Sex-specific associations between the environmental exposures and low-grade inflammation and increased blood pressure in young, healthy subjects.

Long-term exposures to environmental factors including airborne as well as noise pollutants, are associated with cardiovascular risk. However, the influence of environmental pollution on the young population is controversial. Accordingly, we aimed to investigate the relationships between long-term exposures to different environmental factors and major cardiovascular and inflammatory parameters and biomarkers in young, healthy subjects. Representative sample of permanent residents of two cities differing in air and noise pollution levels, aged 15-21 years, were recruited. Krakow and Lublin, both located in southern Poland, were chosen in relation to their similarities in demographic and geopolitical characteristics, but differences in air pollution (higher in Krakow) and noise parameters (higher in Lublin). A total of 576 subjects were studied: 292 in Krakow and 284 in Lublin. All subjects underwent health questionnaire, blood pressure measurements and biomarker determinations. Inflammatory biomarkers, such as CRP, hs-CRP, fibrinogen as well as homocysteine were all significantly higher in subjects living in Krakow as opposed to subjects living in Lublin (for hsCRP: 0.52 (0.32-0.98) mg/l vs. 0.35 (0.22-0.67) mg/l; p < 0.001). Increased inflammatory biomarker levels were observed in Krakow in both male and female young adults. Interestingly, significant differences were observed in blood pressure between male and female subjects. Males from Krakow had significantly higher mean systolic blood pressure (127.7 ± 10.4 mm/Hg vs. 122.4 ± 13.0 mm/Hg; p = 0.001), pulse pressure (58.7 ± 8.9 mm/Hg vs. 51.4 ± 12.3 mm/Hg; p < 0.001) and lower heart rate (p < 0.001) as compared to males living in Lublin. This was not observed in young adult females. Long-term exposure to environmental factors related to the place of residence can significantly influence inflammatory and cardiovascular parameters, even in young individuals. Interestingly, among otherwise healthy young adults, blood pressure differences exhibited significant variations based on biological sex.

Assessment of stress load and its causes among dental students. / Pomiar poziomu stresu i czynników go wywolujacych wsród studentów kierunku lekarsko-dentystycznego.

OBJECTIVES: The aim of this study was thus to assess the stress level among dental students, characterizing the factors that induce it and describing which students are most susceptible. METHODS: Two international, independent and validated to polish language and environment stress questionnaires were used: the Perceived Stress Scale (PSS-10) and the Perceived Medical School Stress Instrument (PMSS). The present study received approval from the Jagiellonian University Bioethical Committee (no. 1072.6120.290.2020). RESULTS: A total of 272 students from all five years of the dental undergraduate degree at Jagiellonian University Medical College were enrolled to the study, including 197 female and 75 male respondents. The overall response rate was 85%. The PSS-10 score for all dental students was 22.14±6.65. A total of 182 (66.91%) respondents had high levels of stress. Female students had significantly higher stress levels than male students, accordingly 22,9±6,51 and 20,12±6,69. Moreover, first and fifth year students had the highest stress level. In the case of PMSS the total score for all dental students was 36.84±8.65. CONCLUSIONS: Perceived stress among Polish dental students is generally high. These findings suggest that support services should be made widely available to all dental students. Such services should be targeted to the specific needs of male and female students as well as to those in specific years of study.

Long-term outcomes and complications associated with operative and nonoperative treatment of distal radius fractures. Do we need to restore anatomy to have satisfactory clinical outcome?

A i m: The aim of this study was to assess long-term outcomes and complications associated with conservative and operative treatment of distal radius fractures and to determine if restoration of radio- graphic parameters influences functional outcomes. I n t r o d u c t i o n: Distal radius fractures (DRFs) are common injuries associated with many complications. Numerous studies suggest that operative treatment with anatomic reduction and restoration of radiographic parameters leads to better functional outcomes than nonsurgical treatment.Materials and Methods: We enrolled 207 patients with isolated DRF (mean age 64 ± 17.9 years, women 150 (72.5%)) to our retrospective, single-center study (101 treated operatively, 106 treated non-operatively). There were no significant differences in sex, age, AO type fracture between study groups. After 3.9 ± 1.6 years (mean ± SD) clinical, functional and radiological assessment was conducted using Disabilities of the Arm, Shoulder and Hand (DASH), Patient Rated Wrist Evaluation (PRWE), 9-Hole Peg Test (9-HPT), grip and pinch strength tools. R e s u l t s: We found higher rates of malunion in nonoperative group (p <0.0001) and worse radiologic parameters such as volar tilt (p <0.0001), teardrop angle (p <0.0001) versus operative cohort. Nevertheless radiological parameters were not correlated with DASH and PRWE results. Moreover, patients aged 50 years and above treated operatively had similar functional outcomes (DASH, PRWE) to those treated nonoperatively. C o n c l u s i o n s: Restoration of anatomic and thus radiologic parameters of radius may not be obligatory to achieve satisfactory functional outcome in patients with DRF aged 50 years or above. Patient is the most important 'factor' in determining appropriate and successful treatment method of distal radius fractures.

