Trends in Mortality Due to Malignant Neoplasms of Female Genital Organs in Poland in the Period 2000-2021-A Population-Based Study.

The aim of this study is to assess mortality trends due to malignant neoplasms of female genital organs (MNFGOs) in Poland between 2000 and 2021. For the purpose of the study, the authors used data on all deaths of Polish female inhabitants due to MNFGO between 2000 and 2021, obtained from the Statistics Poland database. The standardised death rates (SDR), potential years of life lost (PYLL), annual percentage change (APC) and average annual percentage change (AAPC) were calculated. Between the years 2000 and 2021, 138,000 women died due to MNFGOs in Poland. Of this number, 54,975 (39.8%) deaths were caused by ovarian cancer, 37,487 (27.2%) by cervix uteri cancer, and 26,231 (19.0%) by corpus uteri cancer. A decrease in mortality due to cervix uteri cancer (APC = -2.4%, p < 0.05) was the most favourable change that occurred in the period 2000-2021, while the least favourable change was an increase in mortality due to corpus uteri cancer for the period 2005-2019 (APC = 5.0%, p < 0.05). SDRs due to ovarian cancer showed a decreasing trend between 2007 and 2021 (APC = -0.5%, p < 0.05). The standardised PYLL index due to cervical cancer was 167.7 per 100,000 women in 2000 and decreased to 75.0 in 2021 (AAPC = -3.7, p < 0.05). The number of lost years of life due to ovarian cancer decreased from 143.8 in 2000 to 109.5 in 2021 (AAPC = -1.3, p < 0.05). High values of death rates due to MNFGO in Poland, compared to other European countries, show that there is a need to promote preventive programmes and continue to monitor changes in mortality.

Indirect and Direct 65+ Patient Reporting of Non-Steroidal Anti-Inflammatory Drug-Induced Adverse Drug Reactions as a Source of Information on Polypharmacy and Polypharmacy-Related Risk.

Background and Objectives: Non-steroidal anti-inflammatory drugs (NSAIDs), which have anti-inflammatory and analgesic properties, are commonly used in the treatment of various, particularly frequent, as well as chronic, conditions in older patients. Due to common polypragmasia in these patients and a high risk of adverse drug reactions (ADRs) and drug interactions, pain management poses a therapeutic challenge. This study describes the importance of ADR reports in the identification of polypharmacy and the ensuing interactions. Materials and Methods: Both healthcare professionals (HPs) and non-healthcare professionals (non-HPs) reports collected in the EudraVigilance database of NSAIDs, including most commonly co-reported medications and reported reactions, were analysed and differences between HPs and non-HPs reports were identified. Results: In the analysed period and group, non-HPs reported more reactions but indicated fewer drugs as suspect or concomitant. The outcomes of our analysis indicate more HP engagement and more detailed reports of serious ADRs when compared to non-serious individual case safety reports (ICSRs) by non-HPs, which appeared more detailed. Such reactions as kidney failure and increased risk of bleeding are known adverse reactions to NSAIDs and common symptoms of their interactions, which were described in the available literature. They were much more frequently reported by HPs than by non-HPs. Non-HPs more frequently reported reactions that may have been considered less significant by HPs. Conclusions: The differences between healthcare professionals' (HPs) and non-healthcare professionals' (non-HPs) reports may result from the fact that the reports from patients and their caregivers require a professional medical diagnosis based on symptoms described by the patient or additional diagnostic tests. This means that when appropriately classified, medically verified, and statistically analysed, the data may provide new evidence for the risks of medication use or drug interactions.

Post-Traumatic Stress Response and Appendicitis in Children-Clinical Usefulness of Selected Biomarkers.

