Characteristics of paediatric foot arches according to body mass among primary school students in Wroclaw, Poland.

BACKGROUND: The purpose of this study, conducted within the framework of the project entitled 'Let's get the kids moving', was to determine the associations between children's longitudinal and transverse foot arch and their weight, gender and age. METHOD: The pro-health initiative 'Let's get the kids moving' was created by researchers of the Medical University and the Run for Health Foundation. A total of 655 children (51.5% boys) aged 7 to 10 years from primary schools in south-western Poland participated in the study. The mean age of the subjects was 8.7 ± 0.8 years. In all the children, we assessed anthropometric measurements (weight and height) and the longitudinal and transverse arch of the foot under the load of their weight. A two-dimensional foot scanner (Sensor Medica, Italy) was used to examine the plantar part of the children's feet. RESULTS: The data collected from the 655 subjects revealed that excessive weight predisposed them to less longitudinal and transverse arching. The foot shape was not differentiated by gender or age. CONCLUSIONS: Screening school-aged children's footprints can detect abnormalities in the shape of children's feet early on, which allows for early diagnosis of functional or structural flatfoot in children.

Sensorineural Hearing Loss in Patients with Long-COVID-19: Objective and Behavioral Audiometric Findings.

Introduction: The symptoms of COVID-19 are primarily respiratory system disorders. Sensorineural hearing loss can be caused by COVID-19, as other symptoms in the nervous system. Hearing loss may also be the only symptom or complication of this disease or the symptoms of long COVID-19. The study aimed to assess hearing in patients after COVID-19 infection. Material and Methods: The study conducted ENT and full hearing assessment in COVID-19 infection. All patients underwent complete audiological diagnostics, including threshold tonal audiometry, tympanometry, otoacoustic emissions, and auditory brainstem evoked potentials (ABR) tests. The study group included 58 patients aged 23 to 75 years who were diagnosed with COVID-19 infection six months before inclusion in the present study and reported post-COVID-19 hearing impairment. Results: There were statistically significant differences between the control and study groups. Sensorineural hearing loss was found in 65.5% of the tonal audiometry test. The stapes reflex was absent in almost 20% of post-COVID-19 patients. The analysis of ABRs demonstrated longer latencies of wave III, V, and time intervals I-III, I-V in post-COVID-19 patients. Conclusion: COVID-19 can damage the inner ear as well as the auditory pathway. Hearing loss may be the only symptom of COVID-19 or be a late complication of the disease due to postinfectious inflammation of the nerve tissue as a symptom of long COVID-19. Prolonged conduction of the auditory pathway shows the affinity of the virus to the nervous system as a symptom of long COVID. It is advisable to perform hearing diagnostics in patients after COVID-19 and provide them with specialist care.

Dietary habits, physical activity, and self-reported rhinosinusitis in children and adolescents.

Background: Pediatric paranasal rhinosinusitis is one of the more common pediatric diseases of the upper respiratory tract and it entails significant morbidity. Most commonly, it is caused by a viral infection of the nasal mucosa, which spreads through the natural passages within the cavities of the paranasal sinuses, leading to inflammation of the mucosa that lines the nasal cavity and paranasal sinuses. Methods: The objective of this cohort study was to assess whether there is a correlation between pediatric rhinosinusitis, physical activity, and selected dietary habits among pupils aged 6 to 16 years from elementary schools in Wroclaw, Poland. This study - as part of the pro-health program "Let us Get the Kids Moving" - is also aimed at establishing factors that potentially predispose children to developing RS. The survey study was conducted on a group of 2,458 children and adolescents from elementary schools in Wroclaw. The age of the examined children ranged from 6 to 17 years (mean = 10.8 years; standard deviation = 2.7). Results: Rhinosinusitis was more common in the children aged 13-17 years than in those aged 6-9 years (6.4% vs. 1.5%; p < 0.001) or 10-12 years (6.4 vs. 2.6%; p < 0.001). The study revealed a significant positive correlation between rhinosinusitis development and several variables: age > 11 years, attending swimming classes fewer than 1-2 times a week, using a computer, consuming milk, salty snacks, and carbonated sweet drinks, consuming fruit fewer than 1-2 times a week, not attending physical education classes, eating fewer than 4 meals, and not eating breakfast at home (p < 0.05). Conclusion: It is of great importance to establish preventive measures against recurrent upper respiratory tract infections that may predispose children to rhinosinusitis. Introducing healthier, traditional dietary habits and regular physical activity in children and adolescents may result in normal and adequate immune response and proper functioning of the inflammatory control system.

