Intervention for improvement the diet and physical activity of children and adolescents in Poland.

BACKGROUND: The effects of a two-year educational Programme "Keep Balance" addressed to children and adolescents have been evaluated. Its purpose has been to implement the rules of proper nutrition and increasing the level of physical activity on the population level. OBJECTIVE: The main objective of the evaluation was an indication if, after two years of programme activities, outcome indicators have been achieved. MATERIAL AND METHODS: Approximately 400,000 pupils/students from 1600 educational units from the territory of the whole country have been included in the education programme. The efficiency evaluation has been carried out in a sample of n = 1506 pupils/students in the interventional group and n = 1589 in the control group. Education has been addressed to the entire school environment, pupils, students, parents, teachers, headmasters, and the local community. The survey methodology, body weight and height measurements, the BMI index, and EUROFIT physical fitness tests have been used to assess the effects of the education programme in the scope of knowledge and nutritional behaviour regarding physical activity. There were assumed outcome indicators. The certification of schools/kindergartens with "The Certificate of a School/Kindergarten Friendly to Nutrition and Physical Activity" has been used to evaluate the activation of school environments. RESULTS: There was an improvement achieved over the assumed target points in the level of knowledge of pupils/students in the scope of nutrition and the role of physical activity, in the changes of nutritional habits, and in the results of physical fitness tests. There were achieved 20% increase in knowledge in the scope of nutrition and 5% increase in physical activity. There have been changes in the frequency in the consumption of the first breakfast before going to school (by 25% among the younger ones and by 17% among the older ones), an increase in the consumption of bottled water by 49% and reduction of sweet drinks by 19%. The percentage of the pupils/students consuming the recommended 5 meals increased by 33%. Physical fitness indicators were achieved over assumed 5% increase in the individual exercise tests. The Certificate was obtained after meeting the criteria and documenting the durability of the changes by 65% of 1600 educational units included in the Programme. A decrease in the frequency of overweight and obesity occurrence in the whole intervention sample by 1% was obtained; it was greater (but statistically insignificant) among younger students by 3.3% in comparison to the older ones where there was an increase of 1%. CONCLUSIONS: Summing up all achieved results the educational programme "Keep Balance" implemented on the population level aimed at children and adolescents has turned out to be effective and deserves to be continued after minor adjustments. Many positive changes have been identified as well as those that ought to be improved. Comprehensively included education and sometimes small changes in much of nutritional and physical behaviour have influenced the reduction of the percentage of pupils/students with excessive body weight, despite the fact that the average BMI has basically remained on the same level.

Higher vegetable protein consumption, assessed by an isoenergetic macronutrient exchange model, is associated with a lower presence of overweight and obesity in the web-based Food4me European study.

The objective was to evaluate differences in macronutrient intake and to investigate the possible association between consumption of vegetable protein and the risk of overweight/obesity, within the Food4Me randomised, online intervention. Differences in macronutrient consumption among the participating countries grouped by EU Regions (Western Europe, British Isles, Eastern Europe and Southern Europe) were assessed. Relation of protein intake, within isoenergetic exchange patterns, from vegetable or animal sources with risk of overweight/obesity was assessed through the multivariate nutrient density model and a multivariate-adjusted logistic regression. A total of 2413 subjects who completed the Food4Me screening were included, with self-reported data on age, weight, height, physical activity and dietary intake. As success rates on reducing overweight/obesity are very low, form a public health perspective, the elaboration of policies for increasing intakes of vegetable protein and reducing animal protein and sugars, may be a method of combating overweight/obesity at a population level.

Associations of vitamin D status with dietary intakes and physical activity levels among adults from seven European countries: the Food4Me study.

