Relationship between the components of disability definition and the effectiveness of rehabilitation measures as a process.

INTRODUCTION AND OBJECTIVE: The number of disabled persons is most often only estimated. The disabled require multidirectional, effective support in almost every field of functioning. There is no arbitrarily accepted definition of disability, and those currently available outline the ranges of support for which rehabilitation measures are necessary. OBJECTIVE: The aim of the review is to present the problem areas that contribute to the definition of disability and their interdependence and effectiveness in relation to rehabilitation interventions, as well as identification of the most frequent medical and social problems interdependent on the quality and feasibility of rehabilitation interventions. REVIEW METHODS: Scientific literature in Polish and English for 1993-2023 and legal acts concerning the definition of disability, definition of rehabilitation and the problem of employment were reviewed. The following key words were used to search the NIZP-PZH, MZ, JAHEE and ISAP databases: disabled persons, definitions of disability, rehabilitation as a process, synchronization of thematic groups of disability definitions with the rehabilitation process. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: Disability is a public health problem. The actual determination of the extent, medical and social needs of people with disabilities involves methods and measures for classifying people as disabled. The effects of treatment and rehabilitation are assessed by the level of functioning of the disabled in society. SUMMARY: The multiplicity of characteristics included in the definitions of disability account for all problems in health and social terms. In view of the social, environmental and cultural changes, the scope of needs of people with disabilities is also changing, which can be seen in newly-developed definitions, including rehabilitation.

Importance of most frequent needs of the disabled in shaping areas of support in public health. Part. III. Scopes of locomotor capabilities of the disabled from the aspect of demographic and social conditioning and problems hindering daily functioning.

INTRODUCTION AND OBJECTIVE: Disability has an individualized character, both in terms of causes and effects, including limitation of locomotor skills. This is the problem to a great extent determining the level of daily functioning and the quality of life. The aim of the study was assessment of locomotor capabilities according to the demographic, social and health characteristics, and the frequency of problems of daily life according to the scope of locomotor capabilities. MATERIAL AND METHODS: The study included 676 disabled aged 19-98; mean age 64. The survey was carried out using a standardized Disability Questionnaire. RESULTS: Statistically significant differences in categories of locomotor capabilities were observed according to age, education, material standard, housing conditions, legal disability status, and degrees of disability. Ten problems varying in intensity occurred according to the scope of independent moving around: material difficulties, difficulties in settling office matters, loneliness (P<0.0001), too infrequent contacts with the family, negative attitude of surroundings towards disability, material dependence on others, lack of care by relatives and friends, difficult access to environmental nurse, difficult access to services from social worker, necessity of caring for a disabled person. CONCLUSIONS: Locomotor capabilities of the disabled decrease over 64. Low level of education, material standard and poor housing conditions are associated with decreased capabilities for independent moving around without limitations. The types and number of problems with which the disabled struggle depends on the scope of their capabilities for independent moving around. In every dimension of functioning disability belongs to the scope of issues of public health.

Research priorities in the domain of disability - correlation between health and social characteristics. A Polish example.

INTRODUCTION AND OBJECTIVE: In each society there functions a group of the disabled who need assistance. The number and character of dysfunctional consequences determine the types of support, characteristics of health, medical and social problems, where a part of them are interdependent. The interdependence of these needs determine the consistency of rehabilitation actions, which result in the improvement of quality of life of disabled persons in their living environment, especially among rural inhabitants. REVIEW METHODS: The scientific medical, and sociological literature, as well as binding legal Acts from 1978-2021 were reviewed. Materials from Polish and English databases were analysed. Key words related to disability, its definition, models of disability, disability discrimination, inequalities in medical and social care, health and social needs, maps of needs, satisfaction with medical and social care, and quality of life were used. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: Despite the fact that disability is a medical-social phenomenon, many reports concern only the treatment of the consequences of diseases, injuries, genetic/congenital or environmental defects. Disability is frequently identified with disease, which is inappropriate. Many researchers dealing with disability focus - quite rightly - on studies concerning social consequences, because they decide about the level of functioning of these persons in society and level of participation. SUMMARY: Disability is not only a medical and social problem. Treatment does not end the essence of disability. Only interdisciplinary studies can change the life of these persons regarding great possibilities for their participation.

