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The international HBSC (HealthBehaviour in School-aged Children)survey has enabled the comparisonof the patterns of changes with respectto a number of health indicatorsin adolescence.The aim of the study was to showinternational trends and how theposition of Poland in internationalrankings of smoking prevalence haschanged since 2002.

Material and methods: The study comprised 30 countries for whichdata was available from four roundsof HBSC survey (2002-2014). In total,218 759 15-year-olds were surveyed,including 7289 in Poland. For eachcountry a linear trend was estimated,separately for boys and girls, to describechanges in regular smoking(daily or at least once a week).

Results: In the investigated period,the percentage of 15-year-old boyswho smoke every week fell in Polandfrom 26.2% to 15.5%, and the respectivepercentage in girls decreasedfrom 17.2% to 14.7%. This means annualdecrease of 0.88% in boys and0.24% in girls. In a combined internationalsample, exactly the same as inPoland rate of change was noted inboys; however, a definitely faster ingirls (0.95% a year). The highest rateof change was observed in Ukraine,Germany and Norway, while the lowestin Greece, Croatia and Israel. Poland’sposition in the internationalranking moved from 8th to 24th, providingthat the countries are listedaccording to the growing percentageof 15-year-olds of both genders whosmoke regularly.

Conclusions: Decrease in theprevalence of smoking among Polishadolescents, observed from thebeginning of this century, has beenundoubtedly a success related to theimplemented preventive measures.However, attention should be drawnto the strategies launched in countrieswhich achieved better resultsthan Poland, as well as to the reasonsof less positive trends among Polish girls.

Introduction: Neoplastic diseasesare the second leading cause of deathin developed countries. Colorectalcancer is the third most commonmalignancy and the second cause ofcancer deaths worldwide. Lifestyle andrelated health behaviors have impacton health condition and course oftreatment.

Aim: Evaluation of oncologicalknowledge and health behaviors ofpatients with colorectal cancer in relationto social and demographic factors.

Material and methods: The study group consisted of 165 patients withcolorectal cancer treated in the periodfrom May 2010 to December 2014 intwo centers. The mean age of patientswas 61 ± 8.7 years. We rated knowledgeof respondents in the field of cancerand health lifestyle with method of diagnosticsurvey, using the BehavioralHealth Inventory by prof. Juczyński.

Results: The general level of knowledgeon cancer was low, and the levelof severity of health behaviors wasaverage. It has been proven the associationbetween the state of knowledgeconcerning cancer and readiness toadopt attitudes and healthy behaviorsby CRC patients. The level of healthpractices was significantly higherin people with higher education, inwomen and in people with a higherknowledge of oncology. Patients hadlower levels of mental attitude and eatinghabits than the standardized value.

Conclusions: The level of knowledgeof patients with CRC, whichwas observed in clinical practice isassociated with the severity of healthbehavior.

Qualification for specific immunotherapy(SIT) according to theguidelines of the European Academyof Allergy and Clinical Immunology(EAACI) includes medical history,skin prik tests (SPT) and/or measuringthe concentration of sIgE. Itis necessary to perform additionaldiagnostic tests in case of discrepanciesbetween the history and theresults of SPT/sIgE or differencesbetween SPT and sIgE. Basophilactivation test (BAT) assesses theexpression of activation markers ofthese cells, eg. CD63 and CD203c afterstimulation. The aim of our studywas to evaluate the usefulness ofBAT in the qualification for the SIT incomparison to the SPT and sIgE andin case of discrepancies between theresults of SPT and sIgE.The study included 30 patientswith allergic rhinitis (AR) causedby allergy to house dust mite (Dermatophagoidespteronyssinus, Dp)or birch pollen qualified for SIT. Allpatients had SPT, sIgE and BAT determination.The group of patientswith allergy to birch was a controlgroup for Dp allergic and vice versa.BAT with CD63 antigen expressionwas performed using a Flow2CASTtest. Basophils were stimulated withallergen preparation (50, 500, and5000 SBU/ml concentrations). BATresults were expressed as a stimulationindex (SI). For optimal concentrationsof 50 and 500 SBU/mlparameters comparing BAT to SPTand sIgE as the gold standards wereconsecutively: sensitivity 82-100%and 93-100%, specificity 50-94% and47-89%, positive predictive value 65-94% and 61-87%, negative predictivevalue 86-100% and 93-100%. CorrelationBAT - SPT and BAT - sIgE rangedwithin 0.59 to 0.84 and 0.51 to 0.72.BAT was helpful in 2 of 30 patientswith incompatible results of SPT andsIgE.Optimal concentrations for basophilstimulation are 50 and 500 SBU/ml. BAT may be useful diagnostic tool in the qualificationfor the SIT in case of discrepancies between the resultsof SPT and sIgE.