PURPOSE: To report the vitamin D status in adults from seven European countries and to identify behavioural correlates. METHODS: In total, 1075 eligible adult men and women from Ireland, Netherlands, Spain, Greece, UK, Poland and Germany, were included in the study. RESULTS: Vitamin D deficiency and insufficiency, defined as 25-hydroxy vitamin D3 (25-OHD3) concentration of <30 and 30-49.9 nmol/L, respectively, were observed in 3.3 and 30.6% of the participants. The highest prevalence of vitamin D deficiency was found in the UK and the lowest in the Netherlands (8.2 vs. 1.1%, P < 0.05). In addition, the prevalence of vitamin D insufficiency was higher in females compared with males (36.6 vs. 22.6%, P < 0.001), in winter compared with summer months (39.3 vs. 25.0%, P < 0.05) and in younger compared with older participants (36.0 vs. 24.4%, P < 0.05). Positive dose-response associations were also observed between 25-OHD3 concentrations and dietary vitamin D intake from foods and supplements, as well as with physical activity (PA) levels. Vitamin D intakes of ≥5 µg/day from foods and ≥5 µg/day from supplements, as well as engagement in ≥30 min/day of moderate- and vigorous-intensity PA were associated with higher odds (P < 0.05) for maintaining sufficient (≥50 nmol/L) 25-OHD3 concentrations. CONCLUSIONS: The prevalence of vitamin D deficiency varied considerably among European adults. Dietary intakes of ≥10 µg/day of vitamin D from foods and/or supplements and at least 30 min/day of moderate- and vigorous-intensity PA were the minimum thresholds associated with vitamin D sufficiency.

Dietary intake of DHA during pregnancy: a significant gap between the actual intake and current nutritional recommendations

Background: Docosahexaenoic acid (DHA) is indispensable to ensure proper development of the fetal central nervous system and pregnancy duration. Daily intake of DHA should be at least 100 mg higher as compared to the pre-pregnancy values. Objectives: The aim of the study was to evaluate DHA intake during pregnancy and compare it to the current recommendations. Material and methods: A total of 100 pregnant women presenting for labor at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw, were included in the study. DHA intake from the following sources: fish and eggs, and DHA preparations collected based on the questionnaire was investigated. Results: Low dietary DHA intake (median: 60 mg/day) was observed. The values were only slightly higher (median: 90 mg/day) after DHA preparations were taken into consideration because only 28% of the pregnant women used DHA preparations. Overall, 92% of the subjects consumed <200 mg of DHA a day, which was the result of insufficient fish consumption (mean: 15 g/day). Only 10% of the respondents ate fish twice a week, in which case the DHA dietary intake was statistically significantly higher (median: 160 mg/day) (p=0.0232). Total median dietary DHA and EPA intake in the study population was 79 mg/day. Conclusions: The diet of pregnant women is largely deficient as far as DHA intake is concerned. Importantly, it is not possible to comply with current recommendations without dietary supplementation.

Capturing health and eating status through a nutritional perception screening questionnaire (NPSQ9) in a randomised internet-based personalised nutrition intervention: the Food4Me study.

BACKGROUND: National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and evaluate a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. METHODS: Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n = 2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n = 1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. RESULTS: A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (ß = -0.181, p < 0.001) and waist circumference (Β = -0.155, p < 0.001), and positively associated with total carotenoids (ß = 0.198, p < 0.001), omega-3 fatty acid index (ß = 0.155, p < 0.001), Healthy Eating Index (HEI) (ß = 0.299, p < 0.001) and Mediterranean Diet Score (MDS) (ß = 0. 279, p < 0.001). Findings from the longitudinal intervention study showed a greater reduction in BMI and improved dietary indices among participants with lower NPSQ9 scores. CONCLUSIONS: Healthy eating perceptions and dietary habits captured by the NPSQ9 score, based on nine questionnaire items, were associated with reduced body weight and improved diet quality. Likewise, participants with a lower score achieved greater health improvements than those with higher scores, in response to personalised advice, suggesting that NPSQ9 may be used for early evaluation of nutritional status and to tailor nutritional advice. TRIAL REGISTRATION: NCT01530139 .

