The Assessment of the Efficacy of Imperatorin in Reducing Overactive Bladder Symptoms.

Overactive bladder syndrome (OAB) is a prevalent condition that affects the elderly population in particular and significantly impairs quality of life. Imperatorin, a naturally occurring furocoumarin, possesses diverse pharmacological properties that warrant consideration for drug development. The aim of this study was to investigate the potential of imperatorin (IMP) to attenuate the cystometric and biochemical changes typically associated with retinyl acetate-induced overactive bladder (OAB) and to assess its viability as a pharmacological intervention for OAB patients. A total of 60 rats were divided into four groups: I-control, II-rats with rapamycin (RA)-induced OAB, III-rats administered IMP at a dose of 10 mg/kg/day, and IV-rats with RA-induced OAB treated with IMP. IMP or vehicle were injected intraperitoneally for 14 days. The cystometry and assessment of bladder blood flow were performed two days after the last dose of IMP. The rats were then placed in metabolic cages for 24 h. Urothelial thickness measurements and biochemical analyses were performed. Intravesical infusion of RA induced OAB. Notably, intraperitoneal administration of imperatorin had no discernible effect on urinary bladder function and micturition cycles in normal rats. IMP attenuated the severity of RA-induced OAB. RA induced increases in urothelial ATP, calcitonin gene-related peptide (CGRP), organic cation transporter 3 (OCT3), and vesicular acetylcholine transporter (VAChT), as well as significant c-Fos expression in all micturition areas analyzed, which were attenuated by IMP. Furthermore, elevated levels of Rho kinase (ROCK1) and VAChT were observed in the detrusor, which were reversed by IMP in the context of RA-induced OAB in the urothelium, detrusor muscle, and urine. Imperatorin has a mitigating effect on detrusor overactivity. The mechanisms of action of IMP in the bladder appear to be diverse and complex. These findings suggest that IMP may provide protection against RA-induced OAB and could potentially develop into an innovative therapeutic strategy for the treatment of OAB.

Assessment of Quality of Life in Men Treated for Infertility in Poland.

The aim of this study was to assess the quality of life (QoL) of men treated for infertility in Poland. This cross-sectional study was conducted using the Abbreviated World Health Organization Quality of Life questionnaire (WHOQoL-BREF), Fertility Quality of Life tool (FertiQoL) and an author-constructed questionnaire. The study included 1200 men treated for infertility without the use of assisted reproductive technology (non-ART), intrauterine insemination (IUI) and in vitro fertilization (IVF). The control group consisted of 100 healthy men with confirmed fertility. The quality of life assessed by the WHOQoL-BREF questionnaire was significantly lower in study groups in the Environmental domain, compared to the control group (p = 0.009). Statistically significant differences were found in the case of FertiQoL subscales: Emotional, Mind-Body, Relational, and Treatment Environment, depending on applied treatment. Men whose partners were treated without the use of ART assessed their QoL significantly more negatively than those treated with IUI. Reproductive problems and type of their treatment influenced the quality of life of the affected men. Non-ART treatment, rural place of residence, and increased BMI were associated with lower QoL.

Assessment of the effect of estradiol on biochemical bone turnover markers among postmenopausal women.

INTRODUCTION: Estrogen deficiency found in postmenopausal women may lead to disturbances in the balance of bone metabolism. Study of the influence of estradiol on markers of bone turnover may help to understand the mechanisms of bone metabolism and to monitor osteoporosis therapy in postmenopausal women at high risk of fractures. The aim of the study was evaluation of the effect of estradiol on the basic markers of bone turnover in postmenopausal women. MATERIAL AND METHODS: The study was conducted in a group of 92 postmenopausal women, divided into two groups: Gr-1 with low estradiol levels ≤ 10 pg/ml and Gr-2 with reference estradiol levels ≥ 25 pg/ml). Basic markers of bone turnover were examined: Ctx (C-terminal cross-linked telopeptide of type I collagen alpha chain) and OC (osteocalcin); pro-resorptive cytokines: IL-6 and TNF-α; vitamin 25(OH)D3 and lipid profile. Women was also analyzed according to demographic and clinical data. RESULTS: A positive relationship was found between estradiol and the main bone formation marker - OC (p = 0.041, r = 0.213) and IL-6, TNF-α (p = 0.007, r = 0.281 and p = 0.018, r = 0.246, respectivly, but only in the group with a reference hormone level. Moreover, the main markers of bone turnover: Ctx and OC showed a mutual positive correlation (p = 0.013; r = 0.257) in women with reference estradiol levels. Relationships between markers of bone remodeling, pro-resorptive cytokines and vitamin D3 depending on the level of estradiol showed no statistically significant correlation. CONCLUSIONS: The study showed that only in women with the reference estradiol level (≥ 25 pg/ml) were the bone formation and resorption processes balanced.

