The Impact of Platelet-Rich Plasma Application during Cesarean Section on Wound Healing and Postoperative Pain: A Single-Blind Placebo-Controlled Intervention Study.

Background/Objectives: The aim of this study was to evaluate if platelet-rich plasma (PRP) application into the wound during cesarean delivery improves wound healing and reduces pain in the postoperative period. Materials and Methods: A total of 46 patients undergoing cesarean section (CS) were included in this single-blind placebo-controlled intervention study: 23 women in the PRP group and 23 in the placebo group. Every patient was asked to evaluate pain by using the Visual Analogue Scale (VAS) immediately after surgery, as well as 6 and 12 h after the surgery. The use of analgetics was also recorded. The postoperative scar was assessed using the Patient and Observer Scar Assessment Scale (POSAS). Results: There was no case of wound dehiscence in either group. Significant differences between the groups in the scar quality assessment were detected in both patient and doctor POSAS results on days 8, 30 and 90 after surgery in the favor of the PRP group. There was no difference in the pain intensity assessment on the VAS recorded after surgery, but PRP patients required fewer paracetamol doses per day than the control group. Conclusions: PRP application during CS significantly improved wound healing in both short- and long-term assessment. Although it did not influence postoperative pain intensity, it may reduce the use of analgetics after surgery.

Selenium dietary intake and survival among CRC patients.

Background: Despite advances in prevention and treatment, colorectal cancer remains the second most common cause of cancer death. To date, little is known about the role of prediagnostic selenium intake in colorectal cancer survival. Objective: The purpose of the study was to verify whether selenium intake in habitual diet before diagnosis is associated with survival in colorectal cancer patients. Study design: This was a prospective observation of patients primarily recruited for a case-control study between 2000 and 2012 in Cracow, Poland. A group of 671 incident cases of colorectal cancer was included. Habitual diet was assessed using a validated 148-item food questionnaire. 338 deaths were identified throughout 2017 by the Polish National Vital Registry. To evaluate the impact of dietary selenium on survival, the multivariable Cox regression model was used. Results: After standardization for several potential confounders (including key determinants, such as radical surgery, chemotherapy, tumor stage, and dietary factors), a decrease in the risk of death from colorectal cancer was observed in the group with higher dietary selenium intake (≥48.8 µg/day, group mean: 63.9 µg/day) compared to the group with lower dietary selenium intake (<48.8 µg/day, mean: 38.5 µg/day) (HR=0.73; 95% CI: 0.54-0.98) (the median was used for categorization). Conclusion: Our study suggests selenium as an additional dietary factor which may be associated with survival among colorectal cancer patients referred to surgery. Due to the observational nature of the study, the results should be taken with caution. These preliminary findings, however, provide the basis for well-structured clinical trials.

A divisive hierarchical clustering methodology for enhancing the ensemble prediction power in large scale population studies: the ATHLOS project.

The ATHLOS cohort is composed of several harmonized datasets of international groups related to health and aging. As a result, the Healthy Aging index has been constructed based on a selection of variables from 16 individual studies. In this paper, we consider additional variables found in ATHLOS and investigate their utilization for predicting the Healthy Aging index. For this purpose, motivated by the volume and diversity of the dataset, we focus our attention upon data clustering, where unsupervised learning is utilized to enhance prediction power. Thus we show the predictive utility of exploiting hidden data structures. In addition, we demonstrate that imposed computation bottlenecks can be surpassed when using appropriate hierarchical clustering, within a clustering for ensemble classification scheme, while retaining prediction benefits. We propose a complete methodology that is evaluated against baseline methods and the original concept. The results are very encouraging suggesting further developments in this direction along with applications in tasks with similar characteristics. A straightforward open source implementation for the R project is also provided (https://github.com/Petros-Barmpas/HCEP). Supplementary Information: The online version contains supplementary material available at 10.1007/s13755-022-00171-1.

Genotoxicity Associated with 131I and 99mTc Exposure in Nuclear Medicine Staff: A Physical and Biological Monitoring Study.

