Parental Declaration of Adverse Event Following Immunization in a Cross-Sectional Study in Poland.

Vaccines are a well-known and effective preventive measure in communicable diseases. However, like any medical product, vaccines can cause some adverse effects. With increasing population awareness, the number of reported events related to vaccination has increased. Aim: The aim of the study was to assess the frequency and type of reported adverse events following childhood immunization (AEFI), and to recognize the determinant of their occurrence related with a socio-demographic situation, parental knowledge, and/or opinions on vaccinations. Material and Methods: The self-administrated questionnaire was distributed to a group of 3000 random parents or legal guardians living in the Silesian Voivodship (the southern part of Poland) in 2016. The response rate was eventually 41.3% from 1239 participants. Both, the number of children and the percentage of vaccinations given in the studied region, was representative for Poland as a whole. Results: Approximately one-third (32%) of surveyed parents declared the occurrence of AEFI in their children. The most frequently declared AEFIs were: redness, pain, swelling at the injection site (27%), and fever (24.9%). The frequency of reported AEFI was associated with a higher level of parental education and the number of vaccinations given. A negative attitude toward vaccination and the belief that vaccination is unsafe were associated with a higher number of reported AEFI. Conclusions: The results obtained confirmed that the number of declared mild and moderate AEFI is related to a lower parental educational level and is associated with a better experience as a consequence of a higher number of vaccinations given. Frequent AEFI reporters represent negative attitudes toward vaccinations. Further investigation with the exact surveillance system is needed to improve parental trust in vaccination safety.

Sources of parental knowledge about the safety of vaccinations in Poland.

There has been a recent increase in the number of parents refusing vaccination for their children in many European countries, including Poland. This observation necessitates the need to understand parental knowledge in regard to mandatory vaccination of children in these countries. A cross-sectional survey was conducted in 2016 on 1239 parents or legal guardians of preschool and school children in the Silesian Voivodship (Poland) to evaluate their hesitancy in acquiescing to their children mandatory immunization and the relation to this habit in regard to the use of informational sources on children vaccination system in Poland. Medical doctors often provide the basic source of information about vaccination to parents. About one-third (29%) of the respondents from the survey deemed the qualification system for vaccination as either inadequate or bad. 16.9% of the respondents surveyed declared that information received from physicians regarding vaccinations were either incomplete or unconvincing. Results of multivariable analyses confirmed that respondents are less likely to seek information about mandatory vaccinations from medical professionals and more often to misjudged vaccination's qualification system. Participants who used less informative sources (e.g. leaflets) and those with a lower level of education were more likely to avoid vaccination. Greater emphasis on the quality of information provided by medical professionals is crucial in order to avoid doubts about vaccination and to create proper attitudes and adherence to vaccination schedules.

Parental Opinions and Attitudes about Children's Vaccination Safety in Silesian Voivodeship, Poland.

Despite mandatory vaccinations in Poland, the final decision on vaccination in children is taken by their parents or legal guardians. Understanding parents' attitudes and opinions regarding vaccinations is essential for planning and undertaking extensive and properly targeted educational actions aimed at preventing their hesitancy. In 2016, a cross-sectional study was conducted in the Silesian Voivodeship (Poland) in 11 randomly selected educational institutions. The authors' self-administered questionnaire contained 24 mixed-type questions. It was distributed among 3000 parents or legal guardians of children aged 6-13 years; prior consent of the relevant bioethics committee had been obtained. The response rate was 41.3% (N = 1239). Data were analysed using descriptive and analytical statistics, and focused on parental opinions regarding the safety of vaccines. Results of simple and multivariable analyses showed that perceived risk of adverse vaccine reaction (AVR), contraindications and perception of the qualification procedure for vaccination as substandard were significant factors associated with the rating of children's vaccination as unsafe (p < 0.001). Respondents with a lower level of education, compared with those with higher, more often declared vaccinations to be safe (p = 0.03); however, results of multivariable analysis did not confirm that effect. AVR occurrence, finding of contraindication to vaccinations and perception of qualification procedure for vaccination were found to be the most important factors responsible for influencing general public opinions in the field of vaccination safety.

