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Introduction. Correctness of insulin treatment depends on both the experience and skills of the doctor and knowledge and behaviour of the patient. Objective. Evaluation the adequacy of insulin doses administered to diabetes patients in ambulatory conditions. Material and methods. The treatment of 59 patients hospitalized in the Diabetology Ward was evaluated at admission, discharge and 3 months after hospitalization. Results. The mean daily doses of insulin significantly differed at times of evaluation and were: 53.90, 39.31 and 43.34 units, respectively (p≈0.000001). A significant reduction of body weight, 90.86 vs. 88.25 kg (p≈0.000001), was obtained only during hospitalization, and was maintained 3 months after discharge (87.86 kg). Significant differences were also noted in the body mass index (33.44 vs. 32.48 vs. 32.37 kg/m2, p≈0.000001). The change in waist circumference was not statistically significant (107.87 vs. 104.89 cm; p≈0.06). A decrease in the number of hypoglycaemia episodes was observed, but were statistically insignificant (25 vs. 23; p≈0.7). Three months after hospitalization an insignificant decrease of HbA1c level was noted (8.41% vs. 8.03%; p≈0.07). Conclusions. During treatment in the Diabetology Ward the procedure of choice was more frequently a reduction than an increase in insulin doses. This management led to the reduction of the patients’ body weight, improvement of glycaemia, without any significant effect on the diabetes control determined by the HbA1c level.
Epidemiological studies in Poland show that tobacco smoking by adolescents at reproductive age is still frequently observed. This concerns both boys and girls. The study was based on all-Polish population studies of health behaviours of adolescents aged 14-24 (Youth Behavioural Polish Survey – YBPS) conducted in 2011, and the Pregnancy-related Assessment Monitoring Survey (PrAMS). More than 12% of pregnant women do not discontinue smoking in association with becoming pregnant and expose the foetus to tobacco smoke, despite being aware of the hazardous effect of smoking on the health of the mother and child. Smoking in pregnancy is mainly observed among mothers with a low education level and those aged under 23. According to the Baker’s Foetal Origins of Adult Health and Diseases Hypothesis, exposure of the foetus to the components of tobacco smoke results in many perturbations in the form of a lower birth weight, prematurity, worse state of neonates after birth, and higher susceptibility to contacting civilization diseases at the age of adulthood. The results of studies confirm some observations. Polish studies clearly confirmed a lower birth weight of babies delivered by mothers who smoke; however, earlier termination of pregnancy and worse status of neonates after birth were not observed. According to the Baker’s hypothesis, a lower birth weight of babies delivered by smoking mothers during the further life cycle exposes the offspring to the risk of contracting civilization diseases. The efforts undertaken by public health authorities should be biased towards education of the population at reproductive age about the hazardous effect of smoking on the health of the foetus and the offspring born. Women at reproductive age should be encouraged to discontinue smoking in association with the planning of pregnancy and in pregnancy.
The objective of the study was the evaluation of the frequency of occurrence of acute respiratory infections among rural population from the Lublin Region, and verifi cation of the appropriateness of the use of antibiotics in empirical fi rst-line therapy of these diseases. The analysis covered medical records concerning 1,839 patients selected from 27 rural health centres within the period of one year (1 September 2005–31 August 2006). As many as 656 patient visits were recorded, the reasons for which were qualifi ed by physicians as infections of the upper and lower airways. These disorders were diagnosed in 450 patients, which constituted 24.46% of the population examined. The following diagnoses were most frequently made: acute pharyngitis and tonsillitis (31.25% of the total number of diagnoses), acute upper respiratory infections of multiple and unspecifi ed sites (22.25%), and common cold (21.64%). Antibiotics were used in empirical fi rst-line therapy in as many as 82% of the total number of patients. The analysis showed that in the great majority of cases the use of antibiotics was inappropriate. If this situation persists, in the near future it will lead to an increase in the phenomenon of antibioticoresistance in Poland. In order to prevent this situation, it is necessary to carry out an extensive educational action concerning the hazardous effect of excessive use of antibiotics, both among physicians and the whole society.
It is recognized that the levels of women’s physical activity during pregnancy has a direct bearing on the method of delivery and health of the newborn. The main objective of the study was investigation the level of physical activity of women during pregnancy according to the Pregnancy Physical Activity Questionnaire (PPAQ). The subjects of this study were n=2852 post-partum women surveyed together with their newborns, representing all obstetric hospital departments throughout Poland. The questionnaires were completed on a single day during the second week of November 2011. The women were also asked about the amount, range and type of physical activity they performed before becoming pregnant. The Pregnancy Physical Activity Questionnaire was used for precisely measuring physical activity according to the standard metabolically equivalent (MET). In addition, comparisons were made between the weight of the infant and newborn status using the APGAR scale with the amount of physical activity performed by the mothers. There were decidedly low physical activity levels observed in pregnant women compared to those before becoming pregnant. Appropriate interventions can therefore now be targeted through remedial action in Poland. It is important to perform intervention studies intended to test this hypothesis and attempt to identify the most appropriate levels for intensity, duration and frequency of physical exercise during pregnancy. The studies should consider the four domains of daily physical activity and utilize tools that reliably measure exposure variables. Such studies would provide valuable information for recommendations about physical activity during pregnancy.
