Correlates of Blood Pressure and Cholesterol Level Testing Among a Socially-Disadvantaged Population in Poland.

As part of cardiovascular disease prevention, the performance of BMI determination, blood pressure measurement, biochemical tests, as well as a lifestyle-related risk assessment are recommended. The aim of this study was to evaluate the correlates of blood pressure and cholesterol level testing among a socially-disadvantaged population in Poland. This cross-sectional study was performed between 2015 and 2016 among 1710 beneficiaries of government welfare assistance. Face-to-face interviews conducted by trained staff at each participant's place of residence allowed for completion of questionnaires that covered socio-demographic, health and lifestyle-related information. Sixty-five percent of the participants declared a blood pressure and 27% of them cholesterol level testing at least once within the year proceeding the study. A higher chance of having blood pressure testing was observed among the women (OR = 1.5; p = 0.002) and people with high blood pressure (OR = 3.9; p < 0.001). The women (OR = 1.4; p = 0.04) and older people (OR = 1.9; p = 0.02; OR = 2.6; p < 0.001, OR = 2.7; p = 0.002, for the following age groups: 30-39, 40-49, 50-59 years respectively), the respondents who declared health problems such as heart attack (OR = 3.0; p = 0.04), high blood pressure (OR = 2.3; p < 0.001) and type 2 diabetes (OR = 3.3; p = 0.004) and those with a family history of chronic diseases (OR = 1.5; p = 0.03) had a higher chance of cholesterol level checking. Higher healthy lifestyle index, indicating that the study participants have followed almost all of the studied lifestyle-related recommendations, was a significant correlate of cholesterol level testing (OR = 1.7; p = 0.006). Actions that promote lifestyle changes, blood pressure, and cholesterol level testing should take into account the needs of the disadvantaged population and should especially target men, people with existing chronic diseases, and those with unfavorable lifestyle characteristics. With respect to the socially-disadvantaged population, the social assistance institutions and outpatient clinics are the best places to conduct activities promoting a healthy lifestyle. The most commonly applied strategies to promote lifestyle changes can cover risk assessment, increasing awareness, emotional support and encouragement, as well as a referral to specialists.

Mannose-binding lectin (MBL) in adult patients with inflammatory bowel disease.

Inflammatory bowel disease (IBD) refers to disorders associated with progressive inflammatory processes in the gastrointestinal system. IBD consists of two major forms, Crohn's disease (CD), and ulcerative colitis (UC). IBD became a global disease in the 21st century. Its pathogenesis is still not fully understood. Mannose-binding lectin (MBL) is a pattern-recognising molecule, involved in anti-microbial and anti-cancer immunity. It is able to opsonize microorganisms and abnormal host cells, and to initiate complement activation. The aim of this study was to investigate possible involvement of MBL in inflammatory bowel disease in adults. Forty persons diagnosed with CD and 28 with ulcerative colitis were recruited. The control group consisted of 136 healthy persons. Single nucleotide polymorphisms of the MBL2 gene (localised to both promoter and exon 1) were determined as were serum MBL concentrations. The exon 1 variant alleles and MBL deficiency-associated genotypes were more frequent among patients compared with controls, although this difference was not statistically significant. No differences of MBL levels were found between the major groups. However in MBL2 A/A homozygous IBD patients, the median was significantly higher than in corresponding healthy subjects. That was particularly evident in the case of active Crohn's disease (1493 ng/ml vs. 800 ng/ml, p = 0.021). It may suggest that MBL and MBL-dependent complement activation contributes to excessive inflammation and its adverse effects in the course of CD. It cannot also be excluded that high MBL activity constitutes in some cases part of a multifactorial network conducing to development of CD.

Predictors of Counselling Related to a Healthy Lifestyle Carried Out by a General Practitioner.

