Publications by authors named "Grzegorz Juszczyk"

43 Publications

Coronavirus disease 2019 (COVID-19) among hospitalized patients in Poland: a study based on a national hospital registry.

Pol Arch Intern Med 2021 Apr 20. Epub 2021 Apr 20.

Introduction: Coronavirus disease 2019 (COVID-19) has been identified by the World Health Organization as a global pandemic. Poland introduced extensive anti-epidemic measures relatively early, in order to slow down the spread of the disease.

Objectives: The study aims at presenting recent data on COVID-19 hospitalization cases during the first months of this outbreak in Poland.

Patients And Methods: The study is a retrospective, population-based study conducted using hospital discharge records that included a COVID-19 diagnosis. Data were obtained from the National Institute of Public Health, where they had been collected in a Polish hospital morbidity study. Data covered 8840 hospitalization records between February 2020 and September 2020.

Results: In the study group, we analyzed 8252 records of COVID-19 patients first-time hospitalizations, which accounted for 93 % of all hospitalization cases. The study group consisted of 4161 males (50.4% of all patients) and 4091 females (49.6% of all patients). Significantly more patients from urban than rural regions were hospitalized (21.8 per 100,000 vs 20.5 per 100,000; P<0.02). In the period subject to analysis, 1073 in-hospital deaths were observed (13% of all patients), 965 of which occurred during the first-time hospitalizations (11.7% of all patients). In the study group patients with fatal hospitalizations in comparison to patients with non-fatal hospitalizations were significantly older, more frequently from urban areas, and they had more comorbidities.

Conclusions: The study findings, especially differences in patients with fatal and non-fatal hospitalizations, may be helpful in recognizing patients requiring special medical care and preventive measures during hospitalization.
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http://dx.doi.org/10.20452/pamw.15946DOI Listing
April 2021

Patients with epilepsy as drivers in Poland.

Med Pr 2021 Mar 30. Epub 2021 Mar 30.

Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Occupational Diseases and Environmental Health).

Background: Drivers suffering from epilepsy are commonly regarded as a threat to road safety. However, inability to use their own means of transport very often implies specific professional effects and lowers the quality of life. The aim of this study was to analyze the driving status of patients with epilepsy in Poland.

Material And Methods: The prospective study was performed using an independent questionnaire developed by the authors, consisting of 4 parts: 1) socio-demographic information, 2) clinical information, 3) driving information, and 4) opinions about patients with epilepsy as drivers. The study was conducted in November 2018-September 2019. A total of 188 patients completed this study.

Results: More than one-quarter of the patients have a driving license. Among them, 35 individuals (accounting for 18.62% of the whole study group) said that they had received their driving license after the diagnosis of epilepsy. In 10 cases (5.32%), seizures occurred while the patients were driving and in 72 cases (38.30%) while they were traveling as passengers. Among all socio-clinical factors, having a driving license was conditioned by the marital status (p = 0.008) and education (p = 0.007). Other factors did not affect having a driving license or the time of obtaining the license (p > 0.05 for all cases). A relationship was observed between the occurrence of side effects of antiepileptic drugs and the occurrence of seizures while traveling as a car passenger (p = 0.001). Other factors did not affect the occurrence of epileptic seizures while traveling by car, either as a driver or a passenger (p > 0.05).

Conclusions: A significant proportion of the respondents were of the opinion that patients with epilepsy should not be allowed to obtain a driving license, which is probably related to concerns about the occurrence of epileptic seizures while driving. It is necessary to conduct a nationwide educational and information campaign on epilepsy in various aspects. Med Pr. 2021;72(4).
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http://dx.doi.org/10.13075/mp.5893.01079DOI Listing
March 2021

The first SARS-CoV-2 genetic variants of concern (VOC) in Poland: The concept of a comprehensive approach to monitoring and surveillance of emerging variants.

Adv Med Sci 2021 Mar 30;66(2):237-245. Epub 2021 Mar 30.

Academic Center for Pathomorphological and Genetic-Molecular Diagnostics, Bialystok, Poland; Department of Medical Pathomorphology, Medical University of Bialystok, Bialystok, Poland. Electronic address:

Purpose: We analyzed the SARS-CoV-2 genome using our integrated genome analysis system and present the concept of a comprehensive approach to monitoring and surveillance of emerging variants.

Material/methods: A total of 69 SARS-CoV-2 positive samples (with Ct value ​≤ ​28) were tested. Samples included in this study were selected from 7 areas of eastern Poland. All samples were sequenced on an Illumina MiSeq platform using a 300-cycle MiSeq Reagent Kit v2. BWA was used for reads mapping on the reference SARS-CoV-2 sequence. SAMTools were used for post-processing of reads to genome assembly. Pango lineage and Nexstrain were used to identify variants and amino acid mutations. Statistical analysis was performed with R 4.0.2.

Results: This study shows the first confirmed case of SARS-CoV-2 in Poland with the lineage B.1.351 (known as 501Y.V2 South African variant), as well as another 18 cases with epidemiologically relevant lineage B.1.1.7, known as British variant. Supplementary analysis of SARS-CoV-2 sequences deposited in GISAID shows that the share of a new variant can change rapidly within one month. In addition, we show a complete, integrated concept of a networked system for analyzing the variability of the SARS-CoV-2 genome, which, used in the present study, generated data and a variant report within 6 days.

Conclusion: The analyzed viral genomes showed considerable variability with simultaneous clear distinction of local clusters of genomes showing high similarity. Implementing real-time monitoring of new SARS-CoV-2 variants in Poland is urgently needed, and our developed system is available to be implemented on a large scale.
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http://dx.doi.org/10.1016/j.advms.2021.03.005DOI Listing
March 2021

Readiness and Willingness to Provide Immunization Services after Pilot Vaccination Training: A Survey among Community Pharmacists Trained and Not Trained in Immunization during the COVID-19 Pandemic in Poland.

