[Assessment of occupational hazards and their prevention in the work of dental technicians during the COVID-19 pandemic]. / Ocena zagrozen zawodowych oraz ich profilaktyka w pracy techników dentystycznych w czasie pandemii COVID-19.

BACKGROUND: Work of a dental technician is associated with exposure to a number of harmful factors. We can distinguish: chemical, biological, physical and psychophysical factors. They contribute to many diseases, but not all of them are classified as occupational diseases. The main aim of the study was to assess the health hazards that occur in the workplace of a dental technician and their prevention during the COVID-19 pandemic. MATERIAL AND METHODS: An epidemiological cross-sectional study was conducted. A self-created questionnaire form containing 28 questions was used. The link to the survey was shared on social groups associating dental technicians. Participation in the study did not require logging in. During the data collection, the respondents' personal data were not collected and processed. RESULTS: 148 dental technicians participated in the study. The largest group were participants aged 21-25 (32%), the smallest group were people over 50 (6%). The most frequently occupied position was acrylic and plaster. More than 1/3 of those surveyed reported having allergies, most often to acrylic or metal. More than 20% of technicians reported experience of mechanical injuries several times a week or more. 17% of technicians declared professional burnout. 80% of technicians used protective clothing. Personal protective equipment was always used by only 22% of technicians, and as many as 29% of respondents never used the listed protective equipment. CONCLUSIONS: Not all dental laboratories were equipped with the necessary personal protective equipment. The most commonly used personal protective equipment included: disposable gloves, disinfectant liquid and extract. The COVID-19 pandemic contributed to a change in disinfection procedures in more than 1/3 of the respondents. 35% of them started using disinfection only after the outbreak of the pandemic, while most of the changes concerned the improvement of existing procedures. The length of work experience of technicians had an impact on exposure to stress and occupational burnout. Med Pr Work Health Saf. 2023;74(4):289-99.

Selected aspect of Pierre Bourdieu's "Praxis" in the area of decision-making about therapy and medical care.

In the era of increasingly developing medical services, decision-making about therapy and care is conditioned not only by medical and psychological factors, but also by increasingly institutional and social factors. Which of the factors of the social environment and medical institutions play the greatest role in the process of deciding on therapy and medical care? In seeking answers to the questions posed, reference was made to the theory of "praxis" by P. Bourdieu. These theoretical concepts: habitus, capital field, have been presented in such a way that it is possible to see their impact on the decisions of patients and medical staff and to take into account the dependencies and mutual influences between them. The article refers to Polish and English-language literature. Research results and theoretical conclusions on the impact of social factors and the direct institutional environment on the decision formation of various entities involved in the decision-making process have been presented.

Questionnaire-Based Study of 81 Patients in Poland to Evaluate the Course of Inflammatory Bowel Disease and the Effects of the COVID-19 Pandemic on Quality of Life and Mental State from February to June 2021.

BACKGROUND The COVID-19 pandemic affected many people worldwide, including those with chronic diseases. Our objective was to analyze its influence on medical care and the course of inflammatory bowel disease (IBD) in Poland. MATERIAL AND METHODS In 2021, 81 patients in Poland with IBD completed an original anonymous questionnaire about the impact of the COVID-19 pandemic on the course of their disease and mental status. The printed questionnaire was distributed to IBD patients treated at the Gastroenterology Outpatient Clinic of the University Clinical Hospital in Bialystok, and an online questionnaire was sent to patients via social media. Statistical analysis was performed using the chi-squared test, with a significance level of P<0.05. RESULTS The study group consisted of 46 women and 35 men with a mean age of 32.42 years. Fifty-nine patients had ulcerative colitis and 22 had Crohn disease. Patients reported significant deterioration in medication availability (50.62%) and restricted access to gastroenterology outpatient clinics (51.90%) (P<0.05). Of patients who contracted COVID-19, 89.47% did not require hospitalization, 32.10% (26/81) were asymptomatic, mild, or moderate, despite immunosuppressive biological treatment (27.16%, 22/81), or steroids (18.52%, 15/81). Over 50% of respondents stated the pandemic negatively affected their mental state and 30% of them associated that with worsening IBD. CONCLUSIONS During the pandemic, respondents were mainly concerned with difficulties in accessing the gastroenterology clinic and limited drug availability. The pandemic negatively affected patients' mental state. In cases of COVID-19 disease, patients with IBD were mostly asymptomatic and did not require hospitalization, despite therapy affecting the immune system.