Determinants of vaccine hesitancy

Vaccine hesitancy is a worrying phenomenon due to its range and health-related consequences. Secondary epidemiological data on the current situation of vaccination in Poland were analyzed. The source of the analyzed data were obtained from the reports of the National Sanitary Inspection and the National Institute of Public Health­National Institute of Hygiene in Warsaw. Legal basis on vaccination and the responsibilities of physicians related to these regulations were also discussed. Considering the opinions of ECDC experts, factors influencing vaccine hesitancy were identified. Attention was paid to the activities of the anti-vaccination movements, their range of activity and a strategy of action.

Viral hepatitis C in Poland in the Silesian Province between 2005-2014.

INTRODUCTION AND OBJECTIVE: Viral hepatitis C remains one of the major health and social problems related to infectious diseases in Poland. The aim of the study was assessment of the registered changes in the incidence of HCV in the Silesian Province of western Poland during the last 10 years, including age, gender and place of residence. MATERIAL AND METHODS: A retrospective analysis was performed of the HCV incidence between 2005-2014 in the Silesian Province. The crude and standardized incidence rates were calculated for males and females in each year. Subsequently, the territorial diversity of the epidemiological situation in the districts was assessed by calculating the average incidence rate over the entire study period. RESULTS: Incidence rates calculated according to the case definition of 2005 ranged between 5.95/100000 in 2005 to 10.36/100000 in 2014. Analysis of the structure of the incidence showed that during the analyzed period, the majority of hepatitis C cases were related to males (52.5%) rather than females (47.5%), and hepatitis C was more prevalent in younger males (aged 20-49) and older females (aged over 50). After excluding the effect of age, the standardized rates were twice as low, compared to the crude incidence rates. CONCLUSIONS: An increase in the HCV incidence rate was observed in males and females. It is obvious that the detection of additional cases will entail the need to provide funding for the treatment of more patients, which should be included in the map of regional health needs in the coming years. Our study demonstrates the temporal and spatial variability of HCV incidence in the Silesian Province of Poland. The observed increase in the crude and standardized rates suggests that the current registry system of HCV in Poland is more effective now. The current situation is comparable with the data in other EU countries.

Expression of insulin-like growth factor family genes in clear cell renal cell carcinoma.

AIM OF THE STUDY: Despite significant progress in the pathology of clear cell renal cell carcinoma (ccRCC), diagnostic and predictive factors of major importance have not been discovered. Some hopes are associated with insulin-like growth factors. The aim of the study was to compare the expression of genes for insulin-like growth factor family in tumours and in tissue of kidneys without cancer. MATERIAL AND METHODS: Fifty-two patients years with clear cell renal cell cancer were qualified to the study group; patients nephrectomised because of hydronephrosis were included in the control group. Expression of genes were evaluated by RT-PCR. RESULTS: Expression of IGFR-1 gene in tumour accounts for about 60% of cases. The incidence is higher than in corresponding adjacent non-cancerous kidney tissues and higher (but with no statistical significance) than in kidney without cancer. Expression of IGFR-2 gene in tumours has not been established. The incidence of the expression in corresponding adjacent non-cancerous kidney tissues is small. Expression of this gene has been present in all specimens from kidneys without cancer. Expression of IGFBP-3 gene ascertained in all (except four) cases of ccRCC and in the majority of clippings from adjacent tissue. It was not found in kidneys from the control group. IGF-1, IGF-2, and IGFR-1 mRNA copy numbers in ccRCC were higher than in the material from the control group.

[Vitamin D blood levels of students in grades IV-Vl of primary schools in Katowice]. / Stezenie witaminy D we krwi uczniów klas IV-VI szkól podstawowych w Katowicach.

UNLABELLED: Results of studies conducted around the world show a drastic deficiency vitamin D in almost all populations, and the strongest in the group of children and the elderly. The aim of this study was to evaluate the concentration of vitamin D in children aged 10-12 years. MATERIAL AND METHODS: The study included 42 children aged 10-12 years 24 girls and 18 boys).The obtained data were statistically analyzed using STATISTICA 10 (StatSoft Inc. Dell) RESULTS: Half of the subjects (n = 21) had levels of vitamin D i not greater than 14.872 ng/ml (median). The median concentrations of vitamin D was higher in the studied group of boys than girls and amounted to 16.54 vs 14.02. Most patients (n = 18; 42.8%) had levels of vitamin D between 10 and 20 ng / ml (deficiency),7 persons (16.7%) had a severe deficiency (≤10 ng/ml), a significant number of patients (n = 15; 35 7%) had a slight deficiency of vitamin D called moderate hypovitaminosis. Only two individuals (4.8%) had concentrations in the range defined as optimum. CONCLUSIONS: The results of the present study show a deficiency of vitamin D in the study group children aged 10 - 12 years.