Importance of most frequent needs of the disabled in shaping areas of support in public health. Part. II. Disability as a consequence of dysfunction in the state of health disrupting daily functioning based on selected health and socio-demographic characteristics - interdisciplinary problems in the domain of public health.

INTRODUCTION: The disabled are a group with heterogeneous structure of causes and needs. Assessment of these causes and needs requires prospective studies in order to use the results within public health actions, indispensable for pursuing the challenges of sustained development. The aim of the study was determination of the problems and needs of the disabled in various areas of their functioning, according to such characteristics as: gender, age, causes of disability, place of residence, level of education, formal status of disability, and socio-economic standard. MATERIAL AND METHODS: The examined population were 676 disabled aged from 19-98, including 56.4% of females, and 43,6% of males; rural inhabitants constituted 38.0%. The study was conducted by the method of purposive sampling, using the following research tools: the Disability Questionnaire, and the Scientific-Research Protocol. Statistical analyses were performed by means of the statistical package IBM SPSS Statistics v. 27; the p values p<0.05 were considered statistically significant. RESULTS: The most frequently occurring problems were material difficulties, lack of rehabilitation in the place of residence, hindered access to a physician, difficulties with settling official matters, loneliness, too infrequent contacts with the family, negative attitudes of the local community towards disability, and family disagreements. Some of these problems were significantly more frequent among rural inhabitants. CONCLUSIONS: The majority of the problems hindering daily life of the disabled fell within social rather than medical categories. Age, level of education, degree of disability, legal status, and material standard were most frequent determinants of the occurrence of health and social problems according to the place of residence.

Importance of most frequent needs of the disabled in shaping areas of support in public health. Part 1. Analysis of selected demographic and social characteristics of the disabled with consideration of the causes of body dysfunction, legal disability status, and selected characteristics of the state of health.

INTRODUCTION AND OBJECTIVE: The disabled are a group with a heterogeneous structure of causes and needs. The occurring physical, health, and social barriers constitute areas of public health. Assessment of these barriers requires systematic studies in order to use results supporting the tasks of public health, indispensable for pursuing the challenges of sustainable development. The aim of the study was to discuss the selected demographic, social, living and housing, as well as economic characteristics of the disabled rural and urban inhabitants, which are important for shaping the tasks of public health. MATERIAL AND METHODS: The study group consisted of 676 disabled aged 19 - 98 years, including 56.4% of females and 43.6% of males, 38.0% of whom lived in rural areas. The disabled were qualified into a study group by the method of targeted sampling. The research instruments were an author-constructed Disability Questionnaire, and the Research Protocol. Statistical analysis was performed using the software IBM SPSS Statistics v. 27. The p values p < 0.05 were considered statistically significant. RESULTS: The level of risk of the phenomenon of disability was similar among both males and females. Higher risk was observed among widows and widowers, females with a low level of education, the disabled in older age groups, as well as those living in rural areas, maintaining themselves on non-earned sources of income, and running a single person household. The main causes of disability were diseases. CONCLUSIONS: 1. The majority of the population in the study were disabled with a legal grade of disability. 2. The analyzed characteristics fell within two groups: demographic and social, and health characteristics with difficult to separate health and social problems. 3. The most important problems in the area of public health were specified. 4. It is necessary to conduct studies considering demographic and social variables in order to level-up health inequalities between the disabled and those able-bodied. Effective solving of barriers and risks embedded in the social, family, and occupational situation prevents secondary disability, and also provides an opportunity for sustainable development in this population group.

Anti-vaccine movements - a form of social activity for health care, ignorance or diversion aimed at destabilizing the health situation? Part 1. Epidemiological safety. Vaccinations - pros and cons.