Nuclear medicine staff are constantly exposed to low doses of ionizing radiation. This study investigated the level of genotoxic effects in hospital employees exposed to routinely used 131I and 99mTc in comparison with a control group. The study compared the results of physical and biological monitoring in peripheral blood lymphocytes. The effects of confounding factors, such as smoking status and physical activity, were also considered. Physical dosimetry monitoring revealed differences in the individual annual effective dose as measured by finger ring dosimeter and whole-body dosimeter between the 131I- and 99mTc-exposed groups. The DNA damage studies revealed differences between the groups in terms of excess premature chromosome condensation (PCC) fragments and tail DNA. Physical activity and smoking status differentiated the investigated groups. When assessed by the level of physical activity, the highest mean values of tail DNA were observed for the 99mTc group. When assessed by work-related physical effort, excess PCC fragments were significantly higher in the 131I group than in the control group. In the investigated groups, the tail DNA values were significantly different between non-smokers and past or current smokers, but excess PCC fragments did not significantly differ by smoking status. It is important to measure exposure to low doses of ionizing radiation and assess the potential risk from this exposure. Such investigations support the need to continue epidemiological and experimental studies to improve our understanding of the mechanisms of the health effects of radionuclides and to develop predictive models of the behavior of these complex systems in response to low-dose radiation.

Calcium intake may explain the reduction of colorectal cancer odds by dietary selenium - a case-control study in Poland.

BACKGROUND: Colorectal cancer (CRC) has been placed among top three cancer sites in high income countries. Although there are several inconsistencies across studies it is widely accepted that diet contributes to approximately 70% of CRC. Several dietary factors have been investigated; however, the knowledge about the role of trace elements and their interplay with other dietary factors in CRC odds is limited. The aim of the study was to estimate the odds ratio of colorectal cancer associated with the content of selenium in diet, and to check whether dietary calcium is a modifier of selenium effect in the population characterized by low selenium intake. METHODS: Face-to-face interviews were used to gather data on dietary habits (by 148-item semi-quantitative food frequency questionnaire) and covariates among 683 histologically confirmed incident colorectal cancer cases and 759 hospital-based controls in a case-control study. Data was collected in a period between 2000 and 2012. SETTING: Lesser Poland, Central Europe. Logistic regression models were used to assess the role of dietary selenium intake and calcium-selenium interaction in colorectal cancer odds. RESULTS: After the adjustment for several covariates dietary selenium was associated with the decrease of colorectal cancer odds by 8% (OR = 0.92, 95%CI: 0.84-0.99 for every 10µg Se/day increase). In individuals with lower (< 1000 mg/day) calcium content the odds of colorectal cancer was decreased by 13%(for every 10µg Se/day) and by 44% and 66% depending on the categories of selenium intake (60 to < 80 µg/day and ≥ 80 µg/day, respectively). The effect of dietary selenium was modified by dietary calcium (p for interaction < .005). CONCLUSIONS: The study has shown a beneficial effect of dietary selenium for colorectal cancer and a modification effect of dietary calcium in a population characterized by lower levels of selenium intake. The results provide the basis for well-planned controlled trials to confirm the findings.

Evaluation of the prevalence of folic acid supplementation before conception and through the first 12 weeks of pregnancy in Polish women at high risk of fetal anomalies.

OBJECTIVES: Local and international organizations recommend folic acid (FA) supplementation in the periconceptional period. This study aimed to analyse the prevalence of periconceptional supplementation with FA in women at high risk of fetal anomalies refferred for first trimester screening. MATERIAL AND METHODS: Our analysis involved 1,455 women at high risk of fetal anomalies refferred for first trimester screening. FA supplementation was assessed by face-to-face interviews conducted by doctors performing first trimester screening for aneuploidy. RESULTS: FA supplementation before pregnancy was reported by 46.8% of the women and during the first trimester by 57.2% of those studied. Women used FA supplementation more frequently if they had a history of at least one miscarriage (OR 2.2, 95% CI 1.70-2.83; p < 0.001), a history of assissted reproductive techniques (OR 2.25, 95% CI 1.18-4.31; p = 0.014), or were aged between 30 and 34 (OR 2.87, 95% CI 1.47-5.58; p = 0.002). Among 122 women with a history of fetal defects only 50% confirmed FA supplementation before pregnancy and 62.2% during pregnancy (p = 0.488). A similar frequency of FA supplementation was noted among women with epilepsy, diabetes, and hypertension. Less frequent taking of FA was noted among women at least third and subsequent pregnancies (p < 0.001). In the current pregnancy, neural tube defects (NTDs) were less frequent by 86% in the group of women with FA supplementation than in the non-supplementation group (1 case vs 6 cases, respectively) and for other fetal defects by 62.5% (24 vs 40 cases, respectively). CONCLUSIONS: We found an unsatisfactory compliance with recommendations for the use of folic acid supplementation during periconceptional period among women at high risk of fetal defects and folate deficiency, that could have negative effects on the health of child and mother. The study results show the need to increase the awareness of FA supplementation during periconceptional period especially in women with high risk of fetal anomalies.

