Assessment of physicians' career satisfaction in the Silesian Voivodeship, Poland.

OBJECTIVE: Aim: To assess the career satisfaction of physician's in the Silesian Voivodeship, Poland, in relation to selected factors. PATIENTS AND METHODS: Materials and Methods: The questionnaire survey was conducted among 701 physicians and dentists from the Silesian Voivodeship, Poland, in the period from January to December 2018, using the PAPI (Paper and Pencil Interview) method. Physicians' Career Satisfaction was measured and basic socio-demographic, economic and occupational data, concerning lifestyle and health, and also the level of life satisfaction according to the SWLS (Satisfaction with Life Scale) were collected. Moreover, the occurrence of anxiety and/or depressive symptoms according to the HADS (Hospital Anxiety and Depression Scale) were included in the analyses. RESULTS: Results: The career satisfaction of the surveyed Silesian physicians and dentists was moderate. Wages and combining personal life with work were rated the lowest, while interpersonal opportunities were rated the highest. The predictors: age, economic status and body mass index (BMI) were significant; in addition, in younger age group (25-49 years) - practicing sports and chronic fatigue, and in older age group (50-80 years) - the presence of a chronic disease. A moderate correlation between the level of career satisfaction and life satisfaction was revealed, as well as a lower score in people with the occurrence of anxiety and/or depression symptoms. CONCLUSION: Conclusions: The diversified level of career satisfaction of physicians in separated aspects makes it necessary to verify them both at the level of health care units and at higher levels.

Evaluation of phenolic content in selected red fruit juices.

BACKGROUND: Red fruits are characterised by a particularly high content of bioactive compounds, e.g. anthocyanins, tannins, pectins, vitamins and minerals. Dietary supply of proper amounts of antioxidants is essential to reduce oxidative stress, and thus is an important element in the prevention of lifestyle diseases. OBJECTIVE: The aim of the study was to evaluate and compare the content of polyphenols in selected red fruit juices (chokeberry, elderberry, pomegranate, cranberry), as well as to assess the impact of storage time on the content of these compounds in the analysed samples. MATERIAL AND METHODS: The research material consisted of 17 juices (100%): 3 chokeberry juices, 4 elderberry juices, 5 pomegranate juices and 5 cranberry juices, which differed in terms of the manufacturer, type, price range, country of origin and production method. The total polyphenol content was measured by spectrophotometry using the Folin�Ciocalteu reagent. The procedure was based on a modified method described by Waterhouse. Active acidity (pH) was measured with the potentiometric method using a pH-meter and the sucrose content was measured using a refractometer. RESULTS: The highest mean content of polyphenolic compounds was found in chokeberry and elderberry juices. Juice storage time did not reduce the mean content of polyphenolic compounds. The highest sucrose content was found in chokeberry juices and the lowest in cranberry juice. CONCLUSIONS: Chokeberry and elderberry juices had the highest content of polyphenols among the tested products. Juices stored after opening in accordance with the manufacturer's instructions (at 4°C) do not lose their nutritional properties.

The risk of respiratory incidents in response to the increase of ozone concentration in the ambient air, in the Silesian Voivodeship, in 2016-2017.

INTRODUCTION: Due to the high level of urbanization and industrialization, Silesian Voivodeship remains a region with the poorest quality ambient air, especially in the winter season in which alarm levels are constantly being exceeded. However, in the summertime, there are observed short-term episodes of high ozone concentrations for which their impact on the population health is poorly documented. The aim of the study was to assess the risk of daily respiratory health problems related to an increased pollutants concentration typical for photochemical smog. MATERIAL AND METHODS: In the ecological type of study, secondary epidemiological data were used. They were obtained from the National Health Fund (NFZ) in Katowice and included the number of outpatient visits in primary health care and hospitalizations due to respiratory diseases (J00-J99) and selected acute respiratory incidents registered between 01/01/2016 and 31/08/2017 in the Silesian Voivodeship. RESULTS: In the summertime of both years (2016 and 2017), there were observed short-term episodes of photochemical smog in the study region. Obtained results show a significant increase in the risk of outpatient visits due to total respiratory diseases, and also due to acute pharyngitis, acute laryngotracheitis, bronchitis, and asthma in response to the increase in ozone concentration. Similarly, a significant increase in the risk of hospitalization for all respiratory diseases was found, however, it appeared with a delay of at least two to three weeks. In the case of hospitalization due to bronchitis statistically significant risk was observed 2-4 days after the increase in exposure. CONCLUSIONS: The occurrence of registered respiratory incidents was confirmed in response to the increase in ozone concentration, characteristic of the summertime in the Silesian Voivodeship.