INTRODUCTION: Vaccinations are a way accepted by science of preventing infectious diseases. Because of their epidemiological significance, vaccinations are considered compulsory in many countries and their evasion is penalized. Anti-vaccine movements may pose a threat to the epidemiological situation in many countries. The study presents the arguments formulated by opponents of vaccination and provides counter-arguments. MATERIAL AND METHODS: The study is based on the analysis of data stored in scientific databases, information obtained from Google, Bing and Yahoo on the Internet, as well as newspapers, magazines and opinion-forming websites. RESULTS: The slogans propagated by anti-vaccination movements are usually based on easily proven erroneous theories and lies, although there are also arguments expressing belief in the conspiracy of governments, politicians and vaccine manufacturers, or incompetence of scientists and practitioners. CONCLUSIONS: In recent years in Poland, the activity of movements against vaccination has increased significantly, and their propaganda, through its negative impact on social attitudes, threatens to destabilize the epidemiological situation. Analysis of arguments used by the opponents of vaccination suggests a lack of reliable knowledge, religious overtones (addressed to people with fundamentalist personalities), or the ill-will attitudes of anti-vaccine individuals/groups used for their own purposes. Familiarization with the arguments of anti-vaccine propaganda is necessary in order to implement effective methods of fighting such attitudes and beliefs.

Anti-vaccine movements - health care, ignorance or a diversion aimed at destabilizing the health situation? Part 2. Contemporary conditions for the functioning and development of anti-vaccination movements.

INTRODUCTION: Vaccinations are a way accepted by science of the struggle against infectious diseases. Because of their epidemiological significance, vaccinations are considered compulsory in many countries and their evasion is penalized. The WHO experts list anti-vaccine attitudes and movements among the top 10 threats to human health. Most people's refusals are mainly due to fears of anti-vaccine propaganda. Understanding this phenomenon will be the basis for improving the epidemiological situation in Poland. MATERIAL AND METHODS: The study is based on the analysis of data stored in scientific databases, as well as information obtained from Google, Bing and Yahoo and newspapers, magazines and opinion-forming websites. RESULTS: The anti-vaccine movements occur due different motivations, such as ignorance, fear and religious beliefs. Sometimes they can be supported by foreign services aimed at destabilization in selected areas of the globe. CONCLUSIONS: Increased activity and effective propaganda carried out by anti-vaccination movements is possible, among others, thanks to the development of the so-called 2nd generation of the Internet (Web2), enabling the free and difficult to control flow of information. Increasing data indicate that the activity of anti-vaccine movements may be a form of organized action (diversion in cyberspace) aimed at social, epidemiological, and economic destabilization of selected countries and regions. Among the various forms of combating anti-vaccination movements currently used are awareness-raising activities and restrictions on freedom on the Internet by monitoring information flow, blocking materials containing selected phrases or keywords associated with anti-vaccine propaganda, and sanctions imposed on people avoiding vaccination.

Socio-economic development, level of urbanization and consumption of selected food products as factors in the prevalence of overweight and obesity among youths and young adults in Poland.

INTRODUCTION AND OBJECTIVE: Obesity and overweight among teenagers and young adults pose serious problems for the Polish health care system. The aim of this study was to assess the relationships between the prevalence of overweight and obesity and the level of urbanization, consumption of selected food products and socio-economic development in the provinces in Poland. MATERIAL AND METHODS: The material used in this study is based on data published by the Central Statistics Office (GUS) for population, components of the Human Development Index (HDI), urbanization level (URBI), average monthly consumption of selected food products per person, and the percentage of obese and overweight people in the Polish provinces. The prevalence of overweight and obesity in all 16 provinces was analysed in the context of the URBI, HDI, and the average monthly consumption of selected food products. RESULTS: There was no a statistically significant correlation between the number of overweight and obesity cases and the levels of HDI and URBI. The negative correlations were found between the consumption of sugar and URBI (-0,710, p=0.002), bread and grain product consumption (-0.642; p=0.007) and fresh milk consumption (-0.594; p=0.015). Fish consumption correlated with URBI at a moderate level (0.550; p=0.027). The consumption of oils and fats strongly correlated with HDI (-0.788; p < 0,001). In the group of overweight woman, a moderate negative correlation was noted (-0.511; p=0.043) in cheese and curd consumption. CONCLUSIONS: The high level of economic development and urbanization have no direct impact on the prevalence of overweight and obesity in Poland. The results of the study indicate existing dependencies of the consumption of some of selected products with respect to the level of urbanization.

Comparison of the quality of night paediatric urgent care in rural and urban areas of Lublin Province, eastern Poland - Appraisals by parents of children requiring medical attention.

