Biomarkers for polycyclic aromatic hydrocarbons in human excreta: recent advances in analytical techniques-a review.

Polycyclic aromatic hydrocarbons (PAHs) are widespread environmental pollutants that are generated by the incomplete combustion of organic materials. The main anthropogenic sources of PAHs are the combustion of solid fuels for heating purposes, illegal waste incineration, road transport and industries based on fossil fuels. PAHs can easily enter the body because they are present in all elements of the environment, including water, soil, air, and food. Due to their ubiquitous presence, PAHs, may exert a harmful effect on human health. Assessing PAH exposure through biomonitoring mostly involve techniques to measure the concentration of 1-hydroxypyrene in human urine. Nevertheless, through recent progress in analytical techniques, other common metabolites of PAHs in human biospecimens can be detected. A scientific literature search was conducted to determine which hydroxy derivatives of PAHs are markers of PAHs exposure and to reveal the leading sources of these compounds. Techniques for analyzing biological samples to identify OH-PAHs are also discussed. The most frequently determined OH-PAH in human urine is 1-hydroxypyrene, the concentration of which reaches up to a dozen ng/L in urine. Apart from this compound, the most frequently determined biomarkers were naphthalene and fluorene metabolites. The highest concentrations of 1- and 2-hydroxynaphthalene, as well as 2-hydroxyfluorene, are associated with occupational exposure and reach approximately 30 ng/L in urine. High molecular weight PAH metabolites have been identified in only a few studies. To date, PAH metabolites in feces have been analyzed only in animal models for PAH exposure. The most frequently used analytical method is HPLC-FLD. However, compared to liquid chromatography, the LOD for gas chromatography methods is at least one order of magnitude lower. The hydroxy derivatives naphthalene and fluorene may also serve as indicators of PAH exposure.

Prevalence of metabolic syndrome and improper nutritional status among adolescents.

Prevalence of metabolic syndrome (MetS) and its components is a growing issue, including pediatric populations. However, because of many definitions used, it is difficult to assess the true frequency of these problems. The aim of this study was to assess the prevalence of MetS and its components as well as the frequency of problems with inadequate nutritional status among adolescents. One hundred ninety-six teenagers aged 15-18 years, living in Krakow and its vicinity were examined including measurement of blood pressure, anthropometric parameters and blood levels of cholesterol and glucose. The prevalence of MetS was low and varied from 0.5% to 2.0% depending on the definition. Based on Cook's definition of MetS, the most common components were hypertension (12.8%) and hypertriglyceridemia (12.8%). Improper body weight (based on BMI) was found in 23.5% of adolescents, including 5.1% underweight, and 18.4% overweight or obese. According to the body fat percentage (BF%), 45.8% of the boys were underfat and 6.3% had too much body fat, while only 4% of the girls were below the BF% reference values and 15% above. All girls and 86.5% of boys had too low total body water. In conclusion, the prevalence of metabolic syndrome in population of Krakow adolescents was relatively low, but more than 12% of the adolescents had a hypertension or hypertriglyceridemia. Based on BMI most of adolescents were found to have adequate body weight, but examination of fat content in the body high prevalence of underfat was observed, especially among boys.

Chronic bacterial pulmonary infections in advanced cystic fibrosis differently affect the level of sputum neutrophil elastase, IL-8 and IL-6.

Advanced cystic fibrosis (CF) lung disease is commonly characterized by a chronic Pseudomonas aeruginosa infection and destructive inflammation caused by neutrophils. However, the lack of convincing evidence from most informative biomarkers of severe lung dysfunction (SLD-CF) has hampered the formulation of a conclusive, targeted diagnosis of CF. The aim of this study was to determine whether SLD-CF is related to the high concentration of sputum inflammatory mediators and the presence of biofilm-forming bacterial strains. Forty-one patients with advanced CF lung disease were studied. The severity of pulmonary dysfunction was defined by forced expiratory volume in 1 second (FEV1) < 40%. C-reactive protein (CRP) and NLR (neutrophil-lymphocyte ratio) were examined as representative blood-based markers of inflammation. Expectorated sputum was collected and analysed for cytokines and neutrophil-derived defence proteins. Isolated sputum bacteria were identified and their biofilm-forming capacity was determined. There was no association between FEV1% and total number of sputum bacteria. However, in the high biofilm-forming group the median FEV1 was < 40%. Importantly, high density of sputum bacteria was associated with increased concentrations of neutrophil elastase and interleukin (IL)-8 and low concentrations of IL-6 and IL-10. The low concentration of sputum IL-6 is unique for CF and distinct from that observed in other chronic pulmonary inflammatory diseases. These findings strongly suggest that expectorated sputum is an informative source of pulmonary biomarkers representative for advanced CF and may replace more invasive bronchoalveolar lavage analysis to monitor the disease. We recommend to use of the following inflammatory biomarkers: blood CRP, NLR and sputum elastase, IL-6, IL-8 and IL-10.