Self-government HPV vaccination programmes in Poland, 2009-2016.

INTRODUCTION: Cervical cancer is the fourth neoplasm in women with respect to incidence. In Poland, both cervical cancer incidence and corresponding mortality are gradually decreasing. Despite these improvements, the epidemiological situation significantly deviates from European standards. Poland has one of Europe's lowest five-year survival rates at 54.1% for patients diagnosed in 2000-2002, compared to the European mean value of 62.1%. OBJECTIVE: The aim of this study is to present health policy programmes related to HPV vaccinations run by local self-government units in 2009-2016. MATERIAL AND METHODS: The research is based on analysis of already existing data developed by provincial governors and annual information reviews on health-policy programmes implemented by local self-government units presented to the Ministry of Health. All the programmes that included HPV vaccinations have been subjected to analysis. RESULTS: In 2009-2016, local government units implemented a total of 1,204 health policy programmes that covered HPV vaccinations. Under these programmes, 2.05% of girls aged 10-14 were vaccinated. Percentage-wise, these were communes that contributed the most financially to the HPV vaccination programmes, whereas the counties the least. CONCLUSIONS: Local self-government's programmes covering HPV vaccinations conform with the trends outlined in strategic documents on fighting neoplastic diseases. It is possible that the availability of HPV vaccination was limited for girls living in rural communes. Differences in the number of programmes, number of vaccinated girls and the financial outlays allocated for the implementation of HPV vaccination programmes in particular provinces, may be determined by the epidemiological situation in a given region, measured by the incidence rate of cervical cancer.

Self-assessment of Polish pharmacy staff's readiness to promote health.

Background Nowadays, pharmacists are expected to focus not only on dispensing medicines but also on the wellness of the patient. In some developed countries a pharmacist is clearly defined as a health care professional that can make a contribution to improving the general health of the population. Objective To assess the readiness of Polish pharmacy staff to engage in health promotion and educational activities. Setting Community pharmacies in Poland. Method The study group consisted of 308 pharmacy staff (248 pharmacists and 60 pharmacy technicians) employed in Polish pharmacies. The survey questionnaire referred to three domains: systemic solutions for health promotion, readiness of pharmacy staff as a professional group to promote health, personal readiness to promote health. Responses about pharmacy staff's readiness to promote health were scored using a 10-point scale. Scale reliability for all items (overall readiness), and for items within the three domains separately, were tested using Cronbach's α and average inter-correlation coefficient among the items. Main outcome measure Pharmacy staff's readiness to promote health (the questionnaire containing 32 items). Results The overall readiness of pharmacy staff to promote health was rather low (average of 4.6 ± 1.5 in 1-10 scale). The highest scores were obtained for pharmacy staff's personal readiness to promote health (average of 5.5 ± 1.8) which was neutral on the scale. The lowest scores were obtained for systemic solutions for health promotion (average of 3.6 ± 1.4). Readiness of pharmacy staff as a professional group was ranked in the middle (average 4.8 ± 1.8). Surveyed pharmacy staff rated their readiness to promote health in the work environment significantly higher than promoting health in the local community. Female and younger pharmacy staff as well as those with job seniority of less than 5 years, or pharmacy technicians assessed their readiness to promote health significantly higher than others. Readiness to promote health was higher among pharmacy staff working in pharmacies employing up to 3 staff members and at pharmacies with over 200 customers daily. Conclusions The overall readiness of pharmacy staff to promote health was low, especially in the domain of systemic solutions in health promotion.