Stress associated with undergraduate medical courses: A translation and validation of the Perceived Medical School Stress Instrument into Polish and its adaptation to the Polish environment.

OBJECTIVES: Medical students are more susceptible to depression than other students. Moreover, students with the symptoms of depression statistically more often abuse drugs and have suicidal thoughts and anxiety. The level of stress and the factors that lead to in among medical students at Polish universities have not yet been measured. The aim of this study was to translate to Polish and validate the Perceived Medical School Stress Instrument (PMSS-PL) and to measure the resulting version's psychometric abilities. MATERIALS AND METHODS: We validated the Polish translation of PMSS in accordance with the recommendations published by the Translation and Cultural Adaptation group of the Quality of Life Special Interest group of the International Society for Pharmacoeconomics and Outcomes Research. The Perceived Stress Scale (PSS-10) was used as an external test to validate the PMSS-PL questionnaire. A total of 430 undergraduate medical students at the Medical College of Jagiellonian University took part. RESULTS: The mean PMSS-PL score was 36.43 and it varied from 13 to 65. The mean PSS-10 was 21.35. The internal reliability, as indicated by Cronbach's alpha, was 0.803, which means there was internal reliability between PSS-10 and PMSS-PL. Moreover, all questions from PMSS-PL had a positive discrimination power, so each question correlated positively with the other questions in PMSS-PL. CONCLUSIONS: PMSS-PL may be used to psychometrically analyze the stress load on undergraduate medical students at Polish universities. The PMSS-PL may also be used as an external test for validating and calculating the reliability and accuracy of other psychometric instruments.

Foundations of fluoride prophylaxis in Poland and the prosthetic rehabilitation of the masticatory organ in arthropathies and malocclusion: Scientific achievements of Professor Noemi Wigdorowicz-Makowerowa.

Professor Noemi Wigdorowicz-Makowerowa was born in Warsaw to a Polish Jewish family on November 24, 1912. She graduated from the Medical University of Warsaw in 1937 and from the Academy of Dentistry in 1939. In early 1940, she was forcibly relocated to the Warsaw Ghetto, from which she escaped in January 1943. Shortly after the Second World War, in 1946, she started working at Wroclaw University. She conducted multiple studies there on the fluoride prophylaxis of caries, and on temporomandibular joint arthropathy and its etiology. She proved the efficiency of tap water fluoridation in caries prevention through a comparative study on children from schools in Wroclaw and Malbork, where the fluoride concentrations were 0.1 mg/L and 3.2 mg/L, respectively. The incidence of deep caries and the rate of tooth mortality were significantly lower in Malbork. Her long-term studies on the fluoride prophylaxis of caries prompted Professor Wigdorowicz-Makowerowa to found the Scientific and Technical Team for Fluoride Prophylaxis, based at the Department of Dental Prosthetics in the Institute of Dentistry of Wroclaw Medical University, which led to the creation of 35 fluoride water treatment plants in Poland by 1980. Moreover, she emphasized that malocclusion caused by dental caries and tooth loss, bruxism, higher susceptibility to stress, and increased muscle tone may constitute reasons for masticatory organ disorders. In her long career of over 30 years, she published 68 articles about fluorine and its use in dentistry, and 50 articles about temporomandibular joint arthropathy and other masticatory organ disorders.

Higher Mortality in Men Compared with Women following Distal Radius Fracture in Population Aged 50 Years or Above: Are Common Distal Radius Fracture Classifications Useful in Predicting Mortality?

