M. Kozińska, Jerzy Zientek, E. AUGUSTYNOWICZ-KOPEĆ, Z. Zwolska, J. Kozielski
INTRODUCTION In 2007, Poland, the Czech Republic, and Slovakia joined the Schengen Agreement, abolishing restrictions on people crossing the borders. Currently, these areas are places of population movements for economic, family, and touristic reasons. This favors the transmission of infectious diseases, including tuberculosis, and requires enhanced control over the spread of the source of infection in the population of patients living in the border areas. OBJECTIVES The aim of this study was to investigate the genetic relatedness among Mycobacterium tuberculosis complex strains isolated from patients living in 3 border areas: Poland, the Czech Republic, and Slovakia. PATIENTS AND METHODS The study group consisted of 209 patients with tuberculosis diagnosed and treated between 2007 and 2011 in health care facilities in the Silesia Province in Poland (121 patients [58%]), Žilina in Slovakia (57 [27%]), and the Moravian-Silesian Region in the Czech Republic (31 [15%]). Genotyping of strains was performed using spoligotyping and IS6110-Mtb1-Mtb2 polymerase chain reaction. RESULTS Among 209 strains, 23 molecular families (clusters) were identified. Seventeen clusters were identified as national. Six international clusters consisted of 30 strains isolated from patients of various nationalities. CONCLUSIONS We identified 6 potential outbreaks of tuberculosis transmission between patients of different nationalities. The circumstances favorable to potential contacts of patients included mainly travelling to the neighboring countries, hospital stays, and addictions. However, there was no evidence of an epidemiological link between these patients, so it may be assumed that if they had come in contact with one another, it was accidental. We observed that the greater incidence of tuberculosis on the Polish territory did not affect the incidence in the Czech Republic or Slovakia over the analysis period.
{"title":"Transmission of tuberculosis among people living in the border areas of Poland, the Czech Republic, and Slovakia.","authors":"M. Kozińska, Jerzy Zientek, E. AUGUSTYNOWICZ-KOPEĆ, Z. Zwolska, J. Kozielski","doi":"10.20452/PAMW.3263","DOIUrl":"https://doi.org/10.20452/PAMW.3263","url":null,"abstract":"INTRODUCTION\u0000In 2007, Poland, the Czech Republic, and Slovakia joined the Schengen Agreement, abolishing restrictions on people crossing the borders. Currently, these areas are places of population movements for economic, family, and touristic reasons. This favors the transmission of infectious diseases, including tuberculosis, and requires enhanced control over the spread of the source of infection in the population of patients living in the border areas.\u0000\u0000\u0000OBJECTIVES\u0000The aim of this study was to investigate the genetic relatedness among Mycobacterium tuberculosis complex strains isolated from patients living in 3 border areas: Poland, the Czech Republic, and Slovakia. PATIENTS AND METHODS The study group consisted of 209 patients with tuberculosis diagnosed and treated between 2007 and 2011 in health care facilities in the Silesia Province in Poland (121 patients [58%]), Žilina in Slovakia (57 [27%]), and the Moravian-Silesian Region in the Czech Republic (31 [15%]). Genotyping of strains was performed using spoligotyping and IS6110-Mtb1-Mtb2 polymerase chain reaction.\u0000\u0000\u0000RESULTS\u0000Among 209 strains, 23 molecular families (clusters) were identified. Seventeen clusters were identified as national. Six international clusters consisted of 30 strains isolated from patients of various nationalities.\u0000\u0000\u0000CONCLUSIONS\u0000We identified 6 potential outbreaks of tuberculosis transmission between patients of different nationalities. The circumstances favorable to potential contacts of patients included mainly travelling to the neighboring countries, hospital stays, and addictions. However, there was no evidence of an epidemiological link between these patients, so it may be assumed that if they had come in contact with one another, it was accidental. We observed that the greater incidence of tuberculosis on the Polish territory did not affect the incidence in the Czech Republic or Slovakia over the analysis period.","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"75 1","pages":"32-40"},"PeriodicalIF":0.0,"publicationDate":"2019-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73346475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
1054 As a hematology specialist but also an internal medicine specialist, I am a strong supporter of keeping this specialty as an integral and essential discipline of medical sciences. I remember what my teacher and mentor, late Professor Mieczysław Gamski, used to say: he claimed that internal medicine was the queen of medical sciences. I remember that he denied accepting the title of a cardiology specialist because he thought that the title of an “internist” was something that one could be more proud of. He was also encouraging me to have my postdoctoral degree in internal medicine, not in hematology. Since that time the advances in medicine have brought about significant changes, thus nowadays there are no “medical wizards” who would be able to represent the deep and current knowledge in all disciplines (specialties) of internal medicine. However, I think that the education in a multidisciplinary clinic of internal medicine had prepared me to fulfill my life’s passion, which is hematology. It helped me to adopt a holistic attitude towards the patient, it gave me a better ability to make proper decisions regarding treatment, it taught me how to anticipate possible complications and prevent them from occurring. Separating the internal medicine subspecialties as primary specialties was caused by the shortage of available specialists and the fact that the training of young doctors was too long. I think it was a necessary step but it is a shame that it had been preceded by the elimination of the 2 stages previously required for the internal medicine specialty (firstand second-degree specialization). From today’s perspective, I believe that it would have been better to keep the first-degree specialization in internal diseases after which one could continue with different detailed specialties of internal medicine. Even though the current specialty programs include 2 training modules, their practical implementation and the lack of examination upon the completion of the first module (internal diseases) does not guarantee proper and FORUM FOR INTERNAL MEDICINE