Int J Environ Res Public Health 2021 01 12;18(2). Epub 2021 Jan 12.

Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada.

Background: Immunization rates among the adult population in Poland are below desired targets, urging the need to expand this service in the community. During the COVID-19 pandemic, the ultimate goals for limiting the spread of the infection are vaccines against SARS-CoV-2. Pharmaceutical companies are in a race for the fastest possible way to deliver vaccines. Community pharmacists in Poland are recognised as an accessible yet underutilised group of medical professionals. Therefore, involving pharmacists in vaccinations may have beneficial results for the healthcare system.

Objectives: The objectives of this study were to assess the readiness and willingness of community pharmacists following the Pharmacist Without Borders project who had either been trained or not in providing immunization services, and to identify the factors that may support the implementation of such services in Poland.

Methods: This study was conducted among pharmacists between February and August 2020 in Poland. A survey was developed to determine their readiness to provide vaccination services in their pharmacies, to recognise any barriers to vaccinations, as well as the factors necessary to implement vaccination services in Polish pharmacies.

Results: A total of 1777 pharmacists participated in the study, comprising 127 (7.1%) pharmacists trained in vaccinations during the Pharmacists Without Borders project and 1650 (92.9%) pharmacists not participating in the workshops. Pharmacists participating in the workshops more often indicated that providing vaccinations in community pharmacies would improve the overall vaccination rate ( = 0.0001), and that pharmacists could play an important role in advertising and promoting vaccinations ( = 0.0001). For the pharmacists not participating in the workshops, they indicated to a much greater extent possible barriers affecting the readiness to provide vaccinations in pharmacies. They most often pointed out that vaccination services would result in a significant workload increase ( = 0.0001), that pharmacies were not adapted to immunization, and that there were not enough training courses for pharmacists ( = 0.0001).

Conclusion: The pharmacists working in community pharmacies indicated many advantages of vaccinations in pharmacies. This study identified barriers to the introduction of vaccinations and factors necessary to implement these services in pharmacies. The pharmacists trained during the immunization programme of the Pharmacists Without Borders project showed a greater readiness to provide immunization services.
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http://dx.doi.org/10.3390/ijerph18020599DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828205PMC
January 2021

Evaluation of PCL rapid point of care antigen test for detection of SARS-CoV-2 in nasopharyngeal swabs.

J Med Virol 2021 04 6;93(4):1920-1922. Epub 2021 Jan 6.

The Heart Institute, Cincinnati Children's Hospital Medical Center, Ohio, USA.

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http://dx.doi.org/10.1002/jmv.26765DOI Listing
April 2021

[Health protection of employees against SARS-CoV-2 coronavirus infection causing the COVID-19 disease - the current state of knowledge and recommendations].

Med Pr 2021 Feb 2;72(1):69-87. Epub 2020 Dec 2.

Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego / Clinic of Occupational Diseases and Environmental Health).

The COVID-19 pandemic, despite the restrictions and preventive measures applied, has rapidly spread and reached Poland. The adaptation to the dynamically changing epidemiological situation requires a prompt implementation of effective preventive measures. The aim of the publication is to provide current knowledge to all persons involved in the preventive care system, i.e., employees, employers and professionals of occupational medicine, about the epidemiological situation related to SARS‑CoV- 2, as well as recommendations and possible solutions. In order to analyze these issues, a review of literature was conducted based on medical research databases: PubMed, SCOPUS, and the Web of Science Core Collection. The literature was supplemented with studies found on websites of the Ministry of Health and the World Health Organization. Data on the cases of and deaths due to COVID-19 come from reports provided by the Ministry of Health, data published on the websites of the European Center for Disease Prevention and Control, and ourworldindata.org. By the time of submitting the publication, 34 154 cases and 1444 deaths due to coronavirus had been recorded in Poland. Data from published studies suggest that the virus is mainly transmitted via droplets or through contact with contaminated objects and surfaces. Therefore, in the absence of an effective vaccine, preventive actions are based mainly on strategies that minimize the risk of pathogen transmission. In addition to discussing the current epidemiological situation, diagnostic procedures, risk groups and COVID-19 characteristics, the paper presents recommendations and proposed solutions for employers and employees regarding the prevention of SARS‑CoV- 2, along with currently applicable laws and recommendations on employee prophylactic examinations during the pandemic. Subsequently, COVID-19 was discussed in the aspect of an occupational disease and other health threats related to the pandemics. The epidemiological situation regarding coronavirus indicates the need to take immediate and effective actions to minimize infection transmission among employees, and to develop procedures for a quick and effective ability to locate the COVID-19 outbreaks in workplaces. Med Pr. 2021;72(1):69-87.
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http://dx.doi.org/10.13075/mp.5893.01042DOI Listing
February 2021

Flu Vaccinations in Pharmacies-A Review of Pharmacists Fighting Pandemics and Infectious Diseases.

Int J Environ Res Public Health 2020 10 29;17(21). Epub 2020 Oct 29.

Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland.