Physical activity and sedentary behaviors in Polish children and adolescents.

OBJECTIVE: Participating in physical activity (PA) is essential for children's proper development. Promoting physical activity from early school years is considered a highly important prevention task for good health. The aim of this study was to evaluate the level of PA and sedentary behavior of children and adolescents aged 6-17 years attending primary and junior high schools in Wroclaw, Lower Silesia, Poland. The study assessed the frequency of various forms of PA and sedentary behavior in children and adolescents. The age differences in PA and sedentary behavior in the cohort studied was also analyzed. DESIGN: Survey study to assess children's and adolescents' physical activity and sedentary behavior were based on a parent-reported questionnaire. PARTICIPANTS: A total of 2913 children and adolescents aged 6-17 years (average age, 11.38 years) from Wroclaw, Poland, who participated in a pro-health campaign "Let's Get the Kids Moving." This project promotes a healthy lifestyle among primary and middle school students. RESULTS: The frequency of physical activity significantly decreased as children grew older (p < 0.0001). As many as 18.6% of adolescents 13-17 years old undertook the recommended level of physical activity less than once a week. Time spent in front of the television or computer by pupils in group 3 was longer than in younger children (p < 0.0001). Nearly 19% of adolescents (13-17 years old) spent 5 h or more daily in a sitting position in front of the television or computer on weekends. CONCLUSIONS: Polish children and adolescents do not spend the recommended level of time on physical activity and spend excessive time in front of the television and other electronic devices. The level of physical activity decreases as the number of hours spent in a sitting position increases with increasing age. Actions should be taken to avoid the long-term consequences of these behaviors.

Prevalence and Associated Factors of Cigarette Smoking Among Medical Students in Wroclaw, Poland.

Objective: The study aimed to evaluate the nicotine addiction syndrome among students of the medical university of Wroclaw. Materials and Methods: The anonymous self-administered online questionnaire regarding tobacco and e-cigarettes smoking was sent to 5616 students. A total of 407 students from Wroclaw Medical University who fulfilled the questionnaire were enrolled. Results: One-fourth of the surveyed medical students smoke or have smoked cigarettes in the past. About 75% of students report that there is no information about the harmfulness of smoking and its consequences in the course of teaching in medical studies. The majority of students, 74.5% of women and 62.8% of men, agree that nicotine dependence syndrome should become part of the curriculum of medical universities. Conclusion: The proportion of smokers among medical students is very high, and their knowledge of smoking is insufficient. It seems necessary to implement urgent education for medical students about the consequences of smoking and the treatment of nicotine dependence syndrome. The knowledge of future doctors about the harmfulness of smoking in the future will allow reducing the number of patients suffering from smoking-related diseases and may help reduce the number of smokers among students. It seems necessary to intensify the antismoking campaigns in Poland and worldwide.

Nutritional habits according to age and BMI of 6-17-year-old children from the urban municipality in Poland.

