Together with the growing availability of data from electronic records from healthcare providers and healthcare systems, an assessment of associations between different environmental parameters (e.g., pollution levels and meteorological data) and hospitalizations, morbidity, and mortality has become possible. This study aimed to assess the association of air pollution and hospitalizations using a large database comprising almost all hospitalizations in Poland. This time-series analysis has been conducted in five cities in Poland (Warsaw, Białystok, Bielsko-Biała, Kraków, Gdańsk) over a period of almost 4 years (2014–2017, 1255 days), covering more than 20 million of hospitalizations. The hospitalizations have been extracted from the National Health Fund registries as daily summaries. Correlation analysis and distributed lag nonlinear models have been used to investigate for statistically relevant associations of air pollutants on hospitalizations, trying by various methods to minimize potential bias from atmospheric parameters, days of the week, bank holidays, etc. A statistically significant increase of respiratory disease hospitalizations has been detected after peaks of particulate matter concentrations (particularly PM_2.5, between 0.9 and 4.5% increase per 10 units of pollutant increase, and PM₁₀, between 0.9 and 3.5% per 10 units of pollutant increase), with a typical time lag between the pollutant peak and the event of 2 to 6 days. For other pollution parameters and other types of hospitalizations (e.g., cardiovascular events, eye and skin diseases, etc.), a weaker and ununiform correlations were recorded. Ambient air pollution exposure increases are associated with a short-term increase of hospitalizations due to respiratory tract diseases. The most prominent effect was recorded with the correlation of PM_2.5 and PM₁₀. There is only weak evidence indicating that such short-term associations exist between peaks of air pollution concentrations and increased hospitalizations for other (e.g., cardiovascular) diseases. The obtained information could be used to better predict hospitalization patterns and costs for the healthcare system and perhaps trigger additional vigilance on particulate matter pollution in the cities.

Background. Diabetic foot is one of the leading causes of patient disability worldwide. Lower-extremity amputations (LEAs) resulting from this disease massively decrease quality of life, the function of the patient, and incur significant healthcare costs. The aim of this study was to assess trends in the number of amputations, the diagnosis at discharge, and diagnosis-related mortality after LEA procedures in a nationwide population. Methods. Datasets of the National Heath Fund containing information about all services within the public healthcare system in Poland, spanning the years 2010-2019, were analyzed. The source of data regarding mortality was the database of the Polish Ministry of Digital Affairs. Results. Between 2010 and 2019, the annual number of amputations in patients with diabetes increased significantly from 5,049 to 7,759 ( for ). However, the number of amputations in patients with diabetes calculated as a number per 100,000 diabetics decreased significantly ( for ) during this period. Amputations in patients with diabetes accounted for a majority of all amputations; the mean percentage of amputations in patients with diabetes was 68.6% of all amputations (from 61.1% in 2010 to 71.4% in 2019, for ). The most common disease diagnosed at discharge after LEA in diabetic patients was diabetes itself. Vascular pathologies, such as soft-tissue/bone/joint infections and ulcerations, were the next most common. The 30-day mortality rate after LEA was rather high in patients with, as well as without, diabetes (depending on the cause for amputation 3.5-34% and 2.2-28.99%, respectively). Conclusions. The number of LEA in patients with diabetes in Poland increased substantially between 2010 and 2019 along with an increasing number of diabetics. Vascular pathologies, infections, and ulcerations were the most common causes of LEA. The 30-day mortality rate after amputation was rather high and varied depending on the diagnoses at discharge.

The abnormal plantar pressure distribution and value play a key role in the formation of plantar calluses and diabetic foot ulcer. The prevalence of the highest pressure different distribution and its association with various factors among patients with diabetes is not well known. The study purpