Comparative Analysis of the Incidence of Selected Sexually Transmitted Viral Infections in Poland in 2010-2015: A Retrospective Cohort Study.

Sexually transmitted infections (STIs) represent a major cause of morbidity in women and men worldwide. The main aim of this study was to perform a comparative analysis of the incidence of sexually transmitted viral infections in 2010-2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and the National Institute of Public Health-National Research Institute and constituted information from the epidemiological surveillance system in Poland. We collected data on the incidence of the following diseases: genital herpes (HSV), genital warts, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). The key groups with the highest risk of infection were young people between 20 and 29 years of age. The reported data on the incidence of genital herpes in Poland (n = 3378; 1.5/100,000) showed a downward trend, which does not coincide with global trends. Genital warts were the most frequent genital infections in Poland (n = 7980; 3.46/100,000), with significant regional variation. Over the analysed period, the situation of newly detected HIV infections seemed to be stable (n = 7144; 3.1/100,000). The incidence of these infections appeared to be highly correlated with urbanisation rates, which was not confirmed in the case of other analysed infections. The worsening epidemic situation with respect to sexually transmitted infections, the inefficiency of the current surveillance system and the reduction in funding for diagnosis and prevention, combined with inadequate legal solutions, make it necessary to undertake new legal and organisational measures aimed at improving the reproductive health in Poland in terms of sexually transmitted infections.

Comparative Analysis of the Incidence of Selected Sexually Transmitted Bacterial Infections in Poland in 2010-2015: A Retrospective Cohort Study.

Sexually transmitted infections are common infectious diseases. The main aim of this study was to perform a comparative analysis of the incidence of bacterial sexually transmitted infections in 2010-2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and constituted information being the epidemiological surveillance system in Poland. The analysis included data on the incidence of primary and secondary syphilis, gonorrhoea and non-gonococcal urethritis and genital infections. The overall incidence rates were disproportionately lower than European rates and those presented in studies from other countries. Young people, between 20 and 29 years of age, were the key groups at the highest risk of infection. The incidence rate of primary and secondary syphilis was lower in Poland than in Europe or America, but some regions, such as Mazovia and Lodz provinces, were found to have a higher incidence rate than other European rates. The reported incidence of gonorrhoea in Poland was also significantly lower compared with other countries, with a significantly higher number of infections in males than in females, and this was also one of the highest rates in EU countries. During the study period, the number of non-gonococcal genital infections systematically decreased, while in other countries of the European region, the incidence was among the highest of all sexually transmitted infections.

Relationship between self-esteem and stigmatization in psoriasis patients.

INTRODUCTION: Psoriasis is classified as a psychosomatic disease since its development and outcome may be modulated by various psychological factors. Due to the presence of clinical signs visible to others and poor social awareness of the disease, psoriasis patients are not infrequently classified as different or stigmatized, and their value as human beings tends to decrease. AIM: To analyse the relationship between self-esteem and stigmatization in psoriasis patients. MATERIAL AND METHODS: The study included 120 patients with psoriasis vulgaris. The study participants completed Polish versions of the Rosenberg Self-Esteem Scale (RSES) and the 6-Item Stigmatization Scale developed by Evers et al., as well as an original survey containing questions about their sociodemographic characteristics. RESULTS: Mean RSES score of the study participants was 24.1 points. Mean RSES score for female patients was nearly 2 points lower than the mean score for men. Analysis of Spearman's rho coefficients showed that the higher the self-esteem in the study participants the less often they considered themselves unattractive to others (0.23), less often believed that people gaze at their skin lesions (0.23) or avoid them because of their condition (0.38). CONCLUSIONS: Our findings demonstrate clearly that both self-esteem and stigmatization are significant components of psoriasis' influence on the patient life. Psoriasis should not be considered merely as a somatic problem, but also as a significant psychological and social burden.

Relationships between the acceptance of illness, quality of life and satisfaction with life in psoriasis.

INTRODUCTION: Since the skin plays a pivotal role in interpersonal relationships, a chronic dermatological condition (psoriasis), may have a profound effect on the psychological status of patients. AIM: To analyse the effects of skin lesions on satisfaction with life, acceptance of illness and quality of life in psoriasis. MATERIAL AND METHODS: The study included psoriatics recruited at the Dermatology Outpatient Unit of the Regional Hospital in Lomza, Dermatology Outpatient Clinic in Siemiatycze and Dermatology and Medical Cosmetology Centre in Bialystok. The study patients were examined with a demographic survey prepared by the authors, as well as with three validated scales: AIS, SWLS and DLQI. A total of 263 questionnaire sets were handed out to the participants of the study; this pool included 200 questionnaires with complete data that were eventually included in the analysis. RESULTS: Acceptance of Illness Scale scores of the study participants ranged between 8 and 40 pts. Mean AIS scores for female and male psoriatics were similar, 23 and 25 pts, respectively. Based on the distribution of Satisfaction with Life Scale scores, 42 of the study patients presented with high levels of satisfaction with life, whereas 37 and 21 showed moderate and low satisfaction levels, respectively. Quality of life turned out to be the best among 20- to 30-year-old respondents as up to 74.19 of them had Dermatology Life Quality Index scores no greater than 10 pts. CONCLUSIONS: Psoriatics with higher levels of illness acceptance also presented with greater satisfaction with life.

Quality of life in skin diseases as perceived by patients and nurses.

INTRODUCTION: The appearance of the skin and its appendages not only reflects the general body condition, but also exerts an effect on one's self-esteem and self-image, and the way he/she is perceived by the others. AIM: To analyse the quality of life (QOL) in dermatological diseases, assessed by the patients themselves and the nurses being their caregivers. MATERIAL AND METHODS: The survey was completed by 300 patients diagnosed with various dermatological conditions; however, only the data from 281 surveys were considered during the analysis. All patients completed an anonymous questionnaire designed specifically for the purpose of the study. The survey included 32 questions. Moreover, the study patients were surveyed with the Dermatology Life Quality Index (DLQI). Moreover, the study included 1713 nurses employed in various healthcare institutions and providing care to patients with dermatological diseases. The survey for the nurses consisted of 32 questions. RESULTS: Mean DLQI score for the study patients was 12.4 ±8.1 points. Based on the median, lower and upper quartile values, every fourth person presented with DLQI scores > 18 points, half of the respondents had DLQI scores no greater than 12 points, and every fourth respondent experienced good QOL (DLQI score no higher than 5 points). CONCLUSIONS: According to the majority of patients and nurses, individuals with skin conditions are not fully able to cope with their disease and show a negative attitude towards it. The QOL of patients with skin diseases is determined by the type of the dermatological condition.

Satisfaction with life in a group of psoriasis patients.

INTRODUCTION: Psoriasis is one of the most frequent inflammatory diseases of the skin, associated with an epidermal proliferation and a specific morphology of lesions. Patients with psoriasis perceive their appearance specifically; they are frequently rejected by their surroundings and perceive their quality of life as considerably poorer. AIM: To evaluate the satisfaction with life in patients with psoriasis, and to analyze the effect of this disease on the prevalence of depression in this group. MATERIAL AND METHODS: The study included 100 psoriasis vulgaris patients treated at the Voivodeship Outpatient Clinic of Skin and Venereal Diseases in Lomza (Poland). Sociodemographic data of the participants and the clinical characteristics of the disease were collected using a standardized questionnaire survey. The global feeling of satisfaction with life was evaluated with the Satisfaction with Life Scale and the Beck's Depression Inventory. RESULTS: Mean SWLS scores suggested that the examined patients experienced moderate levels of satisfaction with life (18.92 and 18.69 points in women and men, respectively). The life satisfaction was the highest amongst patients between 50 and 60 years of age (p = 0.81). The mean score of the Beck Depression Inventory was at a threshold of mild depression (14.08 and 13.65 points in women and men, respectively). CONCLUSIONS: Our participants presented moderate levels of satisfaction with life. A lower satisfaction with life was associated with a poorer quality of life and a higher prevalence of depressive symptoms.

[The role of metalloproteinases in psoriasis]. / Znaczenie metaloproteinaz w luszczycy.

Metalloproteinases play a crucial role in the destruction processes related to inflammation and carcinogenesis as well as in wound healing, morphogenesis and growth. Destruction of extracellular matrix proteins related to these enzymes activity and following damage of basement membranes favour angiogenesis and inflammatory infiltrations in psoriasis. Metalloproteina-ses activity can be controlled on different levels: genetic expression, enzyme activation or its inhibition. In this paper we discuss recently discovered role of metalloproteinases in the pathogenesis of skin diseases, including psoriasis. The most interesting seems to be results of research on possible application of metalloproteinases inhibitors in psoriasis treatment and usefulness of these enzymes measurement in the management of this disease.

[Lymphogranuloma venereum and HIV infection. A case report]. / Ziarnicawenerycznapachwin i zakazenie HIV. Opis przypadku.

We present a case of a young man with lymphogranuloma venereum in whom HIV infection was diagnosed.

Quality-of-life evaluation in an interferon therapy after radical surgery in cutaneous melanoma patients.

Melanoma is the fastest growing solid tumor in men and women, and despite accounting for only 4% of skin cancer cases, it accounts for more than 79% of skin cancer-related deaths. The present study was designed to evaluate the impact of interferon (IFN) treatment on patients' quality of life (QOL) after radical surgery of cutaneous melanoma. The tests were carried out in a group of patients treated in the Department of Soft Tissue and Bone Cancer, Institute of Oncology, in Warsaw. The present study included 2 groups of the patients, 110 persons each. One group consisted of patients who had been subjected to radical surgery of cutaneous melanoma, and the other one consisted of 110 patients treated with a supplementary interferon alfa-2b (IFN-alpha-2b) therapy. Data were collected by means of an anonymous QLQ-C30 (version 2.0.) questionnaire elaborated and provided by the European Organisation for Research and Treatment of Cancer. The QLQ-C30 questionnaire consisted of 43 questions. The IFN-alpha-2b treatment significantly affected patients' physical condition, mental health, and social life. The emotional state of the patients was more affected during IFN-alpha-2b treatment. Somatic symptoms were also increased in those patients. The IFN-alpha-2b therapy also significantly affected family and social life. In spite of several adverse effects, the patients assessed their QOL as good. The IFN-alpha-2b treatment is troublesome for the melanoma patients. It is important that the treating physician and nurse should be aware of the 4 major categories of IFN-alpha-2b toxicity: constitutional, neuropsychiatric, hepatic, and hematologic. A number of steps can be taken to minimize the morbidity associated with IFN-alpha-2b therapy, resulting in an improvement in both QOL and patient compliance.

The need for health education among patients with psoriasis.

Psoriasis is one of the most common skin diseases with a chronic and recurrent course. The disease requires systematic treatment and appropriate care. Therefore, in the care of the patient with psoriasis, there must also be place for health education. The aim of this study was to determine the need for health education among patients with psoriasis by determining knowledge gaps occurring most frequently. Materials for this study were collected using an anonymous questionnaire created on the basis of the Psoriasis Disability Index (PDI). The study group included 149 patients with psoriasis. It has been proven in previous studies that patients with psoriasis see the need to improve their knowledge of the disease and self-care methods, and the greatest deficit of their education refers to the factors activating the process of the disease and to the methods of prophylactics in psoriasis.

[Evaluation of neutrophils adhesive molecules CD11b/CD18 in the course of photochemotherapy (PUVA) for psoriasis vulgaris]. / Ocena czasteczek adhezyjnych CD11b/CD18 granulocytów obojetnochlonnych w przebiegu fotochemoterapii (PUVA) luszczycy pospolitej.

Psoriasis is a common, chronic dermatological disorder. Inflammatory cells assemble in epidermis in the early stage of acute psoriasis. Accumulation of neutrophils at the site of inflammation depends on the expression of adhesion molecules. A variety of stimuli--mediators or selectins can active CD11b/CD18 molecules on the neutrophils surface. The aim of our study was expression of CD11b/CD18 molecules without and after stimulation by fMLP (formyl-Met-Leu-Phe) in patients with psoriasis vulgaris treated by PUVA. Expression of beta2-integrins was estimated with MFI (mean fluorescence intensity). Neutrophils in patient with acute psoriasis showed an increase in CD11b/CD18 expression. It means about an activation of neutrophils and particular role of those molecules in granulocyte adhesion to epidermis in psoriasis.

[Cytofluorimetric assay for evaluation of CD16 receptor expression and myeloperoxidase (MPO) activity of neutrophils in patients with psoriasis vulgaris treated with PUVA]. / Cytofluorymetryczna ocena ekspresji receptora CD16 oraz aktywnosci mieloperoksydazy (MPO) granulocytów obojetnochlonnych u chorych na luszczyce pospolita, leczonych fotochemoterapia PUVA.

Early histological changes indicate the collecting of neutrophils in the stratum corneum, mainly in the acute psoriasis. Fc gammaRIIIB (CD16) is the specific functional neutrophilic receptor, which is responsible for phagocytosis. Myeloperoxidase (MPO) is granulocyte enzyme playing main role in metabolic activity of neutrophils. We have evaluated CD16 expression and MPO activity of polymorphonuclear granulocytes in the acute psoriasis vulgaris and the influence of photochemotherapy PUVA (psoralen plus ultraviolet light of A wavelength) treatment on these parameters. The expression of CD16 and MPO activity were significantly higher in neutrophils of patients after PUVA.

Difficulties in diagnosing and treating tinea in adults at the Department of Dermatology in Bialystok (Poland).

In the years 1981-2000, the department of dermatology at the Medical University of Bialystok, Poland, carried out a retrospective study of common difficulties in the diagnosis and treatment of tinea. The aim of this study was to assess the incidence of incorrect diagnosis and therapy of tinea and tinea incognito (TI) in the patients hospitalized at the institution over a 19-year period. Tinea was identified in 814 patients (4.3% of all patients). TI was diagnosed in 318 patients (39.1% of all patients with tinea). The most diagnostic-therapeutic problems were observed in the patients with tinea pedis, tinea cutis glabrae superficialis, intertrigo candidamycetica, tinea profunda cutis glabrae and tinea profunda barbae. The most common clinical isolates were T. rubrum, T. mentagrophytes, and Candida albicans. A high percentage of TI was present in comparison with all other tinea conditions.