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EN
Introduction: Incidence, morbidity and 5-year survival rates illustrate the epidemiological situation of colorectal cancer and assess effectiveness of the treatment. In Poland, the National Health Fund is the payer of services. The data related to morbidity, incidence, and 5-year survival may be supplementary to the epidemiological data of the National Cancer Registry. Objective: Analysis of services granted by NHF in Bydgoszcz to persons with diagnosed colorectal cancer in 2006–2011 including the assessment of incidence, morbidity and 5-year survival of the population in the Kujawsko-Pomorskie province. Material and methods: The study analyzed the services recorded in the database of the National Health Fund in Bydgoszcz in 2006-2011 given to patients with colorectal cancer. The Kaplan-Meier method and the gambling rate were used to determine the probability of survival. Results: In 2006–2011, men were offered 10.1% more services than women. The most frequent services regarded colorectal cancer (48.9%), rectal cancer (43.8%) and esophageal cancer (7.2%). In total, 50410 services were provided. Despite increase in the number of women in the population, 388 more men died than women. The probability of survival was 46.8 % and 42.6% for men and women, respectively, furthermore 41.8%, 44.2% and 48.9% for colon cancer and esophageal and rectal folds cancer, respectively. Conclusions: In the Kujawsko-Pomorskie province during the period of 2006–2011, the number of diagnosed colorectal cancers increased as did the overall number of services provided. There was also a downward trend for the total number of services granted in relation to the increase in the number of new diagnosed cases. Incidence and morbidity rates were variable, gradually increasing in subsequent years and amounted to 59/100000 and 67/100000, 355/100000 and 408/100000 in 2010 and 2011, respectively. The probability of 5-year survival was 45.2%. Diagnosis of a disease in patients above 69 years of age increased the likelihood of death.
EN
Excessive concentrations of smog toxicants constitute a critical factor influencing the health quality of inhabitants of urban agglomerations. The exposure to elevated concentrations of suspended particulate matter, sulfur dioxide (SO2), nitrogen dioxide (NO2) and carbon monoxide (CO) is associated with an increase of adverse health effects. Prolonged exposure to air pollution, especially from low emission, may be linked not only to a greater risk of developing cancer of the respiratory system, or cardiovascular morbidity but also to the increased frequency of admissions to hospitals and emergency units as well as medical consultations in surgeries and outpatient clinics. The issue was investigated using the city of Cracow as an example. Attempts were made to find the connection between air pollution in the city of Cracow and the frequency of hospitalization and medical consultations of patients (registered in the city) due to lung and bronchial malignancy and cardiac dysrhythmia taking into account the data from the years 2010-2016 submitted by the Malopolska Regional Branch of the National Health Fund.
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Content available remote Is Age a Risk Factor of Postoperative Complications in Colorectal Cancer?
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EN
Colorectal cancer is the most common malignant neoplasm in elderly with peak of incidence in 7. and 8. decade of life. Elderly patients with colorectal cancer more often require surgery. Advanced age of patients seems to increase the risk of postoperative complications. The aim of the study was to compare the frequency of early complications in two groups of patients: under 75 and over 75, undergoing elective colorectal cancer surgery. Material and methods. 440 consecutive adult patients subjected to colorectal cancer surgery between 08.2006 to 10.2011 in Oncological Surgery Department, Gdynia Centre of Oncology. Group A (over 75 year-of-life): 109 patients, median 79 and group B (up to 75 year-of-life): 331 patients, median 65. Patients requiring emergency surgery were excluded from the study. Postoperative 30-day mortality, anastomotic leakage, wound infection, bowel obstruction, postoperative respiratory and circulatory insufficiency were among analyzed complications. Results. Symptomatic disease was observed in 81.6% of group A and in 83% of group B. Groups A and B were comparable concerning: BMI, gender, tumor staging, rate of curative and palliative resections, and duration of hospital stay. Accompanying diseases were more common in group A (83% vs 65%; p<0.0002). Early complications occurred in 21.1% of patients from group A and in 19.9% from group B. The rate of reoperation in early perioperative period didn’t differ (6.4% vs 5.7%). Features like: age, gender, additional illnesses, tumor location and staging did not influence the occurrence of perioperative complications. Conclusions. Age itself is not a risk factor for postoperative complications in spite of higher rate of accompanying diseases in elderly.
