Insomnia and the level of stress among students in Krakow, Poland / Insônia e nível de estresse em estudantes de Cracóvia, Polônia

Abstract Introduction: Stress and insomnia are increasing problems in young people in highly developed countries. They influence both the physical and psychological aspects of life and seem to be related to each other. Various strategies to cope with stress exist and can be used to reduce its level. The main goal of our study was to find a relationship between insomnia, stress, stress-coping strategies and selected social and medical factors among students. Methods: A cross-sectional study was conducted in March 2017 among students of seven public Krakow universities, using the Perceived Stress Scale 10, an abbreviated version of the Coping Orientation to Problems Experienced inventory (mini-COPE inventory) and the Athens Insomnia Scale. In the statistical analysis, the chi-square, Student's t test and Spearman's rank correlation coefficient were used. Results: A total of 264 students aged 22.22±1.5 years were involved in the study. High stress levels occurred in 10% of the respondents. A statistically higher level of stress was revealed in people suffering from chronic diseases (p=0.006) and in cigarette smokers (p=0.004). The most common stress-coping strategies were active coping and planning. Insomnia was present in 19.7% of the students. Insomnia level was correlated with the intensity of perceived stress (p=0.00; r=0.44). Conclusions: According to our study, one tenth of Krakow students perceive a high level of stress, and one fifth of the respondents suffer from insomnia. There is a strong positive correlation between level of insomnia and level of stress. To ensure high quality of life, problems such as stress and insomnia should be taken into consideration by every general practitioner.

Resumo Introdução: Estresse e insônia são problemas cada vez mais presentes em pessoas jovens em países altamente desenvolvidos. Eles influenciam tanto os aspectos físicos quanto os psicológicos da vida e parecem estar relacionados entre si. Várias estratégias de enfrentamento (coping) do estresse existem e podem ser usadas para reduzir seu nível. O objetivo principal deste estudo foi investigar a relação entre insônia, estresse, estratégias de coping, e certos fatores sociais e médicos em estudantes. Métodos: Um estudo transversal foi conduzido em março de 2017 com estudantes de sete universidades públicas da Cracóvia, na Polônia, utilizando a Escala de Estresse Percebido 10, uma versão abreviada do Inventário para Medir Estratégias de Enfrentamento de Estresse (mini-COPE) e a Athens Insomnia Scale. Na análise estatística, foram utilizados os testes qui-quadrado, t de Student e o coeficiente de correlação de Spearman. Resultados: Um total de 264 estudantes com idade média de 22,22±1,5 anos foram incluídos no estudo. Altos níveis de estresse ocorreram em 10% dos respondentes. Um nível estatisticamente mais alto de estresse foi revelado em pessoas sofrendo de doenças crônicas (p=0,006) e em fumantes (p=0,004). As estratégias de coping mais comuns foram coping ativo e planejamento. A insônia esteve presente em 19,7% dos alunos. O nível de insônia se correlacionou com a intensidade do estresse percebido (p=0,00; r=0,44). Conclusões: De acordo com este estudo, um décimo dos estudantes de Cracóvia percebe um alto nível de estresse, e um quinto dos respondentes sofrem de insônia. Há uma forte correlação positiva entre nível de insônia e nível de estresse. Para garantir alta qualidade de vida, problemas como estresse e insônia devem ser levados em consideração pelo médico generalista.

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry) / Stents Farmacológicos de Primeira Versus Segunda Geração na Síndrome Coronariana Aguda (Registro Katowice-Zabrze)

Abstract Background: There are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting. Objective: The aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS). Methods: This all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year. Results: From the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01). Conclusions: In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.