Pregnancy-related comorbidities and labor induction - the effectiveness and safety of dinoprostone compared to misoprostol.

OBJECTIVES: The aim of the study was to evaluate whether the presence of the disease in pregnancy influences the effectiveness and safety of delivery preinduction with prostaglandins: misoprostol vaginal insert and dinoprostone vaginal gel. MATERIAL AND METHODS: This is aretrospective cohort study conducted of 560 pregnant women. The concomitant diseases mainly recorded were diabetes mellitus, hypertensive diseases, intrahepatic cholestasis of pregnancy, asthma, thrombocytopenia, and hypothyroidism. The primary study outcome was a successful vaginal delivery. The study above others evaluates the time from treatment implementation to the beginning of a labor and to a final delivery, the rate of Cesarean sections, and the presence of delivery complications. RESULTS: Among women with a concomitant disease, Caesarean section was observed more frequently in the misoprostol group. In the dinoprostone group, mothers with the concomitant disease as compared to healthy mothers required more time to the delivery and to achieve the beginning of labor. There were no differences in postpartum complications regardless of the prostaglandins, comorbidities or mothers' age. Neonates of mothers ≥ 35 years old with concomitant disease had lower average Apgar scores. CONCLUSIONS: Our study showed that comorbidities seem to increase the caesarean section risk in the misoprostol preinduction group but in the dinoprostone group they prolong the time needed to achieve an active labour phase and a delivery.

Development and Validation of a Self-Neglect Scale Among Older People: The Study on Challenges for Neglect and Self-Neglect in Poland.

The study aimed to develop and validate a tool to recognize the presence and to evaluate the level of self-neglect in community-dwelling older people. The cross-sectional study included 2,894 face-to-face interviews with randomly selected individuals from among the general population, social service users, and hospital patients. In addition, specially trained interviewers assessed the physical appearance and standards of living. Reliability, content, and construct validity were assessed. The Item Response Theory was used. The following scales were developed: the Self-Reported Self-Neglect Scale (SRSNS), the Objective Assessment of the Level of Self-Neglect-Physical Appearance (OALSN-PA) scale, concerning physical health risks based on the appearance of an individual, and the Objective Assessment of the Level of Self-Neglect-Standards of Living Arrangements (OALSN-SLA) scale, which assesses the physical and personal living conditions. The brevity of the scales makes them useful for the daily practice of health care and social care professionals.

The needs of persons with chronic health conditions to maintain or return to work 30 years after transformation from socialism into capitalism - a preliminary report from the Polish part of the PATHWAYS project.