Comparative Effectiveness of Various Eradication Regimens for Helicobacter Pylori Infection in the Northeastern Region of Poland.

PURPOSE: Due to the lack of systematic data on antibiotic sensitivity, the treatment of the highly prevalent and pathogenic Helicobacter pylori (H. pylori) infection still poses a significant problem. Therefore, the aim of our study was to compare the efficacy of the three most commonly used anti-H. pylori therapies in northeastern Poland. PATIENTS AND METHODS: This was a retrospective, single-center study performed on 289 outpatients with an H. pylori infection. Patients received one of the following three treatment regimens: (1) bismuth quadruple therapy (BQT) for 10 days, (2) metronidazole-based triple therapy (M-TT) for 10 or 14 days, and (3) levofloxacin-based triple therapy (L-TT) for 10 or 14 days. RESULTS: BQT, M-TT, and L-TT accounted for 93.2% of prescribed anti-H. pylori therapies. The overall success rate for all treatment regimens was 84.1% (243/289). The effectiveness of first- and second-line therapy was similar and reached 83.8% and 86.2%, respectively. The efficacy of the individual treatment regimens was as follows: (1) BQT-89.4% (84/94), (2) M-TT-80.6% (112/139) and 78.8% (26/33) for 10 and 14 days, respectively, and (3) L-TT-84.6% (11/13) and 100% (10/10) for 10 and 14 days, respectively. The overall duration of treatment and type and dose of proton pump inhibitor (PPI) had no effect on the treatment efficacy. CONCLUSIONS: In the northeastern part of Poland, 10-day BQT and 10- or 14-day L-TT are effective treatment regimens for H. pylori eradication and have appear to be superior to M-TT. Practitioners in our clinic followed mostly local anti-H. pylori therapy guidelines.

Relationship between Dietary Behaviors and Physical Activity and the Components of Metabolic Syndrome: A Case-Control Study.

Poor diet and low physical activity play an important role in the etiopathogenesis of metabolic syndrome. The aim of this study was to analyze the association between nutrient intake, groups of food products and physical exercise undertaken and the components of metabolic syndrome (MS). The study included 330 patients with MS, and the control group comprised of 270 subjects without MS. The food intake was assessed using 24-h dietary recall, and a 13-item Food Frequency Questionnaire. To assess nutrition knowledge, a Beliefs and Eating Habits Questionnaire was used. The level of physical activity was assessed using the International Physical Activity Questionnaire. Three patterns of behavior were identified: Prudent-Active, Western-Sedentary, and NotPrudent-notWestern-lowActive. In the Prudent-Active group, as compared to the NotPrudent-notWestern-lowActive subjects, the risk of central obesity, hypertension, hypertriglyceridemia, low HDL cholesterol and hyperglycemia occurrence was lower. There was also a lower proportion of patients with MS. As compared to the NotPrudent-notWestern-lowActive subjects, in the Prudent-Active group there was more than a two times higher chance of subjects with a high level of nutrition knowledge. Western diets have been proven to exert a detrimental effect on the components of MS. When designing intervention programs, education of patients with MS on dietary habits and physical activity should be considered.

Expression of VEGF, EGF, and Their Receptors in Squamous Esophageal Mucosa, with Correlations to Histological Findings and Endoscopic Minimal Changes, in Patients with Different GERD Phenotypes.

BACKGROUND: Gastroesophageal reflux disease (GERD) may present as nonerosive reflux disease (NERD), erosive esophagitis (EE), or be complicated by Barrett's esophagus (BE). The explanation as to what determines the phenotype of GERD is awaited. Therefore, we assessed the correlation between the growth factors expression and endoscopic as histologic findings in GERD patients. METHODS: The squamous esophageal epithelium of 50 patients (20-NERD, 7-EE, 15-BE, 8 controls) was examined by: (1) magnification endoscopy with evaluation of minimal GERD changes such as: microerosions, white spots, palisade blood vessels visibility, and intrapapillary capillary loops (IPCLs) appearance, (2) histology, (3) immunohistochemistry with evaluation of the expression of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and their receptors (VEGFR and EGFR). RESULTS: The expression of VEGF, but not VEGFR, EGF, and EGFR, was significantly increased in EE patients compared to NERD patients and controls. VEGF levels correlated significantly with the presence of white spots, but not with other minimal endoscopic and histologic features. The EGFR expression correlated positively with basal cell hyperplasia and enlarged IPCLs. CONCLUSIONS: Our findings suggest a correlation between growth factors expression and findings in conventional endoscopy, formation of endoscopic minimal changes, and histologic lesions.

