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Biomedical subjects

M Krzyzanowski

Publications and source records attributed to M Krzyzanowski.

At least 55 records · Page 3Linked to original sources

A study of the self-perception of being overweight in adult inhabitants of Cracow.

The self-assessment of body weight (normal vs overweight) reported in an interview in a group of 783 men and 1085 women aged 32-83, was compared with weight and height measurements taken a few days after the interview. Among subjects with body mass indices revealing excess weight (over 27 kg/m2 in men and 45 kg/m in women), 24% of men and 15% of women reported having normal body weight. The proportion of overweight persons unaware of their condition was related to age, smoking habit, education and physical activity. In men with hypertension, the proportion of subjects unaware of being overweight was smaller by 25% compared with others. This was not the case in women. A history of cardiovascular disease, diabetes, dyspnea or poor health status had no effect on the awareness of being overweight.

Adult↗

Ventilatory lung function and chronic chest symptoms among the inhabitants of urban areas with various levels of acid aerosols: prospective study in Cracow.

The analysis carried out earlier in Cracow showed that the high level of SO2 and particulate matter (PM) alone cannot be responsible for an excess of chronic chest symptoms and faster lung function deterioration in the population at large. To check the hypothesis that acid aerosols present in the urban air may cause substantial damage of the lungs, data from a 13-year follow-up survey of chronic chest diseases in Cracow (1968-1981) have been reanalyzed. In the plan of the analysis, three areas of the city with various levels of sulfate and sulfur transformation ratio (STR) in the urban air have been defined. In each of the defined areas, the prevalence of chronic chest symptoms, as well as lung function decline, have been studied. In total, the lung function study group consisted of 1414 persons (584 males and 830 females). Those men who lived in the area with the higher sulfate and STR had lower FEV1 levels by about 151 mL than did the residents of the other areas, and this was equivalent to the effect of smoking. In females, the pattern was generally the same. In men, the FEV1 decline rate (mL/year) over the 13-year period was significantly faster by about 11 mL/year in the areas with higher and intermediate STR, which was again equivalent to the effect of smoking. It was found that the level of SO2 and PM in the urban air correlated with the symptom prevalence in women; however, it had no clear impact on lung function deterioration.

Acid Rain↗

Occupational exposures and leukemia.

Using the data from a case-control study performed in 958 age, sex and place of residence matched pairs of adult inhabitants of Polish towns, the risk of leukemia related to work in several occupations was analyzed. The risk of myeloid leukemia was found to be increased by some 90% in electrical workers (p less than 0.10). Also in some medical occupations the risk was significantly increased though small numbers do not allow to establish valid estimates of risk, and all medical occupations, treated as a whole group, do not increase the risk. No increase of leukemia risk was found for occupations connected with agriculture.

Adult↗

[Mortality risk factors in cardiovascular diseases in patients with diabetes mellitus in Warsaw--a 10-year prospective study].

A prospective study was made in the years 1973 through 1983 on mortality among 4591 patients (2095 men and 2469 women) with usually noninsulin dependent diabetes, of 1-10 years duration. The anamnestic data and examination parameters obtained during a cross-sectional investigation served as the prognostic changeables (risk factors) to assess the mortality due the most frequent circulatory diseases. The applied model of the logistic regression allowed an attempt of the assessment of their independent effect. Analysis regarding the sex and the methods of diabetes treatment was done in four groups of mortality causes classified according to the VIII Revision of the International Classification of Disease. Injuries and Causes of Death: 1. Cardiovascular system diseases. 2. Ischaemic heart diseases. 3. Other diseases of the cardiovascular system. 4. Vascular diseases of the brain. The quantitative and qualitative effect of the arbitrarily chosen factor of death risk was of varying importance and was related to the sex and the methods of the hypoglycemising treatments. The effect of ageing was an independent factor of death risk among all analysed causes of mortality in both sexes independent from the methods of the hypoglycemising treatment with the one exception of women treated with insulin who died of stroke. Generally however, the ageing factor showed a greater prognostic value in patients treated with insulin. Hypertension, especially if marked, showed to have the most prognostic value among the all analysed factors of death-risk especially in patients on oral antidiabetics. The risk in this group was due mainly to the cerebral stroke, to a lesser degree to the "other" diseases of the circulatory system, and to the all diseases of the circulatory system but to the least degree it was related to the ischaemic heart disease, in both sexes. Among insulin treated diabetics the hypertension was a death-risk of most importance in men usually due to the vascular brain disease and other diseases of the cardiovascular system but to a lesser degree to the circulatory diseases, as a whole. In women however the marked hypertension increased the death-risk in patients with coexisting circulatory disease, not a particular one, but as a whole. Albuminuria had a pronounced prognostic value, especially if massive, in both types of diabetes, mainly, however, among women who died of any cardiovascular causes.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Are chronic wheezing and asthma-like attacks related to FEV1 decline? The Cracow Study.

