Patients In Poland Research Articles

Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland - a cross-country experience.

In the majority of Western European countries, the coronavirus disease (COVID-19) pandemic has led to a dramatic reduction in urooncological surgeries. Our objective was to evaluate the impact of the pandemic on volume and patterns of urooncological surgery in Poland. This is a retrospective analysis of 10 urologic centres in Poland. Data regarding major oncological procedures performed after the COVID-19 pandemic outbreak (March 15, 2020 - May 31, 2020) were evaluated and compared with data from the respective period in 2019. Between March 15, 2020 and May 31, 2020, a total of 968 oncological procedures were performed in participating centres. When compared to the respective period in 2019 (1063 procedures) the overall number of surgeries declined by 8.9%. The reduction was observed for transurethral resection of bladder tumour (TURBT) (20.1%) and partial nephrectomies (PN) (16.5%). Surgical activity considering radical nephrectomy (RN), nephroureterectomy (NU), and radical prostatectomy (RP) remained relatively unchanged, whereas radical cystectomy (RC) burden showed a significant increase (90.9%). Characteristics of patients treated with TURBT, RC, NU, PN, and RN did not differ significantly between the compared periods, whereas RP in the COVID-19 period was performed more frequently in patients with a higher grade group (p = 0.028) and positive digital rectal examination (p = 0.007). Surgical activity for urological cancers in Poland has been maintained during the first wave of the COVID-19 pandemic. The Polish strategy in the initial period of the COVID-19 crisis mirrors the scenario of hard initial lockdown followed by adaptive lockdown, during which oncological care remained undisrupted and did not require particular priority triage.

Acquired immune deficiency syndrome (AIDS) and late presentation in Poland - data from Test and Keep in Care (TAK) Polska project.

Late presentation (LP) at HIV diagnosis is associated with worse prognosis and an increase in the number of new infections. We analyse the proportion of patients diagnosed late and factors related to LP in Poland in 2016-2017. Data were obtained from 13 out of 17 HIV centres in Poland from 2016 and 2017, including date of diagnosis, age, sex, transmission route, anti-hepatitis C virus (anti-HCV), Venereal Diseases Research Laboratory (VDRL) antibodies, AIDS diagnosis, baseline HIV viral load and CD4 count. Out of 1522 patients, 88.9% were male with median age of 33.6years. Men who have sex with men (MSM) comprised 69.4% of all new infections, heterosexual route of transmission (HTX) 18.2% and injecting drug use (IDU) 4.7%. Late presenters comprised 44.8% of the study group. Factors associated with LP were female sex [odds ratio (OR) = 1.5, 95% confidence interval (95% CI): 1.09-2.08], older age (OR = 1.59, 95% CI: 1.42-1.79 per decade), route of transmission (HTX: OR = 1.96, 95% CI: 1.50-2.56; IDU: OR = 3.17, 95% CI: 1.92-5.37), positive HCV results (OR = 1.90, 95% CI: 1.23-2.95) and syphilis diagnosis (OR = 2.06, 95% CI: 2.29-3.31). Adjusting for these factors, the only independent factors associated with LP were age (OR = 1.52, 95% CI: 1.35-1.71) and route of transmission (HTX: OR = 1.73, 95% CI: 1.23-2.44; IDU: OR = 2.24, 95% CI: 1.25-4.10). Late presentation in Poland follows European trends. A total of 44.8% of all newly diagnosed patients in Poland continue to present late or at the AIDS stage. Independent factors associated with LP/AIDS were older age, IDU and HTX. Patients from these groups should be targeted to improve early diagnosis and medical care.

Assessment of Long-Term Treatment Results in Women Suffering from Anorexia Nervosa in Adolescence.

Reports assessing long-term treatment outcomes for anorexia nervosa (AN) are divergent and refer to different populations. They lack long-term observations in AN patients in Poland. Analysis of the recovery, relapse rate, and predictive factors in patients treated due to AN in adolescence. A total of 201 subjects were given a survey. Ninety-seven women were recruited: 56 reported to the clinic and 41 filled in the survey. The average period from hospitalization to the survey was 7.76 ±4.39 years. Remission was found in 78.4%, 21.6% still pre-sented AN, and 84.2% required a one-off hospitalisation, 10.5% twice. The average BMI was: 20.08 ±3.24 kg/m 2 . The rate of attempted suicides was 6.2%. Predictive factors for poor outcome were as follows: older age of the patient when falling ill, lower SDS-BMI score at the onset of AN, transition from the restrictive type of AN into a binge-eating/purging type, and fail-ure to maintain contact with the mother. 1. Most girls suffering from the restricting type of AN in adolescence are cured permanently. 2. The severity of symptoms in these girls does not eliminate the chance of recovery and achieving important life goals, com-pleting education, finding a life partner, and having children. 3. Girls with a smaller degree of cachexia at onset of AN, with no binge-eating/purging symptoms, maintaining regular con-tact with their mothers, have a better prognosis for recovery. 4. Six per cent of women treated in their youth for AN face the risk of attempted suicide, which points to the need to monitor their mental state for many years.