BACKGROUND: Balanced nutrition is crucial for adolescent's proper physical and mental development. Dietary habits change significantly with a child's development. Along with increasing age and the shift towards adolescence, unhealthy diet-related habits become more common. The objective of the survey study was to determine the differences in nutritional habits between children and adolescents according to their age and body mass index (BMI). METHODS: "Let's get the kids moving" campaign (pol. "Uruchamiamy dzieciaki") was launched in 2016. Within the campaign, the survey study was conducted in 2913 participants between 6 and 17 years old from primary and junior high schools in Wroclaw (Poland). The survey was anonymous, and its supplement was voluntary. Participants were divided into age groups. The study group of 2913 consisted of 29.8% of 6-9-year-olds, 32.7% of 10-12-year-olds, and 37.5% of 13-17-year-olds. Body mass index (BMI) was calculated and further interpreted as a BMI z-scores depending on children's age and gender. RESULTS: A total of 19.3% of participants consumed 3 meals a day or less. Children from the oldest age group (13-17) consumed statistically significantly fewer meals per day than younger children (p < 0.001). Children from the oldest age group (13-17) consumed breakfast statistically less often than children of age group 10-12 years (75.0% vs. 83.6%; p < 0.001) and children of age group 6-9 years (75.0% vs. 84.0%; p < 0.001). Severely thin children consumed breakfast significantly more often than overweight (85.8% vs. 76.3%; p = 0.004) and children with obesity (85.8% vs. 75.9%; p = 0.021). Children with obesity consumed vegetables significantly less often than severely thin (p < 0.008), thin (p < 0.001), and children with normal body weight (p < 0.007). The oldest children (13-17 years) consumed Coca-Cola and SSB (p < 0.001) and fruit-flavored beverages (p < 0.05) significantly more often than children from other age groups. Boys consumed carbonated beverages with added sugar significantly more often than girls (p < 0.01). CONCLUSIONS: Unhealthy diet-related behaviors in children and adolescents may promote overweight and obesity and should be targeted in health promotion programs. Special attention should be paid to 13-17-year-olds, as adolescents from this group made more unhealthy choices than younger children.

A study on health and the association between overweight/obesity and otorhinolaryngological diseases in 6- to 17-year-old children from Wroclaw, Poland.

Introduction: Childhood overweight and obesity have become a global problem in the past three decades. There are very few studies which examine the correlation between body mass index (BMI) and the development of otorhinolaryngological diseases in children. The objective of the study was to determine the association between overweight or obesity in children and the occurrence of otorhinolaryngological diseases. Material and methods: The survey study was based on a parent-reported multidisciplinary questionnaire on children's medical status among elementary and junior high school children in the city of Wroclaw, the capital city of Poland's Lower Silesia region. The children were taking part in the pro-health campaign "Let's Get the Kids Moving". Results: The study was conducted among 2,913 children. A statistically significant correlation was observed between the assessment of the children's BMI and the occurrence of adenoid hypertrophy. Adenoid hypertrophy was more common in the overweight and obese children. The children with adenoid hypertrophy had higher BMI than the children without adenoid hypertrophy. There was a statistically significant correlation between BMI and the incidence of adenoidectomy. There was a statistically significant correlation between BMI and the incidence of tonsillectomy. Conclusions: The development and introduction of preventive programs like "Let's Get the Kids Moving" in the future will contribute to building a healthier society. The study findings suggest that primal prevention may lead to a decrease in the development of otorhinolaryngological diseases. We also showed that higher body mass correlates with higher prevalence of otorhinolaryngological diseases. Further studies are needed to establish the etiopathology of this association.

Vestibular disorders in patients after COVID-19 infection.

Introduction: The COVID-19 clinical symptoms are primarily related to the respiratory system but may also be involved in many others, including the nervous system. Recently, vertigo or dizziness has been described as one of the clinical manifestations and possible complications of COVID-19. Materials and methods: This clinical study was designed to describe the otorhinolaryngological evaluation and videonystagmographic (VNG) findings in patients with an antecedent of COVID-19 infection in the last 6 months. In this study, we sought to investigate the presence of persistent vestibular damage in healed COVID-19 patients and to determine the origin of vertigo by conducting a comprehensive vestibular examination. To evaluate the association precisely, an otoneurological assessement was conducted on all participants. The study group included 58 patients aged 23-75 years with vertigo, who were diagnosed with COVID-19 infection 6 months before the examination. Each participant was submitted to an evaluation consisting of anamnesis, otorhinolaryngological evaluation, and VNG. Results: Spontaneous nystagmus with closed eyes was reported in 8 patients (13.8%). Positional nystagmus was observed in 15 patients (24.1%). Asymmetrical optokinetic nystagmus was observed in 18 patients (31%). A distorted record in the tracking pendulum test was present in 23 patients (39.7%). Square waves were observed in 34 COVID-19 patients (58.6%). Unilateral weakness (UW) was observed in 23 subjects (39.7%); among those with UW, 22 patients (95.7%) also demonstrated directional preponderance contralateral to the UW. Another 16 patients (27.6%) presented only directional advantage. The post-caloric recruitment was present in 38% patients. Conclusion: Patients who had been diagnosed with COVID-19 seem to be more likely to suffer from vertigo/dizziness and to compensate more slowly. COVID-19 infection may cause inner ear damage and lead to vestibular dysfunction. The role of the central nervous system in the onset of equilibrium disorders should be considered. The presence of vertigo of central origin may indicate the neurotropic effect of SARS-CoV-2 following COVID-19. Imbalance may be the only symptom of COVID-19 and may also be a late complication of the disease due to post-infectious inflammation of the nervous tissue. Comprehensive studies are needed to investigate whether COVID-19 can cause long-term vestibular deficits.