 Introduction. The quality of primary medical care for children in Poland is unsatisfactory. In the ranking known as 'the European Health Consumer Index', Poland (taking the patient point of view on healthcare quality) is classified on the 27th position out of the 33 possible. The unsolved problems concern inter alia the quality and availability of night paediatric urgent care. OBJECTIVE: The aim was assessing the quality as well as the level of satisfaction with the night paediatric urgent care in the Lublin Province of eastern Poland. MATERIALS AND METHOD: The materials for this study consisted of 540 parents of children aged 6-16 years benefiting from night paediatric urgent medical assistance in Lublin Province. The survey was conducted using the Original Survey Questionnaire. RESULTS: Inhabitants of the Lublin Province (regardless of place of residence) generally assessed the quality and accessibility of night paediatric urgent care facilities as only satisfactory. Inhabitants living in rural areas have worse access to night paediatric urgent care facilities because of having to travel greater distances, and receive less comprehensive medical assistance than inhabitants living in more urbanized areas, and they are more often referred to hospital emergency departments. During the past five years, both the availability and quality of night paediatric urgent care did not change significantly. CONCLUSIONS: Inhabitants of the Lublin Province (regardless of place of residence) generally assessed the quality as well as accessibility of night paediatric urgent care facilities as only satisfactory. Rural residents have more reasons for dissatisfaction than urban dwellers. Both the quality and availability of such medical care needs to be improved.

Meeting needs for rehabilitation equipment and home adjustments among the disabled in their life environment.

INTRODUCTION: The elimination of functional barriers resulting from disability through the provision of adequate orthopaedic and rehabilitation equipment, and homes adjusted for disability is the precondition for an efficient and independent functioning, and high quality of life of the disabled. The objective of the study was recognition of the needs of the disabled declared by them, and the degree of satisfaction with these needs. METHODS: The study covered 478 disabled from the Lublin Region. The research instrument was the 'Questionnaire for the Disabled' designed by the authors. RESULTS: Considering the needs expressed by the respondents concerning the provision of orthopaedic and rehabilitation equipment and meeting these needs, four groups were distinguished: No Needs - 30.1%, Needs Partially Met - 22.4%, Needs Fully Met - 37.7%, Needs Not Met - 9.8%. The group Needs Not Met was characterized by younger age, in the group Needs Partially Met worse indicators of the state of health were noted, more frequent independent living, loneliness and low material standard. Considering the expressed needs for home adjustments adequate to disability and meeting these needs, three groups were distinguished: No Needs - 59.6%, Needs Not Met - 15.9%, and Needs Met - 24.7%. The group Needs Not Met more rarely covered respondents living in residential homes, compared to those living independently in rural or urban areas. The group Needs Met more rarely included rural inhabitants, while more frequently including the disabled who had a high material standard. CONCLUSIONS: Both the provision of orthopaedic equipment and adjustment of the home to disability are insufficient with respect to the needs. The meeting of these needs is significantly conditioned by high or very high material standard. The lack or incomplete satisfaction with the needs for rehabilitation equipment is associated with a relatively younger age, independent, single residence and low material standard. Living in an residential home means better adjustment of the living environment, and better provision with orthopaedic and rehabilitation equipment.

Realities of ambulatory multi-drug treatment of chronic diseases in rural areas of Lublin Province, eastern Poland - comparison of situations in 2010 and 2013.

INTRODUCTION: The economic stratification observed for many years among the population in Poland, increasing poverty rates, especially those being effects of the current economic crisis in the country, and the rising prices of medicines, are potential risk factors for medication non-adherence among patients in the poorest class of the Polish population. Materials an method. The subjects were 2 groups of inhabitants of rural areas of Lublin Province in eastern Poland. The first consisted of 209 people aged 52-80 years who were surveyed in 2010, the second - 210 people aged 51-88 years, surveyed in 2013. All patients were outpatients who attended the Endocrine Clinic in Poniatowa. The studies were conducted with the use of the standardized survey questionnaire. RESULTS: The problem of medication non-adherence among the surveyed was evident and has risen from 43.1% in 2010 to 54.8% in 2013. Both in 2010 and in 2013, the main reasons for this state of affairs were the financial problems of the surveyed people. During the period 2010-2013, both expenditure on medicine as well as the ratio "patients' expenditure on medicine/expenditure on food" had increased. In 2010, 25 respondents per 209 (12%) expressed the opinion that they had always had sufficient means to buy necessary medications, in 2013 - only 3 per 210 (1.5%). CONCLUSIONS: In 2013, most of surveyed patients (54.8%) did not follow prescribed treatment plans (in 2010-43.1%). In most cases, medication non-adherence were the result of financial problems. Current regulations governing refunding of the costs of medicines may make effective ambulatory treatment of chronic diseases impossible.

