Warsaw District Research Articles

248 Sids Prevention in Poland – Is It Efficient? The Evaluation of Sids Risk Factors Appearance in Warsaw District

Background: Sudden Infant Death Syndrome (SIDS) is sudden, inexplicable death of an infant or young child, which causes are unknown. It is also one of the most common causes of infant deaths in the postneonatal period. The risk factors SIDS include prone sleep position, parental smoking, co-sleeping and overheating are currently well – known. A great world-wide campaign have been undertaken to improve parent's knowledge and to decrease the appearance of the risk factors and SIDS. The aim of our study was to determine if the information movement has been effective enough among the population of Warsaw district.Methods: We compared the appearance of four uncontroversial risk factors (prone sleep position, parental smoking, co-sleeping and overheating) in populations of parents in 1998/99 and 2002/03. A random selection of 202 parents of infants born between 06.1998 and 05.1999 and 207 parents of infants born between 06.2002 and 05, 2003 in the Obstetric Department of the Central Teaching Hospital MSWiA in Warsaw were examined. Both groups of parents were twice interviewed with a questionnaire – just after their child birth and six months later (120 parents answered the second questionnaire in 1998/99 and 136 in 2002/03).Results: The number of mothers who smoked during the pregnancy and the first six months of child life rose up from 9,7% in 1998 to 28,1 in 2002, the total number of infants exposed to one or more adults smoking in the home increased from 50,2% in 1998 to 65,2 in 2002. Placing the children on their backs to sleep was more common in the group of parents examined in 2002 (27,5% vs 8,5%), while less of them are eager to define children's sleeping position as “changeable” (15,75% vs 53,5% in 1998). In 1998 81% of infants regularly co-slept with their parents, and in 2002 – 75%. The temperature >200C was in 64% infant's room in 1998 vs. 50% in 2002.Conclusion: In some areas the campaign has achieved a success (prone sleep position was reduced). Co-sleeping and overheating are similar in both studied groups. Smoking remains a significant health issue with an impact on SIDS, and in 5 years period its appearance increased. Our data suggest that parents have got an unsatisfied knowledge about some risk factors of SIDS. Great efforts are needed to promote to reduce the risk factors among parents and pediatricians. Especially we should endorse non-smoking behavior.

Transient ischaemic attacks: desired diagnosis and management by Polish primary care physicians.

The aim of this study was to assess the competence of Polish primary care physicians in diagnosing and managing patients with transient ischaemic attacks (TIAs) in the carotid territory. A written questionnaire was distributed to all first-contact physicians (n = 100) in one of the seven health care districts of Warsaw (response rate 89%). The questionnaire included three pairs of TIA cases. In each of the pairs, only the age and type varied. Three cases were characterized by transient monocular blindness and the other three by symptoms of hemispheral ischaemia. Physicians confronted with TIA cases had difficulties in diagnosing it. In the cases of monocular blindness, only 20-44% of cases were diagnosed correctly, and hemispheral ischaemia was diagnosed correctly in 46-78% of cases. Patients with no history of non-specific symptoms and with the first attack would have a higher percentage of correct diagnoses in comparison with those with recurrent attacks and a history of non-specific symptoms. Patients with hemispheral ischaemia frequently would be referred to neurologists, and about two-thirds of doctors would refer patients with monocular blindness to ophthalmologists, and fewer than half to neurologists. Antiplatelet therapy would be prescribed by <22% of physicians, while peripheral vasodilatators would be prescribed by up to 60% of them. The results of this study indicate that Polish primary care physicians when confronted with TIA cases would have basic difficulties, especially in diagnosis and management. These results underline the need for changes in the vocational training of primary care physicians, with special attention to frequent family medicine problems.

The new map department in the National Library of Poland and the first steps to the automation of cataloguing its collections

In 1961, when the Krasinski Palace (the Palace of the Republic) was rebuilt, it was given to the National Library's use. All the departments of the Division of Special Collections were placed in the Palace, including the map department. In 1963 the government made a decision to construct a new building for the National Library of Poland. In the beginning it was planned to move all the collections from the buildings, which they had occupied before, placed in three different districts of Warsaw (including the Division of Special Collections) to the new National Library's building. Its construction started in 1977. But during the works on the site and the move of the collections of books and periodicals dating from the 19th and 20th centuries, it became obvious that those departments, and in particular, their collections, took up too much space, and there was no room for them all. So new plans of enlarging the new building of the National Library were made, but the economic crisis which we are now going through in our country has postponed its development until the distant future. Until now, there is still a remaining part of the Division of Special Collections in the Krasinski Palace, the departments which preserve collections of manuscripts, early printed books, graphics and drawings. Special grand exhibitions are also held in the beautiful baroque rooms there.

