Effect of Neonatal Hearing Screening Results on the Lost to Follow-Up at the Diagnostic Level.

(1) Background: An important part of any neonatal hearing screening program is monitoring diagnostic visits to confirm or exclude the presence of hearing loss. In addition, time plays an important role in the diagnosis. We identified the number of children who came for a diagnostic visit and analyzed the time of the first audiological visit, depending on the result of the hearing screening test performed in the first days of a child's life and the presence or absence of risk factors of hearing impairment. (2) Methods: We analyzed 6,580,524 children, of which 8.9% required further diagnostics. The mean time of follow-up diagnostic visit in the analyzed group was 130 days and differed due to the presence or absence of risk factors for hearing loss before and after the neonatal period. (3) Results: Although the risk of hearing loss in children with risk factors is 2.31 to 6.38 times higher than in children without risk factors depending on the result of the screening test, more than 40% of parents do not report to scheduled audiological visits. (4) Conclusions: Doctors, nurses, and midwives who screen hearing at the neonatological level play an important role in educating parents about the possibility of hearing loss in a child and the need for an audiological examination.

The impact of the COVID 19 pandemic on the functioning of the Universal Newborn Hearing Screening Program in Poland.

The Newborn Hearing Screening Program has existed in Poland for almost 20 years. However, for the first time in the history of his activity, he had to deal with large logistic and staffing problems. The analysis compared the years 2020 and 2021 in terms of the functioning of centers that conduct audiological diagnostics of the Program during the Covid-19 pandemic. In order to obtain relevant information, a telephone survey was conducted at the beginning of 2022 with questions about the performance of standard activities related to the Program. Results In 2020, 60 centers conducting audiological diagnostics (66.67%) were suspended, and 30 were working under the sanitary and epidemiological regime (33.33%). In 2021, only 5 (5.26%) diagnostic centers with their headquarters in facilities transformed into so-called homonymous hospitals, dealing only with the treatment of patients infected with SARS-CoV-2 virus, were suspended. Discussion The development of the pandemic and the related limitations around the world had a significant impact on the quality and scope of medical services provided. Many hospitals were quickly transformed into closed centers treating only patients with SARS-CoV-2. Audiological consultations take place in closed, soundproof rooms. Face-to-face contact was required for hearing assessment, fitting hearing aids, troubleshooting, and rehabilitation. The COVID-19 pandemic has forced audiology to modify existing practices. The use of telemedicine was increasingly preferred. In Poland, as all over the world, the scope of remote consultations has expanded, but due to technological and hardware limitations, audiological procedures remained in the sphere of direct contact with the patient. Conclusions In the first year after the announcement of the pandemic, significant difficulties were observed in the functioning of centers dealing with the diagnosis of children with suspected hearing loss. The appearance of the SARS-CoV-2 virus forced us to develop innovative methods of early diagnosis and treatment of children with hearing impairment, which resulted in the stabilization of the work of individuals in the following year.

Summary of the Polish Universal Neonatal Hearing Screening Program 2021year review.

The Polish Universal Neonatal Hearing Screening Program (PUNHSP) has been carried out in Poland for 20 years. Its main goal is to screen newborns for hearing. This examination is performed on the 2-3 days of a child's life, and in addition, information is collected on the risk factors for the development of hearing loss. In total, 486 centers participate in PPPBSuN at three reference levels. By the end of 2021, 7 million children were registered in the PPPBSuN Central Database. The most common type of hearing loss in children was bilateral sensorineural hearing loss, diagnosed in 2021 in 160 children. The report below presents the most important results and conclusions from the functioning of PPPBSuN in 2021.

Follow-up on the diagnostic level of children covered by the Universal Neonatal Hearing Screening Program in Poland, divided into voivodships.

INTRODUCTION: Thanks to the Polish Universal Neonatal Hearing Screening Program (PUNHSP), all newborns in Poland undergo a free, screening hearing examination. Between 2006 and 2015, the average number of tested children per year was 373,477. According to the analysis of The Central Database (CDB), only 55.8% of the children attended the detailed hearing examinations at the second level of the Program. AIM: The aim of this study is to analyse the dates concerning the attendance of the children at the diagnostic level of PUNHSP in different regions of Poland. MATERIALS AND METHODS: To conduct an analysis of this fact and find out the reasons for low attendance at the second level in 2015, a telephone survey questionnaire was developed for parents who had not registered their babies for further consultation - 3,239 randomly selected parents. RESULTS: The analysis revealed that the number of children examined at the second diagnostic level of the program is in fact much higher than the results of The Central Database show. The actual number is 83.6% as opposed to 55.8%. As a result of the telephone questionnaire some inaccuracies in the input data to the CDB were detected. The main errors in gathering the information for the CDB were incorrect OAE test result and no examination performed. C onclusion: In Poland the worst results (i.e. questionnaire results compared to CDB) for the attendance at the diagnostic level were shown in Pomorskie, Lubelskie, Mazowieckie and Podlaskie regions. In many cases there was a large discrepancy between the reality and the information in the CDB. The improvement of clarity concerning the CDB application is important in order to minimise the possibility of malformation in the CDB.