Lifestyle as an important factor in control of overweight and obesity among schoolchildren from the rural environment.

INTRODUCTION: Lifestyle of an individual is responsible for sixty percent of his/her state of health. Many studies of this problem indicate that in the style of life of schoolchildren, anti-health behaviours dominate over health promoting behaviours. OBJECTIVE: The objective of the presented study was recognition of the lifestyle of the rural adolescents with overweight and obesity. MATERIAL AND METHODS: The study covered adolescents aged 15-19, living in the rural environments of the West Pomeranian Region. Finally, the analysis covered 2,165 schoolchildren, and was performed with the use of a self-designed questionnaire form and the BMI was applied. RESULTS: The study showed that overweight occurred more often in the group of examined girls than boys, while obesity was twice as frequent among boys than among girls. Overweight schoolchildren (35.1%) had an adequate diet, while those obese--inadequate (78.3%). In the group of schoolchildren with overweight, passive leisure prevailed over active forms of leisure, 83.8% and 16.2%, respectively. Passive leisure was also dominant among obese respondents. Among as many as 81.8% of schoolchildren with overweight, physical activity was mediocre, while only 8.1% of them were active. The highest percentage of respondents with obesity were totally inactive physically. Obese schoolchildren relatively often experienced stressful situations. It is an alarming fact that both overweight and obese schoolchildren relatively often used psychoactive substances. CONCLUSIONS: A considerable number of respondents with overweight and obesity applied an adequate diet, preferred passive forms of leisure, experienced stressful situations, were characterized by low physical activity, and systematically used psychoactive substances.

Risk factors for the spread of parasitic zoonoses among dog owners and their families in rural areas.

INTRODUCTION: Close animal-human contacts are risky for people, especially in cases of any negligence towards proper veterinary care, deworming procedures, as well as human and dog hygiene. Among possible risks there are parasite zoonoses threats. MATERIAL AND METHODS: The study involved 176 dog owners from rural regions in Lublin province. The original Parasitic Zoonoses Transmission Risk Score (PZTRS) method was used to determine the risk for humans, a method based on the analysis of such criteria as animal-human coexistence conditions and dog hygiene, as well as dewormings negligence. The resulting score ranges from 0-8, where. '0' is a perfect score, '8' is the lowest and means high health risks for humans. RESULTS: Obtained PZTRS values were in the 1-6 range. Median as well as modal values were equal to 4, which means the presence of significant risk of parasitic zoonoses transmission to dog owners and members of their families. CONCLUSIONS: In Polish rural areas, negligence of dog owners' duties, including improper hygiene and dewormings, as well as risky conditions of human-dog coexistence, increase the potential risk of zoonotic parasite diseases spreading. Nowadays, veterinary practices and media have the important responsibility of educating dog owners about the potential risk of zoonotic parasites.

The impact of economic factors on the realities of outpatient multi-drug treatment of chronic diseases in rural areas.

The reform of the health care system in Poland introduced in 1999 brought not ony a lot of disappointments arising from the failure in performing its basic assumptions, but also from the deterioration in access to medical care by patients coming from the poorest class of the Polish population. The subjects were 209 people at the age of 52-80 years including 149 women and 60 men - inhabitants of rural areas of Lublin province. These were outpatients who attended the Endocrine Clinic in Poniatowa. The studies were conducted with the use of the standardized survey questionnaire. Of all 209 respondents requiring long-term multidrug therapies for chronic diseases, 128 (61.2% of those surveyed) reported episodic or permanent noncompliance to treatment regimens, 90 people (43%) had applied medications in a way at variance with medical recommendations. Among the reasons, economic factors were most often mentioned. Ony 21 respondents (10%) expressed the opinion that they had always possessed sufficient means to buy necessary drugs. Current regulations concerning the refunding of costs of medicines may make effective outpatient treatment of chronic diseases impossible. Almost 61.2% of the polled treated themselves contrary to medical recommendations. In most cases, improper courses of treatment were caused by financial problems.