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EN
Introduction. Pelvic exenteration (PE) is a curative or palliative radical surgical procedure applied for advanced or recurrent pelvic or perineal cancers. From 1948 to date, improvements in surgical techniques, including urinary conduits and pelvic reconstruction, have improved its morbidity and mortality. Aim. The present study reviews the evolution of PE, indications, complications and current results. Material and methods. Large case series and studies on PE were searched in PubMed, covering all years available, and recent applications of PE were reviewed. Results. Indications of PE are primary or locally advanced tumors (cervix. rectum. vulva. bladder), recurrence after radiotherapy (cervix), recurrence after primary resection (vulva, vagina, cervix, rectum) and palliative treatment for advanced tumors or pubic fistulas. Contraindication are distant metastases, involvement of iliac vessels, pelvic side-wall or para-aortic lymph nodes and invasion of sacrum proximal to S1/S2 or sciatic foramen. However, recent studies have reported more radical resections, including side-wall and vessels. Patient’s health condition and fitness are also important in decision-making. Conclusion. PE can be the last chance of cure or improving quality of life for advanced or locally recurrent pelvic cancers. 5-year survival rates with PE are better, but complications of such a radical surgery are still high, and should be improved.
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Content available Risk of morbidity in colorectal surgery
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EN
This study examines the risk of morbidity for colorectal surgery undergoing patients. The main aim was to identify important risk factors that influence post-operative complications – morbidity, and to create a model to predict possible complications for a patient before surgery. The source data file contains information about 1177 patients who underwent colorectal surgery between 2001 and 2009 at the University Hospital Ostrava, Czech Republic. According to the surgeons’ judgment the following seven independent variables were included in the analysis: Gender, BMI, American Society of Anaesthesiology (ASA) Classification, Stage of Disease, Number of Previous Operations, Surgical Technique and Operation Severity. Discriminant analysis was used for the data evaluation; statistical software SPSS 18 and NCSS 2004 were used for the calculations.
EN
The article deals with the possibility of predicting the dynamics of teachers’ individual health by the indicators of professional comfort zone changes. The area of professional comfort zone, the level of occupational burnout, the individual health status of teachers in secondary schools was investigated. 19.67 % of the respondents have low level of professional burnout, 34.43 % – average level, 27.05 % – high level, 18,85 % – very high level. Skin diseases, diseases of musculoskeletal system and sensory organs (22.84 %); diseases of cardiovascular and hematopoietic systems (20,45 %); diseases of respiratory system (19.50 %) are the most common nosologies that teachers have. The results showed that the narrowing of the teachers’ professional comfort zone increases the probability of increasing the level of occupational burnout. Morbidity of the respondents with low and high levels of burnout increases with the narrowing of professional comfort zone. Teachers with extremely high levels of burnout while expanding comfort zone are sick more. Data obtained for teachers with an average level of occupational burnout are not statistically significant. Teachers, whose professional comfort zone had expanded during the period of professional training, have low levels of occupational burnout regardless of age and experience. Teachers, whose professional comfort zone had been narrowed during the period of professional training, are prone to burnout proportionally with negative dynamics of professional comfort zone. Professional comfort zone of teachers with middle, high and very high levels of occupational burnout at the time of the survey was significantly lower than in the pre-professional stage. Instead, teachers with low level of burnout have the area of comfort zone located within a little more than on pre-professional stage. It is recommended to take into account the detected peculiarities in using indicators of professional comfort zone for predicting the state of teachers’ individual health and the evaluation in their individual health preservation competence. As the prospects for further research in this direction we consider the development and implementation of valeological and educational technologies of formation and development of individual health preservation competence of the future teachers and teachers-practitioners in order to expand their comfort zones, to prevent the premature professional burnout, prevention of diseases, especially those that have a psychosomatic nature.
EN
The purpose of the article is to draw attention to the increase in morbidity and mortality resulting from cancer disease and to analyze the selected data concerning women and men in Poland and in the world. The article also shows that the morbidity and mortality resulting from cancer disease are projected to rise in the future. The prevention and the screening of the population is imperative to reduce the morbidity and mortality caused by cancer diseases.
PL
Celem artykułu jest zwrócenie uwagi na wzrost zachorowalności i umieralności ludzi z powodu chorób nowotworowych. Analizie poddano wybrane dane dotyczące kobiet i mężczyzn w Polsce i na świecie. Przedstawiono także prognozowaną na dalsze lata tendencję wzrostową w zakresie zachorowań i zgonów. W redukcji liczby zachorowań i zgonów związanych z chorobami nowotworowymi istotną rolę odgrywają działania prewencyjne, w tym badania skriningowe populacji.