Protective effect of intermittent clamping of the portal triad in the rat liver on liver ischemia-reperfusion injury.

BACKGROUND: Intermittent clamping (IC) of the portal triad is an effective method of protecting the liver from ischemia-reperfusion injury (IR). In clinical practice, this method is employed during a resection, but its mechanism is still not clear. OBJECTIVES: To evaluate the effect of IC on rat liver and determine its mechanisms. MATERIALS AND METHODS: Wistar rats were submitted to 60-min IC (cycles of 12-min clamping followed by 4-min reperfusion), and the samples were collected after 1, 6, and 72 hrs of reperfusion. We determined the serum activity of alanine aminotransferase (ALT), and measured the concentration of TNF-α, malondialdehyde (MDA) and myeloperoxidase (MPO) in liver homogenates. The apoptosis of hepatocytes was evaluated immunohistochemically. RESULTS: When compared to the IR rats, the activity of ALT decreased in the IC group in all periods of observation (the highest decrease of ~48% after 1 hr of reperfusion). When compared to the IR group, a statistically significant decrease (p < 0.05) in the TNF-α concentration (~33%) in the IC rats occurred only after 1 hr of reperfusion, and it was accompanied by a decrease in the MPO concentration after 1 and 6 hrs of reperfusion. IC reduces the effects of reactive oxygen species (ROS) activity, which has been confirmed by a statistically significant decrease in MDA concentration by 25%-35% in all studied periods. The limitation of hepatocytes apoptosis due to IC occurs in the early (~26%; p < 0.05) and late (~45%; p < 0.01) phases of reperfusion. CONCLUSIONS: The use of IC in early phase of reperfusion brings about a decrease in TNF-α release, which can be related to liver injury due to neutrophil infiltration and apoptotic cell reduction. It seems that the reduction of lipid peroxidation may also limit the liver injury.

[Eye symptoms in office employees working at computer stations]. / Dolegliwosci ze strony narzadu wzroku u pracowników biurowych zatrudnionych na komputerowych stanowiskach pracy.

BACKGROUND: The aim of the study was to measure the prevalence and intensity of eye symptoms in office workers who use computers on a regular basis, and to find out if the symptoms depend on the duration of computer use and other work-related factors. MATERIAL AND METHODS: Office workers employed at large social services companies in two cities (Warszawa and Katowice) were invited to fill in a questionnaire (cross-sectional study). The questions included work history and history of last-week eye symptoms and eye-related complains. Altogether 477 men and women returned the completed questionnaires. Between-group symptom differences were tested by the chi-square test and verified by the results of multivariate logistic analysis. The examined effects included the role of daily computer use and lighting conditions at work stations. RESULTS: The examined persons complained of such eye symptoms as eye strain, visual acuity impairment and mucosal dryness or eye burning. The following values of symptom prevalence were found in women and men, respectively: eye strain 50.7% and 32.6%, disturbed visual acuity 38.3% and 21.2%, mucosal dryness and eye burning 46.5% and 24.2%. The results of multivariate analysis confirmed the statistically significant effects of lighting intensity and screen flickering on the occurrence of symptoms. CONCLUSIONS: Frequent occurrence of eye symptoms and their associatation with some characteristics of the work environment point to the need of observing ergonomic standards of work stations and of the usage of computers at work.

Estimates of stroke incidence and case fatality in Zabrze, 2005-2006.

BACKGROUND AND PURPOSE: Epidemiological rates for stroke obtained in the United States and Western Europe indicate a decrease in incidence and case fatality. Data published for Poland, as for other Central-Eastern European countries, reported unfavourable results, but this was based on data from the 1990s. The authors evaluated current stroke rates in a population study of the southern Poland city of Zabrze. MATERIAL AND METHODS: A retrospective registry of all stroke cases treated in Zabrze, southern Poland, in 2005-2006, was established, based on data from the National Health Fund. Cases were identified by verifying patient files. Epidemiological rates were calculated and standardized to the European population in both groups: all stroke patients, including recurrent (all strokes, AS), and patients with first-ever stroke (FES) in their history. RESULTS: We registered 731 strokes, including 572 FES cases (78.3%) and 159 recurrent strokes (21.7%). There were 385 strokes in men (52.7%), and 346 in women (47.2%); 88.6% were ischaemic strokes (IS), and 11.4% were intra-ce-rebral haemorrhages (ICH). The standardized incidence rate for AS patients was 167/100 000 (211 for men, 130 for women), and in the FES group 131/100 000 (161 for men, 104 for women). Twenty-eight day case fatality for the AS group was 18.3% (15.4% for IS, 41% for ICH), and 16.6% for FES (13.4% for IS, 40.9% for ICH). CONCLUSIONS: Incidence rates in this southern Poland city are comparable to those reported previously for Poland. Early case fatality decreased, compared to previous data, probably as a result of improved management of acute stroke and hospitalizing all stroke patients.

