Analysis of Attitudes and Practices towards the Influenza Vaccine in High-Risk Adults in Poland.

This study aimed to understand Poles' attitudes and beliefs towards influenza vaccinations in the flu season of 2022-2023, especially among individuals at risk of flu complications. The cross-sectional survey-based study was carried out on a sample of 810 respondents. The questionnaire was disseminated electronically using social media and e-mail. The majority of respondents (71%) could identify "high-risk groups" recommended for influenza vaccination, and 52.01% of respondents reported receiving influenza vaccination at some point in the past, with 32.12% receiving it in the 2022-2023 flu season and 41.09% in the 2021-2022 season. The majority of respondents declaring acceptance of the vaccine for the 2022-2023 season were in the high-risk group. Only 17.28% of respondents declared receiving both influenza and SARS-CoV-2 vaccines in the 2022-2023 season, with the vast majority being respondents from the "high-risk group" (p < 0.0001). Only 26.12% of respondents declared their intention to continue influenza vaccination in the future. Of those expressing the intention to get vaccinated against the influenza virus in future seasons, 46.79% were from the "high-risk group" (p = 0.0087). Results suggest the need for further interaction and education with healthcare providers and targeted informational efforts for at-risk groups regarding the benefits of flu vaccination.

The influence of various endocrine disruptors on the reproductive system.

Various stimulants (VS) are chemicals that disrupt the endocrine system - endocrine homeostasis of the reproductive system - which also known as endocrine-disrupting chemicals (EDCs). These substances are found in the human body, in both the blood and urine, amniotic fluid, or, among others, the adipose tissue. This article presents the current state of knowledge of the effect of EDCs and additional factors such as smoking, alcohol consumption, and cannabis on the gonads. The article is an overview of the impact of EDCs and their mechanism of action, with particular emphasis on gonads, based on databases such as PubMed, EMBASE and Google Scholar, and Web of Science available until May 2022. The impact of human exposure to bisphenol A (BPA) is not fully understood, but it has been shown that phthalates show a negative correlation in anti-androgenic activity in the case of men and women for the anti-Müllerian hormone (AMH). Smoking cigarettes and passive exposure to tobacco have a huge impact on the effects of endocrine disorders in both women and men, especially during the reproductive time. Also, the use of large amounts of cannabinoids during the reproductive years can lead to similar disorders. It has been documented that excessive alcohol consumption leads to disturbed function of the hypothalamus-pituitary-gonadal axis (HPG). Excess caffeine consumption may adversely affect male reproductive function, although this is not fully proven. Therefore, the following publication presents various stimulants (BPA, phthalates, nicotine, alcohol, cannabis) that disrupt the function of the endocrine system and, in particular, affect the function of the gonads.

Pharmacovigilance practice among pediatric neurologists from Poland and Germany.

OBJECTIVES: To compare the pediatric neurologists' knowledge, practice, and barriers to the pharmacovigilance (PV) process in Poland and Germany. METHODS: The research tool was an online anonymous questionnaire on Google Forms e-mailed to pediatric neurologists from Poland and Germany. RESULTS: The questionnaires were handed out to 830 pediatric neurologists and 371 expressed their consent to participate in the study. Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs). Only 34.10% of pediatric neurologists from Poland, and 38.88% from Germany believe that many ADRs are preventable and almost most of them believe it is necessary to report ADRs from children with epilepsy. Unfortunately, in opposite to this knowledge, only 37.79% of respondents from Poland and 40.32% from Germany felt co-responsible for reporting ADRs. The main reason for the neurologists not to report ADRs was a conviction that reporting ADRs would be an additional burden generating extra work. CONCLUSION: There is no big difference between the practice of PV by pediatric neurologists in Poland and Germany. System-regulated PV stabilization in the country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the curricula of academic neurologics courses.

Epilepsy is a chronic disorder characterized by episodic, gratuitous seizures. Most children with epilepsy (CWE) rely on antiepileptic drugs causing adverse drug reactions (ADRs). Many ADRs are preventable if physicians actively participate in pharmacovigilance (PV), which its pivotal role is to ensure the safety of pharmacotherapy by e.g. permanent control of ADRs. The study aimed to compare the pediatric neurologists' (PN) knowledge, practice, and barriers to the PV process in Poland and Germany. The research tool was an online anonymous questionnaire on Google Forms e-mailed to PN from Poland and Germany. Only 34.10% of PN from Poland and 38.88% from Germany believe that many ADRs are preventable and almost most of them believe it is necessary to report ADRs from CWE. Unfortunately, in opposite to this knowledge, only 37.79% of respondents from Poland and 40.32% from Germany felt co-responsible for reporting ADRs. The main reason for the neurologists not to report ADRs was a conviction that reporting ADRs would be an additional burden generating extra work. There is no big difference between the practice of PV by PN in Poland and Germany. System-regulated PV stabilization in the country translates into the practice of maintaining PV.

