Trends in smoking among secondary school and high school students in Poland, 2009 and 2011.

OBJECTIVES: To determine the age and the most common circumstances for smoking initiation along with smoking rates and to evaluate smoking trends for secondary and high school students in Poland during 2009 and 2011. MATERIAL AND METHODS: In 2009, a pilot study was conducted in districts of Poland on high school students and their parents. For statistical analysis, correctly completed questionnaires from 999 students and 667 parents were qualified for use. After the pilot study, a nationwide study of secondary school students and their parents was also conducted in 2009. For statistical analysis, correctly completed questionnaires were used from 9360 students and 6951 from their parents. The research tool was a questionnaire developed by the Chief Sanitary Inspectorate. These studies were then compared to the nationwide research study from 2011. Questionnaires were obtained from a survey of 3548 students from secondary schools and 4423 of those from high schools. RESULTS: Smoking initiation usually begins at ages 12-15 years. Rates of secondary school student smoking at least once in their lifetime were about the same level in the surveyed years (2009 - 9%, 2011 - 11%), whereas rates of high school student smoking increased (2009 - 15%, 2011 - 24%). Moreover, 34% of secondary school student smoked less than once a week, whereas in 2009, only 8% of students had done so. For high school students, a 1/2 smoked every day; similar to 2009. Students usually smoked in parks, on streets or any other open space areas. CONCLUSIONS: From analyzing the smoking trends over the survey period it can be concluded that the problem of smoking increases with respondent age. Int J Occup Med Environ Health 2017;30(5):763-773.

An impaired metabolism of nucleotides underpins a novel mechanism of cardiac remodeling leading to Huntington's disease related cardiomyopathy.

Huntington's disease (HD) is mainly thought of as a neurological disease, but multiple epidemiological studies have demonstrated a number of cardiovascular events leading to heart failure in HD patients. Our recent studies showed an increased risk of heart contractile dysfunction and dilated cardiomyopathy in HD pre-clinical models. This could potentially involve metabolic remodeling, that is a typical feature of the failing heart, with reduced activities of high energy phosphate generating pathways. In this study, we sought to identify metabolic abnormalities leading to HD-related cardiomyopathy in pre-clinical and clinical settings. We found that HD mouse models developed a profound deterioration in cardiac energy equilibrium, despite AMP-activated protein kinase hyperphosphorylation. This was accompanied by a reduced glucose usage and a significant deregulation of genes involved in de novo purine biosynthesis, in conversion of adenine nucleotides, and in adenosine metabolism. Consequently, we observed increased levels of nucleotide catabolites such as inosine, hypoxanthine, xanthine and uric acid, in murine and human HD serum. These effects may be caused locally by mutant HTT, via gain or loss of function effects, or distally by a lack of trophic signals from central nerve stimulation. Either may lead to energy equilibrium imbalances in cardiac cells, with activation of nucleotide catabolism plus an inhibition of re-synthesis. Our study suggests that future therapies should target cardiac mitochondrial dysfunction to ameliorate energetic dysfunction. Importantly, we describe the first set of biomarkers related to heart and skeletal muscle dysfunction in both pre-clinical and clinical HD settings.

HDAC4 as a potential therapeutic target in neurodegenerative diseases: a summary of recent achievements.

For the past decade protein acetylation has been shown to be a crucial post-transcriptional modification involved in the regulation of protein functions. Histone acetyltransferases (HATs) mediate acetylation of histones which results in the nucleosomal relaxation associated with gene expression. The reverse reaction, histone deacetylation, is mediated by histone deacetylases (HDACs) leading to chromatin condensation followed by transcriptional repression. HDACs are divided into distinct classes: I, IIa, IIb, III, and IV, on the basis of size and sequence homology, as well as formation of distinct repressor complexes. Implications of HDACs in many diseases, such as cancer, heart failure, and neurodegeneration, have identified these molecules as unique and attractive therapeutic targets. The emergence of HDAC4 among the members of class IIa family as a major player in synaptic plasticity raises important questions about its functions in the brain. The characterization of HDAC4 specific substrates and molecular partners in the brain will not only provide a better understanding of HDAC4 biological functions but also might help to develop new therapeutic strategies to target numerous malignancies. In this review we highlight and summarize recent achievements in understanding the biological role of HDAC4 in neurodegenerative processes.

Melatonin and cortisol profiles in patients with pituitary tumors.