Determinants of purchasing decisions of innovative aesthetic medicine services in Poland

The market of innovative aesthetic medicine services has been in recent years, one of the broadest segments of the medical services. Therefore, we state that the identification of the choice determinants of aesthetic medicine services is a promising yet still under-researched area of study. In this article, we present the results of an empirical study on the determinants of the purchase of innovative aesthetic medicine services in major cities in Poland. Our respondents included patients of aesthetic medicine clinics, whose sample was selected in a purposive sampling (N = 745). To analyse data, the factor analysis was performed that helped to identify key determinants of the purchase of aesthetic medicine services by patients in Poland. The key determinants of the selection and purchase of aesthetic medicine services include, the reputation of the clinic, the competence and skills of a specialist, providing comprehensive care, and the infrastructure of the clinic.

Awareness of breast cancer patients in Poland about clinical trials as available treatment options.

Breast cancer is the most common cancer in women in Poland and worldwide. Due to growing morbidity and mortality, patients are looking for new therapeutic options. Clinical trials give cancer patients a chance to access innovative treatment often not available in the national healthcare system. Patient awareness of clinical trials is an essential element for the development of the clinical trials market. The purpose of this survey was to obtain information from breast cancer patients about their knowledge of clinical trials. One hundred people were invited to take part in the study, and were recruited into two groups: 50 patients diagnosed with breast cancer less than 40 years of age, and 50 patients with the same disease over 40 years of age. The survey was completed by female patients online. Most of the subjects correctly understood the assumptions of the clinical trial; most often, both groups of subjects obtained information about medical experiments from the Internet. According to the respondents, the most important motivating factor to participate in the clinical trial was the proposed study drug and their current state of health. Patients would more frequently decide to participate in a clinical trial at the time of cancer progression compared to immediately after diagnosis. Commuting to the research center made recruitment of older patients more difficult (40% of older patients versus 16% of younger patients, p = 0.008). Patients with breast cancer are aware of clinical trials and decide to participate in them based on the proposed study drug and their current state of health. Progression of the disease is a factor that increases the willingness to participate in clinical trials.

Chronic total occlusion percutaneous coronary intervention in everyday clinical practice - an expert opinion of the Association of Cardiovascular Interventions of the Polish Cardiac Society.

Coronary chronic total occlusions (CTO) are increasingly encountered during invasive and non-invasive coronary angiography and remain the most challenging lesions for percutaneous revascularization. During recent years success rates and safety outcomes of CTO percutaneous coronary intervention (PCI) have substantially improved, particularly due to the introduction of new techniques and dedicated equipment as well as specialized training programs of CTO operators. Significantly, the steady advances in CTO PCI techniques have coincided with the new data from randomized clinical trials supporting the role of percutaneous recanalization of CTO in relieving angina and improving the quality of life. The current expert consensus document outlines the rationale, clinical outcomes as well as technical, safety and reimbursement issues of CTO PCI. In addition, the requirements for achieving and maintaining competency in CTO PCI among interventional cardiologists are discussed. Finally, we present the modified hybrid algorithm (the so-called Polish hybrid algorithm) providing some unique refinements to the contemporary CTO PCI strategies. Continuous efforts (including active engagement with the payer) are urgently needed to increase guideline-recommended referrals to CTO PCI, and thus improve the quality of life of CTO patients in Poland.