Stevens-Johnson syndrome isan acute, life-threatening, necroticskin and mucosal reaction, mostoften caused by drugs. This casepresents 81-year old Patient withStevens-Johnson syndrome causedby amoxicillin, complicated by acuterenal failure.

Introduction: Cancer appears tobe a major noncardiovascular factoraffecting morbidity and mortality ofheart failure (HF) patients. Risk ofdeveloping cancer seems to increaseover time. It is well documented thatpatients with cancer treated with chemiotherapyare at risk of developing HFand therefore they should be screenedfor HF on regular basis. There is limiteddata whether the opposite should bedone, namely routinely screen eachHF patient for cancer.

Purpose: We hypothesized that inHF patients cancer might be responsiblefor some symptoms that are incorrectlydiagnose as HF related.

Material and methods: The datafrom “Renal Denervation in PatientsWith Chronic Heart Failure andResynchronization Therapy” studyof 18 patients (22% women) aged73.2 (±9.1 years) with HF in NYHAClass II-IV and resynchronizationpacemaker implanted according tocurrent ESC guideliness at least 6months earlier were analyzed. Patientshad symptoms of heart failuredespite optimal HF therapy includingpharmacotherapy and CRT. Medicalhistory including current symptomsof HF was taken, patients’ demographicsand vital signs were assessed.Diagnostic tests in the study groupincluded echocardiography, abdominalCT scan and laboratory tests.

Results: Only in 5 patients CTscan did not show any abnormalities.Renal cysts were present in 5patients, adrenal glands adenomaswere observed in 3 patients and bothchanges were present in 1 patient.Tumors suspected of malignancywere diagnosed in 4 patients - 2 had atumor in adrenal glands, 1 had kidneytumor and 1 had tumors both in kidneyand adrenal gland. All patients withmalignancy were directed for furtheroncological evaluation.

Conclusion: Considering the complexphysiology of HF, there is possibilitythat some HF related mechanismsmight trigger cancer development andpresence of cancer may aggrevate thesymptoms of HF. One should considerevaluation of HF patients on optimal medical therapy, yetstill symptomatic to identify some common forms of cancer.

Objective: The assessment of control of modifiable risk factors among elderly patients with peripheral artery disease (PAD) admitted to the hospital angiology ward.

Methods: The results of treatment of dyslipidemia (DL), hypertension (HT), diabetes mellitus (DM) and prevalence of cigarette smoking were assessed among older (>65 years old, group I) and younger patients (group II) with PAD in a admission day to hospital.

Results: The study population included 154 patients (I--92 and II--65 subjects) aged 67.4 ± 9.4 years, 69.5% men. The study groups presented similar grades of PAD classification by Rutherford. Group I was older (73.5 ± 6.4 vs 58.3 ± 4.7 yrs, p < 0.001), had lower frequency of current smokers (21.7 vs 48.4%, P < 0.001) than group II. Diagnosis of DL, HT and DM were equally frequent in both groups. However, coronary heart disease was diagnosed more frequently in group I than II (52.2 vs 29.0%, p = 0.004). Both groups were similar according to systolic blood pressure (BP) values and levels of glucose and HDL cholesterol. Group I had lower diastolic BP than group II (69.5 ± 11.1 vs 74.0 ± 9.9 mmHg, p = 0.02), but control of HT was similar in both groups (71.7 vs 67.7%). LDL cholesterol levels were lower in a group I than II (2.2 ± 1.0 vs 2.5 ± 1.1 mmol/l, p = 0.04), but LDL cholesterol values < 1.8 mmol/l were observed with similar frequency in both groups (40.2 vs 27.4%).

Conclusions: Patient's age seems to have no important impact on the control of atherosclerosis risk factors in patients with PAD.

Thyrotoxicosis is a pathological syndrome in which tissue is exposed to excessive amounts of circulating thyroid hormones. Including its subclinical form, it is considered as one of the most frequent endocrine disorders in the general population. If not detected in a timely fashion, thyrotoxicosis can have serious health consequences. The most common forms of thyrotoxicosis include diffuse toxic goiter (Graves' disease), toxic multinodular goiter (Plummer's disease), and toxic adenoma (Goetsch's disease). The significant progress in the fields of hormonal assessment, imaging procedures and molecular biology made in recent years has brought about great improvement in the identification, differentiation and treatment of many other disorders associated with thyrotoxicosis. Therefore, this paper discusses the etiopathogenesis, clinical manifestation, biochemical abnormalities and management of thyrotropinoma, resistance to thyroid hormone, de Quervain's, silent, acute, posttraumatic and radiation-induced thyroiditis, Riedel's goiter, differentiated thyroid cancer, struma ovarii, thyrotoxicosis factitia, other forms of iatrogenic thyrotoxicosis, gestational trophoblastic disease, neonatal Graves's disease, familial nonautoimmune hyperthyroidism and McCune-Albright syndrome. On the basis of available studies, some of whom were carried out in the recent years, we provide practical guidelines for clinical endocrinologists dealing with the diagnosis and treatment of thyrotoxicosis.