Asthma, bronchitis respiratory symptoms, allergies and home environment: how are they related?

Introduction: Home environmental conditions can affect the prevalence of childhood asthma and allergies. Aim: To assess the relationship between the prevalence of childhood asthma, bronchitis, and allergies and the condition of the home environment. Material and methods: In 2018 and 2019, a cross-sectional study on 2932 children from elementary schools in the Silesian Voivodship (Southern Poland) was conducted. The questionnaire was based on the International Study of Asthma and Allergies in Childhood (ISAAC). In order to determine the association between the home environment (presence of moulds, furry pets) and respiratory symptoms and diseases, a logistic regression analysis was performed by calculating the odds ratio (OR), determining p < 0.05 as the level of significance. Results: Asthma risk factors were male sex, heating with solid fuel and presence of moulds. The prevalence of respiratory symptoms, bronchitis, and allergic diseases is statistically more common with the presence of moulds in dwellings. A protective effect of the presence of pets on the prevalence of asthma (OR = 0.77; 95% CI: 0.59-0.99), allergy to pet allergens (OR = 0.59; 95% CI: 0.45-0.76), allergy to house dust mite (OR = 0.70; 95% CI: 0.56-0.87) and wheeze in the last 12 months (OR = 0.70; 95% CI: 0.54-0.91) and ever (OR = 0.85; 95% CI: 0.70-1.02) was observed. Conclusions: The study confirmed the known adverse influence of the presence of moulds and heating with solid fuel on the prevalence of asthma, bronchitis, respiratory symptoms and allergic diseases. The protective influence of pets on the occurrence of the health disorders under study was demonstrated.

Differential Regulation of NAPDH Oxidases in Salt-Tolerant Eutrema salsugineum and Salt-Sensitive Arabidopsis thaliana.

Reactive oxygen species (ROS) signalling is crucial in modulating stress responses in plants, and NADPH oxidases (NOXs) are an important component of signal transduction under salt stress. The goal of this research was to investigate whether the regulation of NOX-dependent signalling during mild and severe salinity differs between the halophyte Eutrema salsugineum and the glycophyte Arabidopsis thaliana. Gene expression analyses showed that salt-induced expression patterns of two NOX genes, RBOHD and RBOHF, varied between the halophyte and the glycophyte. Five days of salinity stimulated the expression of both genes in E. salsugineum leaves, while their expression in A. thaliana decreased. This was not accompanied by changes in the total NOX activity in E. salsugineum, while the activity in A. thaliana was reduced. The expression of the RBOHD and RBOHF genes in E. salsugineum leaves was induced by abscisic acid (ABA) and ethephon spraying. The in silico analyses of promoter sequences of RBOHD and RBOHF revealed multiple cis-acting elements related to hormone responses, and their distribution varied between E. salsugineum and A. thaliana. Our results indicate that, in the halophyte E. salsugineum, the maintenance of the basal activity of NOXs in leaves plays a role during acclimation responses to salt stress. The different expression patterns of the RBOHD and RBOHF genes under salinity in E. salsugineum and A. thaliana point to a modified regulation of these genes in the halophyte, possibly through ABA- and/or ethylene-dependent pathways.

Insight into Details of the Photosynthetic Light Reactions and Selected Metabolic Changes in Tomato Seedlings Growing under Various Light Spectra.

The objective of our study was to characterise the growth of tomato seedlings under various light spectra, but special attention has been paid to gaining a deeper insight into the details of photosynthetic light reactions. The following light combinations (generated by LEDs, constant light intensity at 300 µmol m-2 s-1) were used: blue/red light; blue/red light + far red; blue/red light + UV; white light that was supplemented with green, and white light that was supplemented with blue. Moreover, two combinations of white light for which the light intensity was changed by imitating the sunrise, sunset, and moon were also tested. The reference point was also light generated by high pressure sodium lamps (HPS). Plant growth/morphological parameters under various light conditions were only partly correlated with the photosynthetic efficiency of PSI and PSII. Illumination with blue/red as the main components had a negative effect on the functioning of PSII compared to the white light and HPS-generated light. On the other hand, the functioning of PSI was especially negatively affected under the blue/red light that was supplemented with FR. The FT-Raman studies showed that the general metabolic profile of the leaves (especially proteins and ß-carotene) was similar in the plants that were grown under the HPS and under the LED-generated white light for which the light intensity changed during a day. The effect of various light conditions on the leaf hormonal balance (auxins, brassinosteroids) is also discussed.