Frequency of occurrence of the pain form of the temporomandibular disorders and gender distribution.

Temporomandibular disorders includes abnormalities of the masticatory muscles, temporomandibular joints and the surrounding structures. The aim of the study was to carry out a retrospective assessment of the frequency of the pain form of TMD based on the analysis of medical records of patients treated at the Prosthodontic Department at Jagiellonian University in Kraków. MATERIAL AND METHODS: The study included the results of a medical history and a clinical examination of patients, who came for consultation at the Prosthodontics Department at Jagiellonian University in Krakow, due to pain of the masticatory muscles or/and TMJ and painless symptom of TMD like limitation of the jaw movements and joints' sounds. Out of all the analyzed results of the examination of treated patients, a group of patients with a painless and painful TMD was selected. RESULTS: The study involved the results of a detailed specialized functional examination of 334 patients (210 women and 124 men), ranging in age from 41 to 68 years. Analysis of the results of clinical examinations conducted in all patients revealed that 161 had the painless form - SG (99 women and 62 men) and 173 patients had the pain form of the TMD - CG (111 women and 62 men). In the CG 104 patients reported mostly pain in the masticatory muscles, while the remaining (69 patients) had a history of pain in one or simultaneously two TMJs. CONCLUSION: The analysis of the patients forms allows to conclude that more than half of patients seeking help are patients with the painful form of the TMD and these abnormalities occur more frequently in women than in men.

Evaluation of a Polish Version of the Dundee Ready Education Environment Measure.

INTRODUCTION: The Dundee Ready Education Environment Measure (DREEM) is an instrument that assesses the educational environment. AIM: The aim of this study was to psychometrically evaluate a Polish version of the DREEM instrument. MATERIAL AND METHODS: 203 medical students who fully completed the DREEM questionnaire were included in the study. Validity was evaluated through the analysis of construct validity and reliability. RESULTS: After language validation the internal consistency was assessed. Cronbach's alpha for the overall score was 0.93 and the five subscales were: perceptions of learning 0.86, perceptions of teachers 0.82, perceptions of atmosphere 0.75, academic self-perceptions 0.61, and social-self perceptions 0.61. The exploratory factor analyses, however, yielded dimensions that did not fully correspond to the original DREEM subscales. CONCLUSIONS: Internal consistency of the Polish version of the DREEM scale as a whole was excellent, however for each of five originally developed subscales it was lower and vary a lot; construct validity of Polish version was not compatible with the original structure of the DREEM scale but was reasonable. A new five-factor solution obtained in this study could be a reliable tool for assessing the medical education environment in the Polish circumstances, but it will require confirmation in future study.

Infection-associated hospitalizations of women in labour.

BACKGROUND: The article analyzes hospitalizations of women in the postpartum period in the Malopolska Province. Re-hospitalization of women as a result of puerperal complications may be used as an infection control quality measure in this patient population. METHODS: It was a population-based, retrospective analysis using data obtained from the Polish National Health Fund (paying for medical services, financed by all Polish employees contributing 9% of their salaries), collected routinely in 2013-14. The analysis encompassed 29 hospitals and 68 894 childbirths. RESULTS: In total, 1.7% of women were re-hospitalized and 563 of these re-hospitalizations (0.8%) were due to infection. Re-hospitalizations due to infections were significantly more often recorded among women who lived in villages compared with inhabitants of towns (OR 1.6, 95% CI 1.23-1.98; P < 0.001) and in women giving birth in primary referral hospitals in comparison with the second referral or clinical hospitals (OR 2.8, 95% CI 1.69-4.65; P < 0.001). On the one hand, the results of the study indicate that, in patients giving birth, the infection control system is not sensitive enough, and on the other hand, more detailed studies need to cover primary referral hospitals, specifically. CONCLUSIONS: The problem of the infection-associated hospitalizations in the postpartum period is not reliably assessed by infection control professionals and constitutes a challenge for surveillance, including prevention and control. Complications associated with childbirth should be an indication of the quality of healthcare provision and knowledge of the scale of the problem should be the basis for its evaluation and prevention. This is especially true for infections in puerperas.