Assessment of the elementary school students' schoolbag weight in the urban environment in Poland: A cross-sectional study carried out as a part of the 'Lightweight Schoolbag' and 'Let's Get the Kids Moving' projects.

BACKGROUND: Carrying a properly weighted schoolbag is an important factor in preventing the occurrence of muscular skeletal disorder in early school age children. OBJECTIVE: The purpose of this cross- sectional observational study was to examine the schoolbag weight and to determine the percentage of children were carrying overloaded schoolbag. METHODS: The study group included pupils from five primary public schools in Wroclaw, Poland. Anthropometrical measurements such body weight (BW) and height were conducted on 650 children (51.1% of boys). Children's age, gender, Cole's Index was juxtaposed with schoolbag weight. The mean age of the examined students was 8.7±0.8 years (range 7 to 10 years). RESULTS: The mean schoolbags weight was 3.7±0.92 kg, which represented 13.0±3.8% of pupils' BW. The percentage of pupils carry the schoolbags weighing more than 10% of their BW was 77.9%. More than a quarter of Polish children carry school backpack above 15% of their BW. The majority (96.8%) had schoolbags which may be carried on both shoulders. A significant negative correlation was observed between relative schoolbag weight and Cole's Index (rho = -0.44, p < 0.05). CONCLUSIONS: The problem of overloaded schoolbags among elementary school children was frequent. Pupils ought to be educated in the proper packing of their school backpacks. Additionally, parents and teachers should pay attention regarding the contents carried by children in their respective schoolbags.

The effect of middle ear effusion on the inner ear condition in children.

BACKGROUND: Otitis media with effusion (OME) is the most common cause of hearing impairment among children in developed nations. Middle ear (ME) fluid accumulation leads to progressive hearing impairment, usually of the conductive type. In some cases, mixed hearing loss associated with OME has been noted. It was reported that effusion in the ME has a negative impact on the vestibular system of the inner ear. OBJECTIVES: The aim of this random-sample cohort study was to evaluate postural stability and the influence of ME drainage on vestibulospinal reflexes in children with OME, and to determine whether disturbances in the vestibular organ correlate with a sensorineural component in OME-related hearing loss. MATERIAL AND METHODS: The study group consisted of 53 children with bilateral OME who were treated with bilateral ME drainage. The study group was divided into subgroups according to hearing loss. The control group consisted of 29 healthy children. Vestibular function and hearing evaluation were performed before and 4 weeks after drainage. RESULTS: A comparison of the stabilograms of the study group and the control group revealed elevated parameters in most of the tests. In the subgroup with mixed hearing loss, either before or after ME drainage, elevated stabilogram parameters were found in all tests. Posturography revealed vestibular system disturbances before and after ME drainage in the subgroup with mixed hearing loss, especially before ME drainage. The stabilogram parameters in the subgroup with conductive hearing loss after ME drainage were better in most tests in comparison to those before the procedure. CONCLUSIONS: The presence of effusion in the ME has a negative effect on the inner ear. We highlight the importance of monitoring the condition of the vestibular system in all children with OME, especially in cases with mixed hearing loss and more advanced clinical stages of the disease.