Thermal Analysis of Stomatal Response under Salinity and High Light.

A non-destructive thermal imaging method was used to study the stomatal response of salt-treated Arabidopsis thaliana plants to excessive light. The plants were exposed to different levels of salt concentrations (0, 75, 150, and 220 mM NaCl). Time-dependent thermograms showed the changes in the temperature distribution over the lamina and provided new insights into the acute light-induced temporary response of Arabidopsis under short-term salinity. The initial response of plants, which was associated with stomatal aperture, revealed an exponential growth in temperature kinetics. Using a single-exponential function, we estimated the time constants of thermal courses of plants exposed to acute high light. The saline-induced impairment in stomatal movement caused the reduced stomatal conductance and transpiration rate. Limited transpiration of NaCl-treated plants resulted in an increased rosette temperature and decreased thermal time constants as compared to the controls. The net CO2 assimilation rate decreased for plants exposed to 220 mM NaCl; in the case of 75 mM NaCl treatment, an increase was observed. A significant decline in the maximal quantum yield of photosystem II under excessive light was noticeable for the control and NaCl-treated plants. This study provides evidence that thermal imaging as a highly sensitive technique may be useful for analyzing the stomatal aperture and movement under dynamic environmental conditions.

Preventive Analgesia, Hemodynamic Stability, and Pain in Vitreoretinal Surgery.

Background and Objectives: Although vitreoretinal surgery (VRS) is most commonly performed under regional anaesthesia (RA), in patients who might be unable to cooperate during prolonged procedures, general anaesthesia (GA) with intraprocedural use of opioid analgesics (OA) might be worth considering. It seems that the surgical pleth index (SPI) can be used to optimise the intraprocedural titration of OA, which improves haemodynamic stability. Preventive analgesia (PA) is combined with GA to minimise intraprocedural OA administration. Materials and Methods: We evaluated the benefit of PA combined with GA using SPI-guided fentanyl (FNT) administration on the incidences of PIPP (postprocedural intolerable pain perception) and haemodynamic instability in patients undergoing VRS (p < 0.05). We randomly assigned 176 patients undergoing VRS to receive GA with SPI-guided FNT administration alone (GA group) or with preventive topical 2% proparacaine (topical anaesthesia (TA) group), a preprocedural peribulbar block (PBB) using 0.5% bupivacaine with 2% lidocaine (PBB group), or a preprocedural intravenous infusion of 1.0 g of metamizole (M group) or 1.0 g of paracetamol (P group). Results: Preventive PBB reduced the intraprocedural FNT requirement without influencing periprocedural outcomes (p < 0.05). Intraprocedural SPI-guided FNT administration during GA resulted in PIPP in 13.5% of patients undergoing VRS and blunted the periprocedural effects of preventive intravenous and regional analgesia with respect to PIPP and haemodynamic instability. Conclusions: SPI-guided FNT administration during GA eliminated the benefits of preventive analgesia in the PBB, TA, M, and P groups following VRS.

Hospitalization and in-hospital mortality due to COVID-19 in the Silesian Voivodeship during the first year of epidemic.

INTRODUCTION: The Silesian Voivodeship is the region with the highest population density in Poland, three times higher than the national average. These are important circumstances that may favor the transmission of the SARS-CoV-2 virus and, due to the severe course of the disease in many patients, contribute to overloading the healthcare system. AIM: The aim of the study was to evaluate the temporal and territorial variability of hospitalized morbidity and in-hospital mortality in COVID-19 patients treated in the study region. MATERIAL AND METHODS: The research was an epidemiological descriptive study. Secondary epidemiological data were obtained from the registry of the Health Department of the Silesian Voivodeship Office in Katowice. Crude and standardized hospitalized morbidity rates, as well as COVID-19 in-hospital mortality, were calculated. Results were presented in particular poviats and subsequent months of the 2020 year. The capabilities of the ArcGIS 9.2 geographic information system and Statistica 13.3 software were used. RESULTS: The largest number of patients hospitalized due to COVID-19 and the number of deaths occurred in autumn and spring, in both periods in-hospital mortality was over 24%. The poviats with the highest standardized hospitalized prevalence rate were located in the southern part of the Silesian Voivodeship. The highest in-hospital mortality (exceeding 24%) was recorded in Gliwice, Myslowice, Tychy, Bytom and in the Lubliniec poviat. Older people (65+), usually with diagnosed comorbidities, including chronic respiratory and cardiovascular diseases, died more often. CONCLUSIONS: The highest number of patients and deaths due to COVID-19 occurred in autumn. A significant territorial diversification of hospitalized morbidity and in-hospital mortality was demonstrated, the worst situation concerned densely populated poviats and cities. Worse prognosis applied to older patients with comorbidities.

