The relationship between ambient air pollution and life expectancy - an ecological fallacy revisted.

INTRODUCTION: The results of multiple studies indicate the negative impact of exposure to air pollution on human life expectancy. Epidemiological evidence on this relation is in large proportion provided by ecological studies, what causes interpretation difficulties. Poland is a country characterized by large territorial differences in ambient air pollution and in life expectancy. This promotes analyses of the mentioned relationship based on ecological model. AIM: The aim of the study was to analyse the results of a simple ecological study concerning the relationship between life expectancy and air pollution with the focus on the difficulties in interpretation of the results. MATERIAL AND METHODS: The study used a simple ecological study approach. We used the official data on sex-specific life expectancy for year 2018 and annual average ambient air concentrations of PM2.5 in years 2010-2018 for 10 large metropolitan areas in Poland. The data was used as a marker of long-term air pollution levels in particular areas. Associations between life expectancy and air pollution levels were assessed using Spearman correlation analysis. RESULTS: The analysis concerning exposure to air pollution and life-expectancy in several Polish large agglomerations did not show statistically significant associations. CONCLUSIONS: Our ecological study did not show statistically significant associations between life expectancy and ambient air pollution levels measured by means of PM2.5 concentrations. Ecological nature of the population's exposure marker, without considering many important factors influencing length of life, may explain the negative results of the correlation analysis. This is an example of so called ecological fallacy, affecting the used model of epidemiological study.

Acute cardiorespiratory response to ambient air pollution exposure during short-term physical exercise in young males.

BACKGROUND: Physical exercise in the presence of ambient air pollution may increase the absorbed dose of air pollutants. The combined effect of such exposure on cardiorespiratory function in young adults remains unclear. AIM: To determine the acute cardiorespiratory responses in healthy young adults preforming submaximal physical exercise under exposure to high level winter-type ambient air pollution. METHODS: Healthy young males (n=30) performed two separate 15-minute submaximal exercise trials on a cycle ergometer - when air pollutants' concentrations were increased (exposure trial) and when air quality was good (control trial). Each time blood pressure, pulse oximetry, spirometry and fractional exhaled nitric oxide (FeNO) were measured at baseline, directly after exercise and after 15-min of rest. RESULTS: High air pollutants concentrations were observed during exposure trials (PM2.5 24.0-157.0 µg/m3, SO2 8.7-85.8 µg/m3). Group-based correlation analysis showed statistically significant negative correlations between post-exercise declines in FEV1/FVC and SO2, PM10 and PM2.5 concentrations. In individual cases the decrease was recorded only in subjects who exercised under particularly high exposure, and was not related to their BMI, physical activity pattern or allergy status. In multivariate analysis SO2 was a statistically significant predictor of both immediate (OR: 1.09, 95%CI: 1.01-1.17) and delayed decrease in airflow (OR: 1.08, 95%CI: 1.01-1.16), and PM2.5 was also a statistically significantly explanatory variable of post-exercise decline in FEV1/FVC (OR: 1.03, 95%CI: 1.00-1.06). CONCLUSION: In young and healthy males exposure to ambient air pollution during short-term submaximal exercise is associated with a decrease in airflow (FEV1/FVC) and the decrease is more apparent when the exercise takes place under particularly high exposure conditions.

Coexistence of asthmatic and non-respiratory allergic symptoms in children of Batumi Region, Georgia: occurrence and association with known diagnosis of asthma.