Evaluation of dairy products available on the Polish market in the context of nutrient profiles. Clear arguments for reformulation of foodstuffs

Background: Dairy products, which are one of the main groups of products in the diet, are expected to have high nutritional value. The development of food technology often involves changing the nutritional parameters of foodstuffs. Objective: The aim of this study was to determine the nutritional value of dairy products, in the context of nutrient profiles. Material and Methods: The tested products included yoghurts, yoghurt drinks, kefir, cream cheeses and milk desserts available on the Polish market, basing on the information from unit product packaging. Results: The average sugar content in the group of all products was 11 g/100 g. Milk desserts contained the largest amount of sugar (average 14.7 g/100g), whereas kefir ­ the smallest amount (average 6 g/100 g) (p <0.0001). Yoghurts and yoghurt drinks intended for children had higher sugar content than products for the general population (14.4 g vs. 10.5 g/100 g) (p <0.0001). As many as 75% of products were sweetened. Taking into account the natural content of lactose, the estimated amount of added sugar ranged from 6.9 - 12.3 g/100 g. The average fat content in the group of all products amounted to 3.8 g/100 g. In the view of WHO profiles, 71% of products exceeded the permissible sugar content (≤ 10 g/100 g) and 36% exceeded the permissible content of saturated fatty acids (≤ 2 g/100 g). Using more liberal profiles developed by the food industry, the proportion of such products was smaller, but still quite high (34% in case of sugar and 26% in case of saturated fatty acids). In terms of the sugar content, according to regulation introduced in Poland, only 29% of the analyzed dairy products could be offer for children at schools. Among them there are all natural (not sweetened) yoghurts and kefir and only 6% of other sweetened products. Conclusions: There is a justified need for the reformulation of dairy products, especially in terms of added sugar.

Caffeine intake from carbonated beverages among primary school-age children.

AIM: The aim of the study was to assess caffeine intake from cola beverages and energy drinks, as well as the consumption frequency among primary-school-age children in relation to other dietary habits. MATERIAL AND METHODS: The study included 329 children (aged 11-13 years) from five randomly selected schools in Warsaw. Caffeine intake was assessed from a food frequency questionnaire. The face-to-face interview method was selected. RESULTS: 89.7% of the children consumed carbonated beverages whom caffeine, of which nearly 24% consumed energy drinks. The median caffeine intake from carbonated beverages was 0.12 mg/kg body weight/day, accounting for 4.8% of the recommended maximum daily intake from all dietary sources. Frequent consumers of cola drinks were often found to eat fast foods, as well as salty snacks. CONCLUSIONS: Caffeine intake in the studied group of children turned out to be at a safe level. The safe dose of caffeine does not mean that consumption of carbonated drinks should not raise any concerns. The recently established legal ban on selling unhealthy foods at school is a good idea, since the school should not be a place for improper dietary models.

Evaluation of communication and acceptance of the patients by medical personnel

Background: The low level of patient satisfaction recorded in many studies and, at the same time, the level of frustration and burnout, disclosed by medics in the perception of the patient as a 'problem', incline to look for the causes of inadequate relationship between physician and patient. Objective: The aim of this study was to evaluate the level of acceptance of the patient by the medical personnel. The research problem was the acceptance level which was within the range of the communication skills of the nurses and doctors. Another aim was to discover the factors determining this level of acceptance. Material and Methods: Two methods were used in the research process: 1) a diagnostic survey regarding the medical, professional communication skills; 2) testing of professional self-esteem from the medical aspect. The study population consisted of a total of 1,244 respondents divided into the following groups: registered nurses and doctors (729), students of nursing and medical faculties (515). Results: The results of the research showed that in most cases the acceptance of the patient by the medical staff was 'conditional', which translated into the level of frustration or lack of satisfaction with their profession, and ultimately into the level of burnout. The level of patient acceptance by medical staff (unconditional acceptance), depended primarily on age, followed by their profession. However, the relationship between this acceptance and gender and work experience was statistically insignificant. Conclusions: As the method to improve this situation, the expansion of education in the field of interpersonal communication is proposed, adding issues related with both the conditional and unconditional acceptance of the patient, as well as issues regarding how to deal with the patient from the aspect of disease and the psycho-socio-spiritual area.

