High oral carriage of multidrug resistant Gram-negative bacilli in adolescents: the SOPKARD-Junior study.

Introduction: The colonization of the oral cavity by potentially pathogenic antimicrobial-resistant bacteria in adolescents and its consequences is very poorly understood. The present study focused on the occurrence of oral colonization by Gram-negative bacilli (GNB) and their multidrug resistance, including the production of extended-spectrum ß-lactamases (ESBLs) and carbapenemases, among healthy adolescents and risk factors associated with GNB colonization. Materials and methods: This study was conducted as part of "A program for the early detection of risk factors for lifestyle diseases SOPKARD-Junior" (SOPKARD-Junior). Oral samples were collected from 182 adolescents from four public elementary schools in Sopot, Poland, aged 13-14 years. Bacterial strains were identified by the MALDI-TOF MS method. Screening of antimicrobial resistance was performed using a disk diffusion method. The NG-Test® CARBA-5 was used to detect and differentiate the five most widely distributed carbapenemases. Demographic and clinical data were collected and statistical analysis of risk factors was performed. Results: A total of 68 out of 182 (37.4%) healthy adolescents was documented oral colonization with Gram-negative bacilli, including 50/182 (27.5%) multidrug resistant (MDR-GNB) strains. Over 60% of oral carriage concerned three main genera Enterobacter spp., Pseudomonas spp., and Serratia spp., which were detected in 22.1%, 19.1%, and 19.1% of participants, respectively. Citrobacter spp., Escherichia coli, Klebsiella spp., Hafnia spp., Aeromonas spp., Acinetobacter spp., and Stenotrophomonas spp. were also isolated. The antimicrobial resistance to ampicillin (100%), ceftazidime (69.1%), meropenem (60.3%), gentamycin (60.3%), piperacillin/tazobactam (52.9%), and piperacillin (45.6%) were the most common. Among 73.5% GNB strains multidrug resistance was observed, including all Pseudomonas spp. strains. Among MDR-GNB, 30.4% were resistant to four groups of antibiotics, half of the MDR Pseudomonas spp. strains were resistant to 10 groups of antibiotics. Extended-spectrum ß-lactamases were produced by Enterobacter cloacae, Klebsiella spp., and Serratia spp. (7.4%). Colonization by ESBLs-positive GNB strains was significantly associated with recurrent respiratory infections, nasal congestion, and bronchitis (p<0.05). Conclusion: Our study revealed high oral carriage of multi-drug resistant Gram-negative bacilli in healthy adolescents and the association of ESBL-producing strains with respiratory infections. Further studies on oral colonization with GNB are necessary due to the possibility of distinct infections and the acquisition of antibiotic resistance by resident microbiota.

Significant improvements in cataract treatment and persistent inequalities in access to cataract surgery among older Poles from 2009 to 2019: results of the PolSenior and PolSenior2 surveys.

Background and aims: Cataract is the leading cause of visual impairment and blindness among older adults worldwide, that can be corrected through surgical interventions. However, diagnosis and treatment bias can be observed, and it is a major issue for improving health policies. Therefore, we assessed a declared prevalence of cataract and the frequency of surgical treatment of this condition in the Polish population in the years 2009-2019. To provide evidence of health inequalities, we compared operated and non-operated seniors using selected socioeconomic factors and identified variables affecting the availability of cataract surgery services over a 10-year follow-up period. Methods: An analysis based on a survey among 4,905 participants of the nationwide PolSenior study conducted in 2008-2009, and 5,031 participants of PolSenior2 conducted one decade later to assess the health of Poles over 65 years of age. Results: Cataract diagnosis was declared by 25.5 and 28.2% of the study population in PolSenior and PolSenior2 surveys, respectively. Out of those diagnosed with cataract in PolSenior, 46.5% underwent surgical treatment for at least one eye. This rate increased up to 67.9% in the survey conducted 10 years later. Independent factors increasing the chance for cataract surgery in both cohorts included male sex and age > 75 years. Additional factors were self-reported good health status in PolSenior and lack of financial problems in purchasing medicines in PolSenior2. Over the investigated decade, the chances for cataract surgical treatment increased in single-living and widowed patients. The shortage of funds for medications remained the only significant barrier for surgery. Conclusion: Although the prevalence of cataract in the older adult population in Poland has not changed from 2009 to 2019, the rate of cataract surgeries has considerably increased over the analyzed decade. Patients with lower socioeconomic status and women have lower access to surgical cataract management.

