Hospitalizations of patients with sarcoidosis before and during the COVID-19 pandemic in Poland.

INTRODUCTION: Sarcoidosis is a multisystemic granulomatous disease that mostly affects the lungs and lymphatic system. Due to its rarity and variable clinical course, analyses of factors related to sarcoidosis should be based on large databases and long observation periods. OBJECTIVES: The aim of this study was to determine the characteristics of patients with sarcoidosis hospitalized in Poland over a long period (2016-2021). PATIENTS AND METHODS: We conducted a retrospective study using hospital discharge records compiled by the National Institute of Public Health NIH - National Research Institute. We analyzed the records of patients with sarcoidosis from the entire Polish population at their first hospitalization. RESULTS: We identified a total of 15 548 first-time hospitalizations for sarcoidosis. The mean annual disease incidence was 6.8 cases per 100 000. The mean (SD) age of the patients was 45.8 (13.6) years, and it was lower in men than in women (42.9 [12.5] vs 49.8 [14.2] years; P <0.001). There were significantly more hospitalizations among city dwellers (62.3% vs 37.3% for rural residents; P <0.001). At the beginning of the COVID­19 pandemic in Poland there was a decrease in the number of hospitalizations for sarcoidosis, followed by an increase in the subsequent year. The all­cause in­hospital death rate was significantly higher during the COVID­19 pandemic, as compared with the period before the pandemic (7.2 vs 2.3 per 1000; P <0.001). CONCLUSIONS: Health care changes related to the outbreak of the COVID­19 pandemic may have increased the health debt for inpatient sarcoidosis treatment. The occurrence of sarcoidosis in Poland may be related to demographic and territorial factors.

Social marketing in gynecological cancers prevention after the COVID-19 pandemic.

OBJECTIVES: Assessment of the development and description of the characteristics of social marketing in Poland and the United States with regard to the prevention of gynecological cancers and achievements of these countries. MATERIAL AND METHODS: Collective case study based on an analysis of five social campaigns in Poland and five social campaigns in the United States that were focused the gynecological cancers prevention. RESULTS: In the United States, there are more materials available on social campaigns dedicated to the prevention of gynecological cancers, and there are more public organizations that are involved in health promotion activities than in Poland. As opposed to American campaigns, Polish social campaigns did not cover all types of gynecological cancer. The study revealed that Facebook is the most commonly used social media platform by the social campaign organizers. CONCLUSIONS: Social marketing tools still have not been fully implemented in the prevention of gynecological cancers either in Poland or in the United States. However, social marketing in the US seems to be more effective in gynecological cancers prevention than Poland.

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.

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.

Normalization of the Mini-MAC (Mental Adjustment to Cancer) Questionnaire among Cancer Patients.

Cancer is associated with discomfort and many changes in patients' lives to which they must adapt. The main objective of the study was to assess the use of the mini-MAC questionnaire scale among persons diagnosed with malignant cancer and to develop standards allowing differentiation of patients with diagnosed cancer in terms of their style of adjustment to the disease. The mini-MAC questionnaire is a widely used tool in assessing coping strategies among cancer patients. Sten standards have been developed to determine the level of results on the questionnaire scales in the low-average-high categories. The study included 1187 patients diagnosed with malignant cancer who are covered by outpatient care at the Maria Sklodowska-Curie Institute-Oncology Center in Warsaw. The questionnaire concerning mental adjustment to cancer was used (mini-MAC). Patients with cancer most often adopt strategies of fighting spirit and positive reevaluation. The variables that differentiate the results most significantly include gender, presence of metastasis, and the state of undergoing chemotherapy. The mini-MAC questionnaire should be a tool for psycho-oncological diagnosis of patients' attitudes towards cancer. The obtained results indicate that cancer patients are characterized by their constructive style of adjustment to the disease.

Sarcoidosis among hospitalized patients in Poland: a study based on a national hospital registry.

INTRODUCTION: Sarcoidosis is a systemic granulomatous disease mainly affecting the lungs, although granulomas can also involve any other organ. OBJECTIVES: We sought to describe patients during their first hospitalization for sarcoidosis in Poland from 2008 to 2015. To our knowledge, this is the first evaluation of the disease in Poland based on a hospital morbidity database. PATIENTS AND METHODS: We conducted a retrospective, population­based study, using hospital discharge records compiled by the National Institute of Public Health in the years 2008 to 2015. RESULTS: Among the 23 097 patients included in the study, men were predominant (54.7%). The mean and median ages at hospitalization were 44.7 years (95% CI, 44.5-44.9) and 42 years, respectively. Most patients (65%) resided in urban areas. The average annual incidence rate of sarcoidosis was 7.5 per 100 000 (95% CI, 7.1-7.9). The lungs were the most commonly affected organ (57.9%), while the remaining cases included sarcoidosis of lymph nodes and no lung involvement (18%), the skin (1.4%), and other or unspecified sites (22.7%). Skin sarcoidosis occurred significantly more frequently in women, while sarcoidosis of the lungs with coexisting sarcoidosis of lymph nodes was significantly more prevalent in men. Seasonal variability in sarcoidosis incidence was observed. CONCLUSIONS: Sex and age may have a significant impact on the occurrence of sarcoidosis in Poland. Changes in seasonality may suggest the role of environmental factors. These data on sarcoidosis in Poland may be helpful in comparative analyses with other European countries.

Epidemiology of Granulomatosis with Polyangiitis in Poland, 2011-2015.

Granulomatosis with polyangiitis (GPA) is a form of vasculitis that affects small- and medium-sized vessels in many organs. The aim of the study was to describe the epidemiology of GPA in Poland in 2011-2015, including the incidence and prevalence rates. The authors conducted a retrospective, population-based study, using hospital discharge records with GPA diagnosis. GPA incidence was estimated on the basis of the data from the Polish hospital morbidity study carried out by the National Institute of Public Health. The final study group consisted of 1491 patients (749 females, 742 males) who were first time hospitalized with the diagnosis of GPA. The average annual incidence of GPA in Poland was 7.7/1,000,000 (95% CI, 4.1-11.4), and the point prevalence at the end of 2015 was 36/1,000,000. A statistically significant decrease in the GPA incidence was noticed in this study. A 1-year survival rate for GPA was 94%. In conclusion, the incidence and prevalence rates of GPA in Poland are similar to that reported in other European countries. The study provides recent epidemiological data on GPA in Poland, which may be useful for comparisons with other geographical regions.

Presentación clínica colinérgica de la intoxicación aguda por amitraz / Cholinergic clinic report in acute poisonning caused by amitraz

Formamidines are pesticides used in veterinary with activity as acaricides and insecticides. Human poisoning with these products can cause a clinical presentation similar to an organophosphate-pesticide poisoning. This situation can induce errors in diagnosis, with inadequate treatment and toxic or adverse effects of antidotes. We stress the importance of a correct diagnosis in these cases. The cholinesterase dosification in blood allows the fast discard of oragnophosphate-pesticide poisoning. The possibility of detecting 3-methyl-4-aminobenzoic acid in urine be helphul for confirmation of diagnosis. Poisoning by formamidines requires only decontamination (if not many hours have elapsed, if the amount ingested is important, if the respiratory airway can be protected), and symptomatic and/or intensive care measures. Cardiac monitoring and mechanical ventilation might be required. In theory, the fast metabolism of the product allows a short-acting toxic effect. Special attention deserves the solvent, thay may contribute to depression of the central nervous system and might compromise the respiratory function