Acute appendicitis is an inflammatory process which is one of the most frequent global causes of surgical interventions in children. The goal of the study was to determine whether acute phase proteins, that is, C-reactive protein (CRP), procalcitonin (PCT) and neutrophil gelatinase-associated lipocalin (NGAL), interleukin 6 (IL-6), transforming growth factor-beta1 (TGF-ß1) and cortisol (HC) play a role in the pathomechanism of post-trauma stress response of the organism and to establish the impact of the applied surgical procedure and/or of inflammation on their concentrations. An additional purpose was to establish the clinical usefulness of the studied biomarkers in the diagnostics of appendicitis. CRP concentrations were quantified via the immunoturbidimetric method, while the levels of IL-6 and PCT were assessed using a bead-based multiplexed immunoassay system in a microplate format (Luminex xMAP technology); NGAL, TGF-ß1 and cortisol concentrations were determined via the enzyme-linked immunosorbent assay (ELISA) technique. All the investigated biomarkers were assayed twice, i.e., immediately before the surgery and 12-24 h after its completion. Significant increases in CRP, IL-6 and PCT concentrations were found in all children subjected to laparoscopic surgeries (p = 0.001, p = 0.006, and p = 0.009, respectively) and open (classic) surgeries (p = 0.001, p = 0.016, and p = 0.044, respectively) compared to the initial concentrations. The patients undergoing classical surgery moreover presented with significant (p = 0.002, and p = 0.022, respectively) increases in NGAL and TGF-ß1 levels after the procedures. In a group of children undergoing laparoscopic surgery, the appendicitis induced an increase in cortisol concentration, whereas in patients undergoing classical surgery the increase in the levels of this biomarker was caused by the type of performed surgical procedure. Simultaneously assaying the levels of CRP, NGAL and IL-6 (p = 0.008, p = 0.022, and p = 0.000, respectively) may prove useful in clinical practice, enabling the diagnosis of appendicitis in paediatric patients reporting to a hospital with abdominal pains, in addition to data from anamnesis and from clinical or ultrasound examination. The performed study confirms the participation of examined biomarkers in the pathomechanism of post-injury stress reaction of the organism to surgical trauma.

Changes in mortality of Polish residents in the early and late old age due to main causes of death from 2000 to 2019.

Purpose: The aim of the study was to assess mortality trends in Poland between 2000 and 2019 in the early and late old age population (65-74 years and over 75 years). Methods: The work used data on all deaths of Polish residents aged over 65 years (N = 5,496,970). The analysis included the five most common major groups of causes of death: diseases of the circulatory system, malignant neoplasms, diseases of the respiratory system, diseases of the digestive system and external causes of mortality. The analysis of time trends has been carried out with the use of joinpoint models. The Annual Percentage Change (APC) for each segments of broken lines, the Average Annual Percentage Change (AAPC) for the whole study period (95% CI), and standardized death rates (SDRs) were calculated. Results: The percentage of deaths due to diseases of the circulatory system decreased in all the studied subgroups. Among malignant neoplasms, lung and bronchus cancers accounted for the largest percentage of deaths, for which the SDRs among men decreased, while those among women increased. In the early old age, the SDR value increased from 67.8 to 76.3 (AAPC = 0.6%, p > 0.05), while in the late old age group it increased from 112.1 to 155.2 (AAPC = 1.8%, p < 0.05). Among men, there was an upward trend for prostate cancer (AAPC = 0.4% in the early old age group and AAPC = 0.6% in the late old age group, p > 0.05) and a downward trend for stomach cancer (AAPC -3.2 and -2.7%, respectively, p < 0.05). Stomach cancer also showed a decreasing trend among women (AAPC -3.2 and -3.6%, p < 0.05). SDRs due to influenza and pneumonia were increasing. Increasing trends in mortality due to diseases of the digestive system in women and men in the early old age group have been observed in recent years, due to alcoholic liver disease. Among the external causes of mortality in the late old age group, the most common ones were falls. Conclusions: It is necessary to conduct further research that will allow to diagnose risk and health problems of the elderly subpopulation in order to meet the health burden of the aging society.

Excess mortality in Poland during the first and second wave of the COVID-19 pandemic in 2020.