Analysis of the changes in the Polish Universal Neonatal Hearing Screening Program over 15 years of activity.

INTRODUCTION: One of the examples of a nationwide pro-health program in Poland is the Polish Universal Neonatal Hearing Screening Program (PUNHSP). The Program is aimed at early diagnosis and intervention in children with hearing impairments and it is an example of a well-managed program. Presenting the results of the PUNHSP activity as well as organizational aspects and own experience can significantly help institutions managing other programs to achieve high efficiency in their functioning. The aim of this work is a detailed analysis of the Program evaluation during the 15 years of its activity, i.e. the identification of changes and the consequences of their introduction in the perspective of improving quality and efficiency. MATERIALS AND METHODS: The material is PUNHSP data, registered in the Central Database of the Program and organizational information related to management, IT support and PUNHSP infrastructure. The analysis was based on quality assessment parameters (identification of changes and the purpose of their introduction) and effectiveness (consequences of introducing changes). The analysis concerns the whole period of PUNHSP activity - from 2002 to 2017. RESULTS: As a result of the analysis, 13 main modifications of the Program were identified as the "change" criteria and 11 smaller ones - side ones resulting from the necessity to adapt the PUNHSP functionality to current needs. The changes were grouped into five categories: legal, administrative, management, audit and control, as well as IT, changes. DISCUSSION: When analyzing the PUNHSP evaluation, it can be assumed that the changes introduced positively influenced the various aspects of the PUNHSP activity, but do not exhaust the possibilities of further optimization of its activity. CONCLUSIONS: The Program requires constant development in order to increase the efficiency and effectiveness of its operation, and the solutions used in it could be a stimulus to improve and create other pro-health programs.

The report of the Polish Universal Neonatal Hearing Screening Program in 2016.

The Polish Universal Neonatal Hearing Screening Program (PUNHSP) has been carried out in Poland for 14 years. The main aim of this Program is to organize hearing screening tests and to gather the information about risk factors of hearing loss in almost all newborns in Poland. It consists of 496 centers at 3 referral levels. A total of 5 458 114 children had been registered in the Central Database (CDB) of PUNHSP by the 22nd of August 2017. Bilateral sensorineural hearing loss was the most frequently appearing hearing impairment in children. It was diagnosed in 260 cases in 2016. This report presents the most important results and conclusions concerning the running of the PUNHSP in 2016.

Analysis of follow-up at the diagnostic level in the Polish Universal Neonatal Hearing Screening Programme.

Objectives Routine analysis showed that between 1 June and 30 November 2014, only 47.6% of expected follow-up visits at the diagnostic level were registered in the Polish Universal Neonatal Hearing Screening Programme central database. We attempted to detect and analyse the reasons for this low percentage. Methods A telephone survey questionnaire was developed for parents whose children had not registered for consultation at the diagnostic level, or had not received a final diagnosis according to the programme database. Questions aimed to verify the database records and compare these with information received from and given to parents. From the 7888 children not registered at the diagnostic level, 3239 records were randomly selected, i.e. 52.4% of those who had been expected to attend. Results Questions were answered by 1950 parents (60.2% of the selected group). Of these, 52.1% ( n = 734) had attended for diagnostic tests, but this was not recorded in the database. The most common reasons for not attending were the long waiting time for the visit (36.09%), lack of referral to a visit (25.9%) and conscious parent decision (16.35%). Conclusion The telephone survey disclosed omissions in database registration, and that in fact 83.6% of children had attended at the diagnostic level.

Molecular characterization of a seed transmitted clavicipitaceous fungus occurring on dicotyledoneous plants (Convolvulaceae).

