[Dilatation of the left atrium as one of the indicators of worse prognosis in patients treated with intermittent hemodialysis]. / Powiekszenie lewego przedsionka jako jeden ze wskazników gorszego rokowania u chorych leczonych powtarzana hemodializa.

UNLABELLED: Cardiovascular diseases are the most frequent cause of death in patients undergoing treatment with hemodialysis (HD). Echocardiography is the established method in diagnosis and searching for HD patients with an increased risk of death from cardiovascular events. The aim of the study was to show parameters, obtained also in the echocardiographic examination, which are helpful to distinguish persons with the worse prognosis among the group of HD patients. MATERIAL AND METHODS: Observation was done in 56 patients. Echocardiographic examination was performed at baseline before and after HD. The observation lasted 26.3 +/- 13.6 months. The analysis included the effect of the patient demographic characteristics, clinical and echocardiographic parameters: gender, age, duration of renal replacement therapy, body mass index, presence of ischemic heart disease, chronic heart failure, presence of valvular defects, hypertension, pharmacological therapy, systolic and diastolic left ventricular function, the size of the left and right atrium, atrial volume changes that occur due to decreased blood volume during HD treatment on the death risk. RESULTS: In the group of 56 patients significantly worse survival was shown in persons with symptoms of cardiac failure. After 3 years of the observational study in the group without diagnosis of chronic cardiac failure 90.9% patients survived, whereas in the group with diagnosis of cardiac failure 51.0% (p = 0.020). In the group of patients with diagnosis of severe valvular disease 14.3% survived, whereas in the group without severe valvular disease 66.1% survived, (p = 0.009). Among patients without diagnosis of arterial hypertension 30.0% survived; in the group with diagnosis of arterial hypertension 65.9% (p = 0.016). In the group of patients with left atrial dimension > 50 mm all patients died, whereas in the group of patients with left atrial dimension < or = 50 mm 62.6% (p = 0.010) survived. CONCLUSIONS: HD patients with worse survival prognosis can be identified by echocardiographic examination showing risk factors which were severe valvular disease and dilatation of the left atrium.

[Tobacco smoking among hospitalised patients with arterial hypertension]. / Palenie tytoniu wsród hospitalizowanych osób z nadcisnieniem tetniczym.

Currently 33% of the Polish adult population smoke tobacco (42% males and 25% females), which is a serious issue, particularly in the context of cardiovascular diseases. A study of the extent of smoking among patients with arterial hypertension (AH) served as the basis for the present article. The studied group comprised 100 patients hospitalised due to AH, 46 males and 54 females. A survey, aided by a specially designed questionnaire, was the method of the medical part of the study. It concentrated on health-related behaviour patterns conducive, or not, to AH treatment such as: systematic control of blood pressure, proper diet, physical activity, and tobacco smoking. The respondents were also asked to indicate the sources of their knowledge on the proper, in this context, lifestyle. The study revealed that 46.0% of the subjects smoked; most of them males, inhabitants of a large city (both genders), over 50-year-old, and with secondary school education. The majority of the group, while declaratively fully aware, thanks to the received information, of the necessity of the cessation of smoking - fails to react appropriately. Tobacco smoking constitutes a vital issue among the AH patients. The physician is not always the source of knowledge on the threats, associated with the addiction. The fact that 2/3 of the patients aware of the necessity of smoking cessation fails to do so is a reason for concern.

[Causes of hospital admission among 40-year-olds]. / Przyczyny przyjec do szpitala wsród osób czterdziestoletnich.

The work constitutes a part of the larger project "Comparative analysis of some elements of health state among 40-year-old inhabitants of the City and the Province of Poznan, born 1938, 1959", backed by National Committee of Sciences, performed in the Dept. of Public Health, Chair of Social Medicine, K. Marcinkowski University of Medical Sciences, in Poznan. Altogether 1037 persons, born in 1959, were medically examined as to their social background, education, life-style, and their current health picture. Some of the key elements were compared, where possible, with a similar, though much larger group of those born in 1938. The article focuses on the 40-year-olds born in 1959, and describes the causes of their hospitalisation throughout the year preceding the examination. Place of residence, gender and education of the persons examined were taken into consideration. The results point to the prevailing causes of hospitalisation, such as cardiovascular disease, diseases of the digestive and urinary tract, and consequences of accidents and poisonings.

[Tobacco smoking and periodontitis]. / Palenie tytoniu a przebieg choroby przyzebia.

Increasing evidence points to smoking as a major risk factor for periodontitis, affecting the prevalence, extent and severity of disease. The aim of our study was to asses due to clinical and statistical methods the progress of periodontal disease according to general health status and smoking. 123 persons with periodontitis were divided into 4 groups: healthy, diabetes, heart and vessels diseases and osteopenia. Oral hygiene status was established acc. to O Larry Hygiene Index, Gingival status acc to SBI Index, the gingival pocket depth and attachment loss were measured in milimeters. The monitoring took place from 1996 to 2002. In statistical analysis the Friedman and Kruskal-Wallis test were used. The development of inflammation in response to plaque accumulation is reduced in smokers compared with nonsmokers. Smoking promotes chronic gingivitis and attachment loss.

[Reasons for systematic, primary and specialist care of the over-40 population in the city and province of Poznan]. / Przyczyny systematycznej opieki podstawowej i specjalistycznej nad 40-letnimi mieszkancami miasta Poznania i województwa poznanskiego.

The work constitutes a part of a larger project "Comparative analysis of some elements of health state among 40-year-old inhabitants of the City and the Province of Poznan, born 1938, 1959", backed by National Committee of Sciences, performed in the Department of Public Health, Chair of Social Medicine, K. Marcinkowski University of Medical Sciences, in Poznan. Altogether 1037 persons, born in 1959, were medically examined as to their social background, education, life-style, and their current health picture. Some of the key elements were compared, where possible, with a similar, though much larger group of those born in 1938. The article focuses on the 40-year-olds born in 1959, and describes the causes of admission by their respective family physicians, as well as specialists (secondary care). Place of residence, gender and education of the persons examined were taken into consideration. The results point to the prevailing causes of admission, such as arterial hypertension, diseases of the digestive tract (gastric and duodenal ulcer), and of locomotor system.