Association of Gestational Weight Gain With Adverse Maternal and Infant Outcomes.

Importance: Both low and high gestational weight gain have been associated with adverse maternal and infant outcomes, but optimal gestational weight gain remains uncertain and not well defined for all prepregnancy weight ranges. Objectives: To examine the association of ranges of gestational weight gain with risk of adverse maternal and infant outcomes and estimate optimal gestational weight gain ranges across prepregnancy body mass index categories. Design, Setting, and Participants: Individual participant-level meta-analysis using data from 196 670 participants within 25 cohort studies from Europe and North America (main study sample). Optimal gestational weight gain ranges were estimated for each prepregnancy body mass index (BMI) category by selecting the range of gestational weight gain that was associated with lower risk for any adverse outcome. Individual participant-level data from 3505 participants within 4 separate hospital-based cohorts were used as a validation sample. Data were collected between 1989 and 2015. The final date of follow-up was December 2015. Exposures: Gestational weight gain. Main Outcomes and Measures: The main outcome termed any adverse outcome was defined as the presence of 1 or more of the following outcomes: preeclampsia, gestational hypertension, gestational diabetes, cesarean delivery, preterm birth, and small or large size for gestational age at birth. Results: Of the 196 670 women (median age, 30.0 years [quartile 1 and 3, 27.0 and 33.0 years] and 40 937 were white) included in the main sample, 7809 (4.0%) were categorized at baseline as underweight (BMI <18.5); 133 788 (68.0%), normal weight (BMI, 18.5-24.9); 38 828 (19.7%), overweight (BMI, 25.0-29.9); 11 992 (6.1%), obesity grade 1 (BMI, 30.0-34.9); 3284 (1.7%), obesity grade 2 (BMI, 35.0-39.9); and 969 (0.5%), obesity grade 3 (BMI, ≥40.0). Overall, any adverse outcome occurred in 37.2% (n = 73 161) of women, ranging from 34.7% (2706 of 7809) among women categorized as underweight to 61.1% (592 of 969) among women categorized as obesity grade 3. Optimal gestational weight gain ranges were 14.0 kg to less than 16.0 kg for women categorized as underweight; 10.0 kg to less than 18.0 kg for normal weight; 2.0 kg to less than 16.0 kg for overweight; 2.0 kg to less than 6.0 kg for obesity grade 1; weight loss or gain of 0 kg to less than 4.0 kg for obesity grade 2; and weight gain of 0 kg to less than 6.0 kg for obesity grade 3. These gestational weight gain ranges were associated with low to moderate discrimination between those with and those without adverse outcomes (range for area under the receiver operating characteristic curve, 0.55-0.76). Results for discriminative performance in the validation sample were similar to the corresponding results in the main study sample (range for area under the receiver operating characteristic curve, 0.51-0.79). Conclusions and Relevance: In this meta-analysis of pooled individual participant data from 25 cohort studies, the risk for adverse maternal and infant outcomes varied by gestational weight gain and across the range of prepregnancy weights. The estimates of optimal gestational weight gain may inform prenatal counseling; however, the optimal gestational weight gain ranges had limited predictive value for the outcomes assessed.

Outpatient post-partum antibiotic prescription: method of identification of infection control areas demanding improvements and verification of sensitivity of infection registration.

OBJECTIVES: To evaluate data on outpatient antibiotic use in women post-labour as a potential method of monitoring infections in this group of patients. METHODS: Demographic and antibiotic prescription data originated from the registries of the National Health Fund (pol. Narodowy Fundusz Zdrowia). The measure of antibiotic use in this study was the percentage of women who purchased the drugs from prescriptions and DDDs. RESULTS: Among 67917 females who gave birth in the years 2013-14, 5050 (7.4%) purchased antibiotics prescribed by the obstetrician only. The average number of antibiotics bought per person was equivalent to ∼14 DDDs; in most cases (95.7%) these were ß-lactams. Antibiotic use occurred significantly more frequently among younger patients (11.5% patients <18 years of age), those living in rural areas (8.2%) and those who underwent Caesarean section (8.1%). No significant differences were found between the reported day of labour and the post-partum use of antibiotics. CONCLUSIONS: Antibiotic prescribing data can be used to verify/complement the information originating from hospital infection registries to monitor rates of infection in obstetric patients.