Resting Metabolic Rate in Women with Endocrine and Osteoporotic Disorders in Relation to Nutritional Status, Diet and 25(OH)D Concentration.

There are speculations that vitamin D may be an important regulator of the energy metabolism. The aim of this study was to evaluate the influence of serum 25(OH)D concentration and nutritional status on the resting metabolic rate. The study group consisted of 223 women with endocrine and/or osteoporotic disorders. The control group consisted of 108 women, clinically healthy. The total 25(OH)D concentration level was measured with an assay using chemiluminescent immunoassay technology. Indirect calorimetry was applied to assess the resting metabolic rate. The mean resting metabolic rate was significantly lower in the group of women with metabolic disorders than in the control group. A correlation was found between serum 25(OH)D levels in healthy subjects and the resting metabolic rate. Significantly higher resting metabolic rate was found in women with normal serum 25(OH)D levels in comparison to subjects with deficient vitamin D levels. The control group demonstrated a relationship between body fat tissue and fat-free body mass and the resting metabolic rate. Both 25(OH)D concentration and body composition were factors influencing the resting metabolic rate in the group of healthy subjects. More research is needed to clarify the relationship between vitamin D status and metabolic rate in individuals with endocrine and osteoporotic disorders.

Assessment of cardiovascular risk in patients with metabolic syndrome working in the agricultural sector.

INTRODUCTION: Cardiovascular diseases are the main death cause in Poland. Several clinical studies showed association between metabolic syndrome and higher prevalence of diabetes mellitus, cardiac events and mortality. The aim of the study was to estimate cardiovascular complications and death risk in subjects with metabolic syndrome (MS) working in agriculture. MATERIAL AND METHODS: The study included 332 people working in agriculture in Lodz voivodeship, 231 with MS and 101 healthy ones. Increased risk of cardiovascular complications was determined for pulse pressure (pp) >63 mmHg. Based on the SCORE index, 10-year death risk due to cardiovascular complications was estimated taking into account sex, age, smoking, systolic blood pressure and total cholesterol concentration. A value ≥5% was accepted as high risk of death within 10 years. RESULTS: Increased risk of cardiovascular complications (pulse pressure >63 mmHg) was found in 31.60% subjects with MS and 6.93% healthy ones. CONCLUSIONS: High risk of cardiovascular complications and death occurs statistically more frequently in subjects with MS than in the rest of the population.

Profile of new vascular damage biomarkers in middle-aged men with arterial hypertension.

PURPOSE: Normal endothelial function is important for the homeostasis of the cardiovascular (CV) system. The aim of the present study was to determine the profile of key parameters of endothelial dysfunction in middle-aged men that play a significant role in the functioning of endothelial vessels, which seems to be crucial for the early diagnosis of cardiovascular disorders. MATERIALS AND METHODS: The study included 53 men, 20 with hypertension (HTN), 18 with HTN and related diseases, 15 healthy controls Apart from general testing (BMI, biochemical analysis, SBP, DBP), we used the Griess reaction to assess the total amount of nitric oxide (NO), and used ELISA to verify the concentrations of malondialdehyde (MDA), nitrotyrosine (NT), asymmetric dimethylarginine (ADMA), tumor necrosis factor-alpha (TNF-α), monocyte chemotactic protein 1 (MCP-1), and myeloperoxidase (MPO). Furthermore, we assessed the concentration of circulating free DNA (cfDNA) using the fluorescence method. RESULTS: The values of MDA, ADMA, cfDNA, and MPO observed in samples from men with HTN were determined to be higher compared to those from men without HTN. In the group of men with HTN and other concomitant cardiovascular disorders, we observed low concentrations of NO, MDA, and ADMA with high concentrations of cfDNA. CONCLUSIONS: The results obtained for parameters selected for the study, should be considered by cardiologists as a prompt to include in the diagnostic profile the assessment of NO and cfDNA concentrations for risk evaluation and/or diagnosis of endothelial dysfunction in patients suffering from HTN or related complications.

Does place of residence affect patient satisfaction with hospital health care?