OBJECTIVES: An increased burden of chronic diseases in the working age population is observed across high income countries. Persons with chronic diseases (PwCDs) are less likely to maintain or return to work due to several constraints they experience. The purpose of the study was to assess the preferences and needs of PwCDs regarding 6 areas of flexibility at the workplace. It was assessed whether there were any personal characteristics associated with higher or lower expectations and needs. MATERIAL AND METHODS: This was a part of a large multicenter international project, i.e., the PArticipation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project, aimed to contribute to the development of innovative approaches to promote professional integration and reintegration of PwCDs into the work sector. In Poland, 59 respondents diagnosed with different chronic diseases were identified through advocacy groups. An on-line survey was conducted to collect information on their needs and expectations. A cluster analysis was performed to reveal some expectation types which differentiated individuals across 6 analyzed domains, along with a multivariable logistic regression to identify some characteristics associated with a special expectation type. RESULTS: Workplace facilitator items were generally scored as needed ("rather conductive" and "very conductive" groups identified). The factors positively associated with higher needs in this domain were education, and a hindering type of the disease. Unrestricted working hours were very conductive or indifferent, and were positively associated with education. Legal solutions were more conductive for older people. Medical support, access to training, and supervisors' knowledge were needed in general, with no associations with the personal characteristics identified. CONCLUSIONS: Persons with chronic diseases report several facilitators which are needed for them to maintain or return to work, but they are not satisfied with the existing economy in Poland. These needs should be taken into consideration in the effective policy development. Int J Occup Med Environ Health. 2020;33(4):427-44.

Gender perspective in the analysis of the relationship between health and work cessation, and how to deal with it.

OBJECTIVES: The main objective of this study is to examine the relationship between health and an early exit from paid employment in the Finnish, Polish, and Spanish populations. The authors have addressed the following 3 issues: who chooses not to work according to gender patterns, whether the health status is a determinant of being non-employed, and what diseases are associated with being non-employed. MATERIAL AND METHODS: The studied material consists of data from the Collaborative Research on Ageing in Europe (COURAGE in Europe) project. The analysis was based on a sample of 5868 individuals, including 1214 from Finland, 2152 from Poland and 2532 from Spain. In the paper, these data were complemented with the results of the PArticipation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project. RESULTS: The results of the study revealed that self-rated health was a strong predictor of being non-employed for different reasons. Chronic diseases, such as arthritis, angina, diabetes, chronic obstructive pulmonary disease, depression and hypertension, were typically associated with an increased risk of being non-employed due to health problems and early retirement. Women more frequently reported arthritis and depression, while a higher proportion of men suffered from angina and diabetes. CONCLUSIONS: The results obtained by the authors highlight the importance of evaluating gender patterns in work cessation and, at the same time, the importance of gender-focused actions in terms of preventing withdrawal from the labor market. In principle, all chronic diseases have some impact on participation in the labor market. It is worth noting, however, that each of them affects workforce participation in a different manner, depending on the specific disease, country and gender. For this reason, tailored support to every individual's needs is highly recommended. Int J Occup Med Environ Health. 2020;33(3):365-84.

Comparison of Misoprostol versus Dinoprostone for delivery induction among pregnant women without concomitant disease.

OBJECTIVES: Induction of labour is a part of an active prenatal care nowadays and the ideal method of that procedure still remains to be identified. The purpose of this study was to evaluate effectiveness of misoprostol vaginal insert as compared to dinoprostone gel for delivery induction in pregnant women without any comorbidities. MATERIAL AND METHODS: It was a retrospective cohort study of 240 pregnant women. The primary study outcome was successful delivery. Other analysed parameters included time to delivery of a baby, time to the beginning of the first stage of labour, time to vaginal delivery, and duration of all delivery stages. We compared both methods regarding maternal complications during and after delivery. We also reviewed neonatal outcomes such as birth weight, birth length and 1-minute Apgar scores. RESULTS: The patients' basic characteristics were similar regarding their age, gravidity, parity, height, weight and Bishop score. Time to any delivery and to the onset of a labour in the misoprostol group versus in the dinoprostone group was 14.5 vs 35.6 h (p < 0.001) and 9.9 h vs 25.3 h (p < 0.001) respectively. The chance of the beginning of labour and the baby's delivery over time has been observed to be approximately two times higher for misoprostol as compared to dinoprostone. CONCLUSIONS: Our study showed that using misoprostol vaginal insert in comparison to dinoprostone seems to shorten the time to beginning of the first stage of labour as well as the time to the delivery itself. Some lower Apgar scores observed in the misoprostol group requires further investigation.

Validity of a Self-Reported Neglect Scale Among Older Adults in Poland.