Determinants of purchasing decisions of innovative aesthetic medicine services in Poland

The market of innovative aesthetic medicine services has been in recent years, one of the broadest segments of the medical services. Therefore, we state that the identification of the choice determinants of aesthetic medicine services is a promising yet still under-researched area of study. In this article, we present the results of an empirical study on the determinants of the purchase of innovative aesthetic medicine services in major cities in Poland. Our respondents included patients of aesthetic medicine clinics, whose sample was selected in a purposive sampling (N = 745). To analyse data, the factor analysis was performed that helped to identify key determinants of the purchase of aesthetic medicine services by patients in Poland. The key determinants of the selection and purchase of aesthetic medicine services include, the reputation of the clinic, the competence and skills of a specialist, providing comprehensive care, and the infrastructure of the clinic.

EPS2.07 How did the COVID-19 lockdown influence the nutritional status and body composition of cystic fibrosis patients in Poland?

Background: The global COVID-19 pandemic has changed daily life, due to restrictions affecting day-to-day functioning. The strict lockdown changed habits of cystic fibrosis (CF) patients as well. The aim of our study was to evaluate the impact of the one-month strict spring lockdown in Poland on the nutritional status and body composition of CF paediatric patients. Methods: All CF patients between 8 and 18 years old who had both in- and outpatient visits with completed data at the Cystic Fibrosis Centre in Warsaw were included in the study. BMI z-scores (CDC calculator), as well as the fat free mass index (FFMI) and the fat mass index (FMI) were calculated according to the following formulas: FFMI = FFM/height2, FMI = FM/height2. The strict lockdown (SL) in Poland was between 16.03.20 and 20.04.20. The measures were evaluated on average: 3 months before SL (M1);3 months after SL (M2), and 3 months after M2 (M3). Results: 101 CF subjects (51% female), with a mean age of 11.53 ± 3.29 years were assessed. 48% of them were heterozygotes F508del and 80% had pancreatic insufficiency. The highest significant increase in values of BMI z-score and FMI was observed after SL (M2) with decrease in M3 (F = 7.18;p = 0.001;F = 4.71;p = 0.01, respectively). FFMI increased significantly and continually from M1 to M3 (F = 14.17;p < 0.001). The mean values for BMI z-score, FMI and FFMI were, respectively, as follows: M1: [–0.20 ± 0.86;4.00 ± 1.51;13.81 ± 1.86];M2: [–0.05 ± 0.82;4.19 ± 1.54;14.05 ± 1.91];M3: [–0.14 ± 0.84;4.07 ± 1.46;14.17 ± 1.91]. The mean 3 months differences between measures [M2 vs M1] and [M3 vs M2] were negative for BMI z-score [–0.17 ± 0.49;p = 0.005];FMI [–0.21 ± 0.77;p = 0.006];FFMI [–0.07 ± 1.15;p = 0.56]. Conclusion: CF paediatric patients improved nutritional status after strict lockdown with increase both FMI and FFMI, nevertheless a decline with time was observed in BMI z-scores and FMI, but not for FFMI.

Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report.

IntroductionDespite the growing number of studies on the epidemiology of out-of-hospital cardiac arrest (OHCA) in Poland, this issue has not been sufficiently studied. Notably, there has been a lack of uniform Utstein-style data reporting.AimTo evaluate the epidemiology of OHCA, patient characteristics, the laypeople and emergency medical service (EMS) response to cardiac arrest, and outcomes of OHCA patients, based on a prospective registry encompassing a population of 2.7 million Poles.Material and methodsConsecutive, adult, EMS-treated OHCA cases in 2018 were analyzed. Prehospital data were collected using case report forms by EMS. Information on in-hospital procedures and outcomes was based on data from the public payer of health care services. Multivariable logistic regression analysis was performed to find independent predictors of survival to discharge.ResultsA total of 1392 patients were included. Most OHCA occurred at home (74.7%). In 66.8% of OHCA cases, the cardiac arrest was witnessed by bystanders and in another 20.4% by EMS. Laypeople performed cardiopulmonary resuscitation (CPR) in 54.4% of non-EMS-witnessed events, and an automated external defibrillator (AED) was used in 4.6% of patients who received bystander CPR. Finally, 30.7% of all patients were transported to the hospital, and 9.2% survived to hospital discharge. Epinephrine administration, unwitnessed OHCA, longer response time, older age, and initial non-shockable rhythm were independently associated with lower survival to discharge.ConclusionsThe prognosis of OHCA patients in Poland is poor. There is still room for improvement in increasing the prevalence of bystander CPR and AED use before EMS arrival.