Evaluation of hepatitis C surveillance in Poland in 1998.

The aim was to evaluate hepatitis C surveillance in Poland during 1998. Hepatitis C reports were obtained from epidemiology offices. Public health staff were interviewed to collect information on surveillance operations. To estimate the proportion of acute cases among the total reported, a study was conducted in the Warsaw district to validate case reports. A total of 1661 (97.2%) hepatitis C cases were studied. Hepatitis C surveillance was timely and acceptable to the user, but did not provide a number of information elements required to differentiate acute from chronic cases of infection. Of the 268 case reports available in the Warsaw district, only 15 (5.6%) met the acute hepatitis C case definition. It is concluded that hepatitis C surveillance in Poland cannot provide useful incidence estimates and information regarding risk factors for acute infection. A strict case definition and a modified case form with specific questions for HCV transmission routes should be applied.

High case-fatality rates in the Warsaw stroke registry

We studied 1-year survival in 297 patients with first-even-in-lifetime ischemic stroke (FEL-IS) selected from a population-based study of stroke in the Mokotow district of Warsaw. Case fatality rates were 29% at 30 days and 51% at 1 year. These case fatality rates are significantly higher than in other industrialized countries. Early deaths were primarily caused by neurological sequelae of stroke or complications of immobility, whereas late deaths (>30 days) were primarily caused by stroke recurrence or complications of immobility. Predictors of survival were analyzed by life table methods. Adverse predictors of 1-year survival included greater age, low activities of daily living scores, atrial fibrillation, greater weakness, congestive heart failure, and untreated hypertension. Patients with stroke recurrence were more likely to die in the first year. We hypothesize that stroke severity contributes to high case-fatality rates by increasing death caused by both direct neurological sequelae and complications of immobility. Medical comorbidity probably contributes to high case-fatality rates in Poland by increasing stroke recurrence rates and by increasing deaths caused by immobility. We hypothesize that high case-fatality rates in Poland could be reduced by improved rehabilitation of stroke patients to avoid deaths caused by immobility and by better control of medical comorbidity in stroke patients.

Stroke Mortality Rates in Poland Did Not Decline Between 1984 and 1992

Stroke mortality has decreased in most industrialized countries in recent decades. In Poland, as in other eastern European countries, mortality rates for stroke remain high. The Warsaw Stroke Registry (WSR) registered patients in the Mokotów district of Warsaw from 1991 through 1992. The Warsaw Pol-MONICA study registered stroke patients in the North and South Praga regions of Warsaw from 1984 through 1992. Stroke incidence rates, case-fatality rates, and stroke mortality rates were computed based on both studies and compared with published mortality rates based on death certificates. Eight-year trends of stroke incidence, case-fatality rate, and mortality were derived from the Warsaw Pol-MONICA study. The WSR and Warsaw Pol-MONICA studies showed similar incidence rates, mortality rates, and 28-day case-fatality rates for stroke. Mortality rates from the WSR and the Warsaw Pol-MONICA study were similar to rates from death certificate data. Mortality rates in the group aged 35 to 64 years were higher in men (47.5 to 50/100000 per year) than in women (30/100000 per year). Two different population-based studies suggest that stroke mortality is high in Poland because of high 28-day case-fatality rates. Stroke mortality failed to decline in Poland in the period 1984 through 1992 because neither case fatality nor stroke incidence declined in this period.