Obesity in Polish Children and Parents' Perception of Their Children's Weight Status: The Results of the SOPKARD-Junior Study.

One way to counteract the spread of obesity in children is its early recognition by parents. Therefore, the aim of this study was to investigate whether parents' perception of their children's BMI category was consistent with their actual BMI assessment and to determine potential influential factors. The study was conducted as part of the "A program for the early detection of risk factors for lifestyle diseases SOPKARD-Junior" (SOPKARD-Junior), a preventive health program implemented in public elementary schools from 2017 to 2019. The results from 381 children with a mean age of 11.67 (SD = 1.52) were analyzed. Height and weight were measured and BMI was calculated. Surveys were conducted to assess parents' perceptions of their child's weight, along with their sociodemographic status. Nearly one in three parents were unable to correctly identify their children's weight; 25.0% underestimated it, and 6.0% overestimated it. Underestimation was observed along with an increase in the children's BMI weight category, with as many as 57.1% of parents of obese children misclassifying their weight. The child's BMI was the only significant predictor of incorrect assessment. Polish parents cannot properly assess their children's BMI, especially when their child is overweight or obese. In children, weight and height measurements should be taken regularly, rather than allowing weight category to be dependent upon parental weight assessments.

Anthropometric Determinants of Respiratory Sinus Arrhythmia in Children.

BACKGROUND: The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings. METHODS: In a cohort study, 626 healthy children (52% male) aged 10.8 ± 0.5 years attending primary school in a single town underwent a 12-lead electrocardiogram coupled with measurements of height, weight and blood pressure. Indices of respiratory sinus arrhythmia (pvRSA, RMSSD, RMSSDc) were derived from semi-automatic measurements of RR intervals. Height, weight, BMI, blood pressure as well as waist and hip circumferences were compared between subjects with rhythmic heart rate and respiratory sinus arrhythmia, and correlations between indices of sinus arrhythmia and anthropometry were investigated. RESULTS: Respiratory sinus arrhythmia was recognized in 43% of the participants. Subjects with sinus arrhythmia had lower heart rate (p < 0.001), weight (p = 0.009), BMI (p = 0.005) and systolic (p = 0.018) and diastolic (p = 0.004) blood pressure. There were important inverse correlations of heart rate and indices of sinus arrhythmia (r = -0.52 for pvRSA and r = -0.58 for RMSSD), but not the anthropometry. CONCLUSION: Lower prevalence of respiratory sinus arrhythmia among children with overweight and obesity is a result of higher resting heart rate observed in this population.

Depression and smoking - widespread health problems among 14-year-old adolescents in Poland. The results of the SOPKARD-Junior survey. / Depresja i palenie papierosów ­ powszechne problemy zdrowotne wsród polskich 14-latków. Wyniki badania SOPKARD-Junior.

OBJECTIVES: Assessment of prevalence and co-prevalence of depression and substance abuse among Sopot youth. METHODS: In the years 2006-2007, 316 subjects participated in a psychological examination as part of the SOPKARD-Junior program. The assessment was made using the Beck Depression Inventory, the Krakow Depression Inventory and a proprietary questionnaire evaluating the frequency of psychoactive substance use. Adolescents with depressive symptoms in the questionnaire study underwent a psychiatric examination. The SOPKARD-Junior program is a multidisciplinary epidemiologic study that comprehensively assesses the health of the population of 14-year-old junior secondary school students in Sopot. RESULTS: Symptoms of depression were detected in 29.4% of subjects: 37.4% of girls (G) and 20.9% of boys (B) (p < 0.05). In the psychiatric examination, an episode of depression was diagnosed in 4.1% of students (G: 5.5%; B: 2.6%). The rates of substance use (occasional or regular) were: cigarettes - 20.2 % of students (G: 24% and B: 16.4%; p < 0.05), alcohol - 45.9% (G: 50.9% and B: 40.5%; p < 0.05), and illicit drugs - 6.3% (G: 6.2% and B: 6.6%; n.s.). Teenagers with depressive symptoms smoke cigarettes and drink alcohol significantly more often than those without depressive symptoms (smoking rates:30.1% vs. 16.1%; p <0.05; alcohol drinking rates: 61.3% vs. 39.5%; p < 0.05). CONCLUSIONS: (1) Significant prevalence of depressive symptoms was detected among the adolescents in the study. (2) Girls smoke cigarettes and drink alcohol significantly more frequently than boys. (3) The occurrence of depressive symptoms in adolescents almost doubles the risk of tobacco and alcohol use.