The prevalence of cardiovascular risk factors and cardiovascular disease among primary care patients in Poland: results from the LIPIDOGRAM2015 study

Background and aimTo estimate the prevalence of cardiovascular (CV) disease and CV risk factors among Polish patients. MethodsA nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the 4th quarter of 2015 and 1st and 2nd quarters of 2016; 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. ResultsNearly 19% of men and approximately 12% of women had cardiovascular disease (CVD). Over 60% of the recruited patients had hypertension (HTN), >80% had dyslipidaemia and <15% of patients were diagnosed with diabetes (DM). All of these disorders were more frequent in men. In 80% of patients the waist circumference exceed norm for the European population. Less than half of the patients were current smokers or had smoked in the past. Patients with CVD had significantly higher blood pressure and glucose levels but lower low density lipoprotein-cholesterol level. ConclusionsThe prevalence of CVD and CV risk factors among patients in Poland is high. CVD is more common in men than in women. The most common CV risk factors are excess waist circumference, dyslipidaemia and HTN. Family physicians should conduct activities to prevent, diagnose early and treat CVD in the primary health care population.

Quality of Pharmaceutical Services in Independent Pharmacies and Pharmacy Chains in Poland from the Patient Perspective.

IntroductionPatient satisfaction is a key factor in the evaluation of the quality of healthcare services. Measuring patient satisfaction is common in outpatient, specialist, and hospital healthcare, and is also significant in relation to pharmaceutical services. The pharmacy market in Poland has been undergoing transformations for many years. Legal regulations implemented in 2002 resulted in a rapid growth of pharmacy chains and a decrease in the number of independent pharmacies. This situation may have translated into changes in the quality of pharmaceutical services.ObjectiveThe objective of this study was to evaluate patient satisfaction with services provided in independent pharmacies and pharmacy chains in Poland.Patients and MethodsA total of 163 patients using randomly selected community pharmacies in Poland were enrolled in the study. A modified Community Pharmacy Patient Questionnaire (CPPQ) was used.ResultsThe patients highly valued pharmaceutical services provided in Polish pharmacies. The level of service was slightly higher in pharmacy chains. The lowest-rated area was the provision of information on medications, with independent pharmacies higher-rated in this respect. The patients were open to additional services in pharmacies and supported the development of pharmaceutical care.ConclusionIndependent pharmacies and pharmacy chains ensure a similar level of services for patients in Poland. Pharmacy staff should place a special emphasis on providing patients with comprehensive information on medications. The development of pharmaceutical care in Poland will require appropriate legislative preparation.

Assessment of quality of care of patients with ST-segment elevation myocardial infarction.

The 2017 European Society of Cardiology guidelines for the management of ST-elevation myocardial infarction recommended assessing quality of care to establish measurable quality indicators in order to ensure that every ST-elevation myocardial infarction patient receives the best possible care. We investigated the quality indicators of healthcare services in Poland provided to ST-elevation myocardial infarction patients. The Polish Registry of Acute Coronary Syndromes is a nationwide, multicentre, prospective study of acute coronary syndrome patients in Poland. For the purpose of assessing quality indicators, we included 8279 patients from the Polish Registry of Acute Coronary Syndromes hospitalised with ST-elevation myocardial infarction in 2018. Four hundred and eight of 8279 patients (4.9%) arrived at percutaneous coronary intervention centre by self-transport, 4791 (57.9%) arrived at percutaneous coronary intervention centre by direct emergency medical system transport, and 2900 (37.2%) were transferred from non-percutaneous coronary intervention facilities. Whilst 95.1% of ST-elevation myocardial infarction patients arriving in the first 12 h received reperfusion therapy, the rates of timely reperfusion were much lower (ranging from 39.4% to 55.0% for various ST-elevation myocardial infarction pathways). The median left ventricular ejection fraction was 46% and was assessed before discharge in 86.0% of patients. Four hundred and eighty-nine of 8279 patients (5.9%) died during hospital stay. Optimal medical therapy is prescribed in 50-85% of patients depending on various clinical settings. Only one in two ST-elevation myocardial infarction patients is enrolled in a cardiac rehabilitation program at discharge. No patient-reported outcomes were recorded in the Polish Registry of Acute Coronary Syndromes. The results of this study identified areas of healthcare system that require solid improvement. These include direct transport to percutaneous coronary intervention centre, timely reperfusion, guidelines-based medical therapy (in particular in patients with heart failure), referral to cardiac rehabilitation/secondary prevention programs. Also, there is a need for recording quality indicators associated with patient-reported outcomes.