Purpose: The aim of the study was to analyse excess deaths by major causes of death and associated changes in the mortality pattern of the Polish population in 2020 due to the impact of the COVID-19 pandemic. Methods: The study used data on all deaths in Poland which occurred between 2010 and 2020 (N = 3,912,237). 10-year mortality trends for 2010-2019 were determined. An analysis of time trends has been carried out with joinpoint models and Joinpoint Regression Program. Based on the determined regression models, the number of deaths expected in 2020 and the number of excess deaths due to selected causes were calculated. Results: The crude death rates of all-cause deaths increased from 2000 to 2019 at an average annual rate of 1% (p = 0.0007). The determined regression model revealed that the number of deaths in 2020 should have been 413,318 (95% CI: 411,252 to 415,385). In reality, 477,355 people died in Poland that year. The number of excess deaths was therefore 64,037 (15.5%). According to data from Statistics Poland the number of COVID-19-related deaths was 40,028, the number of non-COVID-19 deaths was 24,009. The largest percentage increase over the expected number of deaths was observed for suicide (12.5%), mental and behavioral disorders (7.2%) and diseases of circulatory system (5.9%). A lower than expected number of deaths was observed for malignant neoplasms (-3.2%) and transport accidents (-0.1%). Conclusion: The difference between expected and observed non-COVID-19 deaths in 2020 indicates a need for further analysis of the causes of excess mortality.

Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients after COVID-19.

COVID-19 is not only a short-term infection, as patients (pts) recovering from SARS-CoV-2 infection complain of persisting symptoms, which may lead to chronic fatigue syndrome. There is currently no evidence that nutritional supplements can assist in the recovery of pts with chronic fatigue syndrome. 1-Methylnicotinamide (1-MNA) is an endogenic substance that is produced in the liver when nicotinic acid is metabolized. 1-MNA demonstrates anti-inflammatory and anti-thrombotic properties. Therefore, we investigated whether 1-MNA supplements could improve exercise tolerance and decrease fatigue among patients recovering from SARS-CoV-2. METHODS: The study population was composed of 50 pts who had recovered from symptomatic COVID-19. The selected pts were randomized into two groups: Gr 1 (NO-1-MNA)-without supplementation; Gr 2 (1-MNA) with 1-MNA supplementation. At the beginning of the study (Phase 0), in both groups, a 6-minute walk test (6MWT) was carried out and fatigue assessment was performed using the Fatigue Severity Scale (FSS). Both FSS and 6MWT were repeated after 1 month. RESULTS: A significant improvement in the mean distance covered in the 6MWT was noted at follow-up in Gr 1-MNA, compared with Gr NO-1-MNA. We also noted that in Gr 1-MNA, the 6MWT distance was significantly higher after 1 month of supplementation with 1-MNA, compared with the beginning of the study (515.18 m in Phase 0 vs. 557.8 m in Phase 1; p = 0.000034). In Gr 1-MNA, significantly more pts improved their distance in the 6MWT (23 out of 25 pts, equal to 92%), by a mean of 47 m, compared with Gr NO-1-MNA (15 of 25 pts, equal to 60%) (p = 0.0061). After one month, significantly more patients in the group without 1-MNA had severe fatigue (FSS ≥ 4) compared with the group with supplementation (Gr 1-MNA = 5 pts (20%) vs. Gr NO-1-MNA = 14pts (56%); p = 0.008). CONCLUSIONS: 1-MNA supplementation significantly improved physical performance in a 6-min walk test and reduced the percentage of patients with severe fatigue after COVID-19. The comprehensive action of 1-MNA, including anti-inflammatory and anticoagulant effects, may be beneficial for the recovery of patients with persistent symptoms of fatigue and low tolerance to exercise after COVID-19.

Respiratory Burst and TNF-α Receptor Expression of Neutrophils after Sepsis and Severe Injury-Induced Inflammation in Children.

Systemic inflammatory response syndrome (SIRS) is defined as the systemic host response to infection or a non-infectious factor. The purpose of this study was to evaluate the involvement of reactive oxygen species (ROS) in severe inflammation and to assess the discrimination strength of the neutrophil BURSTTEST assay regarding its etiology in three groups of patients (sepsis, burns, and bone fractures) who met the SIRS criteria. The neutrophil activation (respiratory burst of granulocytes as well as p55 and p75 tumor necrosis factor (TNF-α) receptor expression) was evaluated twice using flow cytometry, and the results were compared with healthy controls and among SIRS subjects. A decreased oxygen metabolism in neutrophils after E.coli stimulation and increased TNF-α receptor expression were found in septic and burned patients on admission, while ROS production augmented and TNF-α receptor expression diminished with the applied therapy. The significant differences in neutrophil respiratory burst intensity among septic and burned patients and those with sepsis and bone fractures were found (however, there were not any such differences between patients with thermal and mechanical injuries). This study indicates that the neutrophil BURSTTEST evaluation might be a clinically reliable marker for differentiating the SIRS etiology.

