Disease In Poland Research Articles

Congenital herpes simplex virus infection among hospitalized infants in Poland.

Congenital herpes simplex virus infection (cHSV) is a rare entity and may pose a life-threatening disease for the newborns. Due to the public health and clinical importance of cHSV infection in infants, the recent data on this disease in Poland should be investigated. The aim of the study was to evaluate the incidence and other factors related to cHSV. The study is retrospective, population-based that utilised the hospital discharge records of cHSV patients. Data were obtained from National Institute of Public Health NIH - National Research Institute in Warsaw, Poland, covering the period 2014-2019. The study group consisted of 1,573 cHSV newborns (841 males and 732 females). Among this group, 70.1% were infants up to 90 days of age and 3.6% were neonates up to 28 days of age. The mean and median age was 98 days (95% CI: 94.5-101.8, SD 74) and 70 days (IQR: 53-104), respectively. Based on the hospital registry the overall average cHSV incidence over the study period was estimated to be 69 per 100,000 live births. The number of cHSV infection fluctuated over the years 2014-2019 with a significant decreasing trend from 2015-2019 (P<0.01). A significantly higher cHSV incidence was observed among patients from urban than rural areas of Poland (88 vs 40/100,000 live births; P<0.001). CHSV incidence may be related to multifactorial conditions for the occurrence of this disease. Further studies on changes in the incidence of cHSV are needed.

Secondary prevention of coronary heart disease in Poland: does sex matter? Results from the POLASPIRE survey.

Adherence to health‑promoting behaviors intended to mitigate modifiable risk factors plays an important role in secondary cardiovascular prevention. We aimed to evaluate sex differences in the prevalence and control of risk factors in patients with coronary heart disease (CHD). The study included 1236 patients who experienced acute coronary syndrome or coronary revascularization within the last 6 to 24 months. Definitions of risk factors and treatment goals were based on the 2016 European Society of Cardiology guidelines on cardiovascular prevention. The prevalence of modifiable risk factors in both sexes was high, and their control inadequate. Women were older (P <0.001) and had a higher accumulation of multiple cardiovascular risk factors than men (P = 0.036). They more frequently had central obesity (P <0.001) and reduced values of glomerular filtration rate (P <0.001). Women more often experienced anxiety (P <0.001), reported lower levels of education (P <0.001) and lower income (P = 0.001), and those in the youngest age group were more likely to be exposed to second‑hand smoking (P = 0.01). A large fraction of the study patients, men and women alike, did not meet the recommended therapeutic goals. For both sexes, participation in cardiac rehabilitation programs was associated with more frequent attainment of the recommended level of physical activity (P = 0.046) and smoking cessation (P = 0.01). The prevalence of cardiovascular risk factors in patients with CHD is high, especially in women. Therapeutic goals are met infrequently in both sexes. This situation calls for widening the access to educational programs and paying greater attention to their proper implementation.

Healthcare practitioners' diagnostic and treatment practice patterns of nonalcoholic fatty liver disease in Poland: a cross-sectional survey.

Nonalcoholic fatty liver disease (NAFLD) awareness is low. NAFLD diagnosis and management by gastroenterologists (GEs) and general practitioners (GPs) in Poland were evaluated. RESTORE was an observational, noninterventional, retrospective cross-sectional survey performed among GEs and GPs with at least 3 years' experience. Computer-assisted web interviews were completed. GEs provided information from patient records. Mean experience was 14.2 (95 GEs) and 22.6 (115 GPs) years. Mean patient numbers with liver disorders consulted per month were 36 (13%; GEs) and 51 (6%; GPs); ~50% were patients with NAFLD. All GEs/GPs used ultrasound; most evaluated transaminases and gamma-glutamyl transferase. More GEs used other imaging techniques and a larger spectrum of laboratory tests than GPs. Physician-identified NAFLD key symptoms were similar for GEs/GPs. GEs noticed less obvious symptoms (abdominal discomfort, drowsiness, fatigability, lack of energy) vs. GPs (abdominal pain/discomfort, dyspepsia). Common comorbidities in NAFLD were similar in GE/GP responses. NAFLD interventions by GEs/GPs (% patients) were diet/lifestyle/pharmacological interventions (54%/59%), diet/lifestyle changes alone (41%/31%) or pharmacological interventions alone (5%/10%). The top three criteria for supportive pharmacological selection were efficacy, tolerability and quality of life improvement for GEs/GPs. The five supportive treatments most commonly prescribed by GEs/GPs were essential phospholipids, ursodeoxycholic acid, timonacic, silybinin/silymarin and ornithine + choline. Information from patient records (n = 380) confirmed GEs responses. NAFLD is not a silent disease as physicians and patients reported many, albeit nonspecific, symptoms. This cross-sectional survey provides important insights into clinical management of NAFLD by GEs and GPs in Poland.