Trends in myocardial infarction incidence and fatality in Warsaw Pol-MONICA population from 1984 to 1988

Myocardial infarction attack rates and case fatality were analyzed between 1984–1988 in a population aged 25–64 inhabiting two districts of Warsaw and consisting of 133,000 men and 149,000 women. WHO MONICA methodology and diagnostic criteria were used. Within a 5-year period 3,595 men and 1,453 women were registered with AMI diagnosis (all MONICA diagnostic categories). Standardized myocardial infarction attack rates changed from 466 to 606/ 100,000 in men and from 178 to 267/100,000 in women respectively. The 5-year linear trends of attack rates were significant in all men aged 25–64 years (increase by 30%) and in men aged 25–34 and 55–64 years. In women these trends were not significant in all women as well as in particular 10-year age groups. Thirty percent of registered men and 20% of women died out of hospital. Total case fatality within 28 days since onset was equal to 43% in men and to 33% in women, showing no changes in men and decreasing slightly in women during the analyzed period. This, and comparable study conducted in 1971 in the Warsaw population, showed an almost 2-fold increase in the incidence of myocardial infarction. It is concluded that the increase in the incidence of AMI without a decrease in the fatality rate contributes substantially to the observed increase in premature ischemic heart disease mortality in the Warsaw population, especially in men.

Monitoring environmental pollution in Poland by chemical analysis of Scots pine ( Pinus sylvestris L.) needles

Maps of the distribution of environmental pollution by sulfur (S), zinc (Zn), cadmium (Cd), lead (Pb), copper (Cu), and arsenic (As) for the territory of Poland and the Warsaw (Warszawa) district were developed on the basis of chemical analysis of Scots pine ( Pinus sylvestris L.) needles collected from randomly selected sampling points during 1983–1985. The maps show deposition zones for the studied elements and can help in identification of sources and directions of air pollution dispersion. This study indicated that vegetation in Poland is greatly endangered by sulfur dioxide (SO 2) and other sulfurous air pollutants, whereas Zn, Cd, Pb, and As do not pose an immediate threat to vegetation in most of the country's territory. However, in the urban-industrial agglomeration of Katowice-Cracow, very high pollution with Z, Cd, Pb and As could limit growth and development of some sensitive plant species. Higher than normal levels of As in some areas of Poland (Upper Silesia, Glogow-Lubin Copper Region, and areas close to the Russian border near Braniewo) might affect the health of humans and animals. Results of this study indicated that Poland's environment was not contaminated with Cu.

Analysis of 30-day stroke mortality in a community-based registry in Warsaw, Poland

Between January 1, 1991, and December 31, 1992, in the upper Mokotow district of Warsaw, Poland (population 182,285), 462 first-ever-in-a-lifetime (FEL) strokes were registered, 12% (55/462) with parenchymatous intracerebral hemorrhages (PICH) and 88% (407/462) with ischemic strokes. Confirmation by either computed tomography or autopsy was made in 72.3% of cases. The overall 30-day case fatality rate (CFR) for FEL strokes was 40% (186/462), 60% for PICH (33/55), and 38% for ischemic stroke (153/407). Of the 186 patients who died within 30 days of their FEL stroke, 49% (91) underwent full autopsy examination. Fifty-two percent of these 91 patients were found to have died from direct neurological sequelae, 21% from cardiac causes, 17% from pneumonia, 5.6% from septicemia, 2.2% from pulmonary emboli, and 2.2% from metastatic cancer. Despite our high 30-day stroke CFR compared with Western Europe and North America, mechanisms of death were similar.

Mortality, morbidity and case fatality from myocardial infarction and the cardiovascular risk profile in the Warsaw population.

The present study, based on the World Health Organization (WHO) MONICA Project design, covers two Warsaw districts inhabited by 274442 people, aged 25-64. In the studied population over the years 1976-1985, no significant time-trends were found of cardiovascular disease (CVD), ischemic heart disease (IHD), myocardial infarction (MI) and cerebrovascular mortality, whereas the hypertension mortality trends increased significantly. The MI attack rate in 1984/85 in men aged 25-64 was 466/100,000 and that of women 173/100,000. Within the last 14-15 years the age-standardized MI attack rates increased by 35% in men aged 35-64 and by 65% in women. The 28-day case fatality was 40% in men and 35% in women. Fatality was highest the first day after the onset of symptoms, and only 66% of men and 72% of women survived the first 3 days after onset. No significant differences in age-standardized mean values of plasma total cholesterol, low-density lipoprotein (LDL)-cholesterol and systolic blood pressure (BP) were found between men and women. Mean values of high-density lipoprotein-cholesterol (HDL) and of the Quatelet index were higher in the female population, whereas the triglyceride level, diastolic BP, and the number of cigarettes smoked daily were higher in the male population. In men, the plasma total cholesterol, LDL-cholesterol and HDL-cholesterol values did not change with age, but the tryglyceride values decreased; in women, the plasma total cholesterol, LDL-cholesterol and triglyceride values increased with age. Mean values of systolic and diastolic BP increased with age in both sexes, whereas the number of cigarettes smoked daily decreased.