Effect of symptoms of climacteric syndrome, depression and insomnia on self-rated work ability in peri- and post-menopausal women in non-manual employment.

OBJECTIVE: The aim of the study was evaluation of the relationship between severity of symptoms of climacteric syndrome, depressive disorders and sleep problems, and the self-rated work ability of peri-menopausal and post-menopausal women in non-manual employment. MATERIAL AND METHODS: The study included 287 women aged 45-60 years, employed in various institutions as non-manual workers. Work Ability Index, Greene Climacteric Scale, Beck Depression Inventory, and Athens Insomnia Scale were used. RESULTS: The examined peri-menopausal and post-menopausal women in non-manual employment obtained good work ability on the Work Ability Index. The severity of menopausal syndrome, according to the Greene Climacteric Scale, was moderate, placing the examined women between results for the general population of women and the pattern for menopausal women. Depressive disorders ranked between low mood and moderate depression. No depression was observed in 59% of the women, whereas moderate depression was observed in 39%, and severe depression in only 2%. Sleep disorders were on the border of normal range. As many as 46% of the women had no sleep problems, which was on the border of normal range in 36%. Only 19% of the examined women suffered from insomnia. Work ability correlated negatively with depression and insomnia severity, as well as with psychological and vasomotor symptoms of climacteric syndrome, but not to its somatic symptoms. CONCLUSIONS: Preventing the occurrence and treatment of menopausal symptoms, sleep and mood disorders may contribute to maintaining the work ability of women in peri- and post-menopausal age.

Changes in interregional migration of patients hospitalized in Poland - 2013-2017.

OBJECTIVES: The aim of the study is to determine the scale of interregional migrating patients' hospitalizations in Poland in 2013-2017, as well as their demographic and medical factors, total costs and time changes. MATERIAL AND METHODS: Data from the NHF (National Health Fund) regarding hospitalizations in a given province of patients registered in another province in Poland in 2013-2017 were statistically analyzed. Times series analyses as well as coefficients of correlation, determination and variation were used. RESULTS: The number of patients hospitalized outside their regional registration and the cost of their hospitalization increased from year-to-year during 2013-2017. There was a large variation in provinces in terms of inflow of patients and costs of their hospitalization, while there was only a small variation in terms of outflow of patients and costs of their hospitalization in the analyzed years. Among the patients hospitalized outside the province where they were registered, there were more women then men, while the age group was dominated by 60-year-olds and their share in the subsequent years increased, while the share of other age groups remained unchanged or decreased. The most and increasingly more from year-to-year hospitalizations outside the regional registration were due to neoplasms and diseases of the circulatory system. CONCLUSIONS: The results of the study may significantly contribute to the proper planning of securing the health needs of the inhabitants of particular regions, and to improving the quality and economic efficiency of health services in individual NHF branches.

Influence of socio-economic factors on emotional changes during the postnatal period.

OBJECTIVES: The aim of the study was to identify socio-economic factors that may influence the emotional changes which occur among new mothers in the first days postpartum. MATERIAL AND METHODS: A group of 541 women completed a questionnaire consisting of 30 multiple-choice questions, Edinburgh Postnatal Depression Scale (EPDS), and Hospital Anxiety and Depression Scale (HADS). Statistical calculations were performed with the use of Statistica v.10 and Cytel Studio v. 9.0.0. RESULTS: The findings revealed the presence of factors which might increase the risk of mood disorders during the postpartum period. CONCLUSIONS: Women who demonstrate warning symptoms should be screened for postnatal emotional changes and mood swings during their hospitalization after delivery. EPDS seems to be a suitable tool for early detection of emotional disturbances.

Social costs of loss in productivity-related absenteeism in Poland.