The phenomenon of population ageing observed over recent years involves growing healthcare needs and the limited staffing and financing of healthcare systems, and as such demands some functional changes in the healthcare model in many countries. This situation is particularly significant in the face of a pandemic, e.g., flu, and currently COVID-19.As well as social education, preventive vaccinations are the most effective method of fighting the infectious diseases posing a special threat to seniors. Despite this, the vaccination coverage level in most European countries is relatively low. This is largely due to patients having limited access to vaccinations. In some countries, implementing vaccinations in pharmacies and by authorized pharmacists has significantly improved vaccination coverage rates and herd immunity, while lowering the cost of treating infections and the resulting complications, as well as minimizing the phenomenon of inappropriate antibiotic therapies. This article presents the role of pharmacists in the prevention of infectious diseases, pointing out the measurable effects of engaging pharmacists in conducting preventive vaccinations, as well as analyzing the models of implementing and conducting vaccinations in pharmacies in selected countries, and depicting recommendations regarding vaccinations developed by international organizations. The presented data is used to suggest requirements for the implementation of preventive vaccinations in community pharmacies.
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http://dx.doi.org/10.3390/ijerph17217945DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7662566PMC
October 2020

Prevalence of Current and Past SARS-CoV-2 Infections among Police Employees in Poland, June-July 2020.

J Clin Med 2020 Oct 11;9(10). Epub 2020 Oct 11.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland.

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine the prevalence of current and past SARS-CoV-2 infections among police employees.

Methods: This cross-sectional survey was undertaken among 5082 police employees from Mazowieckie Province, Poland. RT-PCR testing for current SARS-CoV-2 infection and serological tests (ELISA) for the presence of anti-SARS-CoV-2 IgM+IgA and IgG antibodies were performed.

Results: All RT-PCR tests were negative. The anti-SARS-CoV-2 IgM+IgA index was positive (>8) in 8.9% of participants, including 11.2% women and 7.7% men ( < 0.001). Equivocal IgM+IgA index (6-8) was found in 9.8% of participants, including 11.9% women and 8.7% men ( < 0.001). The IgG index was positive (>6) in 4.3% and equivocal (4-6) in 13.2% of participants. A higher odds of positive IgM+IgA index was found in women vs. men (OR: 1.742) and police officers vs. civilian employees (OR: 1.411). Participants aged ≥60 years had a higher odds of positive IgG index vs. those aged 20-29 years (OR: 3.309). Daily vaping also increased the odds of positive IgG index (OR: 2.058).

Conclusions: The majority of Polish police employees are seronegative for SARS-CoV-2 infection. Vaping and older age (≥60 years) were associated with a higher risk of SARS-CoV-2 infection.
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http://dx.doi.org/10.3390/jcm9103245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600317PMC
October 2020

Occupational risks for SARS-CoV-2 infection: the Polish experience.

Int J Occup Med Environ Health 2020 Oct 22;33(6):781-789. Epub 2020 Jul 22.

National Institute of Cardiology, Warsaw, Poland (Department of Cardiac Arrhythmia).

Objectives: The disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), termed COVID-19, is asymptomatic or mild in most cases. These patients do not need treatment in hospital and can be isolated at home. To date, most studies have been conducted among inpatients with severe COVID-19. In this study, the authors surveyed patients with mild COVID-19 who remained in home isolation, and analyzed the sources and occupational risk factors for SARS-CoV-2 infections.

Material And Methods: This cross-sectional study was carried out on April 17-18, 2020, among patients infected with SARS-CoV-2 who remained in home isolation in Poland. Data were acquired through a structured interview that included questions about the isolation course, symptoms, comorbidities, infection source, household characteristics, occupation, and workplace. Data were presented with descriptive statistics.

Results: Of the 4878 patients in home isolation, the authors were able to contact 3313. Of them, 1191 patients declined their invitation, and 2122 agreed to take part. The median age of the patients included in the study was 50 years; 59% were female. Most patients (92%) had not been abroad before the infection. More than half (55%) knew how they became infected; of them, 75% became infected at work. Of all patients, 70% were occupationally active. Nearly half of the occupationally active patients (48%) worked in healthcare, 3% worked in public administration or defense, 3% worked in transportation, and 2% worked in education. Sixty-five percent of the occupationally active patients worked in companies with >100 employees.

Conclusions: Most of the patients with COVID-19 in home isolation in Poland were occupationally active, wherein the majority of people who were aware of the source of SARS-CoV-2 infection worked in healthcare. As most of the infected patients worked in companies with >100 employees, which is not a Polish employment pattern, the authors expect that smaller companies may have a lower risk of SARS-CoV-2 infections. Int J Occup Med Environ Health. 2020;33(6):781-9.
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http://dx.doi.org/10.13075/ijomeh.1896.01663DOI Listing
October 2020

Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis.

Ann Agric Environ Med 2020 Mar 26;27(1):123-128. Epub 2019 Mar 26.

Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland.

Introduction And Objective: Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis.

Material And Methods: Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant.

Results: Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012).

Conclusions: SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.
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http://dx.doi.org/10.26444/aaem/105925DOI Listing
March 2020

Refusal to Take Sick Leave after Being Diagnosed with a Communicable Disease as an Estimate of the Phenomenon of Presenteeism in Poland.

Med Princ Pract 2020 3;29(2):134-141. Epub 2019 Sep 3.

Medical University of Warsaw, Warsaw, Poland.

Objective: The purpose of this study was to estimate the prevalence of presenteeism in patients with communicable diseases in Poland.

Subject And Methods: This study was based on data from the medical records of 2,529 patients aged 19-64 years. All of the patients were diagnosed with communicable diseases. The inclusion criteria were based on implementing decision concerning communicable diseases made by the Commission of the European Union. Associations between refusal to take sick leave and patients' age, gender, and diagnosis in terms of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) were tested. Linear regression analysis of the data acquired from the patients who agreed to take sick leave was further used to estimate the possible length of sick leave in patients who refused to take it.

Results: The number of patients who refused to take sick leave was 18.1%. The presenteeism rate was related to the age of patients (periods of sick leave were longer in older patients) and the ICD-10 diagnosis (largely in bacterial intestinal infections and measles). The estimated number of days spent on sick leave in patients who refused to take it, assuming that they made a different decision and complied with it, was in the range of 4-6 days.