Caesarean delivery and risk of childhood asthma development: meta-analysis.

INTRODUCTION: Several studies indicate that delivery by caesarean section may be one of the risk factors for the development of childhood asthma. AIM: A meta-analysis was carried out to establish the relationship between delivery by caesarean section and asthma in children. MATERIAL AND METHODS: After a review of bibliographic databases, 41 articles were obtained and 12 of which were accepted for further analysis. The odds ratios (OR) included in the analysis were specified on the basis of data from the presented studies or were calculated using reported prevalence. The analysis took into account unadjusted OR. The heterogeneity of results was assessed using the χ2 test, determining p < 0.05 as the level of significance. The analysis was performed using Statistica 13.3 and kit 4.0.67. RESULTS: Caesarean delivery was associated with an increased risk of development of childhood asthma (OR = 1.41); however, significant heterogeneity of results was demonstrated. A significantly higher risk of asthma was found in children born by caesarean section in the case where the disease was confirmed in a questionnaire-based study (OR = 1.26, 95% CI: 1.05-1.5), and the results of that study were homogeneous. CONCLUSIONS: In the case of the diagnosis of asthma declared by parents in the questionnaire-based study, a significantly higher risk of disease occurrence was observed in children born by caesarean section. Due to the significant heterogeneity of the results of the studies, it cannot be clearly stated that caesarean delivery is a risk factor for the development of bronchial asthma.

Overview of statistical methods for estimating the relative risk of delayed respiratory effect related to ambient air pollution exposure.

INTRODUCTION: The occurrence of smog episodes and their significant impact on human health have forced research focused on risk assessment. Over the years, methods of exposure measuring have been improved, as well as statistical models necessary to the biological response estimation including the risk of incidence or death. AIM: The aim of presented study is to review and evaluate possibilities of statistical methods of delayed respiratory health effects risk assessment related to ambient air pollution exposure. MATERIAL AND METHODS: The review of published data was carried using the PubMed platform from 1994 to the 2020 year. Over 80 references were include in the analysis identifying general characteristics, construction of models estimating the relative risk of respiratory incidents with delayed health effect, and modelling tools available in statistical packages R, SAS, and Statistica. RESULTS: Among various methods of health risk assessment, the Almon model, the Poisson model, and the Distributed Lag Non-Linear Models (DLNM) were most common used. Initially, the Poisson model was used, close to 60% of the cited works apply this method. The interest in the nonlinear modelling implementation has increased (34% of cited papers) in recent years. Mostly researchers used R or SAS statistical software. Usually, was calculated the relative risk of health effect related to short-term exposure (up to a week). About 75% of available papers concern measurements of relative risk in response to the concentration of pollution increase by unit=10 µg/m3. Other describe the risk associated with the exposure increasing by the interquartile range (IQR). CONCLUSIONS: Distributed Lag Non-linear Model DLNM is classified as the statistical tool recommended by researchers due to its flexibility in defining, simplicity in interpretation, and increasingly frequent applications to environmental epidemiology.

Acclimation of the photosynthetic apparatus and alterations in sugar metabolism in response to inoculation with endophytic fungi.