INTRODUCTION AND OBJECTIVE: Measuring the level of patient satisfaction is a useful tool in delivering quality care that is responsive to consumer preferences. Various socio-demographic factors might be considered as potential predictors of patient satisfaction. The aim of the study was to assess whether place of residence (rural/urban) affects patient satisfaction with hospital health care. MATERIAL AND METHODS: Data were obtained using face-to-face questionnaire, administered in five large, urban hospitals in Podlaskie Province, north-eastern Poland, during 2014-2018. The study sample comprised of 1,624 participants (585 rural, 1039 urban) who assessed satisfaction with 28 hospital health care items. The means and standard deviations were presented to compare 28 satisfaction items between the rural and the urban samples. Regression analysis was used to determine whether location difference (rural vs urban) affected patient satisfaction with various domains of hospital health care. RESULTS: The mean results of 28 satisfaction items on the 1-5 scale were similar among the rural and the urban samples, and generally skewed towards positive experiences. In the univariate analysis, significant associations between place of residence and patient satisfaction were identified with regard to three components of inpatient care: 1) hospital settings and staff care, 2) doctors' professional skills, and 3) hospitalization outcomes. After adjusting for socio-demographic variables, the association remained significant only with respect to satisfaction with hospitalization outcomes (b = 0.121; SE = 0.055; p = 0.028). CONCLUSIONS: Some evidence for differences in patient satisfaction by place of residence was found. Study findings may be helpful in implementing care quality improvement programmes.

Importance of financial liquidity in hospital management

INTRODUCTION: Financial liquidity management in hospitals is of great importance in ensuring access to medical care and continuity of health care service provision. It is one of the management's biggest challenges, which the possibility to conduct health care activity depends on. OBJECTIVE: The objective of this study was to assess the financial liquidity of public hospitals, based on the example of public hospitals in Podlaskie Voivodeship in years 2013-2017. MATERIALS AND METHODS: Revenues, expenses and financial performance levels were analysed and financial liquidity was evaluated with reference to current and quick ratios. Public hospitals, whose founding entity is the Podlaskie Voivodeship Self-government, were selected for the study. The assessment of the financial situation was based on the data from the hospitals' financial statements for years 2013-2017. The assessment was made with a special reference to financial liquidity. RESULTS: In years 2013-2017, a steady increase of revenues and expenses was observed in the case-study hospitals. The general financial performance of these entities improved significantly. During the assessment period, the current ratio in the hospitals was average, exceeding the optimal value. In the first hospital group (number of beds>250), the current ratio was below the optimal values (except for 2016). The second hospital group (number of beds<250) was characterised by liquidity ratios above the optimal value. CONCLUSIONS: Management of financial liquidity in hospitals, aimed at maintaining financial liquidity at optimal level, should be the management's priority action when managing the finances of a health care entity. These actions should be multi-directional and based on information about the financial situation of the hospitals and on the hospital's ratio analysis, which is vital for the management's decision making.

Concentration of Selected Elements and Antioxidative Potential in a Group of Males Working in the Metal Industry: Elements And Antioxidative Potential In Men.

The purpose of this study was to show that some elements have a proven antioxidative effect and are essential for the proper development and functioning of the human body. The study also assessed the concentration of selected elements and total antioxidant status (TAS) in a group of male inhabitants of Bialystok, Poland, who are professionally active in the metal industry. The study group comprised 163 men aged 55-64 years. The concentration of the analyzed elements was determined using flame (Zn and Cu) and electrothermal (Se, Cd, and Pb) atomic absorption spectrometry. Spectrophotometric test kits were used to assay the TAS and glutathione reductase (GR) activity in serum. The results suggested the mean concentration of Se in serum was 54.04 ± 12.10 µg/L, which was below the reference range. A significant negative correlation was observed between the concentration of Se in the serum and Pb and Cd concentrations in the whole blood of the studied men. The concentrations of the other elements, antioxidant potential, and GR activity were within the reference range. A statistically significant positive correlation was observed between Pb and Cd, indicating combined exposure and a considerable negative correlation between lead and selenium as well as between lead and TAS. Selenium and TAS are likely to modify the adverse effects of Pb in the bodies of the studied men. The results indicate that it is necessary to constantly monitor men who are occupationally exposed to heavy metals, maintain a healthy lifestyle, and introduce effective preventive measures at a local level.

Inequalities in breast cancer incidence and stage distribution between urban and rural female population in Swietokrzyskie Province, Poland.