OBJECTIVES: The aim of this study was to estimate indirect costs associated with losses in productivity due to sickness absence among registered workers in Poland. MATERIAL AND METHODS: Data on sick leave durations in 2013 was obtained from the Social Insurance Institution (SII) (Zaklad Ubezpieczen Spolecznych - ZUS). Based on the number of assumptions, this data was used for calculating absence durations. The costs of lost productivity were estimated on the basis of the measure of gross value added. RESULTS: Estimated losses in productivity due to absenteeism in 2013 together accounted for 4.33% of gross domestic product (GDP) (17.09 billion euro). In the female population, the total value of losses amounted to 9.66 billion euro, but excluding the costs of pregnancy, childbirth, and puerperium (2.96 billion euro), it was 6.7 billion euro. In the male population, the loss amounted to 7.43 billion euro. The highest overall costs of sickness absence based on age were found in the age group of 30-39 years (5.14 billion euro, including pregnancy, childbirth, and puerperium - 1.474 billion euro; respiratory diseases - 0.632 billion euro, injuries and poisonings - 0.62 billion euro). In the group of people aged > 40 years, the highest cost was generated by bone-muscular diseases (1.553 billion euro) and injuries and poisoning (1.251 billion euro). Higher losses in the productivity of women in addition to pregnancy, childbirth, and puerperium were due to mental and behavioral disorders (0.71 billion euro), diseases of the genitourinary system (0.38 billion euro), and neoplasms (0.35 billion euro). At the same time, in men, compared to women, we observed higher losses due to injuries and poisoning (1.65 billion euro), and diseases of musculoskeletal (1.26 billion euro), nervous (0.79 billion euro), circulatory (0.65 billion euro), and digestive (0.41 billion euro) systems. CONCLUSIONS: Improvement and further development of effective strategies for prevention of complications of pregnancy and chronic diseases in the workplace are necessary. Policies aimed at reduction of sickness absence could potentially increase prosperity and the socioeconomic situation in Poland. Int J Occup Med Environ Health 2017;30(6):917-932.

Telemedical assessment of the level of energy expenditure in overweight and obese individuals.

INTRODUCTION: Increasing the energy expenditure above the elementary level of metabolism by undertaking regular physical activity causes body mass reduction and its maintenance at a healthy level. AIM: To remote assessment of the level of physical activity in a group of overweight and obese individuals. MATERIAL AND METHODS: The research was conducted in the Department of Rehabilitation at the Institute of Rural Health, Lublin, Poland, and included a group of 514 volunteers of both genders (38 ±12 years). The examined group was divided into three subgroups depending on the body mass index (BMI) level (I - normal, II - overweight, III - obese). The level of physical activity at home was assessed based of the short version of the International Physical Activity Questionnaire (IPAQ), conducted by means of a mobile application, and was compared with data registered by the accelerometer of a smartphone. RESULTS: The IPAQ-assessed level of the physical activity expressed in MET-min/week amounted to the following values: group I: 5190.38 ±6629.84, group II: 5099.53 ±6380.97, group III: 3939.31 ±4000.73; and the caloric cost (cal × week-1) amounted to: group I: 5825.47 ±7512.99, group II: 7204.09 ±9187.96), and group III: 7002.10 ±7296.22. Registered levels of physical activity (MET-min/week) were lower than IPAQ-assessed: in group I (3741.24 ±3958.29), in group II (2447.72 ±2156.44) and in group III (1927.42 ±1790.85) (p < 0.05). CONCLUSIONS: The average values of energy expenditure showed a declining tendency, together with an increase in the BMI. On the other hand, the total weekly caloric cost showed the lowest average values in the group with normal body mass.

Intensification of menopausal symptoms among female inhabitants of East European countries.