The aim of the study was to assess whether general practitioners (GPs) monitor and evaluate the health behavior of their patients in the field of a diet, physical activity, and weight control, and whether they provide appropriate counselling as part of this evaluation. Predictors of those activities among physicians were also determined. The cross-sectional study was conducted in the Piotrkowski district among 200 GPs. The questionnaire covered socio-demographic data and lifestyle characteristics of the physicians, their role as healthy lifestyle providers, and whether they assess lifestyle characteristics of their patients and perform healthy lifestyle counselling. More than 60% of the GPs did not evaluate lifestyle features during their patients' examination. In total, 56% of the GPs provided healthy lifestyle recommendations among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations, and 73% of GPs provided recommendations to patients with chronic diseases related to lifestyle. The study showed that the chance to assess lifestyle characteristics of the patients was significantly higher for the GPs who believed that they were obliged to do so (OR = 6.5; p = 0.002). The chance to recommend a healthy lifestyle among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations was 5.9 times higher among the GPs working in the public sector (p < 0.001) and 16.3 times higher for these who believed that they had sufficient knowledge to provide the advice (p = 0.02). The following predictors of providing a healthy lifestyle counselling among patients with diagnosed chronic lifestyle-related diseases were identified: conviction that a GPs is obligated to provide it (OR = 4.4; p = 0.02), sufficient knowledge (OR = 8.7; p = 0.01), and following health recommendations by themselves (OR = 3.9; p = 0.04). Conclusions: The identified predictors are crucial for the development of appropriate strategies aiming at increasing GPs' involvement in preventive measures and consequently at improving the population's health.

Perceived cessation treatment effectiveness among socially disadvantaged light and heavy smokers.

OBJECTIVES: The aim of the current study was to assess the perceived treatment effectiveness and beliefs with respect to the best advisor who could conduct smoking cessation treatment or counseling among socially disadvantaged light and heavy smokers. This could be crucial for implementation of a successful smoking cessation intervention among this vulnerable population. MATERIAL AND METHODS: The current assessments were based on the data collected during the second wave of a cross-sectional study performed in the Piotrkowski District among 1668 adults aged 18-59, entitled to social aid from welfare institutions. Face-to-face interviews were conducted to collect the relevant data. RESULTS: The current daily smoking status was declared by 31% of the participants. About 23% of the study sample (74% of daily smokers) admitted to being heavy smokers with a meaningful difference between men and women (p < 0.05). About 29% of the daily smokers indicated that medications/pharmacotherapy could be a good method for giving up the habit. Fifteen percent of the participants shared the opinion that a smoking cessation specialist is the best advisor for counseling, and only about 7% would choose a general practitioner or pharmacist, and even fewer a nurse, as a person who could provide help to smokers. There were no statistically significant differences in any of the evaluated perceptions between the light and heavy smokers (p > 0.05). CONCLUSIONS: A high share of heavy smokers among socially disadvantaged people, and their perception that medications/pharmacotherapy would be a good solution to quit smoking, underline the need for stronger support for this method, including relevant financing resources and training. However, this method should be applied along with behavioral counseling. Int J Occup Med Environ Health. 2019;32(4):527-36.

Perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland.

OBJECTIVES: This study aimed at assessment of the perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. It is hypothesized that different factors can be considered depending on the level of smoking addiction. Therefore, a comparison between light and heavy smokers was performed. MATERIAL AND METHODS: Data collected during the second wave of a cross-sectional study carried out in the Piotrkowski District in October 2016 - February 2017 among 1668 socio-economically disadvantaged persons constituted the source of information for the present study. Barriers and motivators to smoking cessation among daily smokers were identified via face-to face interviews. RESULTS: About one-third of the studied population admitted to being current daily smokers, almost 75% of whom were heavy smokers. The most common barriers to quitting smoking were related to difficulties in quitting (62%), the lack of willingness to quit (56%), as well as addiction and withdrawal symptoms (craving cigarettes [65%], habit [56%], stress and mood swings [55%]). A significantly higher proportion of such barriers was noted among heavy smokers compared to light smokers (p < 0.05). The following motivations to quit were pointed out by the respondents: available pharmacotherapy (47%), access to a free-of-charge cessation clinic (40%), and encouragement and support provided by their doctor (30%), with no differences between various levels of smoking addiction (p > 0.05). CONCLUSIONS: Developing effective interventions targeted at unique deprived populations requires understanding the barriers and motivators to quitting smoking. Social support and financial issues, including free-of-charge pharmacotherapy and cessation clinics, as well as doctor's encouragement and support, are crucial for successful smoking cessation in this vulnerable population. Int J Occup Med Environ Health. 2019;32(3):363-77.