The role of an endophytic Zygomycete Mucor sp. in growth promotion and adaptation of the photosynthetic apparatus to increased energy demands of its hosts Arabidopsis arenosa and Arabidopsis thaliana was evaluated. Inoculation with the fungus improved the water use efficiency of the plants and allowed for them to utilize incident light for photochemistry more effectively by upregulating the expression of several photosystem I- and II-related genes and their respective proteins, proteins involved in light harvesting in PSII and PSI and carbon assimilation. This effect was independent of the ability of the plants to acquire nutrients from the soil. We hypothesize that the accelerated growth of the symbiotic plants resulted from an increase in their demand for carbohydrates and carbohydrate turnover (sink strength) that triggered a simultaneous upregulation of carbon assimilation. Arabidopsis plants inoculated with Mucor sp. exhibited upregulated expression in several genes encoding proteins involved in carbohydrate catabolism, sugar transport, and smaller starch grains that indicate a significant upregulation of carbohydrate metabolism.

Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene - a questionnaire study.

CLINICAL RATIONALE FOR THE STUDY: Neurological deficits and progressing disability in patients with multiple sclerosis (MS) may hamper daily oral hygiene, but their relations with oral problems have not yet been clearly determined. AIM OF THE STUDY: The aim of this study was to identify the most significant dental problems and limitations of daily oral hygiene in Polish patients with MS. MATERIAL AND METHODS: 199 patients with diagnosed MS (median age 37 years) treated in the neurological outpatient clinic were interviewed using a paper-based questionnaire. They provided answers on oral health, behaviours and the limitations of their daily oral hygiene. Clinical information regarding symptoms, MS phenotype, relapses, medication and degrees of disability was based on medical records. RESULTS: The most frequent symptoms were dry mouth (43.2%) and bleeding from gums (28.1%). Dry mouth was more frequent in patients with secondary-progressive MS (SPMS) than relapsing-remitting MS (65.4% vs 41.3%, p = 0.023). Patients with bleeding from gums had had MS for a longer duration (median 6 vs 4 years, p = 0.002). Difficulties in daily oral hygiene were more frequent in patients with SPMS (24.0% vs 8.1%; p = 0.016). Greater proportions of patients with muscle weakness of limbs, imbalance or pain brushed their teeth irregularly. Frequent (i.e. at least every six months) visits to the dentist's surgery were uncommon in patients with SPMS (12.0% vs 39.7%, p = 0.010). CONCLUSIONS AND CLINICAL IMPLICATIONS: Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS. Daily oral hygiene and oral health self-control is limited in patients with MS, mainly due to motor deficits, balance problems and pain, and this becomes worse with disease duration. To minimise the burden of the disease, patients with MS require better education and improvement in their awareness regarding proper oral health control, such as the use of electric toothbrushes. In addition, patients with chronic and progressive disability from multiple sclerosis may benefit from better organised access to dental care.

Community-based survey as a basis for evidence-based public health: children living in Upper Silesian Industrial Zone.

OBJECTIVE: The aim of the study was to estimate changes in the prevalence of respiratory diseases and disorders between 2003/2004 and 2011/2012 in 13-16 years old children living in Bytom, one of the biggest cities in the Silesia agglomeration and provide the evidence for local policy makers. METHODS: Data from two cross-sectional surveys, based on the Polish version of the International Study of Allergy and Asthma in Childhood (ISAAC) questionnaire, conducted in 2003/2004 and 2011/2012 was used. Response rate in the first and the second survey was 68% and 35%, respectively. The number of analyzed observations was 4,041 and 707 from the first and the second survey. The selection bias was controlled with the propensity score matching and potential determinants of analyzed respiratory diseases and disorders were controlled in the multivariable logistic regression model. RESULTS: We found statistically significant increase in asthma ever diagnosed by medical doctor (4.5% vs. 9.6%; p < 0.01), seizures of dyspnea (8.2% vs. 27.7%; p < 0.01), and chest wheeze (9.6% vs. 19.2%; p < 0.01). CONCLUSION: Our study revealed significant increase in the prevalence of respiratory diseases and disorders after 8 years in adolescents living in the Upper Silesian Industrial Zone. This is a relevant finding which provides the evidence for decision makers in the scope of local public health policies.

Cognitive impairment and BDNF serum levels.