Conclusion: The prevalence of presenteeism in the case of communicable diseases in Poland is lower than in the general population. However, as the refusals to take sick leave took place in the case of potentially contagious diseases, the negative impact on productivity may be significant.
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http://dx.doi.org/10.1159/000503052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098319PMC
January 2021

Work Ability Index (WAI) values in a sample of the working population in Poland.

Ann Agric Environ Med 2019 Mar 28;26(1):78-84. Epub 2018 Sep 28.

Department of Experimental and Clinical Pharmacology, Medical University, Warsaw, Poland.

Introduction: Ability to work is most often defined as a relationship between a person's resources and requirements specific to a particular type of work. It is the result of interaction between job requirements in terms of physical and mental strain, capabilities and skills of the employee, as well as his/her health condition and own evaluation of functioning in a given organizational and social situation.

Objective: The primary objective of the study was to evaluate the current value of the Work Ability Index (WAI) in a sample of employees in Poland.

Material And Methods: The study sample was selected purposefully from 422,000 employees covered by the largest occupational health provider in Poland. The standard WAI questionnaire provided by CAWI (Computer-Assisted Web Interview) methodology was voluntary and completed anonymously by 688 employees within 12 months (0.16% response rate). The results were statistically analyzed using the Pearson's chi-squared test and correlation coefficient, independent-sample T test and one-way analysis of variance (p<0.05).

Results: It was found that the average value of WAI was 37.5 ± 7.7, and 37% of the participants represented low to moderate ability to work. The results showed no significant correlation between the WAI value and its 7 compounds and demographic variables. Nonetheless, a dependency between WAI level and industrial branch was observed.

Conclusions: Subjects with moderate and low WAI (1/3 of the study population) had particular indications to implement prophylactic actions, especially for the health care employees and civil servants, whose ability to work may be subject to accelerated deterioration.
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http://dx.doi.org/10.26444/aaem/91471DOI Listing
March 2019

Immunity to hepatitis A virus among working professionals in Poland - Results of a 3-year serological survey 2013-2015.

Ann Agric Environ Med 2018 Sep 25;25(3):572-575. Epub 2018 Sep 25.

National Institute of Public Health, Warsaw, Poland.

Introduction: Hepatitis A (HA) is caused by infection with the hepatitis A virus (HAV). The differential etiological diagnosis of acute hepatitis is based on a positive result of the serological test detecting IgM class anti-HAV. For epidemiological studies on past infection and seroprevalence of HAV in populations, the tests measuring IgG class anti-HAV or total anti-HAV are used. Since the 1990s, specific prophylaxis is possible by vaccination against HA. In Poland, vaccination is recommended and in majority is performed at own cost.

Material And Methods: Database was obtained from electronic medical records of the 2 major private health care providers networks (Luxmed and Medicover) operating in Poland. During a 3-year period (2013-2015), 1,124 persons with unknown status of anti-HA vaccination were tested for the presence of total anti-HAV. Objective. The aim of the study was to evaluate the seroprevalence of anti-HAV among working professionals in Poland.

Results: Anti-HAV were detected in 603 (53.6%) persons, while 521 (46.3%) tested negative. The study group was divided into 2 subgroups: 25-44 and 45-64-years-old. For detailed statistical analysis, the presence of anti-HAV was considered as a dependent variable, and its predictors were gender, age and the year of the test performance. The presence of anti-HAV was significantly more prevalent in older age group. The lack of specific antibodies was more prevalent in younger age group.

Conclusions: Results of the study show increasing susceptibility to HAV infection in the younger age group, compared with the older age group of corporate professional employees in large cities in Poland. Since the epidemiological situation of HA is currently changing with increasing number of symptomatic cases of HA, it is suggested that employers might consider including an additional procedure of vaccination against HA into their private health insurance portfolio.
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http://dx.doi.org/10.26444/aaem/91467DOI Listing
September 2018

Refusal to take a sick leave as an estimate of the phenomenon of presenteeism in Poland.

Oncotarget 2018 Jun 15;9(46):28176-28184. Epub 2018 Jun 15.

Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland.

Introduction: Absenteeism and presenteeism are two main phenomena related to health problems and professional activity. Presenteeism is the involvement in a professional activity despite being ill. The purpose of the current study is to estimate the prevalence of presenteeism in Poland on the basis of medical records and to explore associations between presenteeism and patients' age, gender and type of medical problem. Another purpose is to provide estimates of the length of sick leave if it was accepted.

Results: The amount of patients who refused to take a sick leave was 27.4%. There was a minor relationship between the refusals and gender (slightly higher in men) as well as strong effects of the age of patients (periods of sick leave were longer in older patients) and ICD-10 diagnosis (largely in acute diseases of the upper respiratory tract). The estimated number of days spent on sick leave in the group of patients that refused to take it, assuming that they made a different decision and complied to it, was in the range between 5 and 10 days.

Discussion: The prevalence of presenteeism in Poland is relatively high. Since the largest proportion of refusals took place in the case of potentially contagious diseases, the negative impact on productivity may be even higher. Even though the relationship between presenteeism and wages remains unclear, the remarkable increase of wages in Poland within the last 20 years may explain the propensity to work despite being ill. Further research needs to consider the simultaneous use of medical records and self-measured productivity loss.