Niewydolność serca — niekorzystne rokowanie u pacjenta ze współistnieniem wielu chorób

Due to its incidence (approx. 750,000 patients in Poland) and simultaneous short survival time (only approx. 50% of patients survive 4 years after the diagnosis), heart failure (HF) poses a serious problem in contemporary cardiology. The clinical case presented below concerns a HF patient with multiple comorbidities which make prognosis significantly more difficult. Clinical assessment is of key importance with regard to the determination of treatment and the decision to implement palliative care. Despite the administration of optimal pharmacological treatment of HF, the condition of the patient in question deteriorated significantly within two months — to such extent that treatment characteristic of the end-of-life period had to be implemented. Such procedure is supported by the current scientific reports suggesting the implementation of palliative treatment already at earlier stages of HF advancement, particularly in patients with severe comorbidities.

Community Pharmacies in Poland-The Journey from a Deregulated to a Strictly Regulated Market.

Community pharmacies are the primary entities providing drugs to individual patients in Poland. The pharmacy market has been changing for many years due to significant changes in market regulations. These changes significantly affect the profitability of pharmacies, which may impact the quality of pharmacotherapy. The small number of pharmacies, which resulted from changes in the law in 2017, can influence the level of patient care. The article presents the community pharmacies market in Poland. Particular attention is paid to the legal regulations affecting community pharmacies and the impact of these regulations on the overall shape of the market. The Polish system’s specificity, including the pharmacy market indicators, has been compared with data from other European Union countries.

Managed care improves prognosis in acute myocardial infarction survivors. Data from the MAnaged Care for Acute Myocardial Infarction Survivors (MACAMIS) Programme

Abstract Background Mortality following acute myocardial infarction (MI) remains high despite progress in pharmacotherapy and interventional treatment. In 2017 a nation-wide system of managed care for MI survivors comprising a continuum of acute treatment of MI, staged revascularization, cardiac rehabilitation, cardiac electrotherapy and cardiac ambulatory care within one year following MI was implemented in Poland. The managed care programme (MCP) includes also the quality of care assessment based on clinical measures (e.g. cardiovascular risk factors control) as well as on the rate of minor and major cardiovascular events. The goal of the analysis was to assess the overall mortality of MI survivors participating and not participating in the MCP. Methods The database of survivors of acute MI discharged from hospital from October 1, 2017 to December 31, 2018 was analyzed. Patients who died within 10 days after discharge were excluded from the analysis. The primary end-point was defined as death from any cause. Propensity-Score Matching (PSM) using nearest neighbor matching was used to form comparable groups of patients participating and not participating in the MCP. The Cox proportional hazard regression analysis was used to assess the relation between MCP and the overall mortality. Results MCP was implemented in the first stage in 48 hospitals spread around the country (about 34% of all hospitals treating acute MI patients in Poland). Out of 87739 analyzed patients (age: 68.1±11.9 years; 55581 men and 32158 women) 34064 were hospitalized in hospitals with MCP implemented. Altogether 10404 patients (11.9% of the whole cohort; 30.5% of those hospitalized in hospitals with MCP implemented) participated in MCP. They were matched with 10404 patients not participating in the MCP. During 324.8±140.5 days of follow-up 7413 patients died. One-year mortality was lower in patients participating in the MCP both when we analyzed the whole cohort (4.4% vs. 9.5%; p&amp;lt;0.001) as well as when we limited the analysis to the PSM groups (4.4% vs. 6.5%; p&amp;lt;0.001, figure 1). MCP was related to the overall mortality in univariate (HR 0.43 [0.39–0.48]) as well as in multivariate analysis (0.64 [0.57–0.71]) in the whole cohort as well as in the PSM cohort (HR 0.63 [0.56–0.72] and 0.64 [0.56–0.72] for the univariate and multivariate analysis respectively). When we limited the analysis to hospitals in which MCP was implemented one-year mortality was 4.3% vs. 6.3% (p&amp;lt;0.001) whereas univariate HR was 0.51 (0.44–0.60) and multivariate HR 0.52 (0.44–0.61). Conclusion The implemented in Poland nation-wide system of managed care for MI survivors is related to improved survival. Therefore, the Ministry of Health plans to implement the programme in all cardiac centers in Poland. Funding Acknowledgement Type of funding source: None

Managed care improves prognosis in AMI patients irrespectively of the hospital setting. Data from the MAnaged Care for Acute Myocardial Infarction Survivors (MACAMIS) Programme