The Undefined Town within a Town. A History of Jewish Settlement in the Western Districts of Warsaw

The Undefined Town within a Town. A History of Jewish Settlement in the Western Districts of Warsaw

The Warsaw district heating system

In Warsaw, Poland, the capacity of the heat-generating power plants in 1982 was 4352 MW and the length of the network was 1187 km. This paper describes the development of this district heating system over the last 30 years. Figures show cross-sections of main ducts and tunnels. La capacité des usines de chauffage de Varsovie était en 1982 de 4352 MW, la longueur de réseau de chauffage était de 1187 km. Le document décrit le développement du système pendat les trente dernière années. Les figures montrent les profils en travers des principaux conduits et des tunnels.

Nieprzystosowanie społeczne i środowiska rodzinne młodzieży systematycznie nadużywającej alkoholu

Nieprzystosowanie społeczne i środowiska rodzinne młodzieży systematycznie nadużywającej alkoholu

Rodziny wieloproblemowe – charakterystyka 222 rodzin z dzielnicy Praga-Północ

Rodziny wieloproblemowe – charakterystyka 222 rodzin z dzielnicy Praga-Północ

Dalsze losy nieletnich i młodocianych sprawców przestępstw

Three follow-up studies were published, dealing with juvenile delinquents and young adult offenders, based on a random sample and material on: ‒ 100 boys charged with larcency, who during the period of the investigation in 1966 were barely 10-11 years old. This research concentrated in turn on all the 10-11 year-old boys charged with larcency and brought before a Juvenile Court in Warsaw; the follow-up period embraced 5 years; ‒ 358 former juveniles (10-16 years old) charged with theft in three districts of Warsaw and brought before a Juvenile Court in 1961-1962, whose further fate was investigated during the period when they were 17-20 years old and from among the same 243 former juveniles 13-16 years old, who in 1972 were already 24-27 years old; ‒ 17-20 year-old young adults released from 40 prisons throughout the country, after having served their sentences for various offences and whose subsequent recidivism was established during the course of 10 years from their release from prison in 1961. Two works, discussing the further recidivism of the juvenile delinquents, convicted for larcency obviously differ markedly regarding the age and follow-up period. The first work deals with the investigated up to the age of 15-16 only, the second also embraces the time when the former juveniles are already approximately 26 years old. However, both works unanimously emphasize the fundamental significance of early initiation of social maladjustment and demoralization for the prognosing of the rapidity and extent of recidivism. They stress the necessity to make use in practice as the only criterion for recidivism of juveniles, each new charge brought before a court and the number of times theft has been committed, being the subject of a given trial. Simultaneously these works reveal unanimously, that the majority of the juvenile delinquents charged with larcency, are brought up in families, which are unable to guarantee them the proper conditions for normal development and that in these families also many brothers of the juvenile delinquents charged with larcency revealed symptoms of social maladjustment and committed offences. The results of the studies under discussion also are unanimous as to the fact that with the majority of the juveniles could be found personality disorders. The material under discussion deserves special attention as regards the juvenile delinquents of the younger age groups. It is of great significance that many of the investigated 10‒11-year-olds charged with larcency committed theft already before. Long years of research, conducted by the Department of Criminology, Institute of Legal Sciences, Polish Academy of Sciences, testify to the fact that the majority of the juvenile delinquents charged with larcency and brought before Juvenile Courts are boys who already previously committed larcency more than once. Disturbance of the socialization process with these juveniles, usually reaches back to their early childhood, requires early discovery and interference at the earliest possible time in the form of surrounding the parents, brothers and sisters of the juvenile delinquent with care and also of controlling them. The results yielded by follow-up studies of the recidivism during a period of 10 years of the 17-20 year-old young adult offenders, released from prison in 1961, concentrate on young people whose recidivism is undoubtedly connected with serious social maladjustment already during their juvenility. Obviously one cannot identify these young adults released from prison with all the 17‒20-year-old young adults convicted by courts who received various sentences. The results of the follow-up studies of the young adult prisoners should contribute to the initiation of systematic, individual research regarding young adults convicted and receiving various prison terms and to the change of certain guiding lines of the penal and penitentiary policy in regard to young adult offenders.