80 Years of the Medicine and Tropical Hygiene Center in Gdynia (1937-2017): The Pioneer Pre-War Years 1937-1939.

The present Interdepartmental Institute of Maritime and Tropical Medicine in Gdynia of the Medical University of Gdansk was formally established in 1939 by the Order of June 5, 1939, of the Minister of Social Welfare, Marian Zyndram-Koscialkowski. However, the Branch of the National Institute of Hygiene in Gdynia was founded 2 years earlier, in 1937 (the first head was Dr. Med. Jerzy Jakóbkiewicz [1892-1953]), and its fruitful activity was ennobled 2 years later by increasing its rank and adding the name "Marine and Tropical Hygiene Institute". These facts are very little known, and therefore worth presenting in the jubilee years of the 80th anniversary of the institution.

Interpopulation study of medical attendance aboard a cruise ship.

The study carried out aboard a cruise ship in the years 1993-1998 involved ship passengers of various nationalities including 3872 Germans aged 23-94 years and 1281 Americans aged 25-94 years. Both nationality groups were divided into two age subgroups: till 64, and 65-94 years. The German younger age subgroup (mean age 53.2 years) consisted of 59% of the passengers, whereas the 65-94 years subgroup (mean age 72 years) was made up of 41% of the ships passengers. On the other hand, 73% of the Americans belonged to the 65-94 years subgroup (mean age 73,4 years), whereas 27% to the younger one (mean age 52.8 years). The number of onboard consultations and their causes were determined. The occurrence of chronic illnesses in both 65-94 years subgroups was assessed by means of a questionnaire. A higher frequency of consultations was found in the Germans (24.38%) than in the Americans (14.05%) (p=0.001). The difference was particularly striking in the people over 65 years of age (30.87% of the Germans as compared with 14.22% of the Americans, p=0.001). The Germans were nearly 4-times more frequently seen than the Americans for cardio-vascular diseases and almost 3-times more often because of gastrointestinal disorders. The discrepancies in the consultation rates were mainly caused by the different insurance systems of both nations. Chronic illnesses as estimated by means of the questionnaire prevailed in the German passengers. The statistically significant differences (13.3% versus 20%, p=0.01 and 0.001) regarded the locomotor system, urinary tract diseases and a group of illnesses including neurological, ophthalmological, ear, skin, malignant diseases and diabetes.

Severe malaria--analysis of prognostic symptoms and signs in 169 patients treated in Gdynia in 1991-2005.

In the period 1991-2005, 169 patients with the diagnosis of malaria were hospitalized in the Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine in Gdynia (from 2003--the Academic Centre of Maritime and Tropical Medicine, Medical University of Gdansk). All the cases were analysed for severity, occurrence of complications and permanent sequelae of the disease. According to the criteria set by the WHO (5), malaria was classified as severe in 36 cases. All of them were Plasmodium falciparum infections or mixed infections: P. f. and another species of the parasite. Patients in this group developed a number of complications, inter alia shock, acute respiratory distress syndrome (ARDS), acute renal failure, blackwater fever, severe anemia, disseminated intravascular coagulation, myocarditis, consciousness disorders of varied degree, acute transient psychoses, and exacerbation of ischemic heart disease. In one case of a pregnant woman, necrosis of the fetus occurred in the course of disease in the 4th month of pregnancy. Moreover, meningoencephalitis was diagnosed in two patients--in one of them concurrently with symptoms and signs of malaria, while in the other one-3 weeks after the symptoms subsided. In 6 patients, permanent sequelae of the disease developed and in 4 patients the disease was fatal. The cause of death was multi-organ failure, with the first sign of poor prognosis being rapidly progressing renal failure resistant to treatment in three men; in one case death resulted from cerebral malaria. In cases of suspected malaria, relapsing malaria or in mixed infections, molecular testing was a valuable complementary tool of diagnosis, which helped in beginning the appropriate treatment.

Malaria relapse and recrudescence among travellers to the tropics.

This study describes 14 cases of relapse and recrudescence of malaria, treated between 1991 and 2003. In that period, 146 patients were hospitalized in the Clinic of the Institute in Gdynia: 20 women and 126 men. In 103 cases the disease was caused by Plasmodium falciparum, in 31 cases by Plasmodium vivax, in 5 cases by Plasmodium malariae, and in 2 cases by Plasmodium ovale. Five patients were found to have mixed infections, with either P. falciparum and P. vivax or P. falciparum and P. ovale. Relapses in patients previously treated in the country or abroad accounted for 9.6% of all the treated cases of malaria. Recrudescences and relapses were diagnosed of both the tropical malaria (6 cases), and the tertian malaria caused by P. vivax (4 cases). Moreover, in 4 patients diagnosis was made of secondary malaria due to P. vivax infection, while the primary attack was caused by invasion of P. falciparum. Also discussed was the issue of drug-resistance of plasmodia and the resulting problems with the treatment.