Association between Compliance with COVID-19 Restrictions and the Risk of SARS-CoV-2 Infection in Poland.

During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study included Polish adults who were asked to complete a validated questionnaire. The study period was from 1 November 2020 to 31 January 2021 and a computer-assisted web interview method was chosen to perform the survey. The study involved 562 women and 539 men. COVID-19 was reported in 11.26% of participants. A good level of compliance with the sanitary restrictions was reported for 38.87% of participants, an average level of compliance for 47.96%, and a low level of compliance for 13.17%. A reduced risk of COVID-19 was associated with the following preventive measures: regular use of protective masks, social and physical distancing in public places, regular use of hand sanitizers with high ethanol content, and the use of disposable gloves in public places. Our survey revealed satisfactory public compliance with the pandemic restrictions. Sanitary and epidemiologic measures to prevent the pandemic were shown to be adequate and effective.

The Mental Health of Poles during the COVID-19 Pandemic.

BACKGROUND: The SARS-Cov-2 pandemic has had a profound impact on all aspects of life in the global population, causing above other, psychological problems. AIMS: The objective of this study was to evaluate the mental health of the Poles during the COVID-19 pandemic. METHODS: A prospective, cross-sectional web-based survey design was adopted. The study horizon was from 1 June 2021, to 31 December 2021. An anonymous, standardized questionnaire was disseminated electronically by means of social media among Polish adults. The following tests were performed: Depression, Anxiety, and Stress Scale (DASS-21), and the Insomnia Severity Index (ISI). RESULTS: A total of 1306 individuals completed the survey. Of the participants, 77.79% were female at a mean age of 34.89 ± (14.79), 62.25% had higher education, and 56.43% were employed. The prevalence of depression, anxiety, stress, and sleep disturbances in this sample were as follows: 50.38%, 43.49%, 61.26%, and 44.74%, respectively. Poor self-estimated health status, the presence of comorbidities, and regular use of nicotine significantly increased the risk of any of the analyzed psychiatric symptoms and sleep disorders. The depression level was significantly associated with age, living alone, health status, and the use of nicotine. Moreover, the level of anxiety was significantly associated with age and health status. The level of stress depended on gender, age, health status, use of nicotine, and being vaccinated against SARS-CoV-2. Sleep disturbances depended on age, health status, the presence of comorbidities, and regular use of drugs. CONCLUSIONS: The Polish population manifested numerous psychological symptoms during the COVID-19 pandemic. There is a need to afford psychological support to them and ensure their mental health.

Impact of the SARS-CoV-2 Vaccination Program on Presenteeism and Absenteeism among Healthcare Workers in Poland.

BACKGROUND: There is sufficient scientific literature on the effectiveness of registered vaccines in preventing SARS-CoV-2 infection, but research on the impact of the COVID-19 vaccination program on social and economic aspects is lacking. In connection with the above, this study aimed to assess the impact of vaccinations on presenteeism and absenteeism among healthcare professionals in the workplace caused by the COVID-19 pandemic. METHODS: A post-marketing, cross-sectional survey-based study was carried out on a sample of 736 actively employed healthcare professionals. Among them, 215 individuals (29.21%) were unvaccinated (control group). The study group consisted of 521 vaccinated respondents, with 52.97% being women and 47.03% men. A self-administered questionnaire was developed and delivered online to the target population group of healthcare workers. RESULTS: A significant association (p < 0.01) was observed between the number of doses of the COVID-19 vaccine received and presenteeism among the respondents. Among the unvaccinated respondents (2.30 ± 1.19) or those vaccinated with only one dose of the SARS-CoV-2 vaccine (2.16 ± 1.11), the COVID-19 pandemic had a significantly higher impact on work performance compared to individuals vaccinated with three doses of the vaccine (1.19 ± 1.11). Moreover, a significant association was found (p = 0.0265) between the number of workdays missed (over the last twelve months) due to COVID-19-related sick leave and the number of doses of the COVID-19 vaccine received. The number of workdays missed due to COVID-19 sick leave was lowest in the group vaccinated with three doses (2.00 ± 6.75) and highest in the unvaccinated group (5.32 ± 16.24). CONCLUSIONS: Our results clearly show that the widely implemented national COVID-19 vaccination program brings tangible benefits both in medical and economic terms. The extent of reducing absenteeism and presenteeism caused by the coronavirus disease depended on the number of vaccine doses administered.