BACKGROUND/AIMS: To investigate the alterations of brain-derived neurotrophic factor (BNDF) serum levels in subjects with different intensity of cognitive impairment and different neurodegenerative processes. MATERIAL AND METHODS: Serum BDNF levels were analyzed by ELISA kit in 378 subjects: 134 Alzheimer's disease (AD) patients, 115 amnestic mild cognitive impairment (MCI) patients, and 129 controls divided into two groups: neurodegenerative control group (ND), consisting of 49 Parkinson's disease patients without any cognitive complaints, and cognitively normal control group (CN), consisting of 80 subjects without any neurological disorders. RESULTS: AD patients had significantly lower (p<0.001) BDNF serum levels compared to MCI, CN and ND controls. Age and education had significant influence on BDNF serum levels regardless the diagnosis or group assignment. We have found no influence of depression on BDNF serum levels either in our group as a whole, or in each group assessed separately. We found significant correlation between BDNF serum levels and cognitive impairments. After multiple comparisons between the groups, we found that, after adjustment for confounding factors (age, gender, education, depression, cognitive impairment), BDNF serum levels were the lowest in AD group (p=0.05). CONCLUSIONS: Advanced age and low educational level are associated with decreased BDNF serum levels. Decreased BDNF serum levels correspond to the severity of cognitive impairment. There is no correlation between BDNF serum levels and depressive symptoms.

[Epidemiology of asthma in adults living in the Silesian voivodeship according to secondary epidemiological data]. / Epidemiologia astmy oskrzelowej u osób doroslych w województwie slaskim na podstawie wtórnych danych epidemiologicznych.

BACKGROUND: Asthma is a serious public health challenge because of the increasing number of people with a new diagnosis and consequently the increasing costs of medical treatment (direct and indirect). The aim of this study is to analyze available epidemiological data with respect to their spatial and temporal variability in the Silesian voivodeship. In addition, the costs incurred by the National Health Fund (Narodowy Fundusz Zdrowia - NFZ) in treating asthmaic patients are analyzed. MATERIAL AND METHODS: The epidemiological descriptive study concerns adult inhabitants of the Silesian voivodeship with asthma diagnosed under the health service delivery system, financed by NFZ, as well as diagnossis and/or hospitalization registed in the routine register run by the NFZ in Katowice. Crude and standardized incidence and prevalence rates are calculated and their changes are evaluated. Spatial variability in districts is evaluated as well and costs incurred by NFZ are revealed. RESULTS: In the years 2006-2010 the standardized rate of asthma remained at a high level of 392.3-469.6/100 000 inhabitants. Greater values were related to women than to men, as well as to inhabitants of districts located in the central and southern parts of the Silesian voivodeship. A slight decrease in the values of crude prevalence rates, from 52/100 000 inhabitants to 42/100 000, is reported. The annual cost of new cases treatment is 17 million PLN while the annual cost of all hospitalizations is at the level of 10 million PLN. CONCLUSIONS: Variability of incidence and prevalence due to asthma in the Silesian voivodeship is observed. An attempt at explaining this diversity requires in-depth research. A slight decrease in the values of both rates over time indicates less significant reduction in expenditure devoted to hospital treatment of asthmatic patients. Med Pr 2017;68(4):479-489.

Chronic obstructive pulmonary disease (COPD) - epidemiology in Silesian voivodeship

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a problem requiring constant surveillance, both clinical and epidemiological. AIM: The aim of study was to analyze territorial and temporal variability of COPD hospitalization and incidence, as far as expenses incurred by the National Health Fund (NHF) due to medical treatment of disease in the Silesian Voivodeship based on secondary epidemiological data. MATERIAL AND METHODS: The epidemiological situation was presented on the basis of available health benefits data registered in adult patients with COPD treated from the NHF budget in the Silesian Voivodeship. The dynamics of incidence rates in 2006­2010, prevalence rates of hospitalization in 2000­2011 and costs of treatment of the disease were investigated. We also present variability of incidence and prevalence in particular districts of study region. RESULTS: The standardized incidence rate of COPD in the Silesian Voivodeship is still high, although it slowly decreased from the value of 656.93/100,000 in 2007 to 470.7/100,000 in 2010. We observed a significant decrease of hospitalization from 217.0/100,000 in 2005 to 117.7/100,000 in 2011. Higher values of both rates refer to men, besides, we observed their spatial variability in particular districts. The average annual cost of new cases of COPD treatment in Silesian Voivodeship was approximately 5 million EUR (20 million PLN), while the annual cost of all hospital admissions decreased substantially from the value of approx.10 million EUR (40 million PLN) in 2003 to approx. 5 million EUR (20 million PLN) in 2011. CONCLUSIONS: We observed temporal and spatial variability of COPD incidence and prevalence in Silesian Voivodeship. Asignificant reduction of COPD hospitalization rate implies serious reduction of expenses incurred by National Health Found.