Abstract Background In 2017 a nation-wide system of managed care for MI survivors comprising acute treatment of MI, cardiac rehabilitation and cardiac ambulatory care within one year following MI was implemented in Poland. The managed care programme (MCP) was proved to be related to lower risk of all-cause death. The goal of the analysis was to assess the effectiveness of MCP in patients discharged from university, district, municipal and non-public hospitals. Methods The database of survivors of acute MI discharged from hospital from October 1, 2017 to December 31, 2018 was analyzed. Patients who died within 10 days after discharge were excluded from the analysis. The primary end-point was defined as death from any cause. Propensity-Score Matching using nearest neighbor matching was used to form comparable groups of patients participating and not participating in the MCP. The Cox proportional hazard regression analysis was used to assess the relation between MCP and the overall mortality. Results MCP was implemented in the first stage in 48 hospitals spread around the country (about 34% of all hospitals treating acute MI patients in Poland). Among them 14 were university, 20 district, 8 municipal and 6 nonpublic hospitals. Out of 34064 patients discharged from hospitals with MCP implemented 10404 patients (30.5%) participated in MCP. They were matched with 10404 patients not participating in the MCP. About 24% of the analyzed patients were discharged from university hospitals, 42% from district hospitals, 20% from nonpublic, 14% from municipal and other hospitals. During 326.3±134.8 days of follow-up 1062 patients died (4.4% vs. 6.5% of patients participating and not participating in the MCP; p&amp;lt;0.001). Hazard ratios related to MCP of patients hospitalized in each hospital categories are presented in the table. Conclusion The implemented in Poland nation-wide system of managed care for MI survivors is related to improved survival in all hospital settings. Funding Acknowledgement Type of funding source: None

Cardiac rehabilitation effectively reduces the number of deaths in the heart failure population (propensity score matched analysis)

Abstract Background Numerous cardiac rehabilitation (CR) studies have demonstrated functional benefits, improvement in quality of life and clinical outcomes from exercise training in patients with heart failure (HF), so CR is consistently recommend for HF patients. However its influence on survival in HF population is unknown. Purpose To assess the influence of CR on survival rate in HF patients. Methods It is a retrospective analysis of 1 620 686 HF patients in Poland in years 2013–2018, based on nationwide Polish Ministry of Health registry, that provides public universal healthcare coverage to all residents and collects detailed information for the entire Polish population (38,495,659 in 2013) since 2009. Within registry, we identified the experimental group of 11 512 HF patients ≥18 years old who underwent CR in 2013–2018. From entire HF population we identified a 1:1 propensity score matched cohort of HF patients, who did not get CR. Results After propensity-score matching, we identified 11,512 patient pairs who underwent/not CR. Average age was approximately 66 years (18–39: 2.1 vs 2.0%; 40–49: 491 – 4.3 vs 4.2%; 50–59: 17.0 vs 17.1%; 60–69: 34.9 vs 35.2%; 70–79: 31.3 vs 31.4%; 80+: 10.4 vs 10.3% respectively), 61% of the participants were males, mainly urban residence nearly 70%, with HF diagnose put during hospitalization 74.5%. Both groups were similar also by comorbidities evaluated by Charlson Comorbidity Index. Patients subjected to CR compared CR negative significantly increased survival risk at 1st, 2nd, 3rd, 4th and 5th year (CR vs CR negative 97.4% vs. 84.9%; 93.9% vs. 77.9%; 89.9% vs. 71.9%; 85.2% vs 66.0%; 81.8% vs 62.1% respectively) – Figure 1. Conclusion Our analysis showed that in heart failure patients, CR was associated with an increased survival rate among HF patients as treated in routine health care system. Figure1 Funding Acknowledgement Type of funding source: Other. Main funding source(s): European Union from the European Social Fund

The prevalence of cardiovascular risk factors and cardiovascular disease among primary care patients in Poland: results from the LIPIDOGRAM2015 study