Background: Ischemic strokes in children are rare. The etiology and risk factors for ischemic stroke in children and adolescence differ from those typical in adults. Clinical symptoms depend on the location, extent of damage of the central nervous system and age. The aim of the study was to compare the clinical picture of ischemic stroke in children at two periods.

Material and methods: The study included children who had a stroke: 32 children (group I) in the years 1968-1998 and 27 children (group II) in 2010-2015. In each case medical history, physical and neurological examination, laboratory tests and neuroimaging were taken. To determine the location of ischemia in children The Oxford Community Stroke Project classification was used. To determine the score of hemiparesis the Ashworth scale was used.

Results: Pregnancy, delivery, neonatal period and neurological history in the majority of children enrolled to the study, was unbounded. Etiology of stroke in first group was found in 20 children. Diagnosis of ischemic stroke was made on the basis of angiography in 13 children, while the remaining 19 based on head CT. TACI were found in 11 children, while PACI had 21 children. In the Ashworth scale I score of paralysis was observed in 14 children; 2 score in 5 children. 3 score had 11 children and 2 children 4 score of paralysis. In the second group, the etiology of stroke was found in 6 children. Ischemic stroke in all children was diagnosed based on CT scans. Additionaly, 24 children had MRI, 4 children had CT angiography and in 5 children MRA. TACI was diagnosed in 3 children, in the next 21 children PACI and POCI in other 3 children. The Ashworth Scale score 1 paralysis were observed in 8 children and score 2 at 16. 2 children had paresis score 3, in 1 paralysis had score 4. No child in group I and II, had hemorrhagic stroke. In the pharmacological treatment of the acute phase of stroke steroidotherapy and diuretics were used, in children with infection antibiotic therapy was introduced. Antithrombotic therapy was administered in 2 children. Neuroprotective treatment (piracetam) and rehabilitation therapy was used. Children with ischemic stroke in group I were hospitalized an average of 80 days. Hospitalization time in group II was an average of 23 days.

Conclusions: 1. In spite of dynamic development of laboratory diagnosis detection of the etiology of ischemic stroke in children has not improved. 2. Computed tomography is still a primary diagnostic tool in the diagnosis of stroke in children. 3. In both groups of children hospitalization in the years 1968-1998 and 2010-2015 clinical consequences after ischemic were observed. 4. Majority of children after ischemic stroke has a small degree of paralysis. 5. Better availability of outpatient multidisciplinary rehabilitation treatment enabled significantly shortened hospitalization of children in 2010-2015.<

The present article refers to the historical characterisation of Odo Bujwid's (1857-1942) research concerning the vaccine against rabies. The introduction refers to the treatment methods applied before Ludwik Pasteur's discovery. The following part refers to Odo Bujwid's own research including diagnostics, characterisation of the symptoms of disease, modification of the original Ludwik Pasteur's method and statistical information. The resume emphasizes that Odo Bujwid's scientific research was the introduction and generalisation the worldwide microbiology knowledge at the polish lands.

Introduction: Reduction of riskfactors of atherosclerosis, lifestylemodification significantly cause the reductionin the incidence, morbidity andmortality of cardiovascular diseases(CVDs). Objective: To evaluate cardiovascularrisk factors and analyze thelifestyle of students finishing the firstyear of studies at selected universitiesin Krakow.

Material and methods: The studywas performed in 2015roku. 566 studentsfinishing the first year of study,including 319 (56.4%) men and 247(43.6%) women were examined. Thestudents were in age from 18 to 27years, an average of 20.11± 1.15 years.They represented 6 different universitiesin Cracow. In order to assesseating habits, lifestyle and analysis ofrisk factors of cardiovascular diseasewas used method of diagnostic surveyusing the survey technique. BMIwas calculated from anthropometricmeasurements. The program Statistica12.0 were used in statistical analysis.

Results: The analysis showed thatmost fruits and vegetables consumeUR students and AWF, least of AGH.Only 34.8% of students regularly consumefish of the sea, there were nosignificant differences between universities.Sports frequently cultivate thestudents of AWF (93% of the studentsof this university). Academy of FineArts students drink the most coffee.Students of AGH frequently consumealcohol. 60% of all students nevertried drugs, but only 25.7% of studentof Fine Arts never tried drugs. Overweightoccurs in 12.6% of students,and obesity in 1.1%.

Conclusions: The most risk factors of atherosclerosisoccur in students of AGH and ASP.The results of the study clearly indicateon the necessity of implementation ofprevention and improvement of healthbehaviors in students of AGH and ASPuniversities.