First two years of reimbursed enzyme replacement therapy in the treatment of Fabry disease in Poland.

Fabry disease (FD) is an ultra-rare genetic lysosomal storage disease caused by pathologic gene variants resulting in insufficient expression of α-galactosidase A. This enzyme deficiency leads to accumulation of globotriaosylceramide and globotriaosylsphingosine in plasma and in different cells throughout the body, causing major cardiovascular, renal, and nervous system complications. Until 2018, reimbursed enzyme replacement therapy (ERT) for FD was available in all European Union countries except Poland. We present the preliminary results of the first two years of reimbursed ERT in Poland. We obtained data from the seven largest academic centers in Katowice, Cracow, Wrocław, Poznań, Gdańsk, Warsaw, and Łódź. The questionnaire included the following data: number of patients treated, number of patients qualified for ERT, and patient characteristics. All centers returned completed questionnaires that included data for a total of 71 patients (28 men and 43 women) as of June 2021. Thirty-five patients with the diagnosis of FD confirmed by genetic testing (22 men and 13 women) had already qualified for reimbursed ERT. Mean (SD) age at the commencement of the ERT program was 39.6 (15.5) years (range 18-79 years). Mean time from the first clinical symptoms reported by the patients to the FD diagnosis was 21.1 (8.9) years, and the mean time from the final diagnosis of FD to the beginning of ERT was 4.7 (4.6) years. FD is still underdiagnosed in Poland. To identify undiagnosed FD patients and to ensure that patients in Poland benefit fully from ERT, implementation of an effective nationwide screening strategy and close cooperation with a network of rare disease centers is advised.

Lyme disease in Poland in 2019.

Lyme disease is caused by Borrelia spirochetes transmitted by ticks of the genus Ixodes. In Poland, Lyme disease is the most common tick-borne disease. The entire territory of Poland is recognized by ECDC as an endemic area of Lyme disease. Environmental factors and climate change are responsible for the increase in the number of tick habitats, which leads to an increased risk of Lyme disease. The aim of the study is to present the epidemiological situation of Lyme disease in Poland in 2019 compared to the previous year. The analysis of the epidemiological situation of Lyme disease in Poland was based on data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the bulletin "Infectious diseases and poisoning in Poland in 2019." In 2019, 20,630 cases of Lyme disease were registered, and 1,701 people were hospitalized. Compared to 2018, there was a shift in the incidence from the first and second quarter to the fourth quarter. The highest incidence of 107.7 / 100,000 population was recorded in the Podlaskie voivodeship, which has belonged to the voivodeships with the highest incidence in the country for many years. Despite an increase in the total number of cases by 2.4% compared to 2018, the percentage of hospitalized cases was lower than in the previous year. Difficulties in the diagnosis of Lyme disease make it impossible to define an unequivocal trend in the epidemiological situation in Poland. A slight increase in the incidence may result from the growing number of infected ticks and a better understanding of the problem of Lyme diagnosis by doctors.

Optimal medical therapy in patients with stable coronary artery disease in Poland: the ISCHEMIA trial experience.