Changes in mortality and years of life lost due to lung cancer in Poland, 2000-2016.

BACKGROUND: The aim of the study was to evaluate trends of mortality and the number of years of life lost due to lung cancer in Poland, in the period 2000-2016. METHODS: The study material was 375,151 death certificates of all inhabitants of Poland who died in the period 2000-2016 due to lung cancer. In order to calculate the number of years of life lost, the authors used indices: SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (per deaths), APC (Annual Percentage Change) and AAPC (Average Annual Percentage Change). RESULTS: The standardized death rate (SDR) due to lung cancer decreased in the analyzed period from 74.5 to 68.3 per 100,000 population (AAPC = -0.6%). The most rapid decrease was noted in the years 2008-2011 (APC = -2.2%). With regards to males, SDR decreased from 148.8 to 114.5 (AAPC = -1.7%), whereas in females, it increased from 25.7 to 37.6 (AAPC = 2.3%). The SEYLLp index, calculated per 100,000 inhabitants, increased from 1189.9 in the year 2000 to 1250.5 in the year 2016. The trend and pace of changes fluctuated. In 2000-2008, the SEYLLp index was increasing at a pace of 0.7%. This growth was followed by a decrease at a pace of -1.2%, noted in 2008-2011. After the year 2011, the indices started to grow at an annual pace of 0.4%. AAPC in the whole study period was 0.3%. Increased mortality in females was responsible for the increase in the number of lost years of life. SEYLLp values in this sex group increased from 464.8 in the year 2000 to 774.7 in the year 2016 (APC = 3.3%).With regards to males, SEYLLp values, calculated for 100,000 male population, decreased in the analyzed period from 1961.1 to 1758.3. CONCLUSIONS: Lung cancer still poses a serious epidemiological problem in Poland and the number of years of life lost due to this cause reflects social and economic implications of premature lung cancer-related mortality. There is a great need to educate, particularly women, and show effective ways of quitting smoking.

[Trends in excess male mortality in the working age population in a region with the highest mortality rates in Poland]. / Trendy nadumieralnosci mezczyzn w wieku produkcyjnym w województwie o najwyzszych wspólczynnikach zgonów w Polsce.

BACKGROUND: The intensity of premature deaths in the Lódz region in 2014 amounted to 40 per 10 000, and was the highest in the country (the average rate for Poland was 32). Excess mortality of men aged <65 continues to be a major medical and social problem. The aim of the study is to analyze time trends of excess male mortality in the working age population in the Lódz region, both in general and due to the most important causes of deaths. MATERIAL AND METHODS: The research material consists of information on 144 589 deaths of the Lódz region inhabitants aged 20-64 in 1999-2014. Crude and standardized mortality rates were calculated, as well as excess male mortality rates both in general and by cause of death. Standardization was carried out using the direct method according to the standard European population. A study of time trends was performed with the use of the joinpoint regression analysis. Average annual percentage rates of changes were estimated. RESULTS: The excess mortality rate of men at the productive age decreased from 2.9 to 2.8 in the Lódz region in 1999-2014. The most important causes of death among men aged 20-64 in 2014 were (rates per 10 000): cardiovascular diseases (19.1), malignant neoplasms (16.6) and external causes of death (12.3). Among women, the most significant were malignant neoplasms (11.1), cardiovascular diseases (5.1) and diseases of the digestive system (2.1). The excess mortality rate of men aged 20-64 in the analyzed period reached the highest values due to external causes of death (5.1-7.3) and cardiovascular diseases (3.0-3.7). The highest rate of the decline in excess male mortality in 1999-2014 was recorded due to malignant neoplasms, on average 1.4% per year (p < 0.05). Meanwhile, the fastest growth concerned external causes of death, on average 1.0% per year (p < 0.05). CONCLUSIONS: Despite the decline in the mortality rates among both sexes, excess male mortality due to external causes of death and cardiovascular diseases increased. Med Pr. 2020;71(3):325-35.

Trends of mortality due to breast cancer in Poland, 2000-2016.