OBJECTIVES: Our recent studies showed that in children in the Batumi region, Georgia, underdiagnosis of asthma is 65%, and that not all children with known asthma had a history of allergic disorders. So, we decided to assess the association of known diagnosis of paediatric asthma with asthma-like symptoms and non-respiratory allergic symptoms and diseases using questionnaire-derived data provided by respiratory health survey. METHODS: Subjects of the cross-sectional population-based study were 3,239 urban and 2,113 rural children aged 5-17 years whose respiratory status was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. For children with a known diagnosis of asthma, the occurrence of respiratory symptoms suggestive of asthmatic tendency and of allergic symptoms and diseases was measured and statistical association of known asthma with the respiratory and allergic symptoms was expressed as odds ratios (OR) and their 95% confidence intervals (95% CI). RESULTS: Respiratory and all allergic symptoms and diseases, except for eczema, were statistically significantly (p < 0.05) more prevalent in children with asthma than in children without asthma. Based on the distribution of asthma vis-à-vis asthmatic tendency without or with allergic symptoms and allergic diseases the following odds ratios expressing likelihood of asthma were obtained: for asthmatic tendency: OR = 18.09 (95% CI: 11.82-27.68), for any allergic symptom: OR = 6.85 (95% CI: 4.69-10.02), for any allergic disease: OR = 10.75 (95% CI: 7.36-15.70), for asthmatic tendency with coexisting any allergic symptom: OR = 18.94 (95% CI: 12.96-27.68), for asthmatic tendency with coexisting any allergic disease: OR = 25.65 (95% CI: 17.47-37.67), and for asthmatic tendency with coexisting any allergic symptom and allergic disease: OR = 27.02 (95% CI: 18.18-40.15). CONCLUSIONS: The findings support the view that in epidemiological setting questionnaire-based studies on asthma seems to more readily identify cases in children with more severe clinical presentation of the disease and with coexisting allergic disorders, perhaps reflecting diagnostic practices of consulting paediatricians.

Spatial variability of SARS-CoV-2 infection in the Silesian voivodeship, Poland.

INTRODUCTION: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and related to infection COVID-19 (coronavirus disease 2019) remain a new and global challenge for public health. Due to the location, specifics of employment, and the high density of population in the Silesia voivodeship it is appropriate to study the available epidemiological data in a region with a potentially higher risk of infection. MATERIAL AND METHODS: In the descriptive model of the study, data on the number of infected, hospitalized, and dead people due to SARS-CoV-2 infection were analyzed. The source of information was daily reports conducted by the Provincial Sanitary and Epidemiological Station in Katowice, in the period from March 5 to August 18, 2020. RESULTS: Results of antigenic molecular tests for SARS-CoV-2 infection in the Silesian voivodeship indicate that in the first half of 2020, the infection rate was approximately 5% and the symptomatic form of the disease was approximately 20%. CONCLUSIONS: The analysis of the frequency of infection and mortality in the poviats reveals a large variation in the occurrence of both phenomena, but the explanation of this difference is not possible due to the descriptive nature of the analysis and the secondary form of epidemiological data.

Impact of changing GOLD guidelines (2007-2011-2017) on assignment of a COPD patient to disease severity category.

INTRODUCTION: The international standard for the recognition and treatment of chronic obstructive pulmonary disease (COPD) is guided by a regularly updated set of criteria developed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). AIM: To investigate the impact of updated COPD management guidelines from 2007 to 2017 (GOLD 2007, GOLD 2011 and GOLD 2017) on the assignment of patients into individual therapeutic groups, examining both individual and population dimensions. MATERIAL AND METHODS: Each of 500 randomly chosen primary care physicians in Poland provided information on 10 individual COPD patients (disease history, clinical status, treatment and pharmacotherapy). This data was used to simulate the consequences of the implementation of the GOLD 2007, 2011 and 2017 guidelines. RESULTS: A group of 298 physicians of 500 approached provided information on 2597 patients (64.2% males) aged 29-96 (61.6 ±11.1 years). Based on GOLD 2007 guidelines, most patients (56.7%) presented a severe stage of COPD. GOLD 2011 updates would significantly increase the proportion of patients with the most severe stage of disease, and this group would be predominantly classified as moderate or severe in GOLD 2007. The implementation of GOLD 2017 guidelines would result in a significant migration of patients towards the lightest (category A) form of the disease. CONCLUSIONS: Updates to the GOLD 2007 COPD guidelines for GOLD 2011 and 2017 would have a significant impact on the classification of patients for particular therapeutic groups. As a result of the migration of patients to particular therapeutic groups, the pharmacological treatment would also change.

Consequences of Changing the GOLD Reports (2007-2011-2017) on the Treatment Regimen of Patients with COPD.