Materials And Methods: The current study is based on data from medical records concerning 550,360 patients aged 19-64. Associations between refusals to take a sick leave and patients' age, gender, as well as diagnosis in terms of ICD-10 (International Statistical Classification of Diseases and Related Health Problems), were tested. Linear regression analysis on the data acquired from the patients who accepted to take a sick leave were further used to estimate the possible length of sick leave in the group of patients that refused to take it.
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http://dx.doi.org/10.18632/oncotarget.25592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6021350PMC
June 2018

Risk assessment of night-eating syndrome occurrence in women in Poland, considering the obesity factor in particular.

Neuropsychiatr Dis Treat 2018 13;14:1521-1526. Epub 2018 Jun 13.

Katowice Faculty, SWPS University of Social Sciences and Humanities, Warsaw, Poland.

Introduction: Night-eating syndrome (NES) involves uncontrolled and most often repeated binge eating during the night. It is related with mood disorders as well as sleep disorders and it may cause obesity. Risks related to NES are obesity, binge eating disorder, bulimia nervosa, affective disorders, and sleep disorders. The objective of this study is to analyze eating habits in terms of the risk assessment of NES occurrence in the population of women in the Masovian Voivodeship (in Poland).

Patients And Methods: Six hundred and eleven women living in the Masovian Voivodeship participated in the study. The average age of the respondents was 22.7 years (median = 23.0; interquartile range = 3.0). The Night Eating Questionnaire (NEQ) was used to assess the risk of NES.

Results: In the studied group of women, 1.3% of cases (N = 12) reached a NEQ total score of ≥25, which indicates a probability of 40.7% for NES, while 0.7% (N = 4) reached a score of ≥30, which indicates a probability of 72.2% for occurrence of this syndrome. The highest average total score was observed in the group of obese people. The level of education of the participants did not significantly affect the NEQ score. A weak correlation was observed between the place of residence variable and the mood/sleep subscale ( = 0.11, < 0.01).

Conclusion: NES may be one of the causes of overweight and obesity; therefore, the need for further studies on this health issue is justified. It is worth pointing out that knowing the conditions responsible for the occurrence of NES, it is possible to suggest a prevention procedure for this condition.
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http://dx.doi.org/10.2147/NDT.S159562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005332PMC
June 2018

Awareness and attitudes towards clinical trials among Polish oncological patients who had never participated in a clinical trial.

Adv Clin Exp Med 2018 Apr;27(4):525-529

Department of Pharmacodynamics, Medical University of Warsaw, Poland.

Background: Participation in a clinical trial significantly shortens waiting time associated with receiving specialist care. Furthermore, it may be the case that, through clinical trials, subjects can access medicines that are not typically available in Poland.

Objectives: The aim of this study was to determine the opinions of oncological patients about clinical trials.

Material And Methods: The research has been carried out during the years 2014-2016. A proprietary questionnaire consisting of 10 closed, single and multiple choice questions about awareness and perceptions of clinical trials, and 5 questions concerning demographic information was used. A group of 256 patients with cancer (54% women, 46% men), aged 21-77 years, was surveyed.

Results: Respondents were statistically more likely to decide to participate in a clinical trial as oncological patients than the healthy volunteers (Pearson's χ2 test p = 0.00006). The desire to qualify for clinical trials in no way depends on the knowledge of side effects (Pearson's χ2 test p = 0.16796).

Conclusions: Our study found that the patients' awareness about clinical trials varied. However, a positive attitude towards research was visible. The main identified barriers to clinical trial participation were fear of possible side effects. Most patients regarded clinical trials as useful, and considered that they are conducted to introduce new treatment/new drug.
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http://dx.doi.org/10.17219/acem/68762DOI Listing
April 2018

[Patient safety in poland according to analysis of medical adverse events].

Wiad Lek 2017;70(6 pt 1):1096-1101

Zakład Ekonomiki i Jakości W Ochronie Zdrowia, Katedra Zdrowia Publicznego, Wydział Nauk O Zdrowiu, Uniwersytet Medyczny Im. Piastów Sląskich We Wrocławiu, Wrocław, Polska.

The paper presents the analysis of rulings from regional commisions on health care malpractice in Poland wiith special attention to patient safety issues. The analysis entails causes, types and consequensence of 469 malpractice claims. In 23,7% of cases the claim was confirmed by commission. The most frequent types of malpractice was body injury. General surgery and othopedis were the major medical specialities when confirmed malpractices took place.
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June 2018

The impact of individualised nutritional therapy according to DASH diet on blood pressure, body mass, and selected biochemical parameters in overweight/obese patients with primary arterial hypertension: a prospective randomised study.

Kardiol Pol 2018 5;76(1):158-165. Epub 2017 Oct 5.

Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences, Warsaw, Poland

Background And Aim: The aim of the study was to assess the impact of individualised nutritional intervention based on the DASH diet (Dietary Approaches to Stop Hypertension) on the nutritional status, blood pressure, and selected biochemical parameters of obese/overweight patients with primary arterial hypertension.

Methods: A total of 131 participants were randomised to the DASH intervention group (DIG; n = 69, 33 males) or the control group (CG; n = 62, 32 males). A three-month nutritional intervention was carried out in the DIG group, while the control group received only standard recommendations. Body weight, height, waist and hip circumference, body composition, blood pressure, serum glucose, and insulin and leptin concentrations were measured at the baseline and after the intervention.

Results: Sixty-four (92.8%) participants in the intervention and 62 (100%) in the control group completed the study. In the DIG group a significant decrease in body mass, systolic and diastolic blood pressure, body fat content, fasting glucose, insulin, and leptin concentrations were observed in comparison to the control group (p < 0.05).

Conclusions: The DASH dietary intervention provides significant benefits to overweight/obese patients with primary hypertension.
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http://dx.doi.org/10.5603/KP.a2017.0184DOI Listing
November 2018

Evidence-based selection process to the Master of Public Health program at Medical University.