INTRODUCTION AND OBJECTIVE: One of the main factors determining the burden of breast cancer is the effectiveness of measures taken to combat this cancer including urban-rural differences. The aim of the study was to analyse the differences in breast cancer incidence and disease stage distribution among urban and rural women in the Swietokrzyskie Province as a part of a strategy for breast cancer control. MATERIAL AND METHODS: The study of disease stage distribution included 483 female residents of Swietokrzyskie Province who were diagnosed in 2013 with invasive breast cancer, and reported to Swietokrzyskie Office for Cancer Registration. Urban-rural differences in breast cancer incidence in 2002-2013 were presented using Range Ratio (RR). Changes in incidence trends in urban and rural areas were analysed using joinpoint models. Annual Percentage Change (APC) of the rates was calculated for each time trend. RESULTS: Breast cancer incidence rate in the urban female population was higher than in rural women with RR, amounting to 1.43. However, the analysis of trends showed that the pace and direction of change were developing negatively among inhabitants of rural areas. In 2002-2013, in rural women, the age-standardized rate (ASR) values increased by 2.8% per year (p<0.05). The course of ASR trends showed statistically significant urban-rural differences (p=0.004). Analysis of urban-rural differences in disease stage distribution revealed a non-significantly higher proportion of cases with localised stage in urban than in rural areas, amounting to 51.0% and 43.9%, respectively. CONCLUSIONS: Existing health inequalities indicate the need to intensify activities in rural areas and should be the starting point for making key decisions in combating breast cancer.

Changes in Dietary Patterns and the Nutritional Status in Men in the Metallurgical Industry in Poland Over A 21-Year Period.

BACKGROUND/AIMS: The study was carried out to evaluate the changes in the eating habits and lipid parameters in a 21-year follow-up on a group of 435 men living in Poland. METHODS: The studied population was composed of the same subjects: a group of men who were first studied in the years 1987-1989 and in 2008-2010. The following data was gathered: body mass, body mass index (BMI), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride concentration in blood serum. RESULTS: The changes in the eating habits among the studied men registered throughout the 21-year period were positive since they showed a reduction in the caloric content of their diet (p < 0.001), lower total fat content (p < 0.001), total amount of carbohydrates (p < 0.001), sucrose (p < 0.001), iron (p < 0.001), and featured more vitamins: A (p < 0.002), B1 (p < 0.001), and C (p < 0.001). An adverse trend was observed in terms of constant calcium shortages in their food portions (ns). A 21-year follow-up of the studied group showed significant differences in terms of weight (p < 0.001), BMI (p < 0.001), and all cholesterol fractions (p < 0.001) in their blood serum, except cholesterol alone (ns). CONCLUSION: It is important to continue observing the dietary trends in the studied group, with the focus on the occurrence of potential changes in their bodies.

Trends of potential years of life lost due to main causes of deaths in urban and rural population in Poland, 2002-2011.

The aim of the study was to analyse the level and the trends of Potential Years of Life Lost due to main causes of deaths in Poland in 2002-2011, with consideration of place of residence, urban-rural. The material for the study was the number of deaths due to main causes in Poland in years 2002-2011, based on data from the Central Statistical Office. Premature mortality analysis was conducted with the use of PYLL indicator (PYLL - Potential Years of Life Lost). PYLL rate was calculated according to the method proposed by J. Romeder, according to which the premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the annual percent change (APC) were assessed using the Joinpoint Regression Programme. Rural/urban ratio was used to presented the differences in premature mortality between rural and urban areas . In years2002-2011, the PYLL rate for all-cause deaths decreased by 13.2% among men and 16.0% among women in rural areas, whereas in urban decreased it decreased by 15.7% among men and 14.9% among women. In 2011, the main causes of PYLL among men in rural areas were: external causes (32.3%), cardiovascular diseases (23.5%) and cancers (19.4%); in urban areas: cardiovascular diseases (24.7%), external causes (24.3%) and cancers (20.9%). Among women in rural areas, the leading causes were: cancers (39.9%), cardiovascular diseases (20.1%) and external causes (15.1%). The main causes of premature mortality among women in urban areas were: cancers (41.7%), cardiovascular diseases (19.6%) and external causes (11.1%). Premature mortality among men in rural areas was significantly higher than in urban for all analysed causes of death, with the exception of ischaemic heart diseases and colorectal cancer. Premature mortality among women in rural areas was significantly lower than in urban for all analysed cause of deaths, except of cerebrovascular diseases, external causes, suicides and traffic accidents. The presented epidemiological situation for premature mortality indicate differences in the state of health of the inhabitants in urban and rural areas in Poland. The leading causes of premature mortality are caused by preventable deaths, which leads to a need to intensify measures in primary and secondary prevention.