Detailed treatment regimens for patients with chronic obstructive pulmonary disease (COPD) were developed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Every few years the method of classification of COPD severity and the treatment recommendations are significantly revised. The aim of this study was to determine the clinical implications of changing GOLD reports (2007-2011-2017) and the impact that these changes would have on pharmacological treatment regimens of patients with COPD. A group of 500 randomly chosen primary care physicians in Poland each provided information on 10 consecutive patients diagnosed with COPD. This data was used to simulate the therapeutic consequences of the update of the GOLD 2007 report to GOLD 2011 and GOLD 2017. Pharmacological treatment algorithms from the GOLD 2007 report prefer the use of inhaled corticosteroids (ICS) and short-acting bronchodilators (60.2% and 50%, respectively). Compared to the GOLD 2007 report, there would be an almost eightfold reduction in the frequency of short-acting bronchodilator using the GOLD 2011 report and over fourfold decrease using the GOLD 2017 report. With each subsequent update of the GOLD report, the frequency of use of ICS would be significantly (p < 0.001) reduced. Pharmacological treatment by the GOLD 2011 and 2017 reports would be dominated by the use of long-acting bronchodilators from the group ß2-agonists and muscarinic antagonist groups. Updates from the GOLD 2007 COPD report to GOLD 2011 and 2017 would have a significant impact on everyday clinical practice. Changes would result in a reduction of treatment intensity.

Childhood asthma in Batumi, Georgia: Prevalence and environmental correlates.

OBJECTIVE: A relative lack of data for Eastern Europe and unknown epidemiology of childhood asthma in Batumi (Georgia) justified a study aimed at determining the prevalence of physician-diagnosed asthma and related respiratory conditions, a comparison of the prevalence of these conditions between urban and rural children, and identification of their environmental correlates. METHODS: Subjects of the cross-sectional population-based study were 3238 urban and 2081 rural children aged 5-17 years whose respiratory status was assessed using the ISAAC questionnaire. RESULTS: The overall prevalence of asthma was larger in rural children than in urban children (2.8% vs. 1.8%, respectively; p = 0.01). Spastic bronchitis occurred with similar frequency in urban (7.8%) and rural children (6.5%). Compared with urban children, rural subjects had dry cough at night (13.1 vs 8.2%, p < 0.001) and attacks of dyspnea (4.7 vs 2.4%, p < 0.001) more often. The prevalence of other symptoms did not differ significantly between urban and rural subjects. Results of multivariate analyses showed that both asthma and spastic bronchitis were associated (p < 0.05) with parental history of asthma, dampness in the house, and poor financial standing of the family. In addition, asthma was related to coal/wood-based heating whereas spastic bronchitis was associated with passive smoking and lower parental education. CONCLUSIONS: The findings show a low prevalence of ever-diagnosed asthma in the examined population. Nosological tradition and similar correlates of asthma and spastic bronchitis suggest that some cases of asthma might be included in the diagnostic category of spastic bronchitis.

Dental status in the Polish senior population and its correlates-Results of the national survey PolSenior.

OBJECTIVE: The aim of the study was to assess dental status of Polish seniors having and wearing dentures in relation to demographic, socioeconomic and lifestyle factors. BACKGROUND: Tooth loss is associated with deterioration of general health status. The epidemiological data on dental status in Poland, including Polish seniors, are fragmented. MATERIALS AND METHODS: The study cohort consisted of 4524 randomly selected participants, aged 65 years and over, representative for Polish seniors. Demographic, socioeconomic, lifestyle factors and dental status were collected using standardised questionnaires. RESULTS: The prevalence of partial and complete edentulism in the Polish senior population was estimated at 45.7% and 47.1%, respectively. Fourteen point four per cent (14.4%) of complete edentulous participants and 31.1% with partial edentulism (1-19 natural teeth) did not have dentures, and one-twelfth of respondents having dentures were not wearing them. The independent correlates of complete edentulism were: female sex, advanced age, rural dwelling, lower education level, physical work in the past, smoking and diabetes. Male sex, age 90+, rural dwelling, type of work, dependence in activities of daily living and partial edentulism were independent correlates of not having dentures and denture disuse. Lower than average personal income was only significant for not having dentures. CONCLUSIONS: Complete edentulism is frequent among older Poles and affects almost 50% of them. It is associated with female sex, age, rural dwelling, poor economic status, smoking and diabetes. Rural dwelling and dependence of daily living are significant correlates of not having dentures and denture disuse.