Factors within the family environment such as parents' dietary habits and fruit and vegetable availability have the greatest influence on fruit and vegetable consumption by Polish children.

OBJECTIVE: To identify determinants of fruit and vegetable (F&V) consumption among school-aged children. DESIGN: A survey study was conducted in October 2010. The questionnaire contained questions concerning social and demographic data, lifestyle and dietary habits, particularly the frequency of F&V consumption, availability of F&V and knowledge about recommended amounts of F&V intake. SETTING: Polish primary schools. SUBJECTS: Children (n 1255) aged 9 years from randomly selected primary schools and their parents. RESULTS: The children's consumption of fruit and of vegetables was influenced by the fruit consumption and vegetable consumption of their parents (r=0·333 and r=0·273, respectively; P=0·001), parents encouraging their children to eat F&V (r=0·259 and r=0·271, respectively; P=0·001), giving children F&V to take to school (r=0·338 and r=0·321, respectively; P=0·001) and the availability of F&V at home (r=0·200 and r=0·296, respectively; P=0·001). Parental education influenced only the frequency of fruit consumption (r=0·074; P=0·01). A correlation between parents' knowledge of the recommended intakes and the frequency of vegetable and fruit consumption by children was noticed (r=0·258 and r=0·192, respectively, P=0·001). CONCLUSIONS: Factors within the family environment such as parents' dietary habits and F&V availability had the greatest influence on the F&V consumption by children. Educational activities aimed at parents are crucial to increase the consumption of F&V among children.

Comparison of maternal and fetal blood levels of caffeine and its metabolite. A pilot study.

OBJECTIVE: The aim of the study was to compare caffeine and paraxanthine concentrations in venous blood of pregnant women and in the umbilical cord blood of their newborns. MATERIALS AND METHODS: Pregnant women who gave birth at the Clinic of Obstetrics, Gynecology and Oncology 2nd Faculty of Medicine, Medical University of Warsaw were included in the study Caffeine and paraxanthine concentrations were analyzed in 30 samples of venous blood serum drawn from the women before delivery and 30 samples of umbilical cord blood serum of their newborns. Caffeine intake in the last 24 hours before delivery was estimated using a questionnaire. Statistical analysis employed a linear logistic regression model, Wilcoxon rank sum test and a non-parametric Spearman's rank correlation coefficient. RESULTS: No difference was found between caffeine concentration in maternal venous blood and neonatal umbilical cord blood. However; paraxanthine level in venous blood was higher than in umbilical cord blood (p = 0.04). CONCLUSIONS: Caffeine consumed by a pregnant woman passes through the placenta to the fetus freely.

Assessing patients' attitudes towards dietary supplements.

BACKGROUND: There is currently many over the counter products on the market that exert nutritional or physiological effects on the human body. The differences between dietary supplements and non-prescription drugs are however poorly understood by the average consumer and may thus affect their expectations as to the desired effect produced on the body. OBJECTIVES: To evaluate patients' knowledge and attitudes towards dietary supplements as compared to non-prescription drugs. MATERIALS AND METHODS: Subjects were 335 patients of the Mazowiecki Voivodeship Hospital in Warsaw, Poland. The data were collected from a face-to-face interview using a single and multiple choice questionnaire with 10 questions on dietary supplements. Statistical analysis used the Chi-square (χ2) test. RESULTS: The majority of respondents were found to be familiar with the term 'dietary supplements', but had difficulties in classifying these products into appropriate categories. Over 55% do not consider dietary supplements to be foodstuffs and more than 40% considered such products to be drugs. Most respondents thought that the main purpose of taking dietary supplements is to improve nutrition, but over one third expected them to also treat disease. Over 70% declared taking notice to which category the non-prescription products they bought belongs to ie. whether non-prescription drugs (medicinal products) or dietary supplements. CONCLUSIONS: Many patients mistakenly believe that dietary supplements are drugs and can be used to treat disease and health disorders. KEY WORDS: dietary supplements, opinion on dietary supplements, nutrition, dietary supplement vs. medicinal product.