The optic tract section at the optic chiasm is expected to disturb the suprachiasmatic nucleus (SCN) rhythm, circadian rhythm and melatonin secretion rhythms in humans, although detailed studies have never been conducted. The aim of this paper was to describe melatonin and cortisol profiles in patients with a pituitary tumor exerting optic chiasm compression. Six patients with pituitary tumors of different size, four of whom had significant optic chiasm compression, were examined. In each brain, MRI, an ophthalmological examination including the vision field and laboratory tests were performed. Melatonin and cortisol concentrations were measured at 22:00 h, 02:00 h, 06:00 h, and 10:00 h in patients lying in a dark, isolated room. One of the four cases with significant optic chiasm compression presented a flattened melatonin rhythm. The melatonin rhythm was also disturbed in one patient without optic chiasm compression. Larger tumors may play a role in the destruction of neurons connecting the retina with the suprachiasmatic nucleus (SCN) and breaking of basic way for inhibiting effect to the SCN from the retina.

Nutrition-related health behaviours and prevalence of overweight and obesity among Polish children and adolescents.

INTRODUCTION: An adequate mode of nutrition is among the most important environmental factors affecting the development of Man and maintenance of a good health status. An improper selection of nutrients and irregular consumption of meals may lead to overweight and obesity. OBJECTIVE: The characteristics of health behaviours of the examined population of schoolchildren, with consideration of nutrition and body weight disorders. A comparison of the opinions of schoolchildren and their parents concerning health behaviours. Development of guidelines for educational programmes carried out in the place of residence of the population of schoolchildren and their parents. MATERIALS AND METHOD: The survey covered a randomised group of schoolchildren attending elementary and secondary schools in the Kalisz Province and province of the city of Kalisz. The study was conducted in May and June 2009, in a randomly selected representative group of 1,100 boys and girls from classes V and VI of elementary schools, and 1,100 secondary school adolescents aged 16-19 and their parents. The studies of schoolchildren attending elementary and secondary schools were compared with the all-Polish studies of junior high school adolescents in the school year 2006-2007. RESULTS: The respondents most often consumed 3-4 meals; however, as many as 26% of junior high school adolescents and 27% of secondary school adolescents admitted that they consume only one meal daily. The schoolchildren show inadequate nutritional habits concerning an insufficient consumption of fruits, vegetables and fish, in favour of high calorific meals and sweet snacks and drinks. Parents improperly assess the body weight of their children and perceive them as slimmer, which is not confirmed by the BMI value for age and gender. CONCLUSIONS: Systematic monitoring and analysis of changes in the health behaviours of adolescents should be a basis for planning health education and promotion programmes. Educational programmes concerning various aspects of health should be implemented in an organized and complementary way, directed not only at schools, but also at entire families and local communities. Knowledge, beliefs, skills and attitudes towards health acquired during the period of adolescence decide about life style in adulthood.

The relationship of purpose in life and hope in shaping happiness among patients with cancer in Poland.

The authors investigated the relationship of purpose of life, and hope in the happiness and life satisfaction of patients with cancer during or following cancer treatment. Fifty cancer patients were interviewed during recovery in two Warsaw medical centers. The primary measures used were Purpose in Life Test, Herth Hope Index, Happiness and Social Well-Being tools by Czapinski, and the Cantril Ladder of Satisfaction with Life, as well as medical and demographic measures. Purpose in life was correlated with measures of happiness, and satisfaction with life. Hope was correlated with current happiness, and four measures of satisfaction with life. Patients who had cancer longer, that is, duration of disease, showed lower scores for purpose in life, and number of friends. The longer the time of cancer treatment, the lower were patients' scores for desire for life. Purpose in life and hope were positively correlated with eleven measures of happiness and satisfaction in life. The cancer variables negatively correlated with loss of friends and six variables of happiness, and satisfaction in life, suggesting the impact that having cancer treatment had on patients' lives. Psychological support in the cancer center was helpful to patients in and out of treatment.

Comparative studies on promotion of health and life style of hospital staff in Sweden and Poland.