Analysis is presented of the relationship between decline in ventilatory function and possible symptoms of bronchial hyperreactivity. Data comes from three consecutive surveys within a 13-year follow-up study of a population sample of 1747 persons (718 males and 1029 females) who completed spirometric testing and interviews. Chest symptoms recorded in the two initial surveys were used as baselines for the prognostic study on FEV1 change. To evaluate changes in lung function the FEV1 decline index, expressed as percentage of FEV1 loss during the study period, was calculated. Chronic wheezing and asthma-like attacks were very strongly related to FEV1 baseline level. Multiple linear regression analysis for each separate symptom including age and smoking habits as confounders and showed that the FEV1 decline index was higher and more significant when wheezing and asthma-like attacks or chronic cough were present. When the combination of symptoms were introduced into the regression model, the effect of wheezing became insignificant. Only attacks of shortness of breath in both sexes and chronic cough in women were significantly associated with more rapid FEV1 decline. However, the effect of persistent wheezing in men had a rather substantial impact on FEV1 change. Comparing the effect of the number of cigarettes smoked with the effect of symptoms, one can see that FEV1 decline due to attacks of shortness of breath is comparable to that seen with heavy smoking. There was no strong evidence that the symptoms under study precede the more rapid FEV1 decline.

Adult↗

The relation of respiratory symptoms and ventilatory function to moderate occupational exposure in a general population. Results from the French PAARC study of 16,000 adults.

Data from the French PAARC (Pollution Atmosphérique et Affections Respiratoires Chroniques) study were used to assess the effect of a priori moderate occupational exposure to dust, gases or chemical fumes on the prevalence of respiratory symptoms and ventilatory function. In this community-based population, without households 'headed' by manual workers, 34% of the 8692 men and 23% of the 7772 women, 25-59 years of age, ever occupationally active, reported some exposure. The studied relationships were adjusted for age, height, smoking habits, socio-occupational class, education and air pollution by logistic or linear regression methods. For men and women, some 50% increase (p less than 0.01) in chronic cough, chronic bronchitis, dyspnoea grade 2 and wheezing prevalence was observed in the exposed group compared to the never exposed, with the strongest association for wheezing. FEV1 and FEF25-75% were not associated with occupational exposure. Among men, FEV1/FVC and FEF25-75%/FVC were significantly lower (p less than 0.001 and p less than 0.05) among the exposed compared to never exposed, but FVC was significantly greater (p less than 0.05). Among women, occupational exposure was significantly related to a lower FEV1/FVC in the subgroup with a history of asthma or wheezing. Results suggest that occupational exposures of relatively low intensity, encountered in the non-industrial work places may constitute a non-negligible risk for respiratory health.

Adult↗

Occupational exposures and changes in pulmonary function over 13 years among residents of Cracow.