[The need of prenatal public health initiatives in Poland]. / Potrzeba dzialan z zakresu prenatalnego zdrowia publicznego w Polsce.

The author emphasizes the achievements of the Polish Gynecological Society in the field of improving the health indicators concerning perinatal mortality among infants during the last two decades in Poland. Attention is paid to the contribution of the members of the Society to organizational change in Polish health care after 1990, which resulted in the improvement of the care of mother and child. It is also underlined that the members of the Society contributed to the creation of early detection system of breast and cervical cancer in Poland. However it is noteworthy that in 'Polish Gynecology' - the publication of the Polish Gynecological Society - the number of reports devoted to risky health behaviors of women during periconceptional period and pregnancy is scarce. The author draws attention to the percentage of women who smoke cigarettes and consume alcohol before and during pregnancy Emphasis is also placed on the problem of nutritional disorders (mainly pathological methods of dieting) among Polish women during the reproductive period and in the first weeks of pregnancy (before the pregnancy is confirmed). These aspects may result in epigenetic changes shaping the phenotype of the offspring. The author refers to the Barker's theory of Developmental Origins of Adult Diseases and warns that the above-mentioned health behaviors of women may bring about negative effects for the offspring and future generations, namely susceptibility to chronic diseases: arterial hypertension, obesity type 2 diabetes and metabolic syndrome. Negative effects for the health of offspring may also result from low level of physical activity of women before and during pregnancy The author concludes that it is necessary to intensify the efforts of the Polish Gynecological Society in the area of prenatal public health.

[Coffee drinking and risk of type 2 diabetes mellitus. Optimistic scientific data]. / Picie kawy a ryzyko cukrzycy typu 2. Optymistyczne doniesienia naukowe.

An alarming increase the prevalence of type 2 diabetes is forcing to constant analysis the lifestyle factors which can affect the risk of this illness. The research in the last ten years revealed new knowledge concerning the inverse association between habitual coffee drinking and risk of type 2 diabetes. The study indicate that people who drink at least 3 cups of coffee per day more seldom have diabetes and positive effect of coffee is rising along with the amount of the coffee in the diet. It is not clear what mechanism may be responsible for such association but the attention is focus mainly on caffeine, polyphenols, magnesium. Because of the fact that high coffee consumption can cause other adverse health effects coffee should not be treat as a public health strategy to prevent type 2 diabetes, but collected data have scientific character at the moment.

Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries.

The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in the Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students' responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1-4 grades, 189; 5-6 grades, 68); 268 Turkish (females, 43.3%; 1-4 grades, 90; 5-6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1-4 grades, 312; 5-6 grades, 138); 512 Azerbaijani (females, 24%; 1-4 grades, 468; 5-6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1-4 grades, 208; 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of enhanced range of integrated training opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.

Importance of legal regulations resulting from technical harmonization in the European Union for improvement of work safety of farmers in Poland.

INTRODUCTION AND OBJECTIVE: Accidents exert a negative effect on the quality and standard of living of rural inhabitants, especially when they make it impossible to continue work on a farm, or this work may be performed only to a limited extent. The creation of effective legal mechanisms which would guarantee the safety of operation of machinery is a crucial issue, it is of a preventive character and considerably limits the number of accidents. Approximately 16.1 million people live in the rural areas and around 2.3 million work in the agricultural sector, which represents 14.5% of all labour in Poland in 2019. OBJECTIVE: The aim of the study was to evaluate the legal regulations resulting from the directives of technical harmonization in the European Union for improvement of safety of work with the use of agricultural machinery in Poland. MATERIALS AND METHOD: The method was critical analysis of legal acts in effect, court rulings, and statistical data concerning accidentsoin farms, made available by the Agricultural Social Insurance Fund (KRUS). BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: As a result of Poland's membership of the European Union, rural areas were covered by globalization processes and single market rules, within which there function legal mechanisms of safety and quality of products. CONCLUSIONS: Analysis of the 16 years of Poland's membership of the EU, resulted in positive results being observed in the use of the directives of technical harmonization, especially in reducing the number of accidents involving agricultural machinery. However, this improvement may result from using newly-purchased, modern and safer agricultural machinery covered by the conformity assessment, and preventive actions carried out by the Agricultural Social Insurance Fund. An impact of other factors, not analysed in the study, cannot be ruled out.