Resumo Fundamento: Os dados sobre o desempenho dos diferentes tipos de stents farmacológicos (SF) no cenário agudo e da vida real são escassos. Objetivo: Comparar a segurança e a eficácia dos SF de primeira e de segunda geração em pacientes com síndrome coronariana aguda (SCA). Métodos: Este registro arrolou pacientes consecutivos com diagnóstico de SCA e tratados com intervenção coronariana percutânea e implantação de SF de primeira ou segunda geração em seguimento de 1 ano. O desfecho primário 'eficácia' foi definido como eventos cardíacos adversos maiores (ECAM), um composto de morte por todas as causas, infarto do miocárdio não fatal, revascularização de vaso-alvo e acidente vascular encefálico. O desfecho primário 'segurança' foi trombose de stent (TS) definitiva em 1 ano. Resultados: Do total de 1.916 pacientes arrolados, 1.328 foram diagnosticados com SCA. Desses, 426 foram tratados com SF de primeira geração e 902, com SF de segunda geração. Não houve diferença significativa na incidência de ECAM entre os dois tipos de SF em 1 ano. A taxa de TS aguda e subaguda foi maior com SF de primeira geração do que com os de segunda geração (1,6% vs. 0,1%, p < 0,001; e 1,2% vs. 0,2%, p = 0,025, respectivamente), mas não houve diferença para TS tardia (0,7% vs. 0,2%, respectivamente, p = 0,18) nem para sangramento gastrointestinal (2,1% vs.1,1%, p = 0,21). Na regressão de Cox, o SF de primeira geração foi preditor independente para TS cumulativa [HR 3,29 (1,30-8,31); p = 0,01]. Conclusões: No registro de SCA, a taxa de ECAM em 1 ano foi comparável nos grupos tratados com SF de primeira e de segunda geração. O uso de SF de primeira geração associou-se a maiores taxas de TS aguda e subaguda, sendo um preditor independente para TS cumulativa.

Prevalence of resistance to aminoglycosides and fluoroquinolones among Pseudomonas aeruginosa strains in a University Hospital in Northeastern Poland

The present study was conducted to investigate the prevalence of genes encoding resistance to aminoglycosides and fluoroquinolones among twenty-five Pseudomonas aeruginosa isolated between 2002 and 2009. In PCR, following genes were detected: ant(2")-Ia in 9 (36.0%), aac(6')-Ib in 7 (28.0%), qnrB in 5 (20.0%), aph(3")-Ib in 2 (8.0%) of isolates.

Molecular epidemiology of Candida albicans and Candida glabrata strains isolated from intensive care unit patients in Poland

Over the last decades, Candida spp have been responsible for an increasing number of infections, especially in patients requiring intensive care. Knowledge of local epidemiology and analysis of the spread of these pathogens is important in understanding and controlling their transmission. The aim of this study was to evaluate the genetic diversity of 31 Candida albicans and 17 Candida glabrata isolates recovered from intensive care unit patients from the tertiary hospital in Krakow between 2011-2012. The strains were typed by random amplified polymorphic DNA (RAPD) polymerase chain reaction using five primers (CD16AS, HP1247, ERIC-2, OPE-3 and OPE-18). The results of the present investigation revealed a high degree of genetic diversity among the isolates. No clonal relationship was found among the C. albicans strains, whereas two C. glabrata isolates were identical. The source of Candida infection appeared to be mostly endogenous; however, the presence of two clonal C. glabrata strains suggested the possibility of cross-transmission of these pathogens. Our study confirmed the high discriminatory power of the RAPD technique in the molecular typing of Candida clinical isolates. This method may be applied to the evaluation of transmission routes of pathogenic fungi on a local level.

Occurrence of Ureaplasma parvum and Ureaplasma urealyticum in Women with Cervical Dysplasia in Katowice, Poland

The aim of this study was to evaluate the occurrence of genital mycoplasmas, especially Ureaplasma parvum and Ureaplasma urealyticum, in women with atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL), compared to women with normal cytology living in Katowice, Poland. Two sterile swabs were used to obtain material from the posterior vaginal fornix of 143 women with squamous intraepithelial lesions and 39 healthy women: first for general bacteriology, second for detection of urogenital mycoplasmas using Mycoplasma IST2 kit. From each positive Mycoplasma IST2 culture DNA was isolated and PCR was performed for identification of U. parvum and U. urealyticum. Mycoplasma IST was positive in 34.1% cases. Urogenital mycoplasmas were demonstrated in women with HSIL significantly more often compared to women with LSIL, ASCUS, and with normal cytology. DNA of U. parvum was demonstrated in majority of Mycoplasma IST2-positive cases, U. urealyticum DNA-only in 9 (4.9%). Predominance of 3/14 serovars of U. parvum was demonstrated. U. urealyticum biovar 2 was present more often in women with squamous intraepithelial lesions.