BMC Med Educ 2017 Sep 11;17(1):157. Epub 2017 Sep 11.

Division of Teaching and Outcomes of Education, Faculty of Health Science, Medical University of Warsaw, Zwirki i Wigury 61, 02-091, Warsaw, Poland.

Background: Evaluation of the predictive validity of selected sociodemographic factors and admission criteria for Master's studies in Public Health at the Faculty of Health Sciences, Medical University of Warsaw (MUW).

Methods: For the evaluation purposes recruitment data and learning results of students enrolled between 2008 and 2012 were used (N = 605, average age 22.9 ± 3.01). The predictive analysis was performed using the multiple linear regression method. In the proposed regression model 12 predictors were selected, including: sex, age, professional degree (BA), the Bachelor's studies grade point average (GPA), total score of the preliminary examination broken down into five thematic areas. Depending on the tested model, one of two dependent variables was used: first-year GPA or cumulative GPA in the Master program.

Results: The regression model based on the result variable of Master's GPA program was better matched to data in comparison to the model based on the first year GPA (adjusted R 0.413 versus 0.476 respectively). The Bachelor's studies GPA and each of the five subtests comprising the test entrance exam were significant predictors of success achieved by a student both after the first year and at the end of the course of studies.

Conclusions: Criteria of admissions with total score of MCQs exam and Bachelor's studies GPA can be successfully used for selection of the candidates for Master's degree studies in Public Health. The high predictive validity of the recruitment system confirms the validity of the adopted admission policy at MUW.
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http://dx.doi.org/10.1186/s12909-017-1007-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594576PMC
September 2017

Analysis concerning nutritional behaviors in the context of the risk of orthorexia.

Neuropsychiatr Dis Treat 2017 21;13:543-550. Epub 2017 Feb 21.

Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.

Orthorexia is recognized as an eating disorder, an obsessive-compulsive spectrum disorder, or a somatoform disorder. The aim of our research was to analyze nutritional behaviors for the assessment of the risk of orthorexia. The authors developed a questionnaire in which 981 respondents participated and used it as a research method. Both men and women ate mostly 4-5 meals per day (46.30% women versus 34.74% men); however, more men than women ate 1-2 meals daily (18.95% men versus 7.9% women). Both place of birth and field of study did not differ in terms of the number of meals. Moreover, it was observed that the number of meals per day was correlated with the declared time spent on planning a diet. People who ate over 3 meals per day more often indicates that they spent >3 h per day on planning their diet in comparison with people who ate only 1-2 meals. Only 17.6% of the respondents declared that they most often ate meals in a company of someone, whereas 45.3% indicated that there was no rule. The remaining 37.1% of the respondents most often consumed their meals alone. Almost twice as many men as women never paid attention to the qualitative composition of nutrition. Women followed a slimming diet more often than men (20.3% versus 5.8%) and this indicated >4 attempts of losing weight. Around one-third of all the respondents suffered or suffer from eating disorders. Owing to insufficient information on orthorexia, it is essential to conduct further research to determine the characteristics of high-risk groups. Taking the growing interest in a healthy lifestyle into account, there is a need to address the problem of orthorexia in the public space.
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http://dx.doi.org/10.2147/NDT.S129660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328602PMC
February 2017

Anti-hepatitis C virus seroprevalence in the working age population in Poland, 2004 to 2014.

Euro Surveill 2017 Jan;22(2)

Department of Public Health, Medical University of Warsaw, Poland.

Hepatitis C virus (HCV) infection is considered by the World Health Organization (WHO) to be a serious public health concern and one of the major public health priorities. In 2005, it was estimated that there are 185 million anti-HCV positive people in the world, which constitutes 2.8% of the global population. Our study estimates the anti-HCV seroprevalence in the working age population (15-64 years-old), mostly urban and suburban residents, in Poland from 2004 to 2014. The studied group consisted of 61,805 working-age population representatives whose data were obtained from electronic medical records of an outpatient clinic network operating on a countrywide level. Positive anti-HCV test results were obtained in 957 patients, representing 1.5% of the whole population studied throughout the analysed period. The average age of all anti-HCV positive patients was 36.8 years. Analysis of the data suggests that the proportion of anti-HCV positive patients decreased over the study period (mean positive anti-HCV = -0.0017 × year + 3.3715; R = 0.7558). In 2004, positive results were noted among 3.2% of patients undergoing HCV antibody tests, but in 2014, the percentage of patients with a positive result stood at 1.1%. The apparent decrease affected men and women similarly. Our study also provides evidence that screening people born before 1965 could be beneficial.
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http://dx.doi.org/10.2807/1560-7917.ES.2017.22.2.30441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404489PMC
January 2017

Incidence and mortality rates in breast, corpus uteri, and ovarian cancers in Poland (1980-2013): an analysis of population-based data in relation to socioeconomic changes.

Onco Targets Ther 2016 7;9:5521-30. Epub 2016 Sep 7.

Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.

Objectives: This study aimed to analyze incidence and mortality trends in breast cancer (BC), corpus uteri cancer (CUC), and ovarian cancer (OC) in Poland in the context of sociodemographic changes.

Materials And Methods: Incidence and mortality data (1980-2013) were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960-2013) were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC).

Results: A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980-1990 2.14, AAPC1990-1996 4.71, AAPC1996-2013 2.21), with a small but significant decrease in mortality after a slight increase (AAPC1980-1994 0.52, AAPC1994-2013 -0.66). During the period 1980-2013, a significant increase in CUC incidence (AAPC1980-1994 3.7, AAPC1994-2013 1.93) was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980-2006 -1.12, AAPC2006-2013 3.74). After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980-1994 2.98, AAPC1994-2013 -0.49), as did the mortality rate (AAPC1980-1994 0.52, AAPC1994-2013 -0.66).