Urinary polycyclic aromatic hydrocarbon metabolites among 3-year-old children from Krakow, Poland.

Polycyclic aromatic hydrocarbons (PAHs) are widespread in the environment and can adversely affect human health. The aim of the present study is to describe the level of PAHs exposure in children living in Kraków, one of the most polluted cities in Poland, and to determine the relationship of urinary biomarkers with environmental PAHsexposure. Urinary monohydroxy metabolites (OH-PAHs) of 20 PAHs were assessed in 218 three-year old children, of which only 10 were present in nearly all the samples: monohydroxy metabolites of naphthalene, fluorene, phenantrene and pyrene. Of the metabolites analyzed, hydroxynaphthalenes were predominant and constituted almost 73% of total excreted OH-PAHs, while 1-OH-PYRene was the least abundant (2.3% of total OH-PAHs). All measured urinary OH-PAHs were statistically significantly correlated with each other (R = 0.165-0.880) but the highest correlation coefficients with other individual OH-PAHs and with total OH-PAHs were observed for 2-OH-FLUOR. Children exposed at home to environmental tobacco smoke (ETS) had higher concentrations of fluorene and pyrene urinary metabolites compared to those without ETS exposure; and those exposed to gas-based appliances used for cooking or heating water had higher levels of fluorene and phenanthrene metabolites than children not exposed. The use of coal, wood or oil for heating was associated with elevated levels of 1-OH-PYRene. Urinary PAHs metabolites only modestly reflect high molecular weight carcinogenic PAHs exposures such as those monitored in air in the present study. None of the measured PAHs metabolites was correlated with airborne PM2.5 and only two were slightly correlated with measured higher molecular mass airborne PAHs. The average concentrations of these specific metabolites in Polish children were much higher than observed in other pediatric populations living in developed countries. Our findings suggest that to capture various sources of PAHs, in addition to 1-OH-PYRene, biomonitoring of PAHs exposure should include 2-OH-NAP and 2-OH-FLUOR.

Lung function growth trajectories in non-asthmatic children aged 4-9 in relation to prenatal exposure to airborne particulate matter and polycyclic aromatic hydrocarbons - Krakow birth cohort study.

BACKGROUND: Patterns of lung function development during childhood can be helpful in understanding the pathogenesis of respiratory diseases. A variety of environmental and lifestyle factors, present from the prenatal period to adulthood, may affect or modulate lung function growth. The aim of this study was to investigate, the associations between individual growth trajectories of children's lung function during childhood and prenatal exposure to airborne fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAH), which were hypothesized to adversely affect spirometry parameters. MATERIAL AND METHODS: The study group comprised 294 non-asthmatic, full term children from the Krakow birth cohort, who underwent annual spirometry testing at the ages of 4-9 years. Individual personal air monitoring of PM2.5 and PAH were performed over 48 h in the second trimester of pregnancy. Possible confounders or modifiers such as child's gender, height, atopic status and exposure to environmental tobacco smoke (ETS) were considered. Polynomial multilevel mixed models were used to assess the growth rates of children's lung functions. RESULTS: Lung function trajectories differed significantly for boys and girls for FVC, FEV1 and FEF25-75. Girls had lower rates of increase than boys: - 20.5 (95%CI: - 32.4; - 8.6) ml/year (FVC); - 19.9 (95%CI: -30.7;-9.0) ml/year (FEV1); and - 32.5 (95%CI: - 56.9; - 8.2) ml/year (FEF25-75). Spirometry functions increased with age; however the growth rate decelerated over time. Significant lung function impairment (lower FVC and FEV1 levels) was observed from 4 to 9 years among subjects prenatally exposed to higher levels of PM2.5 as well as PAH, but not in the case of FEF25-75. No significant differences were observed in the rates of increase over time in relation to prenatal PM2.5 and PAH exposure. CONCLUSION: Our results indicate that in non-asthmatic children high prenatal exposure to airborne PM2.5 and PAH is associated with lower trajectories of FVC and FEV1, but not the rate of increase over time, suggesting that the initial effect is not diminishing in time.