Introduction: Optimal medical therapy (OMT) is the cornerstone of treatment for stable coronary disease with the ISCHEMIA trial showing similar outcomes using OMT with or without an initial invasive approach. Objectives: To describe OMT goal attainment in Polish ISCHEMIA participants compared with other countries. Patients and methods: Among 5179 trial participants, 333 were randomized in Poland. The median follow-up was 3.2 years. OMT targets were: not smoking, high-intensity statin therapy, low-density lipoprotein cholesterol (LDL-C) of less than 70 mg/dl, systolic blood pressure of less than 140 mm Hg, aspirin therapy, and ACEI / ARB, and β-blocker therapy if indicated. Results: Compared with 36 other countries, at randomization, patients in Poland were older (67 [62–75] y vs 65 [58–71] y); P <⁠0.001), more often female (30% vs 22%; P = 0.002), with a longer history of angina (3 [1–9] y vs 1 [0–3] y; P <⁠0.001), and there were more cases of prior myocardial infarction (32% vs 18%; P <⁠0.01) and revascularization (PCI, 40% vs 19%; CABG, 11% vs 3%; P <⁠0.001 for both). The number of OMT goals attained increased from baseline to follow-up visits (5 [4–5] vs 6 [5–6]; P <⁠0.001) in Poland and other countries alike (P = 0.89 vs P = 0.14). In Poland, significant improvements were achieved regarding high-intensity statin therapy (27% vs 50%), LDL-C <⁠70 mg/dl (29% vs 65%), and systolic blood pressure of less than 140 mm Hg (63% vs 81%) (P <⁠0.001 for all), whereas not-smoking (89% vs 89%), aspirin (90% vs 88%), ACEI / ARB (93% vs 95%), and β-blocker therapy (94% vs 90%) remained high. Conclusions: With regular surveillance and contemporary medical therapy, high OMT goal attainment was achievable among the participants of the ISCHEMIA trial in Poland relative to other countries. There is still room for improvement in LDL-C and blood pressure management.

The impact of Pandemic COVID-19 on cases of Borreliosis infection in 2020

Borreliosis (Lyme borreliosis; Lyme disease) is a zoonotic disease caused by spirochetes from the genus Borrelia. In humans, the accidental host of ticks, the infection is transmitted by the bite of the tick - the spirochetes are present in the salivary glands of the tick. Any of the three forms of tick: larva, nymph and adult can be responsible for infection. The most common threats to humans are Borrelia burgdorferii sensu stricto, Borrelia garinii and Borrelia afzelii occurring mainly in Europe. Lyme disease is a complex, multi-stage disease and progresses in 3 stages. The targeted treatment of Lyme disease is based on the administration of antibiotics. The introduction of antibiotics in the early stages of Lyme borreliosis offers a good chance of a complete cure. Lyme disease is a major epidemiological problem in the world. In Europe, the average number of cases per year remains at 65,400. In Poland, the number of infections annually reaches several tens of thousands. According to the National Institute of Hygiene of Poland, which keeps statistics of epidemiological reports, a total of 83,495 people fell sick with Lyme disease in Poland between 2016 and 2019. Whereas in 2020, the number of cases of Lyme disease decreased to 12933. The reason for this is undoubtedly the COVID-19 pandemic, which has dominated health care and focused all the attention of medical workers. This review shows that Lyme borreliosis is a dangerous disease with a high risk of complications. A quick diagnosis is crucial in the therapeutic process. An algorithm should be developed in order to distinguish other diseases from Lyme disease and thus enable an early reaction and treatment.

Tularaemia - a diagnostic challenge.

Tularaemia is an infrequently occurring disease in Poland. It has therefore rarely been taken into account in the differential diagnosis of skin lesions, lymphadenitis, or soft tissue abscesses. This fact, accompanied by non-specific initial presentation, may lead to a delay in diagnosis and a more severe course of the disease. Objective. The aim of the study is to present the current state of knowledge on tularaemia and convince medical professionals to take it into consideration in the diagnosis of skin lesions, lymphadenitis, and tissue abscesses. A literature review using PubMed and other online resources, using terms including 'tularaemia', 'lymphadenitis', etc., was undertaken. Papers were reviewed for relevance and scientific merit. Tularaemia, also known as 'rabbit fever', is a zoonotic infection caused by Francisella tularensis, an aerobic, facultative intracellular, gram-negative bacteria. In Europe, it is mainly spread via tick bites and contact with wild animals such as lagomorphs and rodents. Clinical presentation may differ depending on the transmission route; the ulceroglandular and glandular forms of disease predominate. An early diagnosis and implementation of appropriate antibiotic therapy are the cornerstones of successful treatment and make it possible to avoid a surgical incision and drainage of suppurative complications. Raised awareness and knowledge on tularaemia among health care professionals are required for timely diagnosis and treatment. Arrival from endemic areas, contact with wild animals, tick bites, and exclusion of more common etiologies of presenting signs should prompt consideration of tularaemia. More research is needed for a better understanding of the burden of the disease and its impact on public health in Poland.