BACKGROUND: The aim of the study was to assess trends in mortality and the number of lost years of life due to breast cancer in the female population in the years 2000-2016, with consideration given to differences regarding the level of education and place of residence. METHODS: The analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 92,154 death certificates of all Polish female inhabitants who died in the period 2000-2016 due to breast cancer. The SEYLLp (Standard Expected Years of Life Lost per living person), the SEYLLd (per deaths), the APC (Annual Percentage Change), the AAPC (Average Annual Percentage Change) were calculated to determine years of life lost. RESULTS: The mean age of women who died from breast cancer increased in the study period from 64.7 years to 69.7. The SEYLLp index (per 100,000) increased to 776.8 years in 2016 (AAPC = 0.5%). The most unfavorable changes were observed in the group of women with secondary education. In 2004, the SEYLLp values started to grow at a rate of 2.3% and since 2011, they have been higher than amongst women with elementary education. In the years 2000-2016, the authors observed that SEYLLp was steadily declining (APC = -1.0%) in the group of inhabitants of rural areas, whereas with regards to city dwellers, the SEYLLp index has been increasing since 2004 (APC = 0.5%), which has resulted in increased disproportions regarding the place of residence. CONCLUSIONS: The results of this study showed that breast cancer is becoming a serious epidemiological problem in Poland. There is the need to intensify activities among women at highest risk group and it should be the starting point for making key decision in combating breast cancer.

Standard Expected Years of Life Lost Due to Malignant Neoplasms in Poland, 2000-2014.

The aim of the study was an analysis of mortality trends due to malignant neoplasms in Poland. The study material was a database, consisting of 1,367,364 death certificates of inhabitants of Poland who died during the period 2000-2014 due to malignant cancer. To calculate years of life lost, the SEYLLp index (Standard Expected Years of Life Lost per living person) was applied. We also calculated AAPC (Average Annual Percentage Change). The SEYLLp index (per 10,000 population) due to malignant neoplasms in Poland in males decreased from 586.3 in 2000 to 575.5 in 2014, whereas in females it increased from 398.6 in 2000 to 418.3 in 2014. The greatest number of lost years of life in 2014 was attributed to lung cancer (174.7 per 10,000 males and 77.3 per 10,000 females), breast cancer in females (64.5) and colorectal cancer in males (39.0). The most negative trends were observed for lung cancer in females (AAPC = 3.5%) and for colorectal cancer (AAPC = 1.8%) and prostate cancer (AAPC = 1.6%) in males. Many lost years could have been prevented by including a greater number of Polish inhabitants in screening examinations, mostly targeted at malignant neoplasm, whose incidence is closely connected with modifiable risk factors.

Epidemiology of Mortality Due to Prostate Cancer in Poland, 2000-2015.

The aim of the study was to assess trends in mortality and years of life lost due to prostate cancer (PCa) in Poland in 2000-2015. The crude death rates (CDR), standardised death rates (SDR), standard expected years of life lost per living person (SEYLLp) and per death (SEYLLd) values were calculated. Joinpoint models were used to analyse time trends. In the study period, 61,928 men died of PCa. The values of mortality rates in 2000 (per 100,000) were: CDR = 16.97, SDR = 16.17, SEYLLp = 332.1. In 2015, the values of all rates increased: CDR = 26.22, SDR = 16.69, SEYLLp = 429.5. However, the SEYLLd value decreased from 15.62 to one man who died due to PCa in 2000 to 13.78 in 2015. The highest SEYLLp values occurred in the group of men with primary education (619.5 in 2000 and 700.7 in 2015). They were respectively 2.24 and 2.96 times higher than in men with higher education (275.7 and 237.1). SEYLLp values increased in urban areas (from 295.7 to 449.4), slightly changed in the rural areas (from 391.5 to 400.2). Unfavorable trends in mortality due to PCa in Poland require explanation of the causes and implementation of appropriate actions aimed at mortality reducing.

Years of Life Lost Due to Cervical Cancer in Poland in 2000 to 2015.