Tobacco Health Risk Awareness among Socially Disadvantaged People-A Crucial Tool for Smoking Cessation.

The goal of this cross-sectional survey was to assess the level of knowledge on harmful effects of environmental tobacco smoke (ETS) exposure and active smoking among socially-disadvantaged people in Poland. The study was conducted among 1817 respondents aged 18⁻59 years, who used aid services from local social care institutions in Piotrkowski district. Majority of the participants were aware of the fact that smoking may cause serious diseases and lung cancer (92%). However, those percentages were lower for awareness of ETS and health risk (69.4%) and for awareness of smoking/ETS-associated risk of stroke and heart attack (57%, 68%). The male respondents and smokers had much higher odds of lacking knowledge that smoking causes serious diseases and lung cancer compared to the females (OR = 1.47 and OR = 1.86; p < 0.05) and non-smokers (OR = 2.35 and OR = 2.31; p < 0.001). In addition, those with temporary jobs and the unemployed had a higher risk of lack of knowledge on smoking and lung cancer risk (OR = 2.14 and OR = 1.66; p < 0.05) as well as ETS and the risk of stroke (OR = 1.52 and OR = 1.51; p < 0.05) as compared to those with permanent jobs. The smokers who were aware of four health consequences of smoking indicated an intention to quit smoking within the next month more frequently when compared to those who did not have the knowledge on all of the analyzed harmful effects of tobacco use (19.7% vs. 13.1%; p < 0.05). There is a need to improve knowledge on the dangers associated with active and passive smoking among socially disadvantaged populations.

How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products.

The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes (p < 0.05). The smokers of traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers (p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.

Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland.

This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the "Reducing Social Inequalities in Health" program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes-a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS.

Lectin pathway factors in patients suffering from juvenile idiopathic arthritis.

Both complement activation and certain infections (including those with Yersinia sp.) may contribute to the pathogenesis of juvenile idiopathic arthritis (JIA). We investigated factors specific for the lectin pathway of complement: mannose-binding lectin (MBL), ficolins and MBL-associated serine protease-2 (MASP-2), in 144 patients and 98 controls. One hundred and six patients had oligoarticular disease and 38 had polyarticular disease. In 51 patients (out of 133 tested), Yersinia-reactive antibodies were found (JIA Ye+ group). MBL deficiency was significantly more frequent in the JIA Ye+ group than in patients without Yersinia-reactive antibodies or in controls. Median serum ficolin-2 level was significantly lower (and proportion of values deemed ficolin-2 insufficient greater) in JIA patients irrespective of their Yersinia antibody status. The minority (C) allele at -64 of the FCN2 gene was less frequent among JIA patients than among control subjects. No differences were found in the frequency of FCN3 gene +1637delC or MASP2 +359 A>G mutations nor for median values of serum ficolin-1, ficolin-3 or MASP-2. However, high levels of serum ficolin-3 were under-represented in patients, in contrast to MBL. MBL, ficolin-1, ficolin-2, ficolin-3 and MASP-2 were also readily detectable in synovial fluid samples but at a considerably lower level than in serum. Our findings suggest a possible role for the lectin pathway in the pathogenesis of JIA, perhaps secondary to a role in host defence, and indicate that investigations on the specificity of lectin pathway recognition molecules towards specific infectious agents in JIA might be fruitful.

Smoking Patterns and Smoking Cessation Willingness-A Study among Beneficiaries of Government Welfare Assistance in Poland.

This study examines the prevalence and tobacco use patterns among adult social assistance beneficiaries and their interest in quitting. The results are based on data collected in a cross-sectional survey conducted among adults in the Piotrkowski district. A sample of 3636 social assistance beneficiaries produced a total of 1817 respondents who completed face-to-face questionnaires. Overall, 37.1% of the respondents, including 52.8% men and 29.6% women, were current smokers. Over one third of the smokers reported their willingness to quit. In the study population, several characteristics were significantly associated with the current daily smoking: male gender, low educational attainment, unemployment or temporary employment, lack of awareness of smoking-associated health risks, use of e-cigarettes, and exposure to environmental tobacco smoke (ETS). The intention to quit smoking among the daily smokers was positively correlated with their awareness of smoking-associated health risks, lack of previous quit attempts, and low exposure to ETS. Smoking prevalence among social assistance recipients tends to be higher than in the general population, but more than half of the smokers are willing to quit. There is an urgency to develop policies tailored to the needs of these disadvantaged population groups.