Eating habits of children and adolescents from rural regions depending on gender, education, and economic status of parents.

The proper lifestyle of a child, including proper eating habits, should be monitored to ensure proper physical and psychological development. This applies particularly to rural areas which are economically, socially and educationally backward. The study included 1,341 rural schoolchildren and adolescents aged 9-13 years (734 females, 607 males). The representative survey research was conducted in 2008, making use of an original survey questionnaire. The results showed that the majority of respondents eat improperly. 83.2% of them have regular breakfast, and 62.6% have regular light lunch. Most respondents do not eat more than 4 meals a day (usually 3-4). It is worrying that the consumption of sweets is high (34.9% of the surveyed group eat them regularly), whereas fruit and vegetable consumption is low. In this study, relationships between types of diet and such descriptive variables as gender, parents' educational status, and economic situation of the households are described. In families where the parents have a higher education and the household situation is good, the eating habits are much better. The list of poor dietary habits of pupils from rural schools includes skipping breakfast and/or light lunch, high consumption of sweets and low consumption of fruit and vegetables. There are correlations between improper dietary habits and gender of the children and adolescents, educational status of parents, economic situation of households, and housing conditions.

Successes and pitfalls of chronic peritoneal dialysis in infants - a Polish nationwide outcome study.

INTRODUCTION: Peritoneal dialysis (PD) is a preferred method of renal replacement therapy for end-stage renal disease in children. Recent advances have allowed chronic PD to be provided to children of all ages and sizes. MATERIAL AND METHODS: The study was designed as a national (10 dialysis centres), multicentre retrospective analysis of the medical history of 33 children who started chronic peritoneal dialysis in their infancy between 1993 and 2005, with a follow-up period of at least 24 months. RESULTS: The nutritional status of the infants was unsatisfactory. The mean SDS of body weight at the start was -2.0, at 1 year of age -1.7. Only 40% of infants were adequately nourished at 1 year of age. Long-term follow-up analysis showed that 12 children received a kidney transplant, 13 were still on dialysis (4 changed method) and 6 died (mortality rate in the first year of life of 9%). In 2 children we observed an improvement of renal function. We observed a relatively high (1/8.8 patient-months) peritonitis rate in the analysed children when compared to 1 : 22 patient-months in all children undergoing PD in Poland. CONCLUSIONS: The results of our survey have shown that the management of dialysed infants is still a challenge for the medical team and families, but long-term results of the therapy are encouraging.

[The diagnosis of familial hypomagnesemia with hypercalciuria and nephrocalcinosis in a girl with acute lymphoblastic leukemia--case report]. / Rozpoznanie rodzinnej hipomagnezemii z hiperkalciuria i nefrokalcynoza u dziewczynki chorej na ostra bialaczke limfoblastyczna--opis przypadku.

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare autosomal recessive tubulopathy resulting from mutation in the gene encoding paracelin 1. The main symptoms of FHHNC include excessive urinary calcium and magnesium excretion, nephrocalcinosis, and chronic renal failure. We present 16-year old girl in whom symptoms of FHHNC were accidentally recognized during therapy of acute lymphoblastic leukemia. In our patient, some symptoms of FHHNC were initially taken for the adverse effects of cytostatic therapy that delayed an adequate diagnosis. To the best of our knowledge, this is the first report of FHHNC associated with acute lymphoblastic leukemia. However, in our opinion this association is accidental.

[Congenital and genetic related causes of end-stage renal disease--data from Polish Registry of Renal Rreplacement Therapy in Children 2000-2004]. / Genetycznie uwarunkowane i wrodzone choroby nerek prowadzace do schylkowej niewydolnosci nerek--dane z polskiego rejestru dzieci leczonych nerkozastepczo (2000-2004).