Abstract Background Cardiovascular disease (CVD) is currently one of the leading cause of mortality in the European Union. Well-established, modifiable cardiovascular (CV) risk factors include hypertension (HTN), hypercholesterolaemia, diabetes mellitus (DM), obesity, low activity levels, poor diet and smoking. There are no current estimates on the prevalence of CV risk factors among Polish patients solely in the primary care setting. Methods A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the 4th quarter of 2015 and 1st and 2nd quarters of 2016. 438 primary care physicians enrolled 13,724 adult patients that sought medical care for any medical reason in primary health care practices. Results Nearly 19% of men and approximately 12% of women had CVD. Over 60% of the recruited patients had HTN, &amp;gt;80% had dyslipidaemia and &amp;lt;15% of patients were previously diagnosed with DM. All of these disorders were more frequent in men. Overweight and obesity were present in more than 75% of patients with 80% of them exceeding the waist circumference norm for the European population. Slightly less than half of the patients were current smokers or had smoked in the past. Patients with CVD had significantly higher blood pressure and glucose levels but lower low density lipoprotein-cholesterol level (LDL-C). In patients with CVD, HTN and dyslipidaemia were twice as frequent and DM three times more so than in patients without it (Figure 1). Conclusions The incidence of CVD and CV risk factors among patients attending primary healthcare in Poland is high. CVD is more common in men than in women. The most common CV risk factors are excess waist circumference, dyslipidaemia and HTN. Family physicians working in primary health care, as well as health authorities should conduct activities to prevent, diagnose early and treat CVD in the primary health care population. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): The present study was an initiative of the Polish Lipid Association (PoLA) and the College of Family Physician in Poland (CFPiP). The present study was funded by an unrestricted educational grant from Valeant.

Kazimierz Filip Wize (1873 – 1953) – psychiatra, biolog i filozof

Kazimierz Filip Wize (1873-1953) was a Polish multidisciplinary scholar, a microbiologist, a lepidopterologist, a psychiatrist, and a philosopher. He was an avid promoter of care of the mentally ill. After defending a Ph.D. in medicine in Munich (Germany) in 1899, Wize specialized in bacteriology at the Pasteur Institute in Paris. In 1907 he defended his second Ph.D. in philosophy in Leipzig. Soon, Wize became an internationally active scholar and a prolific writer, working especially on esthetics and the philosophy of medicine. For Wize, philosophy of action was a bridge between abstract academic philosophy, practical ethics, and the philosophy of medicine understood as an art and a science. Later in his life, Wize moved back to practicing medicine, and in the 1930s he specialized in psychiatry. The new field enabled him to apply his esthetic concepts to the treatment of patients and become a pioneer of art therapy. Music, painting, and dance, Wize argued, are a means to achieve serenity and freedom and play an important part in the process of recovery. Much later, Wize witnessed the extermination of psychiatric patients in Poland during a Nazi T4 action.

Psychometric properties of the Polish version of the Multiple Sclerosis Self-Management Scale – Revised

Purpose The main aim of this study was to analyse the psychometric properties of the Polish version of the Multiple Sclerosis Self-Management-Revised Scale. Methods A total of 663 patients with multiple sclerosis were included in this study. The Polish version of the Multiple Sclerosis Self-Management-Revised Scale, The General Self-Efficacy Scale, Multiple Sclerosis Impact Scale-29, and Expanded Disability Status Scale were used. Cronbach’s alpha and McDonald’s omega coefficients were calculated to assess the Polish version of the scale’s reliability. The reliability of the scale’s test items was assessed using an information function with the multidimensional graded response model. Confirmatory factor and principal component analyses were conducted. Results Cronbach’s α and McDonald’s ω were obtained (α = 0.896, ω = 0.909). Correlations between the scores of the Polish version of the Multiple Sclerosis Self-Management-Revised Scale and the General Self-Efficacy Scale (r = 0.34; p < 0.001) and the neurological assessment of patients by a physician (r = −0.23; p < 0.001) were significant. The original factor structure of the scale was not confirmed (Chi2(242) = 1480; p < .001; CFI = 0.829; TLI = .805; RMSEA = 0.088, 90% CI = [0.084-0.092]; SRMR = 0.079). Conclusions Using only the total score of the Multiple Sclerosis Self-Management-Revised Scale is recommended for Polish patients. The scale’s factor structure requires further study. Implications for rehabilitation The Polish version of the Multiple Sclerosis Self-Management-Revised Scale was reliable and valid when used in adult multiple sclerosis patients. At present, we recommend using only the total score of the Multiple Sclerosis Self-Management-Revised Scale. Further research is needed to distinguish the detailed subscales of the Polish version of the tool. The Polish version of the Multiple Sclerosis Self-Management-Revised Scale can be used in clinical practice and for research purposes to assess the general level of self-management in Polish-speaking multiple sclerosis patients in Poland.