INTRODUCTION: Recently, an increase has been observed in the number of patients suffering from diseases which are the consequence of an anti-health life style; therefore it is necessary to undertake proper actions in this area, including those addressed to hospital staff. OBJECTIVES: 1) Comparison of self-reported state of health and life style between hospital staff in Sweden and Poland, and the motivation of these employees to change the to-date life style for one that is more health promoting. 2) Presentation, based on Swedish experiences in the field of health promotion in hospitals, of the possibilities to implement these changes in Polish conditions. MATERIAL AND METHOD: The study covered the staff from the following hospitals: 1) hospitals in Östergötland County, Sweden, and 2) the Ludwik Perzyna Regional Polyclinical Hospital in Kalisz, Poland. The studies were conducted in parallel in Sweden and in Poland during the fourth quarter 2010. The research instrument was a questionnaire form. RESULTS: The following measures should be undertaken by the staff of Polish hospitals: an increase in the consumption of fruit and vegetables, physical activity, organization of workshops aimed at the shaping of skills of coping with stress and relieving stress, assistance in reducing body weight and increasing physical activity. Obligatory breaks at work should be introduced for the consumption of meals and intake of beverages, including water, promotion of fluid replacement would reduce fatigue. An obligatory lunchtime would allow each employee to consume a decent meal, and consequently have respite away from one's own work activities. In order to have a well-functioning staff an employer should, in his/her own interest, decrease potential sick absenteeism, provide incentives for motor activity, e.g. by the organization of groups, reduction of weekly working time on behalf of documented physical activity, or financial support for the purchase of tickets for various forms of physical exercises. Promotion of collective exercise, e.g. common nordic walking for 30 min. during lunch, competition in the largest number of steps made. Promotion of healthy nutrition by the preparation of recipes for meals, several exemplary healthy meals in the form of a healthy alternative breakfast. During this event, a basket of fruit is provided, instead of cakes and sweets. CONCLUSIONS: 1) The life style of the staff of health care facilities is more health promoting in Sweden than in Poland. 2) It is possible to change the life style of employees of health care facilities into one that is more health promoting. Changes in this area have been made in Sweden with a great success; therefore, it is worthwhile implementing in Poland these Swedish experiences which may function also in Polish conditions. 3) The foundations of health promotion in enterprises have been known for a long time; however, considering the fact that the comparative studies show that these foundations are more advanced in Sweden, it is necessary that Polish employers devote more attention to this problem, and become interested in Swedish experiences in this area.

A Becker myotonia patient with compound heterozygosity for CLCN1 mutations and Prinzmetal angina pectoris.

Becker myotonia is a recessive muscle disease with prevalence of > 1:50,000. It is caused by markedly reduced function of the chloride channel encoded by CLCN1. We describe a Polish patient with severe myotonia, transient weakness, and muscle cramps who only responds to lidocaine. In addition, the patient has Prinzmetal angina pectoris and multiple lipomatosis. He is compound heterozygeous for a novel p.W303X and a frequent p.R894X CLCN1 mutation. CLCN1 exon number variation was excluded by MLPA. His son with latent myotonia was heterozygeous for p.R894X. We discuss the potential relations of the three rare diseases and the inheritance of p.R894X.

Nutritional behaviours among pregnant women from rural and urban environments in Poland.

Based on data obtained from the system MoZMaD - PL (Polish Mother and Child Health Monitoring System); an equivalent of the American system PRAMS (Pregnancy Risk Assessment Monitoring System). The health behaviour of a pregnant woman, including adequate nutritional behaviours and supply of all the necessary nutrients, exert an effect on the health of a woman, development of the foetus, and the occurrence of diseases among the offspring at the age of maturity. The objective of the study was analysis of the nutritional behaviours among Polish pregnant women, with particular consideration of the recognition of dietary changes caused by the fact of becoming pregnant. The studies were based on questionnaire forms within the Polish Mother and Child Heath Monitoring System (MoZMaD - PL) implemented in Poland. The precise day of studies is appointed annually for the whole of Poland by the Chief Sanitary Inspector. The questionnaire forms were correctly completed in 2010 by 2,877 women. The replies to the questions were introduced by surveyors into the MoZMaD - PL system, a central database managed by the Institute of Agricultural Medicine. The results obtained were subjected to statistical analysis. More than a half of Polish women change their diet in pregnancy. According to the pregnant women examined, the changes in their diet consist in a more frequent consumption of white meat, fish, fruits and vegetables, as well as milk and dairy products. Favourable changes in diet were observed primarily among the respondents from the urban environment. Considering an insufficient awareness with respect to nutritional behaviours among females at reproductive age, the education of pregnant women and those who plan a pregnancy concerning an adequate diet should be jointly conducted by medical circles, schools, and the media, and directed primarily to women from the rural environment.