Lifestyle-related factors differentiating the prevalence of otorhinolaryngological diseases among 6-17-year-olds from Wroclaw, Poland.

An increased prevalence of sedentary behavior (SB) and a decrease in physical activity (PA) has been noted in recent decades. The aim of the study was to determine the association between the development of otorhinolaryngological diseases, PA and SB. Study draws on data collected from "Let's Get the Kids Moving" study ("Uruchamiamy dzieciaki"), a school-based survey study examining lifestyle factors among a population of elementary- and junior-high-school children in the city of Wroclaw, Poland. The respondents were asked about SB, PA and the prevalence of conditions or groups of otorhinolaryngological conditions: adenoid hypertrophy (AH), rhinosinusitis (RS) and allergic rhinitis (AR). There was a statistically significant association between the frequency of cleaning/vacuuming and the prevalence of AH. There was a statistically significant correlation between the prevalence of RS and screen-based activities on weekdays. AR was more prevalent in children who run less often, are less often engaged in team sports, spend less time outdoors on school days and weekends and spend more time in front of the computer on school days. Our study provides support for the linkage between PA, SB and an increased prevalence of otorhinolaryngological diseases.

Single median maxillary central incisor syndrome and variant in SMO gene associated with SHH pathway.

Solitary median maxillary central incisor syndrome (SMMCI) is a rare congenital oronasal-dental midline anomaly. The aim of this paper is a presentation of a patient with SMMCI without other visible dentofacial anomalies, with a potentially new molecular etiology consisting of a gene-gene reaction and conservative therapeutic approach to nasal obstruction. Potentially pathogenic variants in the SMO gene (p.Gly422Glu) and in P2RY13 gene (p.Trp205*) inherited from the probant's father, and in the PLD2 gene (p.Gln319fs), inherited from the mother were found. A multidisciplinary approach is necessary for the management of patients with SMMCI, including a genetic consultation with genetic tests.

The impact of the patient's condition, diagnostic procedures and treatment on the survival of carcinoma of unknown primary site patients.

INTRODUCTION: Carcinoma of unknown primary site (CUP) refers to 1-5% of all head and neck neoplasms. Very often, the primary site remains difficult to determine. Squamous cell carcinoma is the most frequent histopathological type diagnosed in the head and neck region. According to statistics, a primary site is usually located in the oropharynx. STUDY OBJECTIVE: The study presents diagnostic difficulties and the methods of diagnosing and the therapy of CUP and primary sites in patients treated in the region of Lower Silesia and Silesia. The aim of the study was to show a retrospective analysis of 233 CUP patients to assess how clinical features, diagnosis and treatment affect the survival of patients. MATERIAL AND METHODS: The diagnostics of patients included panendoscopy with specimen collection (nasoendoscopy, laryngoscopy, esophagoscopy, brochoscopy), computed tomography examination of the neck, chest, abdomen and pelvis minor, as well as positron emission tomography examination. Tonsilletomy was performed in 37 patients. Neck dissection was carried out in 109 subjects and 165 patients were treated bt radiotherapy, and 135 by chemotherapy. CONCLUSIONS: Tonsillectomy is required in CUP patients with the negative results of biopsy and imaging tests. It gives a possibility of detecting the primary site and improves the results of treatment and survival of CUP patients.Combination therapy, including surgical treatment and chemoradiotherapy, gives the best therapeutic results in CUP patients. The general condition of patient and younger age have an impact on prognosis and survival.

Long-term evaluation of the effect of middle ear effusion on the vestibular system in children.