In a 13 year follow up study conducted among residents of Cracow the relation of annual rate of decline in FEV1 to occupational exposures was analysed. The study group consisted of 696 men and 983 women aged 19-60 at the start of the study in 1968. They were interviewed three times, in 1968, 1973, and 1981, and decline in FEV1 was estimated for each subject from spirometric measurements in 1968 and 1981. The interviews provided data on exposure at the workplace to dusts, variable temperature, and chemicals or irritating gases, which established duration and time of the exposure. The FEV1 mean level, height, and smoking habits were considered as confounders in the analysis. The study indicated that the most pronounced influence on decline in FEV1 was prolonged and continuing exposure to variable temperature. The effects of dusts, independent of exposure to variable temperature, were much smaller but analysis in occupational subgroups suggest that dust may be important in some, such as workers in the building materials and pottery industry. Relatively immediate effects of exposure to chemicals were detected independently of effects of other exposures. The estimated effects of occupational exposures were of a similar magnitude as those of tobacco smoking though related to much smaller groups. Both effects were additive in accelerating decline in lung function. These results, obtained in the general population and less biased by selection than studies performed in industrial settings, show the importance of occupational factors in the natural history of limitation of airflow.

Adult↗

Hospital use in Poland and the United States.

This report presents national statistics on hospital use from the U.S. National Hospital Discharge Survey and the Polish General Hospital Morbidity Study. Comparisons are made of discharge rates, average lengths of stay, rates of patient care days, and fatality rates by sex, age, and diagnostic category. The similarities and differences between the two countries in population characteristics, health status, health services systems, and health care resources are also described.

Age Factors↗

Changes in lung function determined longitudinally compared with decline assessed cross-sectionally. The Cracow Study.

Longitudinal annual changes in lung function (FEV1) with cross-sectional estimates have been compared in the sample of Cracow inhabitants who underwent epidemiological follow-up on chronic nonspecific chest diseases. The annual rate of FEV1 decline was faster in men than in women. Among male smokers the FEV1 decline rate was 30% greater, while in women smokers 9% faster than in non-smokers. The cross-sectional estimates for annual changes differed in both surveys carried out in the interval of 13 years and were not very much consistent with the average longitudinal annual decline observed in the sample. However, the prediction of annual decline across the age groups showed large inconsistencies. They resulted from the curvilinear pattern in lung function decline over the age groups. It was found that the lung function in the elderly appeared to be more homogeneous and the acceleration of decline rates slowed down. There is some evidence that the flattening of the decline curve among elderly might have been influenced by the selection bias.

Adult↗

The relation of thirteen-year mortality to ventilatory impairment and other respiratory symptoms: the Cracow Study.

The relation of mortality to ventilatory function and some respiratory symptoms detected during interview has been studied in 3047 men and women followed-up for 13 years. The analysis was performed for all natural causes of death, and separately for deaths due to circulatory diseases and neoplasms. The results confirm the strong predictive power of ventilatory impairment for overall and circulatory mortality, even after adjustment for age, cigarette smoking and other factors in logistic regression models. The risk of cancer death in men increased with decrease of FEV1. However, chronic cough, mucus hypersecretion or asthmatic syndrome were not related to subsequent mortality. A strong predictor of overall and circulatory 'mortality' in men was also self-assessed health status. This was independent of other factors.

Adult↗

Factors associated with the change in ventilatory function and the development of chronic obstructive pulmonary disease in a 13-year follow-up of the Cracow Study. Risk of chronic obstructive pulmonary disease.

In a longitudinal, epidemiologic study, we investigated the relation of a number of factors to the loss of ventilatory lung function over time and to the incidence of chronic obstructive pulmonary disease (COPD). Data on 759 men and 1,065 women 19 to 70 yr of age examined twice during a 13-yr period were analyzed. The decline rate in FEV1 was related to age and was greater in persons with lower FEV1 values and in taller persons. The clear relation to smoking was confirmed. Occupational exposure to dusts in men and to variable temperatures in women significantly increased the FEV1 decline rate. In men in blood group A, the loss of FEV1 was smaller than in men in the other blood groups. In women who had had 4 or more children, we observed a faster decline in FEV1. In the analysis of COPD incidence, we confirmed that age, baseline FEV1 value, and, in men, smoking habit are the most important predictors of disease. Among women, also, attacks of breathlessness were demonstrated to increase disease risk twofold (p less than 0.10), even after adjustment for other factors in the logistic regression model. We estimated the index of risk for COPD and predicted 63% of male and 67% of female cases in the top 20% of risk distribution.

Adult↗