[Occupational exposure to HIV in health care workers, Silesia voivodeship]. / Zawodowa ekspozycja pracowników sluzb medycznych na wirus HIV w województwie slaskim.

BACKGROUND: Occupational exposure to HIV is defined as a contact of health care workers with potentially infectious material. The risk of occupational transmission is not high (0.09-0.3%), but it increases in case of percutaneous injuries caused by tools contaminated with infected blood, deep needle stick or direct contact of an infected needle with artery or vein. MATERIAL AND METHODS: The aim of the study was to determine the epidemiology of HIV infections among health care workers in the Silesian voivodeship, in the years 1999-2006 and the conditions of occupational exposure. Data on occupational exposure, collected by the Center for AIDS Diagnosis and Therapy in Chorzów, were analyzed. RESULTS: During the study period, 789 cases of occupational exposure to HIV in the medical staff were documented. In the exposed group women predominated (78.9%). In the occupational group under study, nurses made 65% and physicians 17.5%. Needles were the most frequent (75.2%) source of exposure during injections and left hand fingers (thumb and index finger) were the major targets. Post-exposure prophylaxis with antiretroviral medications was introduced in about 60% of cases (499/789). No HIV transmission was registered. CONCLUSIONS: Nurses run the highest risk of occupational exposure to HIV, usually related with injections. There is a need to continue education in postexposure prophylaxis addressed to medical staff. The development of a standard questionnaire and its practical use could be very useful in monitoring occupational exposure.

[Upper extremities, neck and back symptoms in office employees working at computer stations]. / Dolegliwosci ze strony konczyn górnych, szyi i pleców u osób wykonujacych prace biurowi z uzyciem komputera.

BACKGROUND: To obtain current data on the occurrence ofwork-related symptoms of office computer users in Poland we implemented a questionnaire survey. Its goal was to assess the prevalence and intensity of symptoms of upper extremities, neck and back in office workers who use computers on a regular basis, and to find out if the occurrence of symptoms depends on the duration of computer use and other work-related factors. MATERIAL AND METHODS: Office workers in two towns (Warszawa and Katowice), employed in large social services companies, were invited to fill in the Polish version of Nordic Questionnaire. The questions included work history and history of last-week symptoms of pain of hand/wrist, elbow, arm, neck and upper and lower back (occurrence and intensity measured by visual scale). Altogether 477 men and women returned the completed questionnaires. Between-group symptom differences (chi-square test) were verified by multivariate analysis (GLM). RESULTS: The prevalence of symptoms in individual body parts was as follows: neck, 55.6%; arm, 26.9%; elbow, 13.3%; wrist/hand, 29.9%; upper back, 49.6%; and lower back, 50.1%. Multivariate analysis confirmed the effect of gender, age and years of computer use on the occurrence of symptoms. Among other determinants, forearm support explained pain of wrist/hand, wrist support of elbow pain, and chair adjustment of arm pain. Association was also found between low back pain and chair adjustment and keyboard position. CONCLUSIONS: The findings revealed frequent occurrence of symptoms of pain in upper extremities and neck in office workers who use computers on a regular basis. Seating position could also contribute to the frequent occurrence of back pain in the examined population.

Prevalence and basic determinants of hepatitis C antibodies in medical students in Katowice, Poland.