Prevention of female reproductive system cancer among rural and urban Polish pregnant women.

Based on data obtained from the system MoZMaD - PL (Polish Mother and Child Health Monitoring System; an equivalent of the American system PRAMS (Pregnancy Risk Assessment Monitoring System). In the developed countries prevention programmes proved to be efficient in reducing morbidity and mortality due to breast and cervical cancer. In Poland, these diseases still constitute a very big problem, despite relatively easy and early diagnostics of pathological conditions preceding their development. The objective of the study was analysis of the usage of prophylactic examinations and the assessment of knowledge concerning risk factors of the development of reproductive cancers among pregnant women from rural and urban environments in Poland. The study was based on questionnaire forms within the Pregnancy Risk Assessment Monitoring System (MoZMaD - PL) implemented in Poland. The precise date of the study for the whole of Poland is announced annually by the Chief Sanitary Inspector. The questionnaire forms were correctly completed in 2010 by 2,877 women. The replies to the questions were introduced by surveyors into the MoZMaD - PL system central database managed by the Institute of Agricultural Medicine in Lublin. The results obtained were subjected to statistical analysis. The studies of pregnant women in Poland showed that the situation with respect to the performance of prevention examinations for cervical cancer was significantly worse among rural than urban women. Pregnant women from both rural and urban areas very rarely had breast USG performed. Awareness concerning cervical cancer risk factors was lower among rural than urban women. Also, knowledge concerning the examinations which should be performed for the prevention of breast cancer was poorer among rural, compared to urban women. The recognition of the attitudes of women at reproductive age towards prevention examinations is necessary in order to effectively plan health education and social health promotion campaigns aimed at limiting morbidity and mortality due to cancerous diseases.

Acute collective gas poisoning at work in a manure storage tank.

Cases of deaths in manure or septic tanks are rare in legal-medical practice, more frequently as unfortunate occupational accidents. Poisoning with toxic gases, especially with hydrogen sulfide, is reported as the cause of death, while the exhaustion of oxygen in the air is omitted with the simultaneous excess of carbon dioxide. In such cases, determination of the direct cause of death constitutes a big problem because post-mortem examination does not reveal the specific changes. A case of acute collective poisoning by gases in a manure storage tank is presented of 5 agricultural workers, 2 of whom died. While explaining the cause of poisoning and deaths, toxicological blood tests were performed in the victims of the accident, as well as gases inside the manure storage tank. The post-mortem examinations and toxicological blood tests performed did not allow determination of the direct cause of death. Toxicological tests of gases from inside the manure tank showed a very low concentration of oxygen, with a simultaneous very high concentration of carbon dioxide, and a considerable level of hydrogen sulfide. The cause of fainting of three and deaths of two workers was not the poisoning with hydrogen sulfide, but oxygen deficiency in the air of the tank.

Breast cancer survival gap between urban and rural female population in Podlaskie Voivodship, Poland, in 2001­2002. Population study.

The aim of the study was to evaluate differences in breast cancer 5-year relative survival rates between the urban and rural female population in Podlaskie Voivodship in 2001-2002, before the introduction of the Population Screening Programme in 2006. The analysis was based on 659 breast cancer cases diagnosed in 2001-2002 and registered in CR in Bialystok (Voivodship Cancer Registry). Relative survival and relative excess of risk of death after 5 years of diagnosis as function of age and stage among urban and rural women population were calculated. The results showed that survival rates in Podlaskie Voivodship were low (69.4%) in comparison to the European average (79.4%), and they differed between urban and rural areas. Patients living in rural areas had a much lower survival rate than those living in urban areas at local and regional stage of disease, whereas survivals were higher at the metastatic stage. In all age groups considered in the study, the survivals in rural areas were lower than in urban areas. The multivariate analysis confirmed that both the cancer stage and place of residence are independent prognostic factors. Relationship with age was not confirmed. The research results indicate low curability of breast cancer in Podlaskie Voivodship, and significant differences between urban and rural areas. These results need to be considered in the planning and monitoring of further intervention in order to increase the effectiveness of prevention and treatment standards for more disadvantaged rural areas. It is particularly significant when implementing the National Cancer Control Programme.