First two years of reimbursed enzyme replacement therapy in the treatment of Fabry disease in Poland.

Fabry disease (FD) is an ultra-rare genetic lysosomal storage disease caused by pathologic gene variants resulting in insufficient expression of α-galactosidase A. This enzyme deficiency leads to accumulation of globotriaosylceramide and globotriaosylsphingosine in plasma and in different cells throughout the body, causing major cardiovascular, renal, and nervous system complications. Until 2018, reimbursed enzyme replacement therapy (ERT) for FD was available in all European Union countries except Poland. We present the preliminary results of the first two years of reimbursed ERT in Poland. We obtained data from the seven largest academic centers in Katowice, Kraków, Wrocław, Poznań, Gdańsk, Warszawa, and Łódź. The questionnaire included the following data: number of patients treated, number of patients qualified for ERT, and patient characteristics. All centers returned completed questionnaires that included data for a total of 71 patients (28 men and 43 women) as of June 2021. Thirty-five patients with the diagnosis of FD confirmed by genetic testing (22 men and 13 women) had already qualified for reimbursed ERT. Mean (SD) age at the commencement of the ERT program was 39.6 (15.5) years (range 18-79 years). Mean time from the first clinical symptoms reported by the patients to the FD diagnosis was 21.1 (8.9) years, and the mean time from the final diagnosis of FD to the beginning of ERT was 4.7 (4.6) years. FD is still underdiagnosed in Poland. To identify undiagnosed FD patients and to ensure that patients in Poland benefit fully from ERT, implementation of an effective nationwide screening strategy and close cooperation with a network of rare disease centers is advised.

Risk-factors associated with extremely high cardiovascular risk of mid- and long-term mortality following myocardial infarction: Analysis of the Hyperlipidaemia Therapy in tERtiary Cardiological cEnTer (TERCET) registry

Background and aimsRisk-factor identification and risk stratification are prerequisites to the effective primary and secondary prevention of cardiovascular disease (CVD). Patients at the highest risk benefit the most from the intensive risk-factor reduction. However, the high-risk patients’ group is heterogeneous, and it is increasingly recognised that there is an ‘extreme-risk’ category of patients who may require particularly close attention and intensive therapeutic approach. The aim of this study was to identify subgroups of patients at the highest risk of death following myocardial infarction (MI) that might be considered as those at extremely high CVD risk. MethodsWe used data from 19,582 participants of the Hyperlipidaemia Therapy in tERtiary Cardiological cEnTer (TERCET) Registry (NCT03065543) of patients with ischaemic heart disease in Poland from 2006 to present. Characteristics of 13,052 patients with chronic coronary syndromes (CCS) were compared with those of 4295 patients with myocardial infarction (STEMI and NSTEMI). Multivariable logistic regression with stepwise backward elimination was used to identify risk factors associated with mortality in the 12–36 months following the index hospitalisation. ResultsThe mortality rates were significantly higher in patients after MI than in patients with CCS. In the multivariable analysis, the risk factors most strongly associated with 12-month mortality in patients after MI were left ventricular ejection fraction (LVEF) lower than 35% (hazard ratio [HR] 3.83, 95% confidence interval [CI] 3.14–4.67), age >75 years (HR 1.91, 95%CI 1.55–2.35), multivessel coronary artery disease (HR 1.61, 95%CI 1.30–1.99), atrial fibrillation (HR 1.53, 95%CI 1.21–1.94) diabetes mellitus (HR 1.35, 95%CI 1.11–1.64) and increased LDL-C (HR per 1 mmol/l 1.09, 95%CI 1.01–1.19) or creatinine levels (HR per 10 μmol/L 1.04, 95% CI 1.04–1.05). The risk factors that influenced mortality after 24–36 months were consistent with those after 12 months, with additional low haemoglobin (20–25% risk increase per 1 mmol reduction) and chronic obstructive pulmonary disease (65% risk increase after 36 months). ConclusionsIn our large, single-center real-world analysis, we identified the patients with the highest risk of death who could probably benefit the most from the most intensive therapy, and hence should be considered to be an ‘extreme risk’ population.

Considerations for Home-Based Treatment of Fabry Disease in Poland during the COVID-19 Pandemic and Beyond.