{"title":"The current status and the future of internal medicine: a voice in the discussion.","authors":"A. Hellmann","doi":"10.20452/pamw.3737","DOIUrl":"https://doi.org/10.20452/pamw.3737","url":null,"abstract":"1054 As a hematology specialist but also an internal medicine specialist, I am a strong supporter of keeping this specialty as an integral and essential discipline of medical sciences. I remember what my teacher and mentor, late Professor Mieczysław Gamski, used to say: he claimed that internal medicine was the queen of medical sciences. I remember that he denied accepting the title of a cardiology specialist because he thought that the title of an “internist” was something that one could be more proud of. He was also encouraging me to have my postdoctoral degree in internal medicine, not in hematology. Since that time the advances in medicine have brought about significant changes, thus nowadays there are no “medical wizards” who would be able to represent the deep and current knowledge in all disciplines (specialties) of internal medicine. However, I think that the education in a multidisciplinary clinic of internal medicine had prepared me to fulfill my life’s passion, which is hematology. It helped me to adopt a holistic attitude towards the patient, it gave me a better ability to make proper decisions regarding treatment, it taught me how to anticipate possible complications and prevent them from occurring. Separating the internal medicine subspecialties as primary specialties was caused by the shortage of available specialists and the fact that the training of young doctors was too long. I think it was a necessary step but it is a shame that it had been preceded by the elimination of the 2 stages previously required for the internal medicine specialty (firstand second-degree specialization). From today’s perspective, I believe that it would have been better to keep the first-degree specialization in internal diseases after which one could continue with different detailed specialties of internal medicine. Even though the current specialty programs include 2 training modules, their practical implementation and the lack of examination upon the completion of the first module (internal diseases) does not guarantee proper and FORUM FOR INTERNAL MEDICINE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"64 1","pages":"1054-1057"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79253465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Internal medicine in the future.","authors":"Z. Zdrojewski","doi":"10.20452/pamw.3753","DOIUrl":"https://doi.org/10.20452/pamw.3753","url":null,"abstract":"","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"57 1","pages":"1085-1088"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84873280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
FORUM FOR INTERNAL MEDICINE On the lesser importance of internal medicine Introduction Internal medicine constitutes a unique medical specialty. Not only does it include both outand in patient care, but also involves acute cases and life -threatening conditions. Subjectively, in my view, internal medicine is the essence of medicine, and all the attempts at the reduction of the physician’s role in the health care system result in the system instability. The physician’s scope of activity is extremely wide and is deeply rooted in pathophysiology. When I started my professional journey, the most important educational element was a specialty in internal medicine—extremely difficult and demanding. At that time, the 2-step system required constant education and practical verification of skills. Furthermore, a natural consequence of choosing internal medicine was the necessity of active participation in on-call shifts, especially at the Accident and Emergency Department. Nevertheless, this extremely hard and difficult path gave my friends and me much professional satisfaction, as well as a feeling of being the elite—the chosen ones who can establish a good diagnosis on the basis of an interview, a physical examination, and additional tests. What is more, other hospital departments were unable to function properly without the internal medicine specialist. However, nowadays, there are many of those who would gladly pronounce this specialty dead, and treat it as an unnecessary relic of the past. Some even claim that physicians used to be the opponents of progress. The abovementioned preposterous theses do not reflect the reality and are unfair towards the doctors whose knowledge is frequently underestimated. All in all, it might give the impression that knowledge and clinical practice have become less vital in face of modern imaging, equipment, and laboratory possibilities. In my view, neither the equipment present in our profession, nor any of the biochemical test possibilities, will ever substitute the physician. On the other hand, these novelty methods are extremely expensive, FORUM FOR INTERNAL MEDICINE
{"title":"On the lesser importance of internal medicine: is it right to forget about it?","authors":"M. Ruchała","doi":"10.20452/pamw.3751","DOIUrl":"https://doi.org/10.20452/pamw.3751","url":null,"abstract":"FORUM FOR INTERNAL MEDICINE On the lesser importance of internal medicine Introduction Internal medicine constitutes a unique medical specialty. Not only does it include both outand in patient care, but also involves acute cases and life -threatening conditions. Subjectively, in my view, internal medicine is the essence of medicine, and all the attempts at the reduction of the physician’s role in the health care system result in the system instability. The physician’s scope of activity is extremely wide and is deeply rooted in pathophysiology. When I started my professional journey, the most important educational element was a specialty in internal medicine—extremely difficult and demanding. At that time, the 2-step system required constant education and practical verification of skills. Furthermore, a natural consequence of choosing internal medicine was the necessity of active participation in on-call shifts, especially at the Accident and Emergency Department. Nevertheless, this extremely hard and difficult path gave my friends and me much professional satisfaction, as well as a feeling of being the elite—the chosen ones who can establish a good diagnosis on the basis of an interview, a physical examination, and additional tests. What is more, other hospital departments were unable to function properly without the internal medicine specialist. However, nowadays, there are many of those who would gladly pronounce this specialty dead, and treat it as an unnecessary relic of the past. Some even claim that physicians used to be the opponents of progress. The abovementioned preposterous theses do not reflect the reality and are unfair towards the doctors whose knowledge is frequently underestimated. All in all, it might give the impression that knowledge and clinical practice have become less vital in face of modern imaging, equipment, and laboratory possibilities. In my view, neither the equipment present in our profession, nor any of the biochemical test possibilities, will ever substitute the physician. On the other hand, these novelty methods are extremely expensive, FORUM FOR INTERNAL MEDICINE","PeriodicalId":20343,"journal":{"name":"Polskie Archiwum Medycyny Wewnetrznej","volume":"22 1","pages":"1079-1084"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81610878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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