[Comorbidity diseases in adults with diagnosed interstitial lung diseases among inhabitants of the Silesian voivodeship, Poland]. / Choroby wspólistniejace w przypadku sródmiazszowych chorób pluc u doroslych mieszkanców województwa slaskiego.

BACKGROUND: Interstitial lung diseases form a group of chronic diseases associated with a significant worsening of the quality of life. Proper management of these diseases involves the recognition and treatment of comorbidities, so it implies high direct and indirect costs of therapy. The lack of epidemiological data on the total incidence of interstitial diseases in Poland, as well as of information on their increasing incidence in other European countries justify investigations into epidemiological situation in the Silesian voivodeship (the southern region of Poland). MATERIAL AND METHODS: In a descriptive study registered data provided by the National Health Found in 2006-2010 were used to assess the temporal variability of standardized incidence rates. A data set included interstitial lung diseases and comorbidities in adults aged ≥ 19 years, residents of the Silesian voivodeship. RESULTS: In the period under study standardized incidence ratios for interstitial lung disease declined from 9.7/100 000 adult population to 7.8/100 000 adult population. The most prevalent comorbidities included cardio-vascular diseases, chronic and infectious respiratory diseases, metabolic diseases and musculoskeletal and connective tissue diseases. Comorbidities were found more frequently in older people ≥ 65 years, except for sarcoidosis, which was four times more prevalent in younger people (19-64 years) compared to older patients. The estimated costs of treatment of the analysed diseases reached more than 50 mln zlotys (12 mln dollars) per year. CONCLUSIONS: A small but systematic decrease in the value of the standardized incidence rate for interstitial lung disease has been shown within the range of 9.7-7.8/100 000 adult inhabitants. The most frequent comorbidities included cardiovascular or chronic and infectious respiratory diseases. The high cost of therapy of interstitial lung diseases was largely related to simultaneous treatment of comorbidities. Med Pr 2016;67(6):751-763.

Enhanced chloroplastic generation of H2O2 in stress-resistant Thellungiella salsuginea in comparison to Arabidopsis thaliana.

In order to find some basis of salinity resistance in the chloroplastic metabolism, a halophytic Thellungiella salsuginea was compared with glycophytic Arabidopsis thaliana. In control T.s. plants the increased ratios of chlorophyll a/b and of fluorescence emission at 77 K (F730 /F685 ) were documented, in comparison to A.t.. This was accompanied by a higher YII and lower NPQ (non-photochemical quenching) values, and by a more active PSI (photosystem I). Another prominent feature of the photosynthetic electron transport (PET) in T.s. was the intensive production of H2 O2 from PQ (plastoquinone) pool. Salinity treatment (0.15 and 0.30 M NaCl for A.t. and T.s., respectively) led to a decrease in ratios of chl a/b and F730 /F685 . In A.t., a salinity-driven enhancement of YII and NPQ was found, in association with the stimulation of H2 O2 production from PQ pool. In contrast, in salinity-treated T.s., these variables were similar as in controls. The intensive H2 O2 generation was accompanied by a high activity of PTOX (plastid terminal oxidase), whilst inhibition of this enzyme led to an increased H2 O2 formation. It is hypothesized, that the intensive H2 O2 generation from PQ pool might be an important element of stress preparedness in Thellungiella plants. In control T.s. plants, a higher activation state of carboxylase ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco, EC 4.1.1.39) was also documented in concert with the attachment of Rubisco activase (RCA) to the thylakoid membranes. It is supposed, that a closer contact of RCA with PSI in T.s. enables a more efficient Rubisco activation than in A.t.

[Cytokinins and photosynthesis]. / Cytokininy a fotosynteza.

Almost six decades of studies explained many aspects of cytokinin complex metabolism, such as, biogenesis, degradation, signal perception and interaction with other phytohormones (mainly with auxins). A dual character of cytokinins' action on the nuclear genes (activation and repression) has been explained by recognition of the two types on nuclear receptors, which ensure a precise mechanism of self-control. Cytokinins promote the process of photosynthesis at different levels of plant- and cellular organization (development of leaves and plastids, influence on the photosynthetic proteins, activation of photosynthetic genes, etc.). An anti-senescing action of these hormones has been recently attributed to the activation of intra-cellular invertase, which suppress floem loading and change the sink-source pattern of the leaf.