[Relationship between PM2.5 concentration in the ambient air and daily exacerbation of respiratory diseases in the population of Silesian voivodeship during winter smog]. / Zwiazek stezenia drobnego pylu PM2,5 zawartego w powietrzu atmosferycznym podczas epizodu smogowego z dobowymi zaostrzeniami chorób ukladu oddechowego w populacji województwa slaskiego.

BACKGROUND: Recurring winter smog episodes, recently observed in Poland, have inspired the researches to assess the epidemiological situation concerning the registered exacerbations of respiratory diseases related to worsening of the ambient air quality. MATERIAL AND METHODS: The model comprising the ecological study results and secondary epidemiological data on registered outpatient visits and hospitalizations in the Silesian voivodeship was used. We assessed the effect of smog observed in January 2017 on the number of acute respiratory disorders registered in that month. Aerosanitary situation was obtained from the Provincial Inspectorate for Environmental Protection in Katowice database. RESULTS: It was documented that the increase in PM2.5 concentration (with simultaneously observed unfavorable meteorological parameters) was related to a higher number of acute respiratory disorders registered daily. Moreover, the increase in the number of outpatient visits due to asthma exacerbation or bronchitis was observed on the first day of episode, and hospitalizations took place with delay of 1-2 days. CONCLUSIONS: The preliminary results indicate the relationship between worsening of ambient air quality during the winter smog and the increase in daily number of registered outpatient visits and hospitalizations due to acute respiratory diseases. Med Pr 2018;69(5):523-530.

Dietary supplementation usage by pregnant women in Silesia - population based study.

OBJECTIVES: Despite wide access to gynecological and obstetric advice, informational campaigns, and information online and in magazines aimed at pregnant women, there is a worryingly high percentage of women who still do not use recommended dietary supplementation. The aim of this study was to assess the frequency of micronutrient supplementation by pregnant women and to specify the determinants that impact decisions concerning supplementation. MATERIAL AND METHODS: A cross-sectional survey was conducted between June 2016 and May 2017 among a group of pregnant women visiting gynecological and obstetric clinics in the Silesia region, who have completed an authorized questionnaire developed for the purpose of this study. The questionnaire addressed the women's dietary habits, micronutrient supplementation use, as well as their socio-economic status. Completed questionnaires were obtained from 505 pregnant women. RESULTS: Microminerals and vitamins supplementation during pregnancy was declared by 410 (81.2%) women. The most often used supplement was folic acid (62%). More than one-third of pregnant women (38.4%) declared vitamin D intake. Among the recommended supplements, the least commonly used (30.3%) were polyunsaturated fatty acids (PUFA). Factors contributing to supplementation use during pregnancy are past history of miscarriage and socioeconomic factors, such as: place of residence, financial situation and level of education. Inhabitants of larger cities, women with better self-perceived financial situations, higher education levels and those presenting past history of miscarriage took the supplements significantly more often. CONCLUSIONS: Lower levels of education, low-income financial status and living in rural localities are among the factors correlating with worse adherence to supplementation guidelines.

Comparison of spirometric results obtained from the sitting and standing position in children participating in an epidemiological study.

INTRODUCTION: It is recommended that spirometric testing in children be completed while sitting. Our experience indicates that children prefer standing during spirometry. AIM: We sought to compare spirometric results obtained from the sitting (SIP) and standing (STP) positions. MATERIAL AND METHODS: Two testing sessions were performed in random order (SIP vs. STP: 30-45 min apart) in 118 children (7-13 years), attending one, randomly selected, primary school (response rate: 92%). RESULTS: Acceptable quality was found in 77.9% of STP and 77.1% of SIP maneuvers. Higher values of spirometric variables on STP, compared to SIP, were obtained for forced vital capacity (FVC) (2.12 ±0.41 l vs. 2.11 ±0.39 l) and forced expiratory volume in 1 s (FEV1) (1.78 ±0.36 l vs. 1.77 ±0.35 l) but the differences were not statistically significant. Relative between-position differences (RBPD) ≤ 5% were found with the following frequencies: FVC: 56.4%, FEV1: 69.2%, PEF: 21.7%, and FEF25-75: 24.3%. Similar patterns were found for FEF25, FEF50, and FEF75. Relative between-position differences were related to age in the case of FEV1 (p = 0.005), FEF25 (p = 0.02), and FEF25-75 (p = 0.01) where older children had smaller RBPD. Forced vital capacity RBPD was lower (p = 0.01) in subjects with current wheeze; PEF RBPD were lower (p = 0.02) in children with asthma. CONCLUSIONS: In epidemiological studies, the position of spirometric testing does not affect the results of lung function assessment.