Perceived Relative Harm of Selected Cigarettes and Non-Cigarette Tobacco Products-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland.

The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13-19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.

Susceptibility to cigarette smoking among secondary and high school students from a socially disadvantaged rural area in Poland.

BACKGROUND: To prevent adolescents from becoming smokers, it is essential to understand factors that cause them to become susceptible to smoking (SS). The aim of this study was to examine association between individual and school characteristics and susceptibility to smoking initiation and experimentation in the youth. METHODS: We collected cross-sectional survey data from students aged 13-19 years attending 21 schools from Piotrkowski district. Of 4050 students, 3552 respondents, including 2508 non-smokers, filled in an anonymous, self-administered questionnaire adapted from the Global Youth Tobacco Survey. The univariate and multivariate logistic regression analyses were applied to the study factors linked to SS among the never and ever smoking youth. RESULTS: About 22 % of the never smoking and 57 % of the ever smoking students were found to be vulnerable to smoking. The youth who were males (OR = 1.4; p = 0.001), who were older (OR = 1.1; p = 0.002) and those, whose mothers had medium (OR = 1.8; p < 0.001) and lower (OR = 4.1; p < 0.001) educational levels were more prone regarding future smoking compared to the females, younger ones and those whose mothers were highly educated. The students who lived in households with no smoking ban (OR = 1.4; p = 0.001) and those who had ever tried cigarettes (OR = 3.5; p < 0.001) were more susceptible to smoking comparing to those who indicated smoke-free home and who had never smoked. In addition, having smoking friends (OR = 2.3; p < 0.001), seeing school personnel smoking on the premises of the school (OR = 1.8; p < 0.001) and perceiving smoking girls more attractive than the non-smokers (OR = 3.8; p < 0.001) were the correlates of smoking susceptibility. Finally, the separate analysis among the never smokers indicated that no school training on tobacco harm (OR = 1.3; p = 0.04) is the additional significant factor for susceptibility to smoking initiation. CONCLUSIONS: SS is prevalent in secondary and high school students in Poland. Personal, social and environmental factors are strongly correlated with SS. When addressing the youth, efforts should be focused on the groups at risk, with a comprehensive approach including multiple factors and involving school personnel, parents and the group leaders in tobacco control activities. Projects aimed at changing social norms around smoking and providing the youth with knowledge and skills to resist smoking are also needed. This may help to implement an effective approach to prevent smoking susceptibility and initiation of tobacco use among the youth.

Components of the lectin pathway of complement activation in paediatric patients of intensive care units.

Infections are a major cause of childhood mortality. We investigated components of the lectin pathway of complement activation in the context of sepsis at both genetic and protein levels in neonates, infants and older children. Major components of the lectin pathway and two genes for Toll-like receptors were studied in 87 neonates with confirmed sepsis and compared with 40 babies with infections who did not develop sepsis (disease controls) and 273 infection-free neonatal controls. A second cohort comprised 47 older children with sepsis and 87 controls. Low MBL-conferring genotypes (LXA/O+O/O) were more frequent in sepsis patients than in healthy controls but no significant differences in the frequency of SNPs of other lectin pathway genes (FCN1, FCN2, FCN3, MASP1/3, MASP2) or TLR receptor genes (TLR2, TLR4) were found. One case of primary MASP-2 deficiency was found among healthy pre-terms and one neonate suffering from SIRS was heterozygous for the rare FCN1 gene mutation, +6658 G>A. Generally, sepsis was associated with low serum MBL and low ficolin-2 concentrations on admission. Among neonates, ficolin-1 and MASP-2 levels were elevated in sepsis relative to healthy, but not disease, controls. Unlike neonates, ficolin-3 and MASP-2 levels were lower in older patients than in healthy controls while no difference was found for ficolin-1. With the possible exception of MBL, inherited lectin pathway insufficiencies do not seem to predispose to sepsis, rather changes in protein concentrations reflect alterations in disease course.

Patterns of nicotine dependence in four Eastern European countries.