Current therapy for Anderson–Fabry disease in Poland includes hospital or clinic-based intravenous enzyme replacement therapy with recombinant agalsidase alpha or beta, or oral pharmacological chaperone therapy with migalastat. Some countries around the world offer such treatment to patients in the comfort of their own homes. The 2020–2021 COVID-19 pandemic has pushed global healthcare providers to evolve their services so as to minimize the risk of COVID-19 exposure to both patients and providers; this has led to advances in telemedicine services and the increasing availability of at-home treatment for various procedures including parenteral drug administration. A total of 80% of surveyed Anderson–Fabry disease patients in Poland would prefer home-based treatment, which would be a safe and convenient alternative to clinic-based treatment if patient selection is based on our proposed algorithm. Our recommendations for home-based treatments appear feasible for the long term care of Anderson–Fabry disease patients during the COVID-19 pandemic and beyond. This may also serve as a basis for home-based treatment programs in other rare and ultra-rare genetic diseases.

First two years of reimbursed enzyme replacement therapy in the treatment of Fabry's disease in Poland

First two years of reimbursed enzyme replacement therapy in the treatment of Fabry's disease in Poland

Epidemiology of hypertensive heart disease in Poland: findings from the Global Burden of Disease Study 2016.

IntroductionHypertension may cause target organ damage leading to hypertensive heart disease (HHD). The burden caused by HHD in Poland has not been studied systematically. The purpose of this study was to describe the burden of HHD in Poland in terms of prevalence, mortality, disability-adjusted life years lost (DALY) and key risk factors.Material and methodsData were obtained from the Global Burden of Diseases, Injuries and Risk Factors (GBD) Study database. The GBD uses a wide range of data sources and complex statistical methods to estimate disease burden for all countries by age, sex, and year. HHD was defined by ICD-9 codes 402-402.91 and ICD-10 codes I11-I11.9. From the GBD 2016 estimates, we extracted data for Poland between 1990 and 2016.ResultsHypertensive heart disease is the fourth most important cause of cardio- and cerebrovascular death, after ischemic heart disease, stroke and cardiomyopathy. In 2016, there were about 180 000 people diagnosed with HHD in Poland and close to 5000 HHD-related deaths. HHD prevalence increased from 0.29% in 1990 to 0.47% in 2016 and was higher in women, while mortality increased from 11.2 to 12.7 per 100 000, largely due to population aging. Age-standardized death and DALY rates declined between 1990 and 2016 and were lower than in Central Europe but higher than in Western Europe.ConclusionsOur data suggest a need for national initiatives to improve the diagnosis and treatment of hypertension, slow the progression of HHD, and reduce the related risks and premature deaths.

Adult-onset Still's disease in Poland - anationwide population-based study.

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology, which affects young adults and is associated with multiple organ involvement and life-threatening complications. The aim of the study was to establish the incidence and prevalence of AOSD in Poland, and factors related to this disease among hospitalized patients. A retrospective, population-based study was conducted, using data from hospital discharge records compiled by the National Institute of Public Health in 2009-2018. Based on hospitalization records and census data in a group of the 1,050 patients included in the study, women were predominant (60%) and patients' mean and median ages at hospitalization were 42 (95% CI: 40.8-42.8) and 38 years, respectively. The average annual incidence rate of AOSD during the 10-year period was established at the level of 0.32/100,000 (95% CI: 0.30-0.34), and the point prevalence at the end of 2018 was 2.7/100,000. The most common comorbidities were: cardiovascular diseases (14%), diseases of the musculoskeletal system and connective tissue (14%), endocrine, nutritional and metabolic diseases (9%). AOSD is a rare disease Poland with gender and territorial differences in incidence ratek, and predominance of cardiovascular diseases among comorbidities. The presented data may be useful for comparisons of the Polish population with other geographical regions. Predominance of patients from urban regions and predominance of women may suggest environmental and personal factors in AOSD development; however, further research seems to be necessary.