Adherence of Obese Patients from Poland and Germany and Its Impact on the Effectiveness of Morbid Obesity Treatment.

This study aimed to investigate and compare the adherence of patients treated for morbid obesity living in Poland and Germany. Methods: A cross-sectional international multicenter survey design was adopted. The study involved 564 adult subjects treated for morbid obesity at selected healthcare facilities in Germany (210 participants) and Poland (354 participants). A validated, custom-made questionnaire based on the literature related to this issue was used. Results: The degree of adherence was higher, but not statistically significant, among Polish patients (83.82% vs. 78.33%, p = 0.26140). Patient adherence was associated with gender, age, level of education, duration of obesity, number of health professionals involved in obesity treatment, and type of obesity treatment (p < 0.05). A positive correlation was observed in the case of age, level of education, and a growing number of health professionals involved in obesity treatment, whereas a negative correlation was observed in the case of the duration of obesity. Patients who underwent bariatric surgery significantly more often followed medical recommendations regarding lifestyle changes, compared to obese participants treated only conservatively. Adherence in the field of obesity treatment significantly increases the percentage of total weight loss and excess weight loss due to applied obesity treatment among both Polish and German groups (p < 0.001). Both the percentage of total weight loss and that of excess weight loss were significantly higher in the group of adherent patients compared to the nonadherent patients (p < 0.00001). The levels of perceived anxiety, stress, and depression were significantly higher in nonadherent patients in both countries. Conclusions: These findings confirm the role of adherence in the effective and satisfactory treatment of morbid obesity. There is a great need to improve patient adherence to overcome the consequences of the obesity pandemic.

Comparison of Perceived Weight Discrimination between Polish and German Patients Underwent Bariatric Surgery or Endoscopic Method versus Conservative Treatment for Morbid Obesity: An International Multicenter Study.

Objectives: The aim of this study was to compare the level of discrimination among patients with obesity living in Poland and Germany. Methods: This was a retrospective cross-sectional international multicenter survey study including 564 adult participants treated for morbid obesity at selected healthcare facilities in Germany (210 patients) and in Poland (354 patients). Discrimination was evaluated using a custom-made questionnaire based on the related literature. Results: The level of obesity discrimination did not differ between German and Polish patients (p = 0.4282). The presence of obesity was reported to be associated to a large or a very large extent with the feeling of social exclusion and discrimination by 46.63% of German participants and 42.09% of Polish ones (p = 0.2934). The mean level of discrimination related to the lack of employment was higher in patients who underwent bariatric surgery or endoscopic method than in those who underwent conservative treatment (for Germany: 2.85 ± 1.31 (median, 3) vs. 2.08 ± 1.31 (median, 1), p = 0.002; for Poland: 2.43 ± 1.15 (median, 2) vs. 1.93 ± 1.15 (median, 1), p = 0.005). The level of discrimination was associated with sex, age, the degree of obesity, and treatment-related weight loss (p < 0.05). Conclusions: Our findings confirm that obesity significantly affects the social and economic well-being of patients. There is a great need to reduce weight stigma and to take measures to alleviate the socioeconomic and psychological burden of obesity.

Safety Profile of COVID-19 Vaccines among Healthcare Workers in Poland.