Preferring fried dishes increases risk of benign breast disease, but not breast cancer.

BACKGROUND: Unhealthy diet and cooking method used may influence the risk of breast cancer (BC), but there is only limited evidence with regard to benign breast disease (BBD). The aim of this study was to assess a relationship between cooking technique, especially fried to boiled meals ratio in the diet, and the risk of BC and BBD in a group of Polish women. MATERIAL AND METHODS: A case-control study involving 34 BC cases, 81 BBD cases and 122 healthy controls was conducted between July 2007 and November 2011. All the women were asked about their nutritional habits, especially the way of preparing meat and fish dishes. Then the ratio of fried to boiled meals was calculated. RESULTS: High fried to boiled ratio was associated with increasing risk of BBD, but not BC. Women consuming fried dishes more often than boiled dishes had elevated risk of BBD: OR = 3.04 and OR = 3.65 for the second and the third tertile, respectively. Adjustment for the other confounders only slightly altered this relationship. CONCLUSION: Women who preferred frying as a cooking technique had increased risk of benign breast disease, but not breast cancer. There is a need of more precise investigation to confirm this association.

Body weight and quality of life among adolescents in Krakow.

AIM: The aim of this study was to assess the relationship between body weight and the quality of life among adolescents in Krakow, Poland. MATERIAL AND METHODS: The study comprised 1291 pupils - 632 girls and 659 boys from 17 Krakow middle schools. Their quality of life (QoL) was assessed by means of the Polish version of the KIDSCREEN-27 questionnaire. Five dimensions of QoL were analyzed as low, average and high QoL according to Polish cut-off points. The body mass index (BMI) of the adolescents was classified as underweight, normal weight, or excessive weight according to Polish growth charts. RESULTS: Low QoL was observed significantly more often in girls than in boys. Excessive weight among both girls and boys was found to be a risk factor for low QoL in the "Physical Well-being" dimension as compared to normal weight adolescents. Additionally, boys with excessive weight had a two-fold higher risk of low QoL in the "Social Support % Peers" dimension (OR=2.00; 95%CI:1.14-3.50). Underweight was associated with higher risk of low QoL in the "Physical Well-being", "Autonomy & Parents", and "Social Support % Peers" dimensions, but only among boys. CONCLUSIONS: Both, underweight and excessive weight were associated with low QoL. Excessive weight in youth was linked mainly with lower physical well-being. Underweight was a predictor of low QoL only among boys in the dimensions related to physical health, as well as relations with family and peers.

The quality of life among middle-school adolescents in Krakow.

AIM: The aim of the study was to describe the quality of life of Polish adolescents living in a big city and to investigate whether there are differences in this respect between girls and boys. Moreover, we would like to compare the results concerning the quality of life of the screened adolescents from Krakow with those of their European peers. MATERIAL AND METHODS: The survey was carried out in 2013-2015 in 17 middle schools in Krakow based on anonymous auditorium questionnaires. The analysis included the responses of 1387 pupils - 686 girls and 701 boys. In order to assess the quality of life, the Polish version of the international KIDSCREEN-27 questionnaire was used. Five dimensions of the quality of life (Qol) were analyzed. The specific dimensions of Qol were analyzed using 0-100 point scales, as well as T-scores standardized for the European population. RESULTS: The mean values for five dimensions of quality of life assessed by the KIDSCREEN-27 questionnaire ranged from 54 pts. to 65 pts. (maximum score 100 pts.). However, the results for the Polish adolescents were lower when compared to their European peers. The greatest differences in the level of Qol between Polish adolescents and their European peers involved the following dimensions: Psychological Well-being and School Environment. On average, girls scored their Qol lower than boys in three out of five dimensions (Physical Well-being, Psychological Well-being, Autonomy & Parents; p<0.001). Additionally, using the norm data for the Polish population (sex and age specific), more girls than boys were classified as having low Qol regarding the School Environment (23.5%vs 14.8%; p<0.001). CONCLUSIONS: Polish adolescents scored their Qol lower than their European peers. The quality of life for girls was significantly lower than of boys, except for the relation with their friends and peers (Social Support & Peers).

Relative validity of a semi-quantitative FFQ in 3-year-old Polish children.