BACKGROUND: Evidence of patterns of nicotine dependence, although crucial for developing and implementing effective tobacco control strategies, is limited in the Eastern European countries. The purpose of this study was to evaluate the correlates of high nicotine dependence among adults in Poland, Romania, the Russian Federation and Ukraine. METHODS: The data used in the current analysis is available from the Global Adult Tobacco Survey (2009-2011). Nicotine dependence was assessed using the Heaviness of Smoking Index (HSI), which covers two measures: reported cigarettes smoked per day and time to the first cigarette upon waking. Based on a six-point scale of HSI, nicotine dependence was categorized into low to moderate (score 0-3), and high dependence (score 4-6). Out of 31,936 completed interviews, we used data from 8229 daily smokers. RESULTS: The study results indicate that more than 25 % of daily smokers were highly dependent on nicotine. Higher odds of high nicotine dependence were identified for males (OR = 1.5 in Poland and Romania, OR = 2.7 in Russia; p ≤ 0.001), people between 50-59 years of age (the highest odds in Romania; OR = 4.8; p ≤ 0.001) and those who had started smoking at a young age (the highest odds in Romania, OR = 5.0; p ≤ 0.001). Having fewer restrictions on smoking at home was significantly associated with a high level of nicotine dependence (the highest odds in Romania, OR = 3.0; p ≤ 0.001). A high proportion of the participants had no interest in quitting smoking, with a statistically significantly higher percentage observed among smokers highly dependent on nicotine compared to the less addicted (p ≤ 0.01). CONCLUSIONS: Smokers highly dependent on nicotine constitute a quarter of the Romanian group of daily smokers and even more in the remaining three analyzed countries. Similar patterns of nicotine dependence were observed in all of the investigated countries showing that male gender, younger age at the smoking onset, and fewer restrictions on smoking at home were significantly associated with higher nicotine dependence. The study highlighted the fact that a high proportion of the participants had no interest in quitting smoking. These results underscore importance of policy measures as well as prevention and cessation interventions for smokers who are highly dependent on nicotine, which need to take into account the social gradient in smoking patterns.

Small intestinal bacterial overgrowth syndrome in children.

INTRODUCTION: Small intestinal bacterial overgrowth syndrome (SIBO) is defined as an increased number of nonpathogenic bacteria over 10(5) organisms in 1 millilitre of small intestine content. The most common predisposing factors include, among others, gut motility disorders and chronic use of proton pump inhibitors. The results of recent studies indicate the importance of SIBO in gastrointestinal diseases. AIM: To assess the prevalence of SIBO in children with abdominal pain. MATERIAL AND METHODS: One hundred children (59 girls and 41 boys) aged from 4 to 17 years (mean age: 10.47 ±3.73 years), hospitalised due to abdominal pain, were enrolled in the study. Hydrogen breath test (HBT) with lactulose was established among all patients. Expired air was analysed using a Gastrolyzer (Bedfont). RESULTS: The HBT result was positive in 63 (63%) children with abdominal pain; including 40 girls (67.8%) and 23 boys (56.1%). The test was positive in the group of 29 (46%) children aged under 10 years and in the group of 34 (54%) children aged over 10 years. Among the patients who reported for the control study 88% achieved a normalisation of HBT after treatment. CONCLUSIONS: The prevalence of positive HBT results in the group of patients with abdominal pain is over 60%. Small intestinal bacterial overgrowth syndrome should be considered as one of the causes of abdominal pain in children. The SIBO in children shows a good response to treatment.

Evaluation of HLA-DQ2/DQ8 genotype in patients with celiac disease hospitalised in 2012 at the Department of Paediatrics.