Aseptic meningitis in children: seasonal variation and diagnostic problems as reflected in the authors’ experiences from 2017–2018

Meningitis is the most common infectious disease of the central nervous system both in children and in adults. The incidence of the disease in Poland, similar to Western Europe, is 6–8 cases per 100,000/year, with the highest figure for children up to 4 years of age. Aim of the study: The aim of the study was to make a detailed analysis of aseptic meningitis cases in children, with a focus on aetiology and course of the disease, and laboratory results. Materials and methods: A retrospective analysis was performed on a group of 59 children aged between 2.5 months and 17 years in whom aseptic meningitis was diagnosed based on clinical evaluation. Results: Between May and October 2018, 44 children aged 7.99 ± 3.93 were hospitalised with the diagnosis of nonpyogenic (aseptic) meningitis. In 9 patients (20.5%), enteroviral neurological infection was found, and in 8 (18.2%) Borrelia burgdorferi, in 5 (11.3%) EBV and in 2 (4.5%) HHV-7 neurological infection was diagnosed. For 20 children (45.5%), the cause of infection could not be established. The longest hospitalisation time was associated with Lyme neuroborreliosis. In the same months of 2017, 15 patients were hospitalised at our department with aseptic meningitis. The numbers of cases for different causes were: undetermined – 9 patients (60%), enteroviral – 2 (13%), EBV – 2 (13%), Parvovirus B19 – 1 patient (7%) and VZV – 1 patient (7%). Conclusions: In 2018, a threefold increase was observed in the number of hospitalisations associated with aseptic meningitis in relation to the same period of 2017, with a lasting predominance of boys. Most frequently, the aetiology was undetermined. Among the cases in which the cause was established, the most common aetiology was enteroviral. In 2018, unlike in 2017, cases of hospitalisation for neuroborreliosis were recorded. Incomplete utilisation of the polymerase chain reaction method was considered to be one of the causes of insufficient identification of neurotropic pathogens. A general examination of the cerebrospinal fluid did not differentiate between causes of aseptic meningitis.

Analysis of the structure of medical reports concerning hearing loss due to exposure to noise as an occupational disease in Poland in the years 2017-2018

Introduction and purpose. Hearing impairment caused by noise is defined as a symmetrical, slowly progressing, permanent, receiving loss of hearing, of cochlear or sensoneurinal type, which concerns especially high frequencies. Hearing loss develops within the space of many years of exposure to high levels of noise which causes it to be an occupational disease of those who work in such conditions for a long period of time. The aim of this work was to analyse the structure of medical reports concerning hearing loss as an occupational disease in Poland in the years 2017-2018.Material and method. An analysis concerned cases of diagnosis of hearing loss diagnosed as an occupational disease based on Centralny Rejestr Chorób Zawodowych Instytutu Medycyny Pracy.Results. The occurrence of cases of hearing loss due to occupational factors decreased in 2017 and 2018 compared to 2016. Almost all cases of hearing loss as an occupational disease concerned male workers. This problem is almost non-existent among female workers. Hearing loss was the most prevalent among workers at pre-retirement age and those who worked more than 20 years in exposure to noise. Compared to other occupational diseases, hearing loss is not common in Poland.Conclusions. A decrease in cases of hearing loss as an occupational disease suggests that a system of periodic examination which is 1 examination each year during first 3 years of employment with medical appointment and a reminder of hearing protection works very well. Actions taken by all services (doctors, nurses, Occupational Health and Safety inspectors and employers) responsible for the protection of a worker cause a proper downward trend of diagnoses of hearing loss as an occupational disease among employees in Poland.

Premature Mortality Due to Chronic Obstructive Pulmonary Disease (COPD) in Poland.

Background and objectives: Chronic obstructive pulmonary disease (COPD) is responsible for 5.3% of deaths worldwide and constitutes the third most common cause of death. The deaths from this cause occur over 10times more often in smokers than in non-smokers. Fortunately, for nearly 30 years, the proportion of people smoking tobacco in Poland has been decreasing. This study aims to analyse the change in premature mortality rates of men and women due to COPD in Poland during 2008–2017. Materials and Methods: The time trends of deaths occurring under 65 were analysed. Standardised premature mortality rates were used, as well as the mortality rates for the five-year age ranges, with a breakdown by gender. The Joinpoint model was used to determine time trends. Results: Over the period analysed, premature mortality in the female population decreased by 2.6% from year to year, albeit without statistical significance, and in the male population there was a decrease by statistically significant 5.2% per year. The biggest drop in mortality, almost 10% per year, was observed in the group of females aged between 50 and 54. Among males, the most significant reduction in mortality was observed in groups between the ages of 40 and 54, and it amounted to approximately 8% annually. With increasing age, the dynamics of mortality reduction decreased. Conclusions: The study showed a steady downward trend in premature mortality due to chronic obstructive pulmonary disease in Poland in both genders. The reduction in mortality was at a high level, despite the lower mortality due to this cause than in other European countries.