The objective of the study was analysis of the occurrence and intensity of menopausal symptoms in postmenopausal women from Poland, Belarus, Ukraine, Czech Republic, Slovakia and Poland. The study was conducted during the period 2014-2015 among postmenopausal women living in the areas of Poland, Belarus, Ukraine, Czech Republic and Slovakia. The degree of menopausal complaints was assessed using the Kupperman Menopausal Index and Greene Climacteric Scale. The respondents were additionally asked about age, educational level, place of residence, marital status and age at last menstrual period. Into the study were enrolled women aged 50-65, minimum 2 years after the last menstrual period, who had a generally good state of health and did not use hormone replacement therapy. The results were subjected to statistical analysis. The intensity of all menopausal symptoms measured by the Kupperman Menopausal Index and Greene Climacteric Scale was similar in Poland, Czech Republic and Slovakia. In these countries, severe, moderate and mild menopausal symptoms measured by Kupperman Menopausal Index occurred with a similar frequency. Similar results were also obtained in the subscales of psychological, somatic and vasomotor symptoms according to the Greene Climacteric Scale. Nearly a half of the women from Belarus did not report symptoms measured by Kupperman Menopausal Index. They obtained significantly lower menopausal complaints in the subscales of psychological and somatic symptoms according to the Greene Climacteric Scale, compared to the inhabitants of the remaining countries. The majority of women from the Ukraine had mild menopausal symptoms as measured by the Kupperman Menopausal Index. They had significantly more severe complaints in the subscales of psychological, somatic and vasomotor symptoms according to the Greene Climacteric Scale, compared to the inhabitants of the remaining countries in the study. The intensity of menopausal symptoms in women from Ukraine and Belarus was related with educational level, place of residence, and marital status, whereas in women from Poland, Czech Republic and Slovakia, only with marital status.

Dietary habits among persons hired on shift work.

INTRODUCTION: Shift-work determinates irregular nutrition habits. The quality as well as the quantity of meals consumed by shift-workers can significantly affects their health. OBJECTIVE: The aim of this study was to evaluate the dietary habits of people performing shift work in the Bogdanka mine. MATERIAL AND METHODS: The study was carried out in the Bogdanka mine in Leczna. The questionnaire, which was designed by the author of this dissertation, was conducted among 700 shift-workers, working underground. The results were subjected to statistical analysis based on STATISTICA v. 7.1 (StatSoft, Poland) software. RESULTS: Nearly half of respondents reported regular consumption of meals (40.0%) Interviewees admitted having warm meals during the day (81.4%). The most frequently consumed meal during the day was the hot one (50.9%), three meals and more were consumed the least frequently (8.1%). Almost half of respondents considered their eating habits as inappropriate (46.3%). Among those, nearly half (68.2%) stated that shift - work is the reason for their nutrition habits. More than half of respondents (66.0%) admitted that shift work hampers regular consumption of meals. CONCLUSIONS: Shift work makes nourishment and regular consumption difficult. It contributes to the limited amount of warm meals eaten during the day. In order to maintain preventive health care and the improvement of quality of life, shift workers should be provided with an easier access to meals (including warm one) at specified times of the day.

An assessment of health effects of a cardiological prophylaxis programme in a local community with the use of the SCORE algorithm.

INTRODUCTION: In 2009, the SDR due to cardiovascular diseases was 356.3 per 100,000 people in Poland. The Prophylaxis and Early Detection of Cardiovascular Diseases Programme (PEDCCP) aimed at decreasing mortality caused by cardiovascular diseases (CVD) in Poland by 25%. The global risk of SCORE (European Systematic Coronary Risk Evaluation) has become a reason for implementing pro-health recommendations in order to eliminate risk factors in CVD. METHODS: The presented observation study encompassed 458 participants of the PEDCCP from 2009-2011. The subjects received two arterial blood pressure tests as well as anthropometric measurements. Also, TC, LDL, HDL and TG levels were measured in laboratory tests. Statistical analysis included elements of descriptive and analytical statistics, with bivariate and multivariate logistic regression (odds ratios with 95% CIs). RESULTS: A positive change in SCORE was observed in 13.3% of the subjects. It was higher in almost every third subject of the authors' own study (29.5%). Mostly gender and age contributed to the change in SCORE, but regular glucose levels and no tendency to compete were also relevant. CONCLUSIONS: There is a need to continue such prophylaxis programmes in primary health care to better estimate the risk of mortality due to CVD in local communities.