Non-alcoholic fatty liver and advanced fibrosis in the elderly: Results from a community-based Polish survey.

BACKGROUND & AIMS: Development of non-alcoholic fatty liver (NAFL) is dependent on metabolic factors occurring at an increased frequency with advancing age. Until now, few studies have explored the prevalence of NAFL in aged populations. Our study aimed to determine the prevalence of NAFL and advanced fibrosis in the elderly population participating in a national survey of a community-based elderly cohort. METHODS: A total of 3003 participants (mean age 79.6 years, 46.8% male) were enrolled in the study, after applying the following exclusion criteria: individuals younger than 65 years old (n=829) and those with positive serological biomarkers of HBV or HCV infection (n=391), chronic alcohol ingestion (n=727) or incomplete data records (n=745). Based on the fatty liver index (FLI), the participants were classified into three categories: FLI<30 (no NAFL), 30≤FLI<60 (borderline) and FLI≥60 (NAFL). According to the non-alcoholic fatty liver disease (NAFLD) fibrosis score (NFS), the participants were divided into three advanced fibrosis risk categories: NFS<-1.455 (low risk), -1.455≤NFS≤0.676 (intermediate risk) and NFS>0.676 (high risk). RESULTS: The prevalence of NAFL in the general population was 37.2%; the prevalence reached 51.4% in participants 65-70 years of age and decreased with advancing age (P<.0001). The prevalence of advanced fibrosis was 7.79% (14.8% in the NAFL population) and increased with advancing age (P<.005). CONCLUSIONS: The prevalence of NAFL and metabolically driven advanced fibrosis are relatively common in the elderly population, and these hepatic conditions run in adverse directions with advancing age.

[Profile of adults suffering from COPD in Poland].

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases in adults. It is estimated, that in Poland around two million people suffer from COPD. THE AIM: The aim of this study, was to characterize population of patients with COPD in Poland. MATERIAL AND METHODS: The study, established and coordinated by the Polish Respiratory Society, included a representative sample of 500 GPs where were asked to fill questionnaires on diagnosis and treatment of their COPD patients. The questions dealt with disease history and clinical presentation, COPD severity stage, diagnostic and therapeutic procedures. RESULTS: Altogether 298 physicians (59.6% of invited) provided information about 2756 COPD patients aged 61.6 ± 11.1 years (36.3% were women). According to GOLD recommendations 16.6% of patients had mild, 57.0% moderate, 18.6% severe and 2.1% very severe COPD. Smoking history was declared by 97.8% of respondents. 51.4% of COPD patients had continued smoking. Over the last year Ambulance Service intervened in 19.7% of patients and 29.1% of respondents required hospital treatment of COPD. Among more than 80% of patients, doctor diagnosed limitation in exercise tolerance, and shortness of breath at rest, and in approximately 60% of the respondents were presented productive cough, weakened vesicular murmur and prolonged phase of exhalation. CONCLUSIONS: Despite the diagnosis, more than half of men and women had continued smoking. The number of hospitalizations and emergency intervention positively correlated with the severity of the disease. The survey results emphasize the urgent need for health education in patients with COPD.

Childhood asthma prevalence and risk factors in three Eastern European countries--the Belarus, Ukraine, Poland Asthma Study (BUPAS): an international prevalence study.