Conclusion: After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in mortality rate was observed for BC and OC predominantly at the end of the study period, while for CUC, after a long decreasing mortality trend, a significant increase was observed.
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http://dx.doi.org/10.2147/OTT.S112187DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021054PMC
September 2016

Age at natural menopause in women on long-term methotrexate therapy for rheumatoid arthritis.

Menopause 2016 10;23(10):1130-8

1Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland2Center of Rheumatology, Immunology and Rehabilitation, Dietl Specialistic Hospital, Krakow, Poland3Department of Public Health, Medical University of Warsaw, Warsaw, Poland4Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland.

Objective: The aim of the study was to compare the natural menopause ages of healthy women with those of women with methotrexate (MTX)-treated rheumatoid arthritis (RA), and to specifically assess the effect of disease onset and activity and the use of MTX on the age of the last menstruation.

Methods: We performed a retrospective review of medical records to identify the ages at which menopause occurred in women with premenopausal RA treated with MTX and in women with postmenopausal onset, irrespective of therapy. Natural menopause ages were also compared between participants with and without RA.

Results: Women with premenopausal onset of RA underwent menopause at a significantly younger age than did healthy women (P < 0.001) or those with postmenopausal disease onset (P = 0.001). Menopause also occurred at younger ages in participants with postmenopausal disease onset than in healthy controls (P = 0.012). The study suggested that menopause age was positively correlated with the age at which RA was diagnosed (R = 0.51; P < 0.001) in women with premenopausal RA onset, but was independent of the participant's age at menarche, number of pregnancies, or MTX therapy. Participants with RA onset at ≤ 35 years of age had a ninefold higher risk of premature menopause (P = 0.008).

Conclusions: The age at which menopause occurs in a patient with RA depends on the patient's age at the time of disease onset and its duration, but is not influenced by MTX treatment.
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http://dx.doi.org/10.1097/GME.0000000000000674DOI Listing
October 2016

Cost intensity of identifying contraindications to driving a company car through psychological tests on the basis of real-world data in Poland.

Int J Occup Saf Ergon 2017 Dec 2;23(4):553-557. Epub 2016 Sep 2.

a Department of Public Health , Medical University of Warsaw , Poland.

Objective: The study objective was to determine the cost intensity of identifying contraindications to fleet car driving in preventive care.

Background: The objective of a psychological examination is to identify impaired psychomotor function as well as any intellectual, cognitive or emotional incapacities, which may seriously impede safety.

Method: Real-world data were collected from the healthcare provider in Poland. A total of 8111 anonymous records from psychomotor tests performed between January 1 and December 31, 2012 were analysed.

Results: The number needed to screen to identify one person with contraindications to driving was 737. An individual examination costs PLN 150, thus the estimated cost of identifying one case was PLN 110,550 (EUR 25,000). The average number of tests in a small enterprise with 20-50 fleet cars was estimated at 5-25 in a 5-year period and their cost at PLN 3750 (PLN 750 annually).

Conclusion: Health check-ups include ophthalmological and neurological consultations; therefore, psychological examination of fleet car drivers may be considered excessive due to cost and limited preventive value. High costs may be burdensome mainly to larger companies.

Application: A final decision regarding necessity of psychological testing should be preceded by medical assessment of the risk of work accidents.
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http://dx.doi.org/10.1080/10803548.2016.1221911DOI Listing
December 2017

Diagnosis of hepatitis C virus infection in pregnant women in the healthcare system in Poland: Is it worth the effort?

Medicine (Baltimore) 2016 Jul;95(30):e4331

Medical University of Warsaw Warsaw School of Economics Warsaw University of Technology, Warsaw, Poland.

The hepatitis C virus (HCV) is globally recognized as a serious public health concern. Current statistics indicate that approximately 2% of people worldwide and 1.9% of people in Poland suffer from HCV infection.This study was conducted to assess the anti-HCV seroprevalence in pregnant women in Poland and subsequently provide recommendations on the rationale for obligatory screening.A total of 42,274 women participated in our study, of which 16,130 were pregnant. We were granted access to their health data stored in the form of electronic medical records kept by the network of outpatient clinics throughout Poland.The lowest rate of positive anti-HCV test results was found in women ages 25 to 34 (0.73%); however, younger and older age groups had similar rates (15-24 = 0.86%; 35-44 = 0.84%). Additional analysis of data from the period between 2011 and 2014 revealed a downward trend in the proportion of positive anti-HCV tests among pregnant women (mean positive anti-HCV = -0.001 × year + 1.9451; R = 0.7274). Regardless of the gradual increase in the number of female patients undergoing screening between 2004 and 2015, there has been a constant decrease in the rate of positive cases. The rate of pregnant women potentially infected with HCV was twice as lower than that in a control group of women undergoing tests for other medical circumstances: 0.76% vs 1.67% (P < 0.0001).Analysis of real-world data of female patients in Poland provides evidence that screening based on an individual's medical history and behavioral risk factors in clinical circumstances would be more effective than obligatory testing of all pregnant women.
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http://dx.doi.org/10.1097/MD.0000000000004331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265851PMC
July 2016

Implementation of electronic health records in Polish outpatient health care clinics - starting point, progress, problems, and forecasts.

Ann Agric Environ Med 2016 Jun;23(2):329-34

Medical University of Warsaw, Poland.

Introduction: The Act on Information System in Health Care, dated 28 April 2011, imposes an obligation to record patients' medical documentation in an electronic form (EHR - Electronic Health Records) on the providers of health care services, starting from 1 August 2014. On 23 July 2014, an amendment of the Act was enacted, based on which the date of obligatory introduction of health records in paper or electronic form was postponed until 31 July 2017. At various health care entities there are two different methods of creating health records (HR); therefore, the implementation of the provisions of the Act poses a significant number of problems and complications.