UNLABELLED: One of the objectives of Polish Registry of Renal Replacement Therapy in Children established on 31st Dec. 2000 was to collect complete data on etiology of end stage renal disease (ESRD) in polish children. MATERIAL AND METHODS: Data on 469 patients (251 boys, 218 girls) aged 0-22 years treated with renal replacement therapy (RRT) at 13 pediatric dialysis units in Poland from 2000 to 2004 were analyzed. The mean age at start of dialysis was 10 years and 3 months. Renal diseases were defined according to EDTA coding system. Data is presented for the whole group, in 5-year age groups and separately for both sexes. RESULTS: Congenital and genetic renal diseases were the cause of ESRF in 56% of the polish population of children and adolescents on RRT. 39% of causes were acquired diseases, 5% remained unidentified. Congenital and genetic causes dominated in children < 5 years of age (71%). They accounted for 49%, 61% and 45% of causes in the consecutive 5-year age groups. The most numerous group of congenital diseases leading to ESRF were uropathies 37% and 25% of causes in the consecutive age groups. In boys the most frequent uropathy was obstructive uropathy (25%), the majority caused by posterior urethral valves. In girls the most frequent uropathies were reflux nephropathy (10%) and nephropathy secondary to neurogenic bladder (9%). Uropathies were followed by renal hypo-dysplasia without urinary tract anomalies (11%) and cystic diseases (10%). CONCLUSIONS: Congenital kidney anomalies and genetic diseases are the leading cause of end-stage renal disease in children up to 15 years of age.

[Ten-year experience in renal replacement therapy in children. A report from Dialysis Center, Department of Pediatric Nephrology, Children's University Hospital in Lublin]. / Jak dializujemy dzieci ze schylkowa niewydolnoscia nerek w ciagu dziesiecioletniej dzialalnosci Stacji Dializ Kliniki Nefrologii Dzieciecej AM w Lublinie.

Since January 26th of 1996, when our center was established, 34 children (19 boys and 15 girls) with end-stage renal disease (ESRD) were treated with renal replacement therapy. Maintenance hemodialysis (HD) and peritoneal dialysis (PO) were received by 28 and 6 patients, respectively. In our patients, the most common cause of ESRD were congenital urinary system malformations (61.7%) and glomerulonephritides (20.6%). Duration of renal replace-ment therapy varied from 6 months to 8 years. In 71.5% of children on HD, vascular access was established by arteriovenous fistula, and in the remaining--by permanent venous catheter. Adequacy of renal replacement therapy was estimated by Kt/V ratio. In patients on HD and PO, Kt/V ratios were 1.27 and 1.9 per 7 days, respectively. In 82.4% of patients, pre-dialysis arterial hypertension was observed. During renal replacement therapy arterial hypertension was diagnosed in 73.5% of children. Anemia resulting from ESRD was treated with recombinant human erythropoietin and erythropoietic medicines. In all children, recommended hemoglobin and hematocrit levels were achieved. In our patients, parameters of calcium and phosphate handling were also monitored. The mean serum intact parathormone levels in HD and PO children were 304 pg/ml and 302.2 pg/ml, respectively. We also summarized the occurrence of hepatotropic viral infections and endocrine disturbances including hypothyreosis and short stature in our patients. 3 children died due to ESRD complication. 22 (64,7%) children received cadaver-donor renal transplants.

[Incidence of urinary system malformations in children with the nephrotic syndrome]. / Ocena czestosci wystepowania wad ukladu moczowego u dzieci z zespolem nerczycowym.

The purposes of the study were a) to assess the incidence of urinary system malformations in children with the nephrotic syndrome (NS) and b) to estimate their effect on clinical course of the NS. A retrospective analysis comprised medical records of patients aged 2-18 years hospitalized in the Department of Pediatric Nephrology, University Children's Hospital, Lublin. Urinary tract infections (UTI) occurred in 28% of children with the NS. Imaging evaluation revealed urinary system malformations in 21.2% of children with the NS and UTI. Urinary system malformations constituted 5.9% of all children hospitalized because of the NS. Urinary system malformations included vesico-ureteral reflux (42.8%), renal duplication (28.6%), renal agenesis (14.3%) and diverticulum of the bladder (14.3%). In 48% of children with the NS and urinary system malformations, frequent recurrences of the syndrome were observed.