to terminate the pregnancy, the possibility of virus transmission through the placenta, isolation of the newborn after birth, and breastfeeding. The aim of this study was to review the current state of knowledge about SARS-CoV-2 infection and COVID-19 disease in pregnant women. Because the epidemic began in China, most of the available literature comes from studies conducted there. The studies used to prepare this review article are the first non-randomized studies containing small groups of examined women. They do not provide clear indications, but show that in an epidemic situation, special care should be taken in pregnancy management, making decisions about termination of pregnancy, and handling of the newborn baby to minimize the risk of subsequent health consequences. Further analysis is needed on the incidence of COVID-19 among pregnant women and its consequences. This will allow us to develop recommendations on how to deal with patients in the future in case of repeated epidemic emergencies.

Virtual Reality Vestibular Rehabilitation in 20 Patients with Vertigo Due to Peripheral Vestibular Dysfunction.

BACKGROUND Vestibular compensation is disrupted in patients with chronic vestibular syndrome. Vestibular rehabilitation is an exercise therapy that optimizes the process of vestibular compensation. This study aimed to evaluate virtual reality (VR) vestibular rehabilitation in 20 patients with vertigo due to peripheral vestibular dysfunction at a single center.Our study aim was to initially assess the impact of using virtual reality technology in vestibular rehabilitation. MATERIAL AND METHODS The subjects were 20 patients with unilateral vestibular hypofunction (UVH), as confirmed by videonystagmography. These were divided into 2 groups: Group 1 underwent vestibular rehabilitation using virtual reality and Group 2 was treated by conventional therapy. A VSS-SF questionnaire and the VAS scale were used to assess the effects and levels of patient satisfaction with therapy. RESULTS Both groups demonstrated significantly (P.

Epidemiological Analysis of the First 1389 Cases of COVID-19 in Poland: A Preliminary Report.

BACKGROUND The World Health Organization has declared COVID-19 a global pandemic. This paper presents an epidemiological analysis of the first phase of the COVID-19 epidemic in Poland. MATERIAL AND METHODS This cross-sectional study was carried out between 3 and 27 March 2020 on a sample of 1389 laboratory-confirmed COVID-19 cases in Poland. Data were obtained from epidemiological reports collected by the Chief Sanitary Inspectorate. Analysis includes the number of COVID-19 cases, number of deaths, number of hospitalizations, number of people quarantined, and number of laboratory tests performed. RESULTS The first case was confirmed on 4 March 2020. Over 24 days after the first case, the total number of confirmed infections rose to 1389 (34,000 laboratory tests were performed). The highest incidence rates (over 5 per 100,000) were observed in the 2 central administrative regions (Mazowieckie and Lódzkie) and in the south-western region of Dolnoslaskie, which borders the Czech Republic and Germany. Based on available data about age and sex, a clearly higher incidence was observed in the 20-29 years (4.0 per 100,000), 40-49 years (4.1 per 100,000), and 50-59 years (4.3 per 100,000) age groups. In the period analyzed (24 days), there were 16 confirmed deaths (average age 65.5 years; 81.2% males). CONCLUSIONS The proportion of women and men with confirmed COVID-19 infection was similar to the sex ratio in the general population. Infections were relatively less common in those aged under 20 years. The largest numbers of confirmed cases were detected in 3 of the 4 largest cities, each of which has an international airport.

Public Health Interventions to Mitigate Early Spread of SARS-CoV-2 in Poland.

This study aimed (1) to present public health interventions to mitigate the early spread of SARS-CoV-2 implemented in Poland between January 9 and March 29, 2020, and (2) to analyze the potential impact of these regulations on the early phase of the COVID-19 outbreak in Poland. All legal regulations published in the Journal of Laws between January 9 and March 29, 2020, were analyzed. Out of 406 legal regulations identified, 56 were related to the COVID-19 outbreak. Moreover, the official announcements published on the governmental websites dedicated to the coronavirus and health issues were analyzed. On March 4, Poland reported the first laboratory-confirmed COVID-19 case. On March 9, Poland introduced border sanitary control. Six days after the first laboratory-confirmed COVID-19 case, all mass events in Poland were banned. All schools and universities were closed 8 days after the first COVID-19 case. All gastronomic facilities and sport and entertainment services were limited starting on March 14. Eleven days after the first COVID-19 case, controls at all Polish borders were introduced, and a ban on entry into Poland by foreigners (with some exemptions) was implemented. Starting on March 15, all citizens returning from abroad had to undergo compulsory 14 days self-quarantine. On March 20, a state of epidemic was announced, which resulted in new social distancing measures starting on March 25. In Poland, compared to other European countries, far-reaching solutions were implemented relatively early to reduce the spread of infection.