The factor harmful to the quality of human life--shift-work.

UNLABELLED: The system of human activity, which is established by genetics and regulated by outer and inner factors, is associated with many characteristics which maintain the body in the best condition and ensure appropriate life quality. OBJECTIVE: To evaluate of life quality among male shift-workers. METHODS: Research based on a self-devised questionnaire, conducted among 700 shift-workers, followed by statistical analysis of the results. RESULTS: Nearly a half of respondents (43.00%) reported that shift-work influences the quality of their family life. Remarkably, such an opinion was often stated by people with children (46.01%) p<0.05, the divorced (58.22%), married people (44.74%) and bachelors (25.33%), respectively. Fathers usually indicated lack of contact with their family as well as irregular consumption of meals (66.91%). Almost every third respondent noted that their shift type of work negatively influence their sexual life (31.14%). CONCLUSIONS: It was shown that shift-work negatively influences the respondents' life quality in the form of deterioration of the quality of family life; the respondents, regardless of marital status, age and having children, most often complained about the lack of contact with the family and irregular eating with them; negative influence on sexual life, which was the case in one-third of respondents. In order to encourage healthy behaviour and increase the quality of life of people performing shift-work, training and programmes should be introduced. These would help shift- workers to adjust their work time to their family and social life.

Engagement in risky behaviours by 15-19-year-olds from Polish urban and rural areas.

INTRODUCTION: Anti-health behaviours pose a threat to the health status of the adolescent population in Poland. Among other things, the use and abuse of tobacco, alcohol and psychoactive substances are very dangerous as they may give rise to further health inequalities in young people. The aim of the research was to compare scopes of anti-health behaviours of adolescents in rural and urban areas in Poland. MATERIAL AND METHODS: The study consisted of 1,580 adolescents (aged 15-19 years) ­ 596 from urban areas and 984 from rural areas of the Zachodniopomorskie Province in Poland. RESULTS: 25.61% of 15-19-year-old city dwellers and 30.57% of their rural peers are active tobacco smokers. The smoking habit is more popular among female adolescents than among their male peers. 4.64% of rural 15-19-year-olds, and 4.52% of their city peers, are addicted to narcotics, 11.16% of the surveyed rural adolescents and 6.7% of their peers living in urban areas are addicted to alcohol. More than 50% of adolescents drink alcohol occasionally. CONCLUSIONS: A significant number of young people in both rural and urban areas are engaged in risky health behaviours. The frequency of such behaviours depends on the age, gender and place of residence. These disproportions may contribute to future health inequalities in rural and urban areas.

The origin of stress, its causes, symptoms and frequency of appearance among the students of Medical University of Lublin.

Students in some determined situations, for example before an examination in a new environment are exposed to many somatic and psychic reactions. Stress can be determined (or shown) as a syndrome of somatic and psychic changes which can be the consequences of difficult situations to overcome. Some symptoms of stress are: tachycardia, excessive perspiration, dyspeptic symptoms, sleep and menstruation disorders. Different types of reactions and their frequency due to stress among the students of Medical University of Lublin were examined by means of a questionnaire.

[Patients' satisfaction with primary health care services]. / Satysfakcja pacjentów z uslug medycznych swiadczonych w podstawowej opiece zdrowotnej.

Thanks to the system transformations in Poland, the offered health services have changed as well as the attitude toward the patient. Market rules today referring to medicine as a product make patients simply clients. Nowadays institutions must improve their standard to survive on the market. The best way for them to estimate the standard of their services is patient's satisfaction understood as meeting one's need in relation to one's expectations. Answers for both open and closed questions included in anonymous questionnaires were analyzed. The questions were formulated so that that we could estimate correctness of procedures connected with the functioning of primary outpatient clinic. The aim of the study was to analyze primary outpatient clinic patients' satisfaction with the health services. Patients' answers show that they are satisfied with the GP's health services and with services not connected directly with treatment. According to patients' opinions, the analyzed primary clinics are worth recommendation.