EN
Oesophagus is common primary localization of digestive system cancer. Recent analyses suggest the role of vegetarian food in reduction of cancer risk. The role of vegetables intake in oesophageal cancer prevention still needs to be proved.Objective. The estimation of the role of vegetables intake in oesophageal cancer risk based on published case-control studies using meta-analysis methods.Methods. The selected literature published till 2009 from MEDLINE, PubMed, Scopus, Embase, CancerLit, Google Scholar and Cochrane Library databases were included into meta-analysis. The following search terms, key words and text phrases were used: esophageal cancer, cancer risk, oesophageal cancer risk, oesophageal neoplasm; oesophageal neoplasm risk, diet, dietary habits, vegetables and life style. Articles investigating vegetables intake were reviewed and selected for further analysis.Results. Twelve studies have fulfilled the established criteria. The meta-analysis has confirmed the protective effect of vegetables against oesophageal cancer development. The vegetables intake, more frequent than once per week, reduce oesophageal cancer risk (relative risk 0.52; 95% CI 0.38-0.71). The declared intake more frequent than once daily was connected with reduction of cancer development about of 57% (relative risk 0.43; 95% CI 0.32-0.58). The dose-dependent manner of vegetables intake was observed against oesophageal cancer development.Conclusion. The vegetables intake is associated with reduced risk of developing an oesophageal cancer. The total reduction of oesophageal cancer risk is associated with frequency of vegetables intake in the diet.
EN
This paper presents the usage of logistic regression for predicting the classification of patients into one of the two groups. Our data come from patients who underwent Phadiatop test examinations and patients who underwent colectomy in the University Hospital of Ostrava. As the predictor variables were chosen personal and family anamneses for Phadiatop test and the physiological and operative scores for colectomy. For Phadiatop test, both of these anamneses were divided into four categories according to severity ranked by doctors. Scores for morbidity were based on the POSSUM system. The psychological score comprises 12 factors and the operative score comprises 6. The categorical dependent variable which we want to predict was Phadiatop test (respectively morbidity). The model for Phadiatop test was tested with the use of a medical database of 1027 clients and morbidity was tested upon a medical database of 364 clients. The developed models predict the right results with 75% probability for Phadiatop test and 70% probability for morbidity in surgery.
EN
The article deals with the current issues of interconnection between public health and the quality of water resources. It was proposed to determine environmental safety areas in the basins of small rivers based on environmental morbidity valuation. Four phases are herewith determined: hazard identification, exposure assessment, environmental mortality rate assessment, decision-making regarding the need for implementation and water protection measures. In order to assess the influence of the state of river quality on the health status of the population in the certain administrative region, the impact factor of recreational water use was introduced. The risks related to organoleptic, sanitary and toxicological properties of water; epidemiological water hazard are considered.
EN
INTRODUCTION: Road traffic accidents is a major public health problem with an estimate to become the ninth leading cause of death worldwide. Pakistan yearly spends around 100 billion rupees on injuries and ranks 5th due to the fatality associated with road traffic accidents. Seat-belt use decreases the fatality amongst drivers and front-seat passengers by around 45–50%. Therefore, the current study was aimed to determine seat belt use among drivers and front passengers and its association of demographic factors. MATERIAL AND METHODS: A cross-sectional study was carried out from October 2016 to March 2017. The city was categorized into five major geographical areas and from each of these areas two roads were randomly selected from the list of the available roads. Data collection was done in the petrol pumps located on these roads and every fifth vehicle interviewed. Data was collected on an adapted tool with information regarding use of seat-belt and socio-demographic factors. Data was analyzed, using STATA version 13.1. RESULTS: A total of 1690 vehicles were interviewed during the time period. Around one third (35.5%) of the drivers were using seat-belt when approached and none of the front passengers. Around three fourth (72.2%) of the drivers reported avoiding fines and penalties as the main reason for using seat-belts. The main reason reported for not wearing seat-belt was embarrassment and was reported by around half of the drivers (45.6%) and front passenger (42.8%). On logistic regression education, type of vehicle and years of experience were independently associated with seat-belt use. Driving experience and education were negatively associated with seat-belt use while the use was less in private cars compared to taxis. CONCLUSIONS: Seat belt use in drivers of the metropolitan city of Peshawar was quite low and ironically was none in the front passengers. Avoiding fines and penalties was the main reason for seat-belt use which was common in taxis. Policy makers and planners should impose regulations and implementation of seat-belt use by all passengers to reduce the morbidity and mortality following road traffic accidents.