Parafunctions, Signs and Symptoms of Temporomandibular Disorders (TMD), in Children with Attention-Deficit Hyperactivity Disorder (ADHD): the results of the SOPKARD-Junior study / Parafunkcje, oznaki i objawy zaburzen czynnosciowych narzadu zucia (TMD) u dzieci z zespolem nadpobudliwosci psychoruchowej z deficytem uwagi (ADHD): wyniki badania SOPKARD-Junior

OBJECTIVES: The aim of the study was to compare the prevalence of parafunctions and signs and symptoms of TMD in a population group of children with and without ADHD. METHODS: The study included all 5th grade children of all public primary schools in Sopot (untreated, unguided children). The reporting rate was 91%. At the first stage of the psychological-psychiatric study both parents and children filled in the CBCLand YSR questionnaires. At the next stage, in the group of children selected during the screening, aqualified child psychiatrist conducted asemi-structured diagnostic interview K-SADS-PLand diagnosed ADHD. Parafunctions, signs and symptoms of TMD were assessed by conducting a direct interview with a child and a clinical examination by a dentist. RESULTS: There were significant differences (p < 0.05) between children with ADHD and without ADHD associated with parafunctions such as chewing gum (76.47% vs. 46.07%), nail biting (70.59% vs. 40.45%) and bruxism (52.54% vs. 26.22%), the number of signs and symptoms of TMD (1 sign or symptom 0.0% vs. 32.21%; 4-7 signs or symptoms 17.65% vs. 3.75%). CONCLUSIONS: In children with ADHD, symptoms of temporomandibular joint disorders and parafunctions were significantly more frequent. These studies suggest that children with ADHD constitute agroup of increased risk for TMD in the future. Interdisciplinary treatment of an ADHD patient by a psychiatrist and a dentist is necessary.

An assessment of health status and health behaviours in adolescents: main points and methods of the SOPKARD-Junior programme.

INTRODUCTION: The study involved preparing and implementation a model of complex screening programme for adolescents and comparison of anthropometric examinations between the population of the SOPKARD-Junior programme and representative sample of Polish children in the same age. MATERIAL AND METHODS: The screening programme in 14-15 year old pupils (n = 282) included: anthropometric, blood pressure, echocardiographic, electrocardiographic, carotid arteries, kidney and thyroid ultrasound examinations, as well as respiratory, dental and masticatory system, orthopaedic, psychological and psychiatric assessment. Blood and urine tests were also performed. The results of anthropometric examinations from the SOPKARD-Junior and OLAF programmes were used for comparative analysis. RESULTS: Statistically significant (p < 0.001) differences between young people from Sopot and their peers in the general Polish population were found in height (+3.61 cm for boys), body mass (+5.19 kg for boys and +3.99 kg for girls), body mass index (+0.99 kg/m2 for boys and +1.33 kg/m2 for girls), waist circumference (+4.52 cm for boys and +4.52 cm for girls) and hip circumference (+2.51 cm for boys). The highest attendance rate was achieved for examinations performed in school (e.g. anthropometric and blood pressure measurements - n = 268; 95%) and the lowest for the echocardiograpy performed in local hospital (n = 133; 47%). The mean score of the programme quality (scale 1-6) assessed by children was 4.63. CONCLUSIONS: The SOPKARD-Junior programme represents an attempt to develop a model of screening assessments for teenagers in Poland. Preliminary results of the SOPKARD-Junior programme indicate small differences in the biological development of Sopot youth in comparison with their peers from Polish population of the OLAF programme. The high attendance rate on research conducted at the school indicate that proposed health examinations in adolescents are acceptable and feasible.