Iodine-deficiency prophylaxis and the restriction of salt consumption - a 21st century challenge.

The World Health Organization (WHO) issued a recommendation (Technical Consultation: Paris 2006, Luxembourg 2007) that salt consumption, as a risk factor for hypertension, atherosclerosis, myocardial infarction, stroke, and select cancers, should be restricted. The European Commission looked to adhere to this recommendation by creating the High Level Group on Nutrition and Physical Activity. According to WHO recommendations, a daily allowance of 5 g NaCl (i.e., 2 g Na) for individual salt consumption should not be exceeded. At present, mean individual salt consumption in Poland totals 13.5 g, of which salt used in household constitutes 8.8 g. In some regions of Poland, this number reaches upwards of 15.0 g/person. The Position Paper on Initiatives Aimed at Decreasing Salt Consumption in Poland, developed by an expert group at the National Food and Nutrition Institute, set the course for intervention, including changing recipes for massproduced food products and large-scale catering, improving oversight by food control agencies, and continuing legislative changes. These interventions should also include education directed towards consumers, food producers, public health professionals, healthcare workers, and media representatives. The Position Paper of the Polish Hypertension Society also sets the course for promoting restricted salt consumption and controlling hypertension on a population level. However, household salt is the main carrier of iodine in the Polish model of iodine prophylaxis. Thus, any interventions also require synchronized action with the Polish Council for Control of Iodine Deficiency Disorders. Current efforts aimed at preventing iodine-deficiency look to increase consumption of other iodine-rich products (e.g., milk, mineral water) with standardized levels of iodine. Once they achieve an iodine concentration of 0.1-0.2 mg, these products can easily supplement any decrease in physiological iodine levels resulting from reduced salt consumption. Also required are wide-ranging educational campaigns which will be coordinated by the new designated WHO Collaborating Centre for Nutrition at the Chair of Endocrinology at Jagiellonian University, Collegium Medicum in Kraków. (Pol J Endocrinol 2010; 61 (1): 135-140).

Gestational vitamin D concentration and other risk factors versus fetal femur length.

Introduction: Vitamin D plays a crucial role in the development of healthy fetal bone tissue. Analysis of fetal bone parameters versus maternal vitamin D status is necessary to shed some light on the matter. The aim of the study was to investigate the relationship between maternal and cord vitamin D concentrations and other factors which might affect fetal bone development and femur length.Material and methods: The study included 94 term pregnancies, delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Fetal femur length was measured during an ultrasound examination on admission to the delivery unit. Total 25(OH)D concentrations were measured in maternal and cord blood. Direct interview with a dietician was used to collect lifestyle and nutrition data. Multiple regression analysis was used for statistical analysis.Results: No statistically significant relationship was found between vitamin D concentrations and fetal femur length, either in maternal (p = .7709) or cord (p = .7751) blood samples, despite the fact that low vitamin D concentrations, which might indicate aberrations in fetal bone development, were detected in 50.0% of the mothers and 28.7% of the newborns. Also, no relationship was confirmed for the remaining parameters, including nutritional factors (calcium or caffeine intake, vitamin/mineral supplements).Conclusion: Low vitamin D concentrations during pregnancy and lifestyle factors had no negative associations with fetal femur length.

Effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS - retrospective analysis of data from Almaty, Kazakhstan, 2010-2015.