OBJECTIVES: The aim of the study was to assess the relative validity of a semi-quantitative FFQ (SFFQ) which measures the usual dietary intake of 3-year-old children. DESIGN: The children's daily dietary intake was measured using the SFFQ. The average intake of three 24 h dietary recalls (24hDR) was calculated as a reference method. Wilcoxon's rank test and Spearman's rank-correlation coefficient were used to compare nutrient intakes assessed by both methods. The level of agreement between the SFFQ and the repeated 24hDR was determined by the Bland-Altman method. To assess the agreement in quartile distribution, the weighted kappa coefficient (κ w) was used. SETTING: Krakow, Poland. SUBJECTS: One hundred and forty-three 3-year-old children and their mothers, participants of a prospective cohort study. RESULTS: Overall, the SFFQ overestimated energy and nutrient intakes compared with the repeated 24hDR. The median correlation coefficient for energy and nutrient intakes was 0·456, with higher results for Ca, P and riboflavin. Although the κ w value showed only slight to fair agreement between the two methods, about 75 % of the children were classified into the same or adjacent quartile and the level of agreement assessed by the Bland-Altman method for most of the nutrients investigated was good. CONCLUSIONS: The study indicated that the SFFQ might be a useful tool to assess dietary intakes of nutrients by small children, especially for ranking them according their nutrient intake.

Post-discharge surveillance of urinary tract infections in patients following hip and knee arthroplasty: Identifying targets for infection prevention and control.

This population-based study aimed to evaluate the incidence of urinary tract infections following hip and knee arthroplasty (HPRO and KPRO) and identify urinary tract infection risk factors among Polish patients. The analysis included data from 83,525 patients, with incidence rates of 0.7% and 0.49% after HPRO and KPRO, respectively. We identified women, individuals over 65 years old, residents of long-term care facilities, patients with chronic circulatory, endocrine, or digestive diseases, and those operated on due to trauma as targets for infection prevention and control.

Treatment Outcomes of Adolescents Compared to Younger Pediatric Patients with Acute Myeloid Leukemia: Do They Need a Special Approach?

BACKGROUND: The reports of studies that compare the survival of adolescents and young adults with younger children with acute myeloid leukemia (AML) are contradictory. PATIENTS AND METHODS: We retrospectively analyzed 220 AML patients aged 0-18 years treated in pediatric oncologic centers in Poland from 2015 to 2022. The evaluated group included 31 infants (below 1 year), 91 younger children (1-9.9 years), 59 older children (10-14.9 years), and 39 adolescents (15-18 years). RESULTS: A 5-year overall survival for adolescents was not significantly inferior compared to younger and older children (74.3 ± 7.6% vs. 80.5 ± 4.4% vs. 77.9 ± 5.1, p = 0.243). However, relapse-free survival was lower in adolescents compared to younger children (76.5 ± 7.8% vs. 65.7 ± 9.0%, p = 0.049), and treatment-related mortality tended to be higher (10.3% vs. 4.4%, p = 0.569). In the univariate analysis, high-risk genetics [HR, 2.0 (95% CI 1.1-3.6; p = 0.014)] and a leukocyte count at diagnosis above 100,000/µL [HR, 2.4 (95% CI 1.3-4.6; p = 0.004)] were found to be unfavorable prognostic factors for survival. CONCLUSIONS: Although we have not found that age over 15 years is an unfavorable factor for overall survival, the optimal approach to therapy in adolescents, as in other age groups, is to adjust the intensity of therapy to individual genetic risk and introduce targeted therapies when indicated.

Corrigendum: SARS-CoV-2 antibody response after mRNA vaccination in healthcare workers with and without previous COVID-19, a follow-up study from the University Hospital in Krakow, Poland.

[This corrects the article DOI: 10.3389/fimmu.2022.1071204.].

Post-discharge occurrence of surgical site infections after hip or knee arthroplasty surgery in Poland, a population-based study.