The aim of the study was to compare the safety profiles (prevalence of both local and systemic side effects) of COVID-19 vaccines (Pfizer−BioNTech, Moderna, Oxford−AstraZeneca) among healthcare workers (doctors, nurses, and pharmacists) administered with a first and a second dose of the vaccines. Another goal of the research was to evaluate potential demographic and clinical risk factors for the frequency and intensity of side effects. A post-marketing, cross-sectional survey-based study was carried out on a sample of 971 respondents (323 doctors, 324 nurses, and 324 pharmacists), all more than 18 years old, who have taken two doses of the following SARS-CoV-2 vaccines: BNT162b2 (Pfizer−BioNTech) (group 1), mRNA-1273 (Moderna) (group 2), and ChAdOx1 nCoV-19 (Oxford−AstraZeneca) (group 3). A validated, self-administered questionnaire was developed and delivered online to the target population group of healthcare workers. The survey was conducted during the third wave of the COVID-19 (1 February 2021−1 July 2021) pandemic. It was based on the CAWI (computer-assisted web interview) method. Questionnaires were disseminated using selected social media. The BNT162b2 (Pfizer−BioNTech) vaccine was the most commonly administered COVID-19 vaccine among healthcare professionals in Poland (69.61%). Side effects following a SARS-CoV-2 vaccine were reported by 53.11% of respondents in group 1, 72% in group 2, and 67.59% in group 3. The following were the most common side effects regardless of the type of vaccine administered: pain at the injection site, headache, muscle pain, fever, chills, and fatigue. The number and intensity of reported side effects following administration of a BNT162b2 (Pfizer−BioNTech) vaccine were significantly lower than in the other two study groups (p < 0.00001). Risk factors for side effects following administration of one of the SARS-CoV-2 vaccines subject to the analysis included being female, young, and suffering from a diagnosed allergy. Our results clearly show that the short-term safety profiles of the eligible COVID-19 vaccines (Pfizer−BioNTech, Moderna, Oxford−AstraZeneca) are acceptable. Nevertheless, the two-dose COVID-19 vaccines available in Poland differ significantly in the frequency of both local and systemic side effects and their intensity. Women, young people, and patients diagnosed with allergies are particularly exposed to the risk of side effects. Further studies are needed to determine the long-term safety profile of COVID-19 vaccines.

The Impact of Health Policy on Patients' Awareness of the Risks Associated with Obesity: An International Multicenter Study in Poland and Germany.

Background: Recent studies indicate that the treatment of obesity is unsuccessful. The cause of this situation is that patients are not sufficiently educated about therapeutic methods and the health consequences of not treating obesity. Moreover, obesity prevention strategies differ significantly between EU countries. Objective: The primary aim of this study was to examine and compare the level of obesity-related knowledge and illness perception among obese patients from Poland and Germany. Methods: A prospective cross-sectional international multicentre study was conducted. The study included 564 subjects above 18 years old (210 German patients and 354 Polish patients) with obesity. A validated custom-made questionnaire was used to evaluate obesity-related knowledge. Patient illness perception was evaluated using Polish and German language versions of the standardized Brief Illness Perception Questionnaire (B-IPQ). Results: Obese patients from Germany had significantly higher level of obesity-related knowledge than patients from Poland (22.01 ± 4.68 vs 19.17 ± 6.59, p<0.0001). Obesity-related knowledge was associated with the patient's education, patient participation in therapeutic educational programs, patient's perception of the illness, age and the number of healthcare professionals involved in the patient's treatment process. Conclusion: The level of obesity-related knowledge among both Polish and German patients is unsatisfactory. This study suggests that health education is required to facilitate informed choices and support the use of cognitive approaches educating patients on the health consequences of obesity.

Assessment of the Impact of the COVID-19 Pandemic on the Pro-Health Behavior of Poles.

The SARS-CoV-2 virus pandemic has exerted enormous impacts on individuals' lifestyle, economics and social life. The aim of the study was to assess the impact of the COVID-19 pandemic on health-promoting behaviors of a sample of the Polish population, including dietary supplementation, physical activity, eating habits, and the implementation of preventive vaccinations. Within the scope of a survey, data was collected from 1101 adult respondents residing in Poland (862 women and 239 men). An anonymous questionnaire prepared based on the scientific literature was used as a research tool. The survey was conducted during the second wave of COVID-19 using the CAWI (Computer-Assisted Web Interview) method by disseminating the questionnaire using selected social media. We found that, during the COVID-19 pandemic, the respondents were more likely to maintain healthy eating habits and use dietary supplementation; however, the majority engaged in physical activity less frequently and had a sedentary lifestyle. Most felt no need to undergo preventive influenza vaccinations. The COVID-19 pandemic significantly increased the health awareness of the analyzed group from the Polish population. However, the obtained results are not fully satisfactory; therefore, there is a need to promote a healthy lifestyle and pro-health behaviors as part of social campaigns.