Association of lifestyle and other risk factors with breast cancer according to menopausal status: a case-control study in the Region of Western Pomerania (Poland).

PURPOSES: The purpose of this study was to examine the association between family history, reproductive, anthropometric, lifestyle factors and risk of breast cancer according to menopausal status, using data from a case-control study conducted in the Region of Western Pomerania (Poland). METHODS: A total, 858 women with histological confirmed breast cancer and 1085 controls, free of any cancer diagnosis, aged 28-78 years, were included in the study. The study was based on a self-administered questionnaire. Logistic regression was used to compute odds ratios and 95% confidence intervals and a broad range of potential confounders was included in analysis. RESULTS: Protective effect of a late age at menarche, a longer period of breast-feeding, increased levels of: recreational physical activity, total vegetables or fruits intake, and intake of vitamins on the risk of breast cancer was observed among both pre- and post-menopausal women. Familial history of breast cancer, active or passive smoking, experience of a crude psychological stress were positively associated with breast cancer regardless menopausal status. Current body weight, current body mass index, increased alcohol intake elevated breast cancer risk in postmenopausal women, while these factors did not alter risk among premenopausal women. Increased consumption of red meat or animal fats elevated the risk in premenopausal women. More educated premenopausal women had lower breast cancer than those graduated from elementary school. Low family income increased the risk in premenopausal women. CONCLUSION: There is evidence for a dose-response relationship between several lifestyle factors and breast cancer risk. The results also suggest that some different mechanisms may operate in breast cancer etiology in pre-and post-menopausal women. A multifactorial process of breast cancer development, the complex interaction between physical activity, diet, energy intake and body weight, inconsistent and inconclusive data on breast cancer risk factors coming even from well-designed epidemiological studies are the case for continual update knowledge on primary prevention and identification of changes in behavior that will reduce the risk.

Self-reported childhood physical activity and breast cancer in adulthood.

The association between physical activity during childhood and breast cancer risk was examined. To study this question data on physical activity in childhood were analyzed. A hospital-based case-control study of 250 Polish incident breast cancer cases (49.2% of eligible) and 301 (41.4% of all selected) frequency matched for age controls was conducted in 2003-2004 in the Region of Western Pomerania. Women were asked to compare their total physical activity at ages 10-12 years and 13-15 years with the activity of their female peers by choose from one of three categories: less active, equally active, more active, the best describing their activity. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using univariate and multivariate logistic regression, fitted by the method of maximum likehood. Women who reported having been physically more active than their peers at ages 10-12 years had an age-adjusted OR=0.88 (95% CI=0.36-2.15, P for trend=0.37) as compared with those reported being less active. Adjustment for potential confounders and total lifetime physical activity decreased the risk estimate to OR=0.25 (95% CI=0.06-1.10, P for trend=0.15). For physical activity at ages 13-15 years, both an age-adjusted and multivariate adjusted ORs were also decreased among women who were at least such active as their peers, but the reductions were not statistically significant. For women who were more physically active than their peers during both age periods the adjusted OR was 0.30 (95% CI=0.11-1.34, P for trend =0.21). These results show no protective role for physical activity in childhood on breast cancer development among women aged 35-75 years. Further investigations employing larger sample sizes with comprehensive assessment of physical activity during the childish years are needed to verify this evidence.

Impact of Chlamydia trachomatis and HPV Infection Among Sexually Active Teenage Girls in Upper Silesia, Poland

No abstract available.