BACKGROUND: Potential exposure of medical students to infectious material and the lack of specific prevention measures could contribute to an increased risk of HCV infection in this group. OBJECTIVE: To find out if the occurrence of HCV antibodies is more frequent in medical students than in non-medical students and to determine risk factors for HCV antibodies in students. METHODS: A cross-sectional study performed in 2003-2004 included 566 medical students (Medical University, Katowice) and 517 students of non-medical faculties (University, Katowice). HCV antibodies were determined using the 3rd generation EIA test, in doubtful cases a Western-blot INNO-LIA-HCV confirmation test was applied. Risk factors were identified based on questionnaire derived data. Between-group difference in the prevalence of positive anti-HCV tests was evaluated by means of ch2 test and candidates for risk factors were evaluated according to logistic odds ratios. RESULTS: Prevalence of HCV antibodies was statistically insignificantly lower in medical students (1.4%) than that in non-medical students (1.9%). In the group of 1068 subjects with no history of ever-diagnosed viral hepatitis the respective figures were 1.4% and 1.7%. In this group the presence of the positive anti-HCV tests was associated with dermal cosmetic interventions in the past (logOR=4.85), percutaneous medical interventions (excluding surgery) (logOR=3.18) and individual history of blood transfusion (logOR=1.71). However, the results were not statistically significant. CONCLUSIONS: Medical students at the Medical University in Katowice, Poland are not at increased risk of HCV infection. The findings suggest an important role of cosmetic and percutaneous medical interventions, and blood transfusion as risk factors for HCV infection.

[Viral hepatitis type C among medical workers in Silesian voivodeship in years 1996-2003]. / Wirusowe zapalenie watroby typu C wsród pracowników sluzby zdrowia w województwie slaskim w latach 1996-2003.

Viral hepatitis is the most frequent occupational disease among medical workers in Poland. It has been estimated on 72% of all work-related infection diseases diagnosed in the year 2001, and was hepatitis C. The aim of the study was to estimate incidence of viral hepatitis type C among medical workers in Silesian voivodeship in years 1996 to 2003. The source of our data was standardized documents of occupational diseases collected in sanitary-epidemiological centers in the voivodeship. The highest incidence was reported among auxiliary workers (48/10,000) and laboratory staff (46/10,000). The smallest incidence of hepatitis type C was achieved for nurses and midwives (18/10,000). Obtained results revealed a large county-to-county variation in HCV incidence and simultanously increase of incidence.

[Assessment of the occurrence and basic determinants of hepatitis C virus (HCV) infection among medical students in Silesian voivodeship]. / Ocena czestosci i podstawowych uwarunkowan zakazen wirusem zapalenia watroby typu C (HCV) wsród studentów wydzialów lekarskich w województwie slaskim.

HCV infection may result in serious health consequences such as chronic hepatitis C and liver cancer. In Poland, the data on the prevalence of HCV infection is limited and available information suggests an increased risk among young males. The aim of the study was to assess the prevalence of hepatitis C virus (HCV) infection between medical and non medical students, and to explore probable routes of HCV transmission. The project was conducted as a cross-sectional study. The study group included medical students (IV, V and VI year) and non medical students as a control group. The subjects were examined in the period from November 2002 to January 2003, (study group: n = 221; control group: n = 129). Serum samples were tested for antibody to HCV by ELISA method and anti-HCV positive samples were verified using Western Blot Line technique. Probable routes of infection were assessed by questionnaire. Preliminary results obtained in 29% of the target group suggested, that the prevalence of positive anti-HCV among students was 2.6% (95% PU: 1.2%-4.8%). It was higher among non medical than medical students (4.7% vs 1.4%). Anti-hepatitis C virus seropositivity was associated with a history of hepatitis. Verification of 9 positive anti-HCV cases proved only 1 HCV infection. Results presented in this paper are preliminary and will be verified after obtaining data for 600 medical students and for 600 subjects in the control group.

[Epidemiology of HCV infection in Poland and the world]. / Epidemiologia zakazen wirusem zapalenia watroby typu C (HCV) w Polsce i na swiecie.

The WHO data indicate HCV infection as a very important problem for public health. About 3.1% of world population was infected in the years 1975-1980. According to WHO prognosis number of infected persons is still growing. The importance of this problem is illustrated by the fact of its priority range of WHO, European Union Health programs as well as National Health Program in Poland. Clinical picture and lack of epidemiological data make the data about real endanger incomplete. The prevalence of HCV infection have never been established unequivocally, and available data are different. Current (1999) PZH register gives the number of hepatitis C cases as 1988, and incidence rate was 5.1 per 100,000. Epidemiology of HCV infection is basically shaped by the way of infection. Infection by blood and blood products did not tested for anti-HCV antibodies as well as using infected medical instruments are well documented. There are also possibilities of sexual, perinatal and household infections. Acupuncture, tattoo and other manipulations living to skin discontinue also favour the HCV infection. The risk of infection connected with health care serving is the most important for patients as well as for healthcare professionals.