BACKGROUND: The prevalence of asthma and other allergic diseases among children living in Eastern is not well described. Our objective was to estimate and compare the prevalence of asthma, respiratory symptoms and allergic diseases in children in Belarus, Ukraine, and Poland as well as to identify risk factors for these conditions. We also sought to profile and compare children with asthma between locations. METHODS: Data were collected as a part of an international, multicenter, cross-sectional study of childhood asthma: The Belarus Ukraine Poland Asthma Study (BUPAS). Subjects were children aged 7-13 years attending primary and secondary schools in the urban and surrounding rural area of Grodno (Belarus), Ternopil (Ukraine) and Silesia Region (Poland). Physician-diagnosed respiratory diseases and symptoms as well as allergic diseases were ascertained using the ISAAC questionnaire completed by the parents. RESULTS: In total there were 4019 children from Belarus (rural: 2018, urban: 2001), 4493 from Ukraine (1972; 2521), and 4036 from Poland (2002, 2034). The overall response rate was 76.7%. Groups were similar in case of gender and age (p > 0.05). Almost all analyzed respiratory and allergic conditions differed significantly between countries including asthma [Poland (rural, urban): 3.5%, 4.1%; Ukraine: 1.4%, 2.1%; Belarus: 1.4%, 1.5%], spastic bronchitis (Poland: 2.7%, 3.2%; Ukraine: 7.5%, 6.5%; Belarus: 6.4%, 7.9%), and chest wheeze in the last year (Poland: 4.8%, 5.2%; Ukraine: 11.5%, 13.0%; Belarus: 10.7%, 10.0%). These differences remained after adjustment for potential confounders. Risk factor associations were generally similar between outcomes. Symptom characteristics of children with asthma between countries were not consistent. The ratio of current wheeze:diagnosis of asthma differed by country: (Rural areas: Belarus: 10.9:1, Ukraine: 17.3:1, Poland: 2.4:1; Urban areas: Belarus: 8.1:1, Ukraine: 7.3:1 Poland: 1.9:1). CONCLUSIONS: The findings show large between-country differences and relatively low prevalence of asthma and allergic diseases in children of Western Belarus and Ukraine. There is evidence for underdiagnosis of asthma in these regions.

[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.

[Validation of ORTO-15 Questionnaire in the group of urban youth aged 15-21]. / Walidacja kwestionariusza ORTO-15 w grupie mlodziezy miejskiej w wieku 15-21 lat.

AIM: The aim of the study was the validation and adaptation of the ORTO-15 Questionnaire in the group of the Polish schoolgirls and schoolboys. METHODS: The study included 399 participants (15-21 years old), all of them high school students in the city of Sosnowiec. The ORTO-15 is a tool created in Italy by L.M. Donini, comprising of 15 items describing intensification of orthorexia risk (population diagnosis). The validation procedure incorporated three basic methods to be applied in the reliability analysis - the comparison of double tests with the same method, the statistical properties analysis of test items as well as analysis of the relation of test items with the general test result. Moreover, the compliance of the ORTO-15 Questionnaire results with other questionnaire focused on eating habits (EAT-26) was studied. RESULTS: The reliability analysis of the ORTO-15 Questionnaire based on repeatability of the responses presents a very good (kappa: 0.81 - 1.00 for 5 items) and a good repeatability (kappa: 0.61 - 0.80 for 10 items). The reliability analysis based on the value of the Cronbach's α reached a satisfactory level (0.7 - 0.9). A full agreement of in the occurrence of orthorexia risk and the risk of eating disorders concerned 47.2% (Kappa = 0.04; 95% CI: 0.004 - 0.09) for the Ortho-40 and 88.2% (Kappa = 0.32; 95% CI: 0.17 - 0.47) for the Ortho-35. CONCLUSIONS: The ORTO-15 questionnaire is a reliable tool to identify the risk of ON in population studies in the group of urban youth aged 15 - 21.

The prevalence of chronic kidney disease and its relation to socioeconomic conditions in an elderly Polish population: results from the national population-based study PolSenior.

BACKGROUND: Rapidly progressing ageing of worldwide populations is likely to increase the occurrence of chronic kidney disease (CKD) in the next decades. However, until now little is known about the prevalence of CKD in the Polish elderly population. The aim of this study was to assess the prevalence of CKD and its relation to socioeconomic conditions in the Polish elderly population. METHODS: A glomerular filtration rate estimated (eGFR) according to the CKD-EPI formula and urine albumin/creatinine ratio were determined in 3797 out of 4979 randomly selected elderly subjects from the national survey study PolSenior. Additionally, some socioeconomic factors related to the prevalence of CKD were also analysed. RESULTS: The prevalence of CKD in the Polish elderly population was 29.4%. Only 3.2% of elderly subjects with CKD were aware of the disease. CKD was more frequent among urban dwellers, non-smokers, alcohol abstinents and those with low physical activity. Decreased eGFR was more frequent among less educated women, better educated men, blue collar female workers and white collar male workers. Increased albuminuria was associated with low physical activity. CONCLUSIONS: (i) CKD affects almost one-third of the elderly Polish population. (ii) In Poland elderly subjects with CKD are usually unaware of their kidney disease. (iii) In Polish elderly population, CKD is more frequently present among urban residents, non-smokers, abstainers and less physically active people. (iv) Only in women is higher educational status related to the lower risk of CKD.