BACKGROUND AND OBJECTIVES: The purpose of the study was to create and validate a tool that could be implemented easily to recognize the presence and assess the level of neglect in community-dwelling older adults, and to provide information about the prevalence of the phenomenon in different subgroups of older adults in Poland. RESEARCH DESIGN AND METHODS: The cross-sectional study of elder neglect and self-neglect was conducted in Lesser Poland in 2017. It included 2,443 face-to-face interviews with randomly selected community-dwelling individuals from among the general population (1,635), social service users (280), and hospital patients (528). Classical Test Theory and Item Response Theory (IRT) were used to build the scale, and its content and construct validity and reliability were assessed. RESULTS: The Self-Reported Neglect Scale (SRNS) with a 2-factor structure (basic needs and psychological needs dimensions) was created. Results of the IRT analysis showed high item discrimination (2.7-4.8 for the first factor, 0.8-3.2 for the second). The 1-year prevalence of neglect as a percentage of nonzero values of the SRNS was estimated at 11.4%. DISCUSSION AND IMPLICATIONS: The SRNS exhibited good psychometric properties. It may have promise as a tool for the assessment of neglect in epidemiological studies as well in the everyday practice of medical professionals and social workers.

Assessment of the nuclear medicine personnel occupational exposure to radioiodine.

PURPOSE: To physically and cytogenetically screen medical personnel of Department of Endocrinology and Nuclear Medicine, Holy Cross Cancer Center, Kielce, Poland (DENM) who are occupationally exposed to 131I. MATERIALS AND METHODS: The exposure was monitored by whole-body and finger ring dosimeters. The thyroid iodine intake was measured by a whole-body spectrometer equipped with two semiconductor gamma radiation detectors. A cytokinesis-block micronucleus assay and the premature chromosome condensation technique were used to assess the aberration score. Cytogenetic analyses were carried out on a group of 29 workers and were compared to 32 controls (healthy donors), matched for gender and age. RESULTS: On average, the exposed group showed a significantly higher frequency of genetic damage and a higher proliferation index compared to the control group. Smoking status, age and duration of exposure influenced the observed effects in both groups. No differences in measured biomarkers were observed after stratification of the exposed group into two subgroups based on the measured 131I activity below and above 6 Bq. CONCLUSION: The findings suggest that radiation protection principles based on whole-body and finger ring dosimetry, supported by activity measurements with a whole-body spectrometer, may be insufficient to monitor the absorbed dose estimation of the nuclear medicine staff who are occupationally exposed to 131I. Furthermore, their future health risks are influenced by confounders. Direct assessments comparing physical and biological dose estimations on the larger group are needed to accurately monitor occupational radiation exposure.

Research Project Evaluation-Learnings from the PATHWAYS Project Experience.

BACKGROUND: Every research project faces challenges regarding how to achieve its goals in a timely and effective manner. The purpose of this paper is to present a project evaluation methodology gathered during the implementation of the Participation to Healthy Workplaces and Inclusive Strategies in the Work Sector (the EU PATHWAYS Project). The PATHWAYS project involved multiple countries and multi-cultural aspects of re/integrating chronically ill patients into labor markets in different countries. This paper describes key project's evaluation issues including: (1) purposes, (2) advisability, (3) tools, (4) implementation, and (5) possible benefits and presents the advantages of a continuous monitoring. METHODS: Project evaluation tool to assess structure and resources, process, management and communication, achievements, and outcomes. The project used a mixed evaluation approach and included Strengths (S), Weaknesses (W), Opportunities (O), and Threats (SWOT) analysis. RESULTS: A methodology for longitudinal EU projects' evaluation is described. The evaluation process allowed to highlight strengths and weaknesses and highlighted good coordination and communication between project partners as well as some key issues such as: the need for a shared glossary covering areas investigated by the project, problematic issues related to the involvement of stakeholders from outside the project, and issues with timing. Numerical SWOT analysis showed improvement in project performance over time. The proportion of participating project partners in the evaluation varied from 100% to 83.3%. CONCLUSIONS: There is a need for the implementation of a structured evaluation process in multidisciplinary projects involving different stakeholders in diverse socio-environmental and political conditions. Based on the PATHWAYS experience, a clear monitoring methodology is suggested as essential in every multidisciplinary research projects.