Impact of bariatric surgery on depression, anxiety and stress symptoms among patients with morbid obesity: international multicentre study in Poland and Germany.

BACKGROUND: There is a need to investigate how adopting different strategies for treating obesity in different countries in the European Union affects the psychological well-being of patients. AIMS: The aim of this study was to perform a comparative evaluation of psychiatric symptoms (depression, anxiety and stress) in patients undergoing bariatric surgery versus patients receiving conservative treatment for morbid obesity in Poland and Germany. METHOD: A multicentre international prospective cohort study with 155 patients who underwent bariatric surgery and 409 patients who received conservative weight reduction treatment. Evaluation of the psychiatric symptoms was carried out for each patient at baseline and after 12 months of active treatment using a standardised Depression Anxiety Stress Scale questionnaire (DASS-21) questionnaire. RESULTS: After 12 months of active treatment, the level of psychiatric symptoms (depression, anxiety and stress) significantly decreased in both groups of patients: surgically treated versus conservatively treated patients from Poland and also from Germany. The median change in level of psychiatric symptoms among patients from both countries was significantly higher among surgically treated patients compared with conservatively treated patients (Poland P < 0.0001; Germany P < 0.0001). Improvements in the patient's mental health as a consequence of treatment were dependent on the specific strategy for treating obesity adopted in the analysed countries, the percentage of total weight loss and on gender. CONCLUSIONS: The use of bariatric surgery in both Poland and Germany compared with non-surgical treatment for obesity resulted in more measurable benefits in the form of a decrease in psychiatric symptoms (depression, anxiety and stress) and reduction in body weight.

A Comparison Between the Therapeutic Effect of Metformin Alone versus a Combination Therapy with Insulin in Uncontrolled, Non-Adherence Patients with Type 2 Diabetes: Six Months Follow-Up.

PURPOSE: The study aimed to compare the metabolic effects of an intensive dose of metformin alone among non-adherence patients with type 2 diabetes versus in combination with insulin among adherence patients. METHODS: The prospective cohort study was carried out on a sample of 140 patients above 18 years old, divided into two groups. The first group (n=70) was recommended metformin monotherapy in an intensive dose of 2-3 g/day, whereas the second group (n=70) was prescribed metformin (1-2g/day) in combination with insulin. FPG, HbA1c, BMI, blood pressure, TC, TG, HDL-C, LDL-C, creatinine, and eGFR were measured for each patient at baseline and after a follow-up of 6 months of active treatment. RESULTS: After six months of active treatment using monotherapy with an intensive dose of metformin, only 11.43% of patients achieved the target levels of HBA1c below 7%. In the group of patients treated using a combination of metformin with insulin, after six months of active treatment, 45.72% achieved HBA1c levels below 7% (p<0.0001). Compared with an intensive dose of metformin alone, the combination of insulin and metformin was associated with improved glycemic control (change of fasting blood glucose: 2.49 mmol/l vs 1.30 mmol/l, p=0.0016). Metformin use alone, as compared with insulin, was associated with a significant increase in HDL-C (+0.03 mmol/l vs -0.14 mmol/l, p=0.0485). Increased baseline obesity and increased baseline glycemia were the factors related to the likelihood of failing to achieve the target levels for HbA1c. CONCLUSION: Metformin proved to be more effective in controlling hyperglycemia when combined with insulin therapy. Our study shows how many health benefits loss patients who, despite systematic diabetes education, do not agree to change their treatment in the form of adding a second drug, including insulin.

Impact of patient knowledge on hypertension treatment adherence and efficacy: A single-centre study in Poland.

Introduction: Recent studies show that treatment of arterial hypertension is unsuccessful. This is due to the patients' insufficient knowledge of about the therapeutic methods and the consequences of not treating arterial hypertension. Objectives: The aim of the study was to evaluate the patients' knowledge concerning therapeutic options, prophylaxis, and complications of arterial hypertension. The study also assessed the effect of such knowledge on hypertension treatment adherence and efficacy. Patients and Methods: The survey included 488 patients (250 female and 238 male), aged over 18 years, diagnosed with and treated in outpatient and inpatient settings at selected healthcare institutions in Poland. A custom-made questionnaire, based on references on this subject, was the key tool in the present study. Information about the course of the disease and evaluation of hypertension treatment efficacy was based on the patients' medical records. Results: The study found that 54.7% of the subjects had good knowledge about arterial hypertension, 40.0% had average knowledge, and 5.3% had poor knowledge. The extent of knowledge about the disease was significantly dependent on the level of education and the place of receiving medical care (p< 0.05). Good knowledge was significantly associated with controlled blood pressure, number of antihypertensive drugs used, frequency of hospitalization, as well as with medication adherence, and healthy lifestyle behaviours (p< 0.05). Conclusions: More than half of the patients presented good knowledge but a large group still had poor knowledge, especially patients with a low level of education and with hypertension treated at a general practitioner's clinic. The results of our study clearly show that knowledge about arterial hypertension affects medication adherence and healthy lifestyle behaviours and improves hypertension treatment efficacy.