Perinatal mortality in urban and rural areas in Poland in 2002-2012.

AIM: The aim of this study was to analyze the level and trends of perinatal mortality by mother's place of residence (urban vs rural area) in Poland in 2002-2012. MATERIAL AND METHOD: This study was based on the data of the Central Statistical Office on the number of live births, infant deaths (0-6 days) and stillbirths by mother's place of residence (urban vs rural area), reported in 2002-2012 in 16 provinces and Poland in general. Joinpoint model was used to analyze perinatal mortality rate trends over time and average annual percent change (APC). Urban/rural ratio was employed to demonstrate the differences in perinatal mortality between urban and rural areas. RESULTS: In the period analyzed, perinatal mortality in Poland decreased by 3.4% (p<0.05) and 2.7% (p<0.05) per year in urban and rural areas, respectively. Having considered urban areas, perinatal mortality rate was decreasing at the fastest pace in the following provinces: Pomorskie (APC) = -6.6%, p<0.05), Warminsko-Mazurskie (APC) = -5.4%, p<0.05), Lubuskie i Swietokrzyskie (APC = -4.5%, p<0.05) while for rural areas - Dolnoslaskie (APC = -4.3%, p<0.05), Wielkopolskie, Zachodniopomorskie (APC = -3.7%, p<0.05) and Slaskie (APC = -3.2%, p<0.05). CONCLUSIONS: In the study period, a decrease in perinatal mortality was reported in Poland, both in urban and rural areas. The level of perinatal mortality rate as well as the pace of these changes differed between provinces.

Trends of premature mortality in Swietokrzyskie Province (Poland), years 2002-2010.

BACKGROUND: Premature mortality in younger age groups influences the society as far as social and economic aspects are concerned. Therefore, it is important to come up with a tool which will allow to assess them, and will enable to implement only these health care measures that bring tangible benefits. That is the reason for introducing PYLL rate (PYLL - potential years of life lost), which is an addition to the analysis of premature mortality as it includes the number of deaths due to a particular cause and the age at death. OBJECTIVE: The purpose of this study was to analyse the level and trends of PYLL rate according to death causes in years 2002 -2010 in Swietokrzyskie Province. MATERIAL AND METHODS: The material for the analysis was the information from the Central Statistical Office on the number of deaths due to all causes registered among the inhabitants of Swiytokrzyskie Province in years 2002-2010. Causes of death were coded according to the 10th revision of the International Classification of Diseases. The analysis of premature mortality was carried out with the use of PYLL rate. PYLL rate was calculated according to the method proposed by Romeder, according to which the premature mortality was defined as death before the age of 70. The analysis of time trends of PYLL rate and the APC (annual percent change) of the PYLL rate were calculated using jointpoint model as well as the Jointpoint Regression Program (Version 4.0.1 - January 2013). RESULTS: In men, in years 2002 - 2007 PYLL rate increased by 1.5% per year (p<0.05). From year 2007 the trend went downward and PYLL rate decreased on average by 3.1% per year till year 2010. External causes of death, cardiovascular diseases and cancers in years 2002 - 2010 were the reason for almost 74.0% PYLL in men. In year 2010 PYLL rate due to all death causes amounted to 8913.8/105 and was three times higher than in women (2975.5/10(5)). In women, however, during the analysed period PYLL rate did not change significantly, and was dominated by cancers, cardiovascular diseases and external death causes. Similarly to men, those three groups of death causes were responsible for an average 76.0% PYLL. CONCLUSIONS: The analysis of the causes of premature mortality in Swietokrzyskie Province shows that in the majority of cases it is due to preventable deaths, which calls for the necessity of more intensive measures in primary and secondary prevention as well as the improvement in treatment standards, mainly of cardiovascular diseases, cancers, injuries and accidents.

Premature mortality due to cancer in Swietokrzyskie Province (Poland) in 1999-2010.