Gender-related differences in the multi-pathway effect of social determinants on quality of life in older age-the COURAGE in Europe project.

PURPOSE: Gender-related differences in life expectancy, prevalence of chronic conditions and level of disability in the process of ageing have been broadly described. Less is known about social determinants, which may have different impacts on quality of life in men and women. The investigation aims to reveal gender-related differences in social determinants on quality of life assessed by a multi-pathway model including health, social, demographic and living place characteristics. METHODS: The study group consisted of 5099 participants aged 50+ representing general populations of three different European regions (Finland, Poland, Spain) who participated in COURAGE in EUROPE Project. Standardized tools were used to measure quality of life (WHOQOL-AGE) and social determinants (COURAGE Social Network Index, OSLO-3 Social Support Scale, UCLA Loneliness Scale, participation scale and trust). A multipath model considering exogenous predictors (demographic, economic), mediators (social) and endogenous outcome (QOL) was created to reveal the role of determinants. Gender-related differences were investigated across three age categories: 50-64; 65-79 and 80+. RESULTS: The model (RMSEA = 0.058; CFI = 0.939) showed the effects of all of the investigated determinants. Gender-related differences in the association between social constructs and QOL were observed for social networks in the group of 80+, for social support in the group of 50-64 and 65-79 years, and for social participation in the group of 65-79 years. Males benefited more (in QOL) from social networks and social support, and women from social participation. CONCLUSIONS: The research provides valuable knowledge about the role of social determinants in QOL considering complex relations between different social constructs. Additionally, the results showed gender-related differences in the associations between social networks, social support, social participation and QOL, suggesting that men might benefit more from the interventions in the first two. Although our research did not investigate the effects of interventions, the results show directions for future investigations, how to shape social interventions at the population level to improve quality of life of older adults, and thus help achieve successful ageing.

Health insurance or subsidy has universal advantage for management of hospital malnutrition unrelated to GDP.

BACKGROUND AND OBJECTIVES: Protein-energy and micronutrient malnutrition are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and parenteral (PN) nutrition in institutional and home settings. METHODS AND STUDY DESIGN: An international survey was performed between January and December 2014 in twenty-six countries from all continents. Electronic questionnaires were distributed to 28 representatives of clinical nutrition (PEN) societies, 27 of whom responded. The questionnaire comprised questions regarding a country's economy, reimbursement for CNS, education about and the use of EN and PN. RESULTS: The prevalence of malnutrition was not related to gross domestic product (GDP) at purchasing power parity (PPP) per capita (p=0.186). EN and PN were used in all countries surveyed (100%), but to different extents. Reimbursement of neither EN nor PN use depended on GDP, but was associated with increased use of EN and PN in hospitals (p=0.035), although not evident for home or chronic care facilities. The size of GDP did not affect the use of EN (p=0.256), but it mattered for PN (p=0.019). CONCLUSIONS: A worldwide survey by nutrition support societies did not find a link between national economic performance and the implementation of medical nutrition services. Reimbursement for CNS, available through health insurance systems, is a factor in effective nutrition management.

Enriched enteral nutrition may improve short-term survival in stage IV gastric cancer patients: A randomized, controlled trial.

OBJECTIVE: The aim of the study was to determine whether the postoperative use of enteral nutrition enriched with arginine, glutamine, and omega-3 fatty acids influences survival in patients diagnosed with stomach cancer. For the purpose of the study, the second wave of the trial performed in 2003 to 2009 was done. METHODS: Ninety-nine patients who underwent surgery for gastric cancer (27 F, 72 M, mean age: 62.9 y) met the inclusion criteria. Of those, 54 were randomized to standard and 45 to enriched enteral nutrition (EEN). In all patients, short- and long-term (5 y) survival was analyzed. RESULTS: Analysis of the overall survival time did not reveal differences between groups (P = 0.663). Until the end of the third month, however, there were nine deaths in the standard enteral nutrition group and no deaths in the EEN group (16.7% versus 0.0%, P = 0.004). The univariate analyses suggested that the EEN group may have lower risk, especially during the first year after intervention. A significant reduction in the risk of death was seen during the early period after surgery (first 6 mo) in the EEN group in stage IV patients (hazard ratio = 0.25, P = 0.049). The use of enriched enteral diet did not influence, however, the risk of dying when patients were analyzed together. CONCLUSIONS: The study does not support the beneficial effect of enriched enteral nutrition in long-term survival; however, the positive impact on the stage IV patients suggests the need for further, more detailed studies.