Effect of Different Blood-Pressure-Lowering Regimens on the Blood Pressure Control among Hypertensive Patients Treated in Hospital Conditions.

BACKGROUND: Scientific references lack sufficient amount of data on analyses of the reasons for hospital admissions or assessment of efficacy of arterial hypertension treatment at hospitals. OBJECTIVES: The aim of the study was to evaluate the efficacy of antihypertensive drug therapy on the blood pressure control among hospitalized hypertensive patients. Methodology. A cross-sectional retrospective study consisted of 204 patients aged 18-65 years admitted to the hospital due to hypertension between January 2018 and December 2018. The study was based on analysis of electronic records, obtained from the medical database of the selected healthcare facility. RESULTS: As a result of the treatment applied at the hospital, 65.19% of the patients achieved the desired degree of blood pressure normalization (≤130/80 mmHg). Vast majority of the patients during their stay at the ward would receive three or more hypertensive drugs (63.73%). The most frequently prescribed antihypertensive drug combinations included bitherapies such as diuretics + ACEI and ACEI + ß-blockers and tritherapy such as diuretics + ß-blockers and calcium channel antagonists and diuretics + ACEI and ARBs. The highest blood-pressure lowering effects were observed among patients receiving combination therapy of a ACEI, a diuretic, and a ARBs. Tritherapy induced a significant mean reduction of inpatients`s SBP compared with bitherapy (p=0.0001). CONCLUSION: During their hospital stay, vast majority of patients (65.19%) achieved normal values of blood pressure, mostly owing to combined treatment with several hypertensive drugs. Efficacy of the most frequently used combinations of hypertensive drugs in normalizing arterial pressure varies.

Managing metastatic bone pain: New perspectives, different solutions.

Bone metastases are the most frequent cause of cancer-induced bone pain (CIBP). Although palliative radiotherapy and pharmacotherapy conducted according to World Health Organization (WHO) analgesic ladder are the treatment of choice for CIBP reduction, these methods are not always successful, especially with regard to alleviation of incidental pain. Antiresorptive drugs (bisphosphonates) are able to inhibit bone destruction (loss), proliferation of cancer cells and angiogenesis, but their prolonged use may lead to a spectrum of adverse effects. In this paper, types of bone metastases, their complications, as well as diagnostic and therapeutic implications are presented. Moreover, the paper discusses presently used CIBP treatment methods and research directions for future methods, with special focus on bone metastases.

Compliance Among Adolescents with Arterial Hypertension.

BACKGROUND: The term "compliance" means the degree to which the patient's behavior, applying medication or certain lifestyle changes, is consistent with arrangements communicated to him by a doctor or other healthcare professional. Literature indicates that the degree of adherence to medical recommendations for hypertensive patients is unsatisfactory, making it the main cause of the low effectiveness of antihypertensive therapy. OBJECTIVES: The aim of the study was to assess the compliance of adolescents in the field of pharmacological and non-pharmacological methods of hypertension treatment. MATERIAL AND METHODS: The study included 62 patients (20 women, 42 men) diagnosed with hypertension and treated in specialist healthcare facilities. As a research tool, a questionnaire prepared on the basis of recent literature was used. RESULTS: The vast majority of respondents (72.7%) declared that they were regularly taking antihypertensive drugs. The proportion of patients regularly taking antihypertensive drugs was higher in patients treated with monotherapy than with polytherapy (48.5% vs. 24.2%). Among the methods of non-pharmacological treatment of hypertension, the most accepted lifestyle change in the study population was smoking cessation (83.8% of respondents) and reduction of salt consumption (64.5% of respondents), and the least acceptable lifestyle change was maintaining proper body weight by eating a low calorie diet (30.6% of respondents). CONCLUSIONS: Adolescents with hypertension adhere in varying degrees to medical recommendations related to the hypertension treatment. The available literature indicates that the currently effective way to improve cooperation with the patients is education.