Telomere length in elderly Caucasians weakly correlates with blood cell counts.

BACKGROUND: Age-related decrease in bone marrow erythropoietic capacity is often accompanied by the telomere length shortening in peripheral white blood cells. However, limited and conflicting data hamper the conclusive opinion regarding this relationship. Therefore, the aim of this study was to assess an association between telomere length and peripheral blood cell count parameters in the Polish elderly population. MATERIAL AND METHODS: The substudy included 1573 of 4981 subjects aged 65 years or over, participants of the population-based PolSenior study. High-molecular-weight DNA was isolated from blood mononuclear cells. Telomere length (TL) was measured by QRT-PCR as abundance of telomere template versus a single gene copy encoding acidic ribosomal phosphoprotein P0. RESULTS: Only white blood count (WBC) was significantly different in TL tertile subgroups in all subjects (P = 0.02) and in men (P = 0.01), but not in women. Merely in men significant but weak positive correlations were found between TL and WBC (r = 0.11, P < 0.05) and RBC (r = 0.08, P < 0.05). The multiple regression analysis models confirmed a weak, independent contribution of TL to both RBC and WBC. CONCLUSIONS: In the elderly, telomere shortening limits hematopoiesis capacity to a very limited extent.

Regional and temporal variability of GP concultations due to asthma in children aged 0-18 years in Silesian voivodeship.

UNLABELLED: The aim of this study was to analyze the spatial and temporal variability of the ratio describing outpatient medical visits due to asthma in children aged 0-18 years, living in Silesian voivodeship. MATERIAL AND METHODS: Descriptive study was conducted, in which secondary epidemiological data concerning number of medical outpatient visits due to asthma of children in the age of 0-18 years, were analyzed. The required data from the period 2007-2010 were reported on the MZ-11 form. To assess the temporal or spatial variability in Silesian voivodeship the ArcGIS 9.2 Software was used. RESULTS: Significant spatial and temporal variability of outpatient medical visits due to asthma in children have been discovered. The systematical increase of outpatient visits rate was observed (respectively 20.8 and 26.9% compared to the starting year). The largest values of the ratio concern the central region of the Silesian voivodeship. Most frequently outpatient medical visits due to asthma were related to children aged 5-14 years. CONCLUSIONS: Systematic and detailed analysis of the data collected in the health care system can replace the routine reporting and may be used to identify needs for public health.

[Treatment of asthma in Poland by primary care physicians--results of PulmoScreen study]. / Leczenie chorych na astme bedacych pod opieka lekarzy POZ--wyniki ogólnopolskiego badania PulmoScreen.

INTRODUCTION: Proper treatment of asthma patients is crucial for long-term control of the disease. OBJECTIVE: The aim of the study was to evaluate the treatment of adult asthma patients by primary care physicians in the light of international GINA guidelines. MATERIAL AND METHOD: The cross-sectional study included a representative sample of 1852 general practitioners (GPs) who were asked to complete questionnaires on the diagnosis and treatment often consecutive patients with asthma who are under their care. RESULTS: Altogether 1250 GPs provided information about 10,981patients. During the entire duration of the disease 50.9% were ever treated by systemic corticosteroids. In the current treatment of asthma inhaled steroids were used in 78.8% of cases, oral steroids in 5.8%, intravenous steroids in 1.3% and intramuscular steroids in 0.7% of patients. SABA were used in 63.1% of patients, LABA in 57.1%, methylxanthine in 25.1%, leukotriene modifiers in 21.1%, anticholinergics drugs in 15.5%, cromones in 1,9%, and antihistamines in 23.1% of adult patients with asthma. In 88.8% cases LABA treatment was combined with inhaled corticosteroids. In 83.8% of cases therapeutic regimens were in line with the GINA guidelines. CONCLUSIONS: There is a need for systematic educational activities addressed to primary care physicians.