Economy matters to fight against malnutrition: Results from a multicenter survey.

BACKGROUND AND AIM: Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the state's economy on the implementation of EN and PN to define its role in ONCA. MATERIAL AND METHODS: an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n = 20). RESULTS: EN and PN were used in all countries surveyed (100%), but to different extent. The country's income significantly influenced the reimbursement for EN and PN (p < 0.05). It was also associated with the overall use of tube feeding and PN (p = 0.05), but not with the use of oral nutritional supplements (p = 0.165). The use of both, EN and PN at hospitals was not depended on the economy (p > 0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p = 0.042). CONCLUSIONS: Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition.

Aberrations Involving Chromosome 1 as a Possible Predictor of Odds Ratio for Colon Cancer--Results from the Krakow Case-Control Study.

BACKGROUND: There is still an open question how to predict colorectal cancer risk before any morphological changes appear in the colon. OBJECTIVE: The purpose was to investigate aberrations in chromosomes 1, 2 and 4 in peripheral blood lymphocytes analyzed by fluorescence in situ hybridization technique as a tool to assess the likelihood of colorectal cancer. METHODS: A hospital-based case-control study included 20 colon cancer patients and 18 hospital-based controls. Information about potential covariates was collected by interview. The frequency of stable and unstable chromosome aberrations in chromosome 1, 2 and 4 was assessed by fluorescence in situ hybridization technique. RESULTS: Colorectal cancer patients, as compared to controls, had a relatively higher frequency of chromosome 1 translocations (median: 3.5 versus 1.0 /1000 cells, p = 0.006), stable aberrations (3.8 versus 1.0 /1000 cells, p = 0.007) and total aberrations (p = 0.009). There were no differences observed for chromosomes 2 and 4. Our results showed an increase in the odds of having colon cancer by about 50-80% associated with an increase by 1/1000 cells in the number of chromosome 1 aberrations. CONCLUSIONS: The results revealed that the frequency of chromosomal aberrations, especially translocations in chromosome 1, seems to be a promising method to show a colon cancer risk. Additionally, our study suggests the reasonableness of use of biomarkers such as chromosome 1 aberrations in peripheral blood lymphocytes in screening prevention programs for individuals at higher colon cancer risk to identify those who are at increased risk and require more frequent investigations, e.g. by sigmoidoscopy.

Sleep duration and mortality among older adults in a 22-year follow-up study: an analysis of possible effect modifiers.

The aim of this study was to assess the relationship of sleep duration and all-cause mortality among 2,449 Polish community-dwelling older citizens of Krakow observed during 22 years of follow-up. In particular, the role of some demographic, psychosocial and health-related conditions were investigated in terms of modification effect. In the prospective study, background information was gathered by face-to-face interview. Vital data were obtained from the population registry. Cox regression models were used to assess the role of sleep duration in mortality, in the analyses of potential effect modifiers and the shape of the relationship. Sleep duration was observed to be a significant predictor of all-cause mortality. Life-weariness, functional activity, total number of chronic diseases and age (65-79, 80+) were found to be effect modifiers for the relationship between sleep duration and mortality. Further investigation showed a U-shaped mortality risk associated with the duration of sleep among individuals with a high level of life-weariness, high functional activity and in individuals aged 80 and over. On the other hand, a linear relationship between longer sleep duration and mortality was observed among older people with no experience of life-weariness, without chronic diseases, with medium functional activity and aged 65-79, but also among those who reported three and more chronic conditions. Results of our study support available evidence showing the relationship between sleep duration and mortality among older adults and suggest that any public health intervention in this area should consider also other coexisting modifiable psychosocial and functional determinants.