Objective: The objective of the study is to present the starting point, progress, problems and forecasts regarding the implementation of electronic health records at health care entities which provide services within the scope of specialized outpatient care (SOC).

Materials And Method: The subjects of this research were 475 health care entities which provide services within the scope of specialized outpatient care (SOC) operating in Poland. The applied research tool was a survey questionnaire. The applied research technology was a Computer Assisted Web Interview (CAWI). The research was conducted between February - April 2014. The data was analyzed with the chi-squared test of independence.

Results: In the period of the research, 233 health care entities were at the stage of preparation for the implementation of HER: 116 - in the process of implementation; 72 - after implementation, and only 54 were already recording their documentation in an electronic form.

Conclusions: Most health care entities providing specialized outpatient care would not have complied with the provisions of the Act on Information System in Health Care had the deadline for implementation of EHR not been postponed. Five months before the date stipulated in the first version of the Act (August 2014), about 74% of health care entities covered by this study did not yet have a ready EHR system. The study also showed that 2 years is insufficient time for the entire process of informatization of a health care establishment.
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http://dx.doi.org/10.5604/12321966.1203900DOI Listing
June 2016

Analysis of Quality of Life Subjective Perception by Patients Treated for Prostate Cancer with the EORTC QLQ-C30 Questionnaire and QLQ-PR25 Module.

J Cancer Educ 2017 Sep;32(3):509-515

Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.

Prostate cancer in men is the second most occurring cancer in Poland and represents approximately 13.2 % of all cancers. At the same time, it is the third largest cause of death in men, being responsible for approximately 8 % of deaths. The study was conducted among patients of Oncological Hospital in Wieliszew. The study included 83 men diagnosed with prostate cancer at the age of 51-84 years. The patients gave their written consent to participate in the study, to which the overall standardized questionnaires EORTC QLQ-C30 and QLQ-PR25 for patients with prostate cancer was applied. Significant deterioration of the state of health due to cancer was indicated by a total of 10.84 % of patients. At the same time, it was found that although there are differences between quality of life in various age groups of respondents, they are statistically insignificant (Chi2 = 59.96; p = 0.00734; R = 0.09; p > 0.05). Subjective QoL did not depend on the stage of cancer treatment, type of therapy, or significant deterioration in the patient's state of health in the last stage of disease. Both disease and therapy have impact on quality of life in all its dimensions, in particular as regards the patient's physical functioning and his frequent fatigue. There is a strong relationship between a patient's subjective assessment of quality of life and pain that significantly hampers everyday activities. This demonstrates the need for continuous monitoring and relieving pain directly associated with cancer and methods of its treatment.
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http://dx.doi.org/10.1007/s13187-015-0954-5DOI Listing
September 2017

Age-related trends in anti-Mullerian hormone serum level in women with unilateral and bilateral ovarian endometriomas prior to surgery.

Reprod Biol Endocrinol 2015 Nov 24;13:128. Epub 2015 Nov 24.

Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland.

Background: Endometriosis is a well-known cause of infertility, and the anti-Mullerian hormone (AMH) is an accepted biomarker of ovarian reserve and response to artificial reproductive technology procedures. The present study was a prospective analysis of age-dependent AMH serum concentration in women with bilateral and unilateral ovarian endometriomas before therapy onset compared with healthy controls.

Methods: This prospective cross-sectional study included 384 women aged 18-48 years. AMH serum concentration was assessed between days 3 and 6 of the menstrual cycle in 78 patients with bilateral and 157 patients with unilateral ovarian endometriomas and compared with 149 healthy controls. Ovarian endometriosis was confirmed histopathologically, and data were presented as medians with interquartile range (IQR).

Results: Stage III endometriosis was diagnosed in 53.2 %, stage IV in 18.3 %, stage V in 23.4 % and stage VI in 5.4 % of the patients. Patients with bilateral ovarian endometriomas showed the lowest median AMH levels compared with patients suffering from unilateral ovarian endometriosis (0.55; IQR: 0.59 vs. 2.00; IQR: 2.80; p < 0.001) and the control group (0.55; IQR: 0.59 vs. 2.84; IQR: 3.2; p < 0.001). Median AMH concentration values were not significantly different between patients with unilateral ovarian endometriosis and the healthy controls (2.00; IQR: 2.80 vs. 2.84; IQR: 3.2; p = 0.182). A strongly negative correlation between AMH levels and age was confirmed in healthy individuals (R = -0.834; p < 0.001) and women with unilateral ovarian endometriomas (R = -0.774; p < 0.001). Patients with bilateral ovarian endometriosis showed a significantly negative but only moderate correlation between AMH levels and age (R = -0.633; p < 0.001), which was significantly lower than in the healthy controls (R = -0.633 vs. R = -0.834; p = 0.006) but not in the patients with unilateral ovarian endometriosis (R = -0.663 vs. R-0.774; p = 0.093). Based on a multivariate regression analysis, only bilateral localization of ovarian endometrial cysts (p = 0.003) and patient age (p < 0.001), but not left/right localization of unilateral cyst or cyst volume, were negatively associated with AMH serum concentration.

Conclusion: According to our data, unilateral ovarian endometriosis had a moderately negative and nonsignificant effect on AMH-based ovarian reserve evaluated prior to surgery, irrespective of age. In contrast, the ovarian reserve was significantly reduced in women with bilateral ovarian endometriomas.
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http://dx.doi.org/10.1186/s12958-015-0125-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657379PMC
November 2015