INTRODUCTION: Celiac disease (CD) is a permanent intolerance to gluten that occurs in genetically predisposed individuals and leads to small intestinal mucosa damage. According to ESPGHAN guidelines from 2012, CD can be diagnosed in a patient with characteristic clinical symptoms, in whom, anti-tissue transglutaminase antibodies (> 10 times the upper limit) are found, endomysial antibodies (EMA) is confirmed and a positive genetic test is obtained. In these conditions no small-bowel biopsies are required. AIM: Evaluation of the presence of HLA-DQ2 and HLA-DQ8 haplotypes in children with previously diagnosed CD, hospitalised in 2012 at the Department of Paediatrics and Immunology and/or the Gastroenterological Outpatient Clinic, and their relatives. MATERIAL AND METHODS: Blood samples of 22 subjects, including 9 children with CD diagnosed on the basis of clinical symptoms, serological investigations and small-intestine biopsy, 7 diagnosed on the basis of clinical symptoms and serological investigations, 2 with the suspicion of CD on the basis of clinical symptoms and 4 relatives of a child with CD. METHODS: HLA-DQ2/DQ8 test, automatic evaluation by EUROArrayScan. RESULTS: The presence of HLA-DQ2 and/or HLA-DQ8 genotype was confirmed in 16 children with CD diagnosed on the basis of clinical symptoms and serological tests with/without intestinal biopsy, in 2 with the suspicion of CD and in 1 relative of a celiac child. CONCLUSIONS: The evaluation of HLA-DQ2/DQ8 haplotype confirms the genetic predisposition to CD in subjects with the disease diagnosed previously on the basis of clinical symptoms, serological tests or intestinal biopsy. Genetic testing is particularly indicated for the diagnosis of CD in infants consuming gluten for a short time and in small amounts.

Family recognition of celiac disease.

Celiac disease is a permanent intolerance to gluten that leads to small-bowel mucosal villous atrophy during autoimmune processes in genetically predisposed individuals. At present the diagnosis of celiac disease is based on characteristic clinical symptoms, the results of serological investigations (tissue transglutaminase ten times the upper limit of normal, presence of antiendomysial antibodies - EMA) and positive results of genetic examinations. The aim of this study is to present a medical history of a family in which the mother and younger son were diagnosed with celiac disease (confirmed by genotype examination). Before the genetic examination, the father and the elder son were also suspected of suffering from this disease (they were on gluten-free diets). The authors emphasize the usefulness of HLA-DQ2/DQ8 determination in first-degree relatives of celiac patients.

Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009-2010).

BACKGROUND: Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview) among adults. Moreover, we evaluated motives for giving up smoking from former smokers. METHODS: Data on former as well as current smokers' socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs) and 95% confidence interval (CI) of the broad number of variables on successful cessation of smoking. RESULTS: Among females the quit rate was 30.4% compared to 37.9% in males (p < 0.01). Former smokers declared concerns about the health hazard of smoking (60.8%) and the high price of cigarettes (11.6%) as primary reasons for smoking cessation. Older age, high education attainment, awareness of smoking health consequences was associated with long-term quitting among both genders. Also employed males had over twice the probability of giving up smoking compared with unemployed, and being religious did not contribute to successful smoking cessation. CONCLUSION: Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake.

Changes in smoking prevalence and exposure to environmental tobacco smoke among adults in Lódz, Poland.

UNLABELLED: Comprehensive monitoring informs the stakeholders about the level of tobacco epidemic and helps to allocate tobacco control resources where they are most needed and will be most effective. The aim of the paper was to evaluate the prevalence of daily cigarette smoking and environmental tobacco smoke (ETS) exposure among adult citizens of Lódz area in Poland between year 2001 and 2010 by selected characteristics. MATERIAL AND METHODS: For the purpose of the presented analysis, data were used from 3 cross-sectional studies on randomly-selected 3,874 adults from the Lódz area, conducted in 2001, 2005 and 2010. Changes in the rates between the surveys were assessed by odds ratio. RESULTS: Smoking prevalence remained stable but high between 2001-2010. There was an inverse relationship between smoking prevalence and educational level for both genders (p for trend ≤0.01) in each survey. For men in all surveys, the prevalence of current daily tobacco smoking decreased with increased income (p for trend ≤0.01), and also for women in the 2009-2010 survey (p for trend =0.03). The statistically significant changes for the comparison of 2001 and 2005 surveys were observed for exposure to ETS (p<0.001). Percentages of men and women who declared exposure to environmental tobacco smoke at least one hour per day decreased significantly. Furthermore, the proportion of people who declared exposure to ETS decreased with the increasing age of participants (p for trend ≤0.005), level of education for men in both surveys, and for women in the 2001 survey (p for trend ≤0.003), and income for both men and women in the 2001 survey (p for trend <0.001). CONCLUSION: Established, long-term tobacco surveillance systems of smoking and ETS exposure, based on nationally and locally representative samples, are necessary in Poland.