The impact of high­density lipoprotein on oxidant-antioxidant balance in healthy elderly people.

INTRODUCTION    There is an inverse relationship between high­density lipoprotein cholesterol (HDL-C) levels and the risk of atherosclerosis. OBJECTIVES    The aim of the present study was to assess the oxidant-antioxidant balance in elderly people with different concentrations of HDL-C. PATIENTS AND METHODS    A total of 541 people aged 60 years or older were examined, of whom 90 individuals with no acute or severe chronic disorders had their waist circumference, body mass index, percentage of body fat, and blood pressure measured. Fasting and 120­minute glycemia was determined in an oral glucose tolerance test, following which 15 patients with type 2 diabetes were excluded. Fasting plasma levels of lipids, total antioxidant status, and thiobarbituric acid-reacting substances (TBARS), as well ast the activity of erythrocyte superoxide dismutase 1 (SOD­1) were assessed. Based on HDL-C levels, participants were divided into the high HDL­C group (≥40.0 mg/dl and ≥50.0 mg/dl for men and women, respectively; n = 50) and the low HDL­C group (<40.0 mg/dl and <50.0 mg/dl for men and women, respectively; n = 25). RESULTS    The groups did not differ in terms of age, blood pressure, body mass index, percentage of body fat, and glucose concentration. The high HDL­C group had lower waist circumference (P <0.02) and lower triglyceride concentrations (P <0.00001). Increased TBARS levels (P <0.0005) was observed in the low HDL­C group. There were no differences in SOD­1 activity and total antioxidant status between the groups. CONCLUSIONS    HDL-C levels, which are known to reflect the antiatherogenic activity of HDL, including antioxidant properties, may indicate increasing oxidative stress in healthy elderly individuals.

LIPID PROFILE OF POLISH PRIMARY CARE PATIENTS AGED 35-55 YEARS LIVING IN THE DISTRICT OF PLESZEW.

In Poland, more than half of the adult population suffers from lipid disorders. Among the 18 million Polish people with hypercholesterolemia, over 10.8 million are unaware of this problem. To estimate the lipid profile of selected primary care patients in the district of Pleszew (Western Poland), general practitioners (GPs) recruited 681 patients aged 35-55 years in 2011. Fasting serum lipids were evaluated. We found statistically significant differences in all lipid parameters between all younger (35-45 years) and older (46-55 years) patients, between all female and male subjects, between women and men ages 35-45 years; in total cholesterol (TC), LDL-cholesterol (LDL-C) and triglycerides (TG) between younger and older female population; in HDL-cholesterol (HDL-C) and TG between women and men ages 46-55 years. Dyslipidemia, both, newly detected and previously treated, was detected in 591 patients (86.8%): 322 females (84.3%) and 269 males (90.0%). The highest percentage of lipid disorders was found in males aged 46-55 years (91.9%) and the lowest among women aged 35-45 years (78.0%). Age and gender differences in the prevalence of dyslipidemia proved of statistical importance. Among 155 patients on lipid-lowering therapy, only 28 subjects (18.1%) reached the target value of serum lipids. The prevalence of lipid disorders among primary care patients aged 35-55 years in the district of Pleszew was significantly high, and it was proved that dyslipidemia is statistically prominent in males and older patients. Polish healthcare professionals should make more efforts to improve the detection and treatment of lipid disorders.

Aliskiren - an alternative to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in the therapy of arterial hypertension.

There has been enormous progress in antihypertensive therapy over the last few decades. However, the management of arterial hypertension is still insufficient and more efforts are needed to improve both non-pharmacological and pharmacological treatment of this widely prevalent disease. Renin-angiotensin-aldosterone system (RAAS) inhibition is crucial both for blood pressure (BP) control and for prevention of organ damage or its development in patients with hypertension. Angiotensin-converting enzyme inhibitors and/or sartans block RAAS incompletely. Aliskiren is one of the novel drugs that has been introduced to antihypertensive therapy recently. Up to now no trial has confirmed that aliskiren is efficacious in reducing cardiovascular events. Double RAAS blockade with aliskiren was not always safe. This review article presents the current view on the place of aliskiren in the therapy of arterial hypertension.