The aim of the study was an analysis of years of life lost due to cervical cancer in Poland in the period 2000 to 2015 with consideration given to differences related to education and place of residence. The study material was 28,274 death certificates of all female inhabitants of Poland, who died in 2000 to 2015 due to cervical cancer. In order to calculate years of life lost, the authors used indices: SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (per deaths) and AAPC (Average Annual Percentage Change). The SEYLLp index (per 100,000) due to cervical cancer in Poland decreased from 394.3 in 2000 to 220.9 years of life in 2015 (AAPC = -3.6%). Women with university education lost the smallest number of years of life (SEYLLp = 139.0 in 2000 and 53.7 in 2015; AAPC = -5.4%), whereas those with elementary education had the greatest number of years of life lost (524.2 and 312.8; AAPC = -3.4%). Women living in rural areas lost on average 329.5 years in 2000 and 177.0 in 2015 (AAPC = -3.8%). In city areas, the values were 428.6 and 247.1 (AAPC = -3.4%). Many of the years of life lost could have been avoided by including more women, particularly those with elementary education, in screening examinations.

Territorial differences in years of life lost due to premature mortality in inhabitants of Poland

INTRODUCTION: Reduction of social and territorial differences with regards to health of a population is one of the most crucial global problems of public health. An analysis of years of life lost focuses on social and economic aspects of premature mortality. AIM: The aim of the study is to analyze territorial differences in years of life lost due to premature mortality in inhabitants of various regions of Polan d, according to the most important causes of death, with consideration given to classification categories of ICD-10. METHODS: The study material included a database which contained information gathered from 387,312 death certificates of inhabitants of Poland in 2013. The SEYLLp index (Standard Expected Years of Life Lost per living person) was used to calculate standard expected years of life lost. RESULTS: The absolute number of years of life lost in inhabitants of Poland for the year 2013 was 4,168,256 in males and 2,536,447 in females, which corresponded to 2,237 years per 10,000 males and 1,277 per 10,000 females. Inhabitants of the Lodz Province are characterized with the highest number of years of life lost (2,858 years per 10,000 males and 1,544 per 10,000 females), whereas inhabitants of the Subcarpathian Province are characterized with the lowest number of years of life lost (1,833 years per 10,000 males and 1,039 per 10,000 females). In the male group, the highest SEYLLp values were contributed by: ischemic heart disease (217 years), malignant neoplasms of the trachea, bronchi and lungs (175 years) and cardiac insufficiency (156 years), whereas in the female group, the causes included: cerebral diseases (106 years), cardiac insufficiency (105 years) and ischemic heart disease (103 years) CONCLUSIONS: There are huge territorial differences in Poland with regards to a number of years of life lost. Thus, there is a need to continue studies in order to find an explanation for these differences and gradually eliminate them.

Years of life lost of inhabitants of rural areas in Poland due to premature mortality caused by external reasons of death 1999-2012.

INTRODUCTION: External causes of death are the third most common causes of death, after cardiovascular diseases and malignant neoplasms, in inhabitants of Poland. External causes of death pose the greatest threat to people aged 5-44, which results in a great number of years of life lost. OBJECTIVE: The aim of the study is the analysis of years of life lost due to external causes of death among rural inhabitants in Poland, particularly due to traffic accidents and suicides. MATERIAL AND METHODS: The study material included a database created on the basis of 2,100,785 certificates of rural inhabitants in Poland in the period 1999-2012. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost due to external causes of death. Joinpoint models were used to analyze time trends. RESULTS: In the period 1999-2012, 151,037 rural inhabitants died due to external causes, including 27.2% due to traffic accidents and 25.2% due to suicides. In 2012, the SEYLLp was 1,817 per 100,000 males and 298 per 100,000 females. Among males, suicides (SEYLLp = 633 years per 100,000) and traffic accidents (SEYLLp = 473 years per 100,000) contributed to the largest number of years of life lost. Among females, SEYLLp values were: 109 years due to traffic accidents and 69 years due to suicides (per 100,000). Among males, SEYLLp values started to decrease in 2008 at the average annual rate of 3.2%. In the group of females in the period 1999-2012, SEYLLp values were decreasing by 2.4% per year. CONCLUSIONS: The decreasing trend of the number of lost years of life due to external causes among rural inhabitants does not apply to suicides among men. The SEYLLp due to this group of causes has been steadily increasing since 1999. Analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.