THE PURPOSE OF THE STUDY: The purpose of the study was to analyze the level and the trends of premature mortality caused by selected cancers in Swietokrzyskie Province in years 1999-2010. MATERIAL AND METHODS: The material for the study was the data published in the Swietokrzyskie Cancer Registry on the number of deaths caused by cancers as well as the information from the Central Statistical Office on the number of deaths due to general death causes in Swietokrzyskie Province in years 1999-2010. The premature mortality analysis was conducted with the use of PYLL indicator (PYLL - potential years of life lost). PYLL rate was calculated according to the method proposed by J. Romeder, according to which the premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the average annual percent change (APC - annual percent change) were assessed usingjointpoint models as well as the Jointpoint Regression Program (Version 4.0.1 - January 2013). RESULTS: In year 2010 cancers were responsible for 18.3% of PYLL in men and 48.1% in women. In years 1999-2010 PYLL rate in men decreased due to lung cancer (APC=0.75%) and stomach cancer (APC=1.2%). The increase in rate of PYLL was noted for colorectal cancer (APC=3.3%, p<0.05) and prostate cancer (APC=1.6%). In women, rate of PYLL increased due to lung cancer (APC=6.2%, p<0.05), colorectal cancer (APC=2.9%), breast cancer (APC=1.8%) and ovarian cancer (APC=0.15%). Rate of PYLL decreased due to cervical cancer (APC=4.3%, p<0.05) and stomach cancer (APC=1.5%). SUMMARY AND CONCLUSIONS: During the analysed period the highest increase of premature mortality was observed in colorectal cancer in both sexes and lung cancer in women, a slightly smaller increase was noted for breast cancer and prostate cancer. What is particularly important is the trend and a slight decrease of premature mortality rate caused by lung cancer in men and its significant decrease for cervical cancer as well as stomach cancer in both sexes.

The breast-conserving surgery of women with breast cancer in Podlaskie Voivodeship (Poland). Population study.

INTRODUCTION: The results of breast cancer treatment depend mainly on better detection in mammography screening and, consequently, a higher proportion of women with early stage of the disease. They depend also on a better access to health care services and the effectiveness of oncological treatment. One of the methods of breast cancer control is a breast-conserving surgery. With a proper patients' classification for the treatment, the results of the breast-conserving surgery do not differ in relation to mastectomy. That's why, the availability of breast-conserving surgical methods is particularly important, especially in a population in which a population screening is conducted. OBJECTIVE: The analysis of the selected aspects of the breast cancer treatment's standard in Podlaskie Voivodeship. PATIENTS AND METHODS: In years 2001-2002, 709 cases of women with breast cancer were reported to the Voivodeship Cancer Registry in Bialystok. 659 women were diagnosed with a primary invasive breast cancer. Based on a cohort of 499 women treated with radical methods the following indicators, recommended by WHO for the evaluation of the breast-conserving surgery's availability, were calculated: a percentage of patients with whom breast-conserving surgery was used, a proportion of breast cancer cases receiving post-operative breast radiotherapy after breast-conserving surgery and a proportion of breast-conserving surgery in pT1 cases. RESULTS: The breast-conserving surgery has been used much less frequently in Podlaskie Voivodeship than in Western Europe, but more frequently than in Poland in general. CONCLUSION: It should be aimed to provide a surgical treatment with the use of breast-conserving surgical methods to the highest possible percentage of patients. The increase of the percentage of patients treated with breast-conserving surgery methods can be a result of an effective screening realisation.

Differences in results of breast cancer curative treatment between urban/rural female population in Podlaskie Voivodship of Poland before introduction of the National Cancer Control Programme.

The aim of the study was to evaluate differences in the results of the curative treatment received by women with breast cancer in urban and rural area in Podlaskie Voivodship in 2001-2002 before the introduction of the National Cancer Control Programme. The analysis was based on 449 women with breast cancer, who received curative treatment in years 2001-2002. Relative 5-year survival rates as function of age and stage among urban and rural women population were calculated. The results showed that survival rates in Podlaskie Voivodship among curatively treated women with breast cancer were 81.9% but they differed between urban and rural areas. Patients living in rural areas had much lower survivals than those living in urban areas at local and regional stage of disease. In all age groups considered in the study survivals in rural areas were lower than in urban ones in which survivals were higher in 55-64 age group. These results indicated the necessity intervention in order to increase the access to the health care system and effectiveness of early detection and also improved treatment standards for more disadvantaged rural areas. These results should be also considered in monitoring of the National Cancer Control Programme introduction in Poland in 2006.