What Are the Costs of Diagnostics and Treatment of Lyme Borreliosis in Poland?

Lyme borreliosis (LB) is a growing epidemiological threat in many areas of the world, including North America and Europe. Due to the lack of effective protection against this disease, it seems important to ensure a timely diagnosis for effective treatment and the prevention of serious health consequences. The aim of this study was to assess the costs of diagnosis and treatment of Lyme disease in Poland. The costs incurred for the medical payer were analyzed. The cost of hospitalization due to LB for one patient in 2018 was estimated to be ~582.39 EUR, which constituted 53.10% of the average monthly salary of that year. In the analyzed period (2008–2018), the number of people treated by medical services due to Lyme disease increased, both in hospitalization and ambulatory specialist care. Although, the costs of hospitalization were the highest of the two, we noticed a change ratio between hospitalization and ambulatory specialist care in favor of the latter.

Lyme disease in Poland in 2018.

Lyme disease is the most common tick-borne disease, caused by spirochetes of the genus Borrelia, transmitted by ticks of the Ixodes genus. According to ECDC, Poland should be considered as an endemic area. The risk of Lyme disease incidence in-creases with tick habitats increase, which is a response to environmental factors and climate change. The aim of the study is to assess the epidemiological situation of Lyme disease in Poland in 2018 compared to the situation in previous years. The epidemiological situation of Lyme disease in Poland was assessed on the basis of the data sent to NIPH-NIH by voivodeship sanitary-epidemiological stations and published in the bulletin 'Infectious diseases and poisoning in Poland in 2018' . In 2018; 20,150 Lyme disease cases was registered, 2,124 people were hospitalized. You can also see an increase in cases in the second and third quarter in favor of the fourth quarter. The epidemiological situation in Western European countries is similar to the situation in Poland. The inability to determine the clear trend of the epidemiological situation in Poland indicates the sensitivity of the surveillance system, but also the difficulty in new cases diagnosis. You can also see a decrease in the number of cases, which may be a sign of having the right tools or experience in the Lyme disease diagnosis.

First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Miśkiewicz-Migoń I, Miśkiewicz-Bujna J, Mielcarek-Siedziuk M, FrÄ czkiewicz J, Gorczyńska E, Kałwak K. First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland. Pediatria Polska - Polish Journal of Paediatrics. 2021;96(1):68-70. doi:10.5114/polp.2021.104831. APA Miśkiewicz-Migoń, I., Miśkiewicz-Bujna, J., Mielcarek-Siedziuk, M., FrÄ czkiewicz, J., Gorczyńska, E., & Kałwak, K. (2021). First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland. Pediatria Polska - Polish Journal of Paediatrics, 96(1), 68-70. https://doi.org/10.5114/polp.2021.104831 Chicago Miśkiewicz-Migoń, Izabella, Justyna Miśkiewicz-Bujna, Monika Mielcarek-Siedziuk, Jowita FrÄ czkiewicz, Ewa Gorczyńska, and Krzysztof Kałwak. 2021. "First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland". Pediatria Polska - Polish Journal of Paediatrics 96 (1): 68-70. doi:10.5114/polp.2021.104831. Harvard Miśkiewicz-Migoń, I., Miśkiewicz-Bujna, J., Mielcarek-Siedziuk, M., FrÄ czkiewicz, J., Gorczyńska, E., and Kałwak, K. (2021). First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland. Pediatria Polska - Polish Journal of Paediatrics, 96(1), pp.68-70. https://doi.org/10.5114/polp.2021.104831 MLA Miśkiewicz-Migoń, Izabella et al. "First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland." Pediatria Polska - Polish Journal of Paediatrics, vol. 96, no. 1, 2021, pp. 68-70. doi:10.5114/polp.2021.104831. Vancouver Miśkiewicz-Migoń I, Miśkiewicz-Bujna J, Mielcarek-Siedziuk M, FrÄ czkiewicz J, Gorczyńska E, Kałwak K. First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland. Pediatria Polska - Polish Journal of Paediatrics. 2021;96(1):68-70. doi:10.5114/polp.2021.104831.