Introduction and objective: Diabetic patients are at high risk for peripheral arterial disease (PAD) characterized by symptoms of intermittent claudication or critical limb ischemia. Measurement of ankle-brachial index (ABI) has emerged as the diagnostic tool of choice, because it is relatively simple, non-invasive and inexpensive. It is also an independent marker of increased morbidity and mortality from cardiovascular diseases. The aim of the presented study was to assess the relationship between current glycemic control defined by glycated hemoglobin (HbA1c) level, and quantitative changes in the arteries of the lower limbs in patients with type 2 diabetes. Materials and methods: 175 patients with type 2 diabetes hospitalized in the Diabetology Ward were studied. VENO Doppler and a sphygmomanometer were used to assess blood flow. Results: The average level of HbA1c was assessed at 8.48%. Although the average level of ABI indicator was 1.20 (normal), only 45% of evaluated patients had their individual index within the normal range. Signs of ischemia were found in 17.7% of examined subjects. There was no conclusive correlation between ABI and HbA1c levels. Conclusions: The current level of glycemic control evaluated as HbA1c has no direct impact on the advancement of diabetic angiopathy evaluated as ABI.
The alarming problem of a decline in physical activity among children and adolescents and its detrimental effects on public health has been well recognised worldwide. Low physical activity is responsible for 6% of deaths worldwide and 5-10% of deaths in the countries of the WHO European Region, according to country. Within the last decade, many initiatives have been launched to counteract this phenomenon. The objective of presented study was analysis of the level of physical activity among adolescents and young adults in Poland, according to the IPAQ questionnaire. The study group covered 7,716 adolescents: 5,086 children attending high school and secondary schools and 2,630 university students. Low physical activity was noted among 57% of schoolchildren and 20.84% of students. Analysis of the level of physical activity according to the IPAQ indicated that it was lower among girls, compared to boys. An additional analysis, with the consideration of the place of residence, showed that the highest percentage of the population with low physical activity was noted in the rural areas (29.30%), while among the urban inhabitants of cities with a population above 100,000 it was on the level of 23.69% and 20.57%. Median for weekly physical activity by respondents` gender was on the level of 1,554.00 MET*min. weekly among females, and 2,611.00 MET*min. weekly among males (p<0.000). The highest weekly physical activity expressed in MET*min. was observed among the inhabitants of towns with a population less than 100,000, whereas among the rural population and inhabitants of large cities with a population of over 100,000 the weekly physical activity was on a similar level (1,830.50 and 1,962.00 respectively). An extended analysis of respondents’ physical activity showed that during the day students spend significantly more time in a sedentary position, compared to schoolchildren. The presented results of studies indicate the necessity to continue and intensify actions to promote various forms of physical activity among students and schoolchildren. A constant decrease in physical activity observed among children and adolescents suggests that it is necessary to pay greater attention to this social group while developing health programmes.
Alcohol related harm is a global problem for public health where frequent consumption of large amounts of alcohol constitutes a serious health risk, particularly to vulnerable groups such as adolescents, pregnant women and newborns. The epidemiological study on health-lifestyle behaviour, especially alcohol consumption, was performed on a randomised group of post-partum women’s health behaviour during pregnancy, covering drinking habits, was undertaken in 2010, 2011 and 2012, (n=8,237) according to the PRAMS model including effects on the foetus and newborn; women being selected from obstetric and gynaecological wards. In this Polish study, only 14% of women did not consume alcohol before becoming pregnant while 15% of women drank alcohol throughout the entire period of pregnancy. In addition, awareness of the harmful effects of alcohol consumed, especially of small amounts, before and during pregnancy is low among Polish women. It is also alarming that more than 55% of physicians who provide care for pregnant women do not discuss with them the harmful effect of alcohol on the organism of the mother and foetus, whereas over 2% of doctors even recommend the consumption of alcohol in pregnancy. With reference to the Barker’s Foetal Origin of Diseases Hypothesis, the authors suggest such alcohol drinking behaviour of women during their reproductive ages and while pregnant may exert negative health effects on offspring, mainly in the form of susceptibility to contracting chronic diseases. Such findings pose a risk to future generations in Poland and require remedial/educational action targeted on health care professionals and public like.
Dental diseases and tooth loss result in various health, psychological, and even social problems. The objective of the study was determination of the number of missing teeth among adult rural and urban inhabitants of the Lublin Region, and whether or not there is a relationship between missing teeth and place of residence, and other socio-economic factors, such as: gender, age, education level and the occupation performed (farmer/non-farmer). Data concerning the number of missing teeth were collected from 3,388 individuals. The mean number of missing teeth among the respondents in the study was 13.6. This mean value was significantly higher among the rural than urban inhabitants. Tooth loss was significantly more often found among females than males, this relationship being statistically significant only in the subpopulation of rural inhabitants. According to expectations, the largest number of missing teeth was found in respondents aged over 60, among those aged 31–60 this number was nearly 2.5- fold smaller, while the smallest number of missing teeth was observed among respondents aged 18–30. The largest number of missing teeth was noted among respondents who possessed incomplete elementary or elementary education, followed by those with elementary vocational and secondary school/post-secondary school education, whereas this number was the smallest among respondents who had university education level. Farmers had a significantly larger number of missing teeth, compared to respondents who performed non-agricultural occupations. Using an analysis of regression, the relationship was confirmed between the number of missing teeth, and the respondents’ gender, age, education level, place of residence, and occupation performed. Discrimination analysis was applied to show the relationship between the occurrence of total edentulism and the respondents’ age, gender, education level and place of residence. It was observed that age was the variable which most strongly discriminated the occurrence of this characteristic, followed by education level, as well as gender and place of residence, which were the weakest discriminatory variables.
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