Ergoline alkaloids (syn. ergot alkaloids) are constituents of clavicipitaceous fungi (Ascomycota) and of one particular dicotyledonous plant family, the Convolvulaceae. While the biology of fungal ergoline alkaloids is rather well understood, the evolutionary and biosynthetic origin of ergoline alkaloids within the family Convolvulaceae is unknown. To investigate the possible origin of ergoline alkaloids from a plant-associated fungus, 12 endophytic fungi and one epibiotic fungus were isolated from an ergoline alkaloid-containing Convolvulaceae plant, Ipomoea asarifolia Roem. & Schult. Phylogenetic trees constructed from 18S rDNA genes as well as internal transcribed spacer (ITS) revealed that the epibiotic fungus belongs to the family Clavicipitaceae (Ascomycota) whereas none of the endophytic fungi does. In vitro and in vivo cultivation on intact plants gave no evidence that the endophytic fungi are responsible for the accumulation of ergoline alkaloids in I. asarifolia whereas the epibiotic clavicipitaceous fungus very likely is equipped with the genetic material to synthesize these compounds. This fungus resisted in vitro and in vivo cultivation and is seed transmitted. Several observations strongly indicate that this plant-associated fungus and its hitherto unidentified relatives occurring on different Convolvulaceae plants are responsible for the isolated occurrence of ergoline alkaloids in Convolvulaceae. This is the first report of an ergot alkaloid producing clavicipitaceous fungus associated with a dicotyledonous plant.

[Individual sensitivity to the mutagenic agents in patients with larynx cancer]. / Ocena wrazliwosci pacjentów z rakiem krtani na czynniki mutagenne.

Patients with different cancers, induced mostly by numerous mutagenic factors, present increased genetic susceptibility to mutagenic agents known as "hidden chromosomal instability". This type of genetic instability can be detected in vitro after treating chromosomes with clastogenic substances, for example by using "bleomycine test". The purpouse of our study was to evaluate a hidden chromosome instability in patients with squamous cell carcinoma of larynx (SCCL) and to establish correlations between genetic results and both histological grade of the tumor and clinical progression of disease. Cytogenetic analysis of 126 of patients diagnosed with SCCL and 98 of controls was performed in vitro on peripheral blood lymphocytes. The analysis of sensitivity to bleomycine of larynx cancer patients in relation to histological grade of the tumor proved, that increased numbers of chromosome breaks as well as and percentage of aberrant metaphases are correlated with the tumor grading. Mean number of chromosome breaks per cell (b/c) in patients with larynx cancer was 1,01 (+/- 0.43), while in the control group was 0.74 (+/- 0.29) per cell (chi2 p < 0.001). Percentage of aberrant metaphases (% am) in patients with SCCL was 42.18 (+/- 11.61) and 36.05 (+/- 10.22) in the control (chi2 p < 0.001). The group of hypersensitive patients (b/c > 1) consisted of 51.5% percent of larynx cancer patients, while in the control, hypersensitivity occurred only in 20.4% of subjects (chi2 p < 0.001). Possible chromosome instability (0.8 < b/c < 1) was found 11.9% patients with SCCL and in 20.4% of controls (not statistically significant). Increased sensitivity to bleomycine in patients with SCCL in comparison to the control group was found. Most sensitive to bleomycine was the group of patients diagnosed with SCCL graded G2 (Scheffe's test p < 0.05)

Opposite responses in two DNA repair capacity tests in lymphocytes of head and neck cancer patients.

Genomic instability has long been recognized as the main feature of neoplasia and a factor modulating individual cancer susceptibility. There are attempts to find effective assays of both individual DNA repair capacity and genetic instability, and their relation to the cancer risk. Genetic predisposition plays an important role in the etiology and development of head and neck squamous cell carcinoma (HNSCC). The aim of our study was to search for a correlation between chromosomal instability and DNA repair capacity in HNSCC patients and healthy controls. The chromosomal instability was measured by the number of bleomycin (BLM)-induced chromosomal aberrations and diepoxybutane (DEB)-induced sister chromatid exchanges. The DNA repair capacity was assessed using the DEB-induced adaptive response (AR). The HNSCC patients in our study showed a significant increase in chromosomal instability after a preterminal exposure of their lymphocytes to either BLM for the last 5 h or DEB for the last 24 h of incubation. However, the AR was higher in HNSCC patients than in the control group, suggesting an increase in the DNA repair capacity in the cancer patients as compared to the control. There is no correlation between the DNA repair capacity estimated on the basis of preterminal exposures to BLM and DEB and the DNA repair capacity estimated on the basis of the adaptive response to DEB. The preterminal exposure and the adaptive response test may activate different DNA repair mechanisms.