INTRODUCTION: Distal radius fractures (DRF) are one of the most common fractures with growing incidence in developed countries and are a reliable predictor of another osteoporotic fracture. Data concerning DRF mortality are conflicting and vague. Usefulness of common DRF classification systems in predicting mortality is unexplored. METHODS: We identified all patients hospitalized between January 1st 2008 and May 30th 2015 with isolated distal radius fracture, aged 50 y/o or above, in a 1st level trauma center in Poland. Fractures were evaluated according to AO, Frykman, and Fernandez classifications. Mortality ratios and long-term survival analysis with Kaplan-Meier estimator and log-rank tests with univariate and multivariate Cox proportional hazards model were used. RESULTS: We enrolled 1308 consecutive patients. The average age of the entire cohort was 72.5 ± 12 years. The study group consisted of 256 men (19.6%) with mean age 66 ± 12 y/o and 1052 women (80.4%) with mean age 74 ± 12 y/o. Men were statistically younger at the time of the fracture than women (p<0.0001). After 1-year follow-up the overall study group mortality ratio was 4.5%, being 2.2-fold higher in men compared to women. In long-term survival analysis, excess men mortality remained significant. Factors associated with higher mortality at any point of the study were age (HR: 1.08, 95%CI: 1.07-1.10, p<0.000001), male sex (HR: 1.92, 95%CI: 1.34-2.77; p<0.001), AO type A (HR: 1.64 95%CI 1.19-2.25, p<0.01), and Frykman type I (HR: 2.12 95%CI: 1.36-3.29, p<0.001). CONCLUSION: Distal radius fractures are connected with premature mortality. Men have higher mortality compared with women following distal radius fracture in population aged 50 years or above. Simple extra articular fractures classified as AO type A or Frykman type I may be predictors of higher mortality in DRF cohort.

Risk of injury to the sural nerve during posterolateral approach to the distal tibia: An ultrasound simulation study.

When surgeons operate on the foot and ankle, the most common complication that may arise is injury of the cutaneous nerves. The sural nerve (SN) is potentially at risk of being injured when treating fractures involving the distal tibia using the posterolateral approach. The aim of this study was to evaluate how differences in length and position of the surgical treatment of fractures involving the distal tibia can affect the risk of SN injury. The study involved 40 healthy volunteers (n = 80 lower limbs). Ultrasound simulation of each potential surgical incision site was used to locate the SN and to assess the risk of injury. The study showed that the SN predominantly travels more posteriorly at levels more proximal from the tip of the lateral malleolus. At these more proximal points of the SN's course, it was proven that there was an overall increased incidence of iatrogenic injury to the SN in incisions made closer to the Achilles tendon. Based on these results, a quasi 3 dimensional figure was created showing the anatomical structures of this region to identify areas at high risk for SN injury. By revealing how length and position of the surgical incision can influence the risk of SN injury, we hope to provide information to surgeons on the optimal technique to avoid iatrogenic SN injury while operating on the distal tibia via a posterolateral approach. Clin. Anat. 31:870-877, 2018. © 2018 Wiley Periodicals, Inc.

Cardiological aspects of carbon monoxide poisoning.

AIM: The aim of this study was to assess cardiological manifestations of carbon monoxide (CO) poisoning. Background/introduction: Carbon monoxide intoxication is one of the most important toxicological causes of morbidity and mortality worldwide. Early clinical manifestation of CO poisoning is cardiotoxicity. MATERIALS AND METHODS: We enrolled 75 patients (34 males and 41 females, mean age 37.6 ± 17.7 y/o) hospitalized due to CO poisoning. Laboratory tests including troponin I, blood pressure measurements, HR and electrocardiograms (ECG) were collected. Pach's scale scoring and grading system was used to establish severity of poisoning. RESULTS: Grade of poisoning is positively correlated with troponin I levels and systolic blood pressure. Moreover, troponin levels are significantly correlated with exposition time, lactates and are higher in tachycardiac, hypertensive and positive ECG subpopulations. COHb levels are indicative of exposure but do not correlate with grade of poisoning. The main cause of CO poisoning were bathroom heaters - 83%, only 11% of examined intoxicated population were equipped with CO detectors. CONCLUSIONS: Complex cardiological screening covering troponin levels, ECG, blood pressure and heart rate measurements as well as complete blood count with particular attention to platelet parameters should be performed in each case where CO intoxication is suspected. More emphasis on education on CO poisoning is needed.