INTRODUCTION: According to data from the National Centre for Prevention and Control of AIDS, in the Republic of Kazakhstan, 45.8% of patients in the symptomatic stages of HIV infection are diagnosed with tuberculosis (TB) which is the cause of death in 36% of patients infected with HIV. OBJECTIVE: The aim of the study was to conduct a retrospective analysis of the effectiveness of tuberculosis (TB) chemoprophylaxis among people living with HIV in the Republic of Kazakhstan (RK) in Central Asia. MATERIAL AND METHODS: Materials and method. A retrospective analysis of patient health status was performed for each of the 648 patients (323 in the study group and 325 in the control group) during 2010-2015. Data from outpatient treatment charts were used concerning each patient infected with HIV observed at AIDS Treatment Centres. From among the 648 patients infected with HIV, 136 were receiving isoniazid in 2010, and 187 in 2011. The control group consisted of 325 people living with HIV (PLW HIV), who did not received isoniazid during observation. RESULTS: Results. The incidence of TB in patients who underwent chemoprophylaxis did not exceed 0.555/ 100,000 population in the first year of observation. Within 5 years, the TB incidence dropped to 0. In the control group, the TB incidence rate during the first year of observation was 3.262/100,000, with a decrease to 0.364 observed in 2015. Cumulated incidence rate in 2011-2015 in the study group accounted for 1.276/100,000. In the control group, the cumulative incidence was 4.3 times higher and accounted for 5.527. A significant difference in the mortality rate due to TB in the study and control groups was observed, the share of deaths due to TB in study group was 21.6% - nearly 3 times lower than in the control group (57.0%). CONCLUSIONS: Conclusions. The effectiveness of chemoprophylaxis for TB depends on biomedical, organizational and cultural factors. The presence of HIV co-infections is a special situation. Opposite to the majority of reports, in own study, no drug-resistant forms of tuberculosis were observed in relation with chemoprophylaxis with isoniazid. In the examined population, TB chemoprophylaxis reduced the incidence and cumulative incidence of TB among PLW HIV by 3.4-4.8 times. Isoniazid chemoprophylaxis decreased 4-fold the annual and cumulative mortality due to TB.

Changes of cytotoxicity of Ti-6Al-4V alloy made by DMLS technology as effect of the shot peening.

OBJECTIVE: The aim the study was to investigate the impact of the shot peening process on the condition of the surface layer and biological properties of titanium alloy produced by means of the Direct Metal Laser Sintering (DMLS) method. MATERIAL AND METHODS: Specimens were prepared by the EOSINT M280 metal sintering laser system. The surfaces were subjected to the shot peening process using three different media, i.e. steel shot, nutshell granules and ceramic beads, after which they were subjected to profilometric analysis, scanning electron microscopic (SEM) observations and energy dispersive X-ray spectroscopy (EDS) tests, as well as to assessment of biological compatibility in terms of cytotoxicity (SH-SY5Y cell lines). RESULTS: The general results obtained from the tests indicate satisfactory biocompatibility of the examined surfaces and that the impact of the shot peening process on the titanium alloy cytotoxicity is acceptable. CONCLUSIONS: The lowest cytotoxicity was demonstrated by the surfaces modified by ceramic beads than the nutshells and the biggest steel shot correspondingly. Moreover, the shot peening process carried out by means of CrNi steel and ceramic shot caused the reduction of surface roughness when, for the surface processing by means of nutshell granules, the increase of surface roughness was observed compared with the unmodified surface of titanium alloy samples.

Caffeine Intake During Pregnancy and Neonatal Anthropometric Parameters.

Caffeine is a psychoactive substance that may affect the normal course of pregnancy, therefore its intake during that time should not exceed 200 mg/day. The aim of this study was to evaluate caffeine intake among pregnant women from the Warsaw region. The study was conducted among 100 pregnant women who delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Caffeine intake from coffee, tea, and energy drinks was measured using a questionnaire. Direct interviewing was used, with all interviews conducted by the same dietitian. Multiple regression analysis was used to investigate the relationship between caffeine intake and anthropometric measurements of the newborns. Mean caffeine intake among pregnant women was 68 ± 51 mg/day. Only 2% of the respondents exceeded the safe dose of 200 mg. Tea (mostly black) was the source of 63% of all caffeine. No relationships were found between caffeine intake and neonatal weight, length, or head and chest circumference (p > 0.05). Caffeine intake in our study population was relatively low and did not negatively affect fetal growth.