PL
WSTĘP: Wypadki drogowe to poważny problem zdrowia publicznego, który według szacunków może stać się dziewiątą główną przyczyną zgonów na świecie. Pakistan rocznie wydaje około 100 miliardów rupii na leczenie obrażeń i zajmuje piąte miejsce z powodu śmiertelnych wypadków drogowych. Korzystanie z pasów bezpieczeństwa zmniejsza śmiertelność wśród kierowców i pasażerów siedzących z przodu o około 45–50%. Dlatego obecne badanie miało na celu określenie użycia pasów bezpieczeństwa wśród kierowców i pasażerów na przednim fotelu oraz powiązanie czynników demograficznych. MATERIAŁ I METODY: Badanie przekrojowe przeprowadzono od października 2016 r. do marca 2017 r. Miasto zostało podzielone na pięć głównych obszarów geograficznych i z każdego z tych obszarów losowo wybrano dwie drogi z listy dostępnych dróg. Zbieranie danych odbywało się w stacjach paliwowych znajdujących się przy tych drogach i przeprowadzaono wywiad w co piątym pojeździe. Dane zebrano na dostosowanym narzędziu z informacjami dotyczącymi stosowania pasów bezpieczeństwa i czynników społeczno-demograficznych. Dane zostały przeanalizowane przy użyciu STATA w wersji 13.1. WYNIKI: W czasie badania przeprowadzono wywiad z 1690 użytkownikami pojazdów. Około jedna trzecia (35,5%) kierowców korzystała z pasów bezpieczeństwa, ale żaden z pasażerów na przednim fotelu. Około trzy czwarte (72,2%) kierowców wskazało na unikanie kar jako główny powód używania pasów bezpieczeństwa. Głównym powodem, dla którego zgłaszano brak zapinania pasów bezpieczeństwa, było zażenowanie i zgłosiło je około połowa kierowców (45,6%) i pasażerowie z przodu (42,8%). W edukacji regresji logistycznej rodzaj pojazdu i lata doświadczenia były niezależnie związane z używaniem pasów bezpieczeństwa. Doświadczenie w prowadzeniu pojazdu i edukacja były negatywnie związane z używaniem pasów bezpieczeństwa, podczas gdy korzystanie z nich było mniejsze w samochodach prywatnych w porównaniu do taksówek. WNIOSKI: Używanie pasów bezpieczeństwa przez kierowców metropolii Peszawar było dość niskie i, jak na ironię, żaden z pasażerów nie korzystał z pasów. Unikanie grzywien i kar było głównym powodem używania pasów bezpieczeństwa, który był powszechny w taksówkach. Decydenci i planiści powinni narzucić przepisy i wdrażać stosowanie pasów bezpieczeństwa przez wszystkich pasażerów, aby zmniejszyć zachorowalność i śmiertelność w wyniku wypadków drogowych.
EN
The connection between the rate of height loss in older people and their general health status has been well documented in the medical literature. Our study was aimed at furthering the characterization of this interrelationship in the context of health indices and mortality in a hospitalized population of Polish adults. Data were collated from a literature review and from a longitudinal study of aging carried out in the Polish population which followed 142 physically healthy inmates, including 68 men and 74 women, for at least 25 years from the age of 45 onwards. Moreover, cross-sectional data were available from 225 inmates, including 113 men and 112 women. These subjects were confined at the same hospital. ANOVA, t-test, and regression analysis were employed. The results indicate that the onset of height loss emerges in the fourth and five decade of life and there is a gradual acceleration of reduction of height at later stages of ontogeny in both sexes. Postmenopausal women experience a more rapid loss of height compared with men. The individuals who had higher rate of loss of height (≥3 cm/decade) tend to be at greater risk of cardiovascular events and all-cause mortality. In conclusion, our findings suggest that a systematic assessment of the rate of loss of height can be useful for clinicians caring for elderly people because of its prognostic value in terms of morbidity and mortality.
EN
The movement of the baby boomers into the middle ages made the 45-65 age cohort the largest and the fastest growing segment of population in the first decade of the 21st century. This demographic expansion will have multiple consequences for ageing society. This paper aimed to provide an overview on biology of midlife transition. Physical characteristics, midlife-specific morbidity and mortality were described with focus to sexual dimorphism in physique and gender gap in mortality and morbidity. These characteristics made midlife a separate and unique stage of life. In-depth knowledge of this life stage may be useful in identifying and solving problems of ageing individuals and population.
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