Arthroplasty is a common procedure improving functioning of patients and their quality of life. Infection is a serious complication that determines subsequent management of the prosthesis and the patient. The aim of the study was to investigate the incidence of post-discharge surgical site infections (SSI) and their risk factors. A retrospective analysis of an anonymized database from the National Health Found for 2017 of 56,068 adult patients undergoing hip replacement surgery (HPRO) and 27,457 patients undergoing knee replacement surgery (KPRO). The cumulative incidence of post-discharge SSI was 0.92% for HPRO and 0.95% for KPRO. The main risk factors for hip SSI were male gender, diseases of hematopoietic, musculoskeletal and nervous system. The risk factor for knee SSI was male gender. All comorbidities significantly increased the risk of SSI. The ICU stay and antibiotics administered at discharge in studied population increased the risk of detection of SSI after HPRO and KPRO by up to four and seven times, respectively. For both procedures rehabilitation after surgery and total endoprosthesis decreased incidence of SSIs. The lower experience of the center was related to higher SSI incidence in HPRO in primary (1.5% vs. 0.9%) and in revision surgeries (3.8% vs. 2.1%), but in KPRO, lower experience only in primary surgeries was significantly associated with SSI. The cumulative incidence of post-discharge SSI in Poland is higher than in other European countries. Special attention should be paid to patients with chronic diseases.

Gemtuzumab ozogamicin for relapsed or primary refractory acute myeloid leukemia in children-the Polish Pediatric Leukemia and Lymphoma Study Group experience.

Background: Gemtuzumab ozogamicin (GO), one of the first targeted drugs used in oncology, consists of an anti-cluster of differentiation 33 (CD33) monoclonal antibody bound to a derivative of cytotoxic calicheamicin. After the drug withdrawn in 2010 due to a significantly higher rate of early deaths, GO regained approval in 2017 for the treatment of newly diagnosed, refractory, or relapsed acute myeloid leukemia (AML) in adults and children over 15 years of age. The objective of the study was a retrospective analysis of clinical characteristics, treatment outcomes, and GO toxicity profile in children with primary refractory or relapsed (R/R) AML treated in Poland from 2008 to 2022. Methods: Data were collected through the Polish Registry of Acute Myeloid Leukemia. From January 2008 to December 2022, 35 children with R/R AML were treated with GO in seven centers of the Polish Pediatric Leukemia and Lymphoma Study Group. Results: Most of the children (30 of 35) received only one GO cycle in combination with various chemotherapy cycles (IDA-FLA, DOXO-FLA, FLA, FLAG, and others). Eighteen children (51%) achieved complete remission (CR), 14 did not respond to treatment, and three progressed. GO therapy was followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 18 children in CR. The 5-year overall survival (OS) after GO therapy was 37.1% ± 8.7% for the total cohort. There was a trend toward a superior outcome in patients with strong expression of CD33 expression (over 50% positive cells) compared with that in patients with lower expression of CD33 (OS, 41.2% ± 11.9% versus 27.8% ± 13.2%; p = 0.5; 5-year event-free survival, 35.4% ± 11.6% versus 25.7% ± 12.3%; p = 0.5, respectively). Children under 15 years have better outcome (OS, 34.9% ± 10.4% versus 30% ± 14.5%, p = 0.3). The most common adverse events were bone marrow aplasia, fever of unknown origin, infections, and elevated liver enzyme elevation. Sinusoidal obstruction syndrome occurred in two children. Conclusions: The use of GO in severely pretreated children, including those under 15 years of age, with previous failure of AML treatment is a feasible and effective bridging therapy to allo-HSCT with an acceptable toxicity profile.

Determinants of Quality of Life among Adolescents in the Malopolska Region, Poland.

Knowledge about predictors associated with quality of life (QoL) in adolescents is important for public health. The aim of the study was to indicate determinants of the different dimensions of QoL in the fields of demographic, socio-economic factors, general health and lifestyle in a sample of Polish adolescents. The cross-sectional study was carried out in a southern region of Poland among 804 schoolchildren from junior high schools and upper secondary schools. The quality of life was measured using the Polish version of the KIDSCREEN-52 questionnaire. The author's questionnaire concerning determinants of the adolescents' quality of life was also used. In the analysis of the quality of life, standardized results on the European population (T-score) and categorization on the low, average and high quality of life were taken into account. Defining the possible determinants of the adolescents' quality of life was made by the multivariate logistic regression models. The highest prevalence of low QoL was observed in the school environment (53.4%) and the psychological well-being (51.6%) dimensions of the KIDSCREEN-52. The factors that increased the risk of the low assessment of the quality of life were, inter alia, female sex for physical well-being, psychological well-being, self-perception, autonomy, parent relation and home life, and financial resources, higher school year for physical well-being, psychological well-being, moods and emotions (2nd grade of upper secondary school only), self-perception, social support and peers, and school environment, and dissatisfaction in appearance for physical well-being, psychological well-being, moods and emotions, self-perception, school environment, social acceptance and bullying.