BACKGROUND: Otitis media with effusion (OME) is one of the most common clinical conditions in childhood. Fluid accumulation in the middle ear may impact inner ear. OBJECTIVES: The purpose of this random sample cohort study was to investigate whether the past history of middle ear effusion has a long-term negative impact on the vestibular system in children. MATERIAL AND METHODS: The study was carried out on 22 children aged 7-15 years who had undergone drainage of the middle ear 5 years before evaluation. The control group consisted of 29 healthy children aged 4-17 years. Vestibular function was examined using sway posturography and electronystagmography (ENG). RESULTS: The stabilogram parameters of the study group and the control group were compared. The field of developed area (FDA) and the average body sway velocity (ASV) were analyzed. Elevated stabilogram parameters of FDA and ASV, both with eyes open and eyes closed, were found in the study group. Statistically significant values (p < 0.05) were present for ASV with eyes open and with eyes closed. The ENG recordings were analyzed in both groups. In the study group, spontaneous nystagmus was observed in 40.9% of the children and positional nystagmus occurred in 63.6% of the children. According to tests, eye tracking test was impaired in 27.3% of cases. Rotatory chair testing revealed asymmetry in 18.2% of the children. CONCLUSION: The presence of effusion in the middle ear in the past has a negative impact on the vestibular part of the inner ear. Clinicians should be aware of the possible negative impact of middle ear effusion on the vestibular function in children with a history of otitis media with effusion. With seeimingly asymptomatic children clinicians should inquire parents about symptoms of dysequlibrium and imbalance.

[Haemangiopericytoma of the nasal cavity as a cause of recurrent epistaxis--case report]. / Haemangiopericytoma nosa jako przyczyna nawracajacych krwawien--opis przypadku.

A case of haemangiopericytoma of the nasal septum in 73-year-old female admitted to the Department of Otolaryngology of Wroclaw Medical University with a history of recurrent epistaxis and progressive right monolateral nasal respiratory obstruction is reported. On admission presented smooth, cyanotic, easily bleeding lesion in the nasal cavity on the right. Nose CT scans identified presence of a soft-tissue mass arising from the nasal septum. She was treated with a complete surgical resection of the mass. The diagnosis was established based on the careful histopathological examination. Haemangiopericytomas are rare soft-tissue neoplastic lesions, occurring mainly in adults, originating from pericytes and primarily arising in the lower extremities and retroperitoneum. Haemangiopericytomas of head and neck are very unusual and comprise about 15 to 30%; of these, approximately 5% occur in the sinonasal area. Authors have presented etiology, symptomatology, histopathological features, differential diagnoses, diagnostic and therapeutic management. Malignant and benign clinical course have been described.

[Epidemiological evaluation of salivary gland tumors in the Wroclaw ENT Department patients in the years 2001-2010]. / Ocena epidemiologiczna nowotworów gruczolów slinowych u pacjentów leczonych w Klinice Otolaryngologii we Wroclawiu w latach 2001-2010.

UNLABELLED: Salivary gland tumors represents approximately 3% of all head and neck neoplasms. Most of them are benign and located in the parotid gland. AIM: Epidemologic analysis of salivary gland neoplasms in the Wroclaw ENT Department. MATERIAL AND METHODS: 304 patients (170 women, 134 men) with histologically confirmed salivary gland tumors treated in the years 2001-2010 were reviewed retrospectively. RESULTS: Benign tumors were diagnosed in 83.9% of patients, malignant lesions constituted 16.1% of cases. The average age of patients were 55 years. Pleomorphic adenoma and Warthin's tumor constituted the most common benign tumor (93.3%). Among malignant tumors--adenoid cystic carcinoma (24.5%) and adenocarcinoma (22.5%) were the most frequent. Neoplasms located in submandibular gland and in minor salivary gland in the vast majority of cases were malignat: 35.1% and 38.9%, respectively. Parotid gland tumors were malignant in 11.7%. An increase of salivary gland neoplasms total number, predominantly in men, and in malignant neoplasms percentage: from 13.8% in the years 2001-2005 to 17.7% in the years 2006-2010, was noted. CONCLUSIONS: Most of salivary gland neoplasms are benign. Pleomorphic adenoma and Warthin's tumor (93.3%) constituted the most common benign tumors, adenoid cystic carcinoma (24.5%) and adenocarcinoma (22.5%) were the most frequent malignant tumors. Malignant tumor patients were avereage 12.5 years older than benign tumors persons. More than 1/3 of submandibular gland and minor salivary glands neoplasms were malignant. An increase of malignant lesions was noted--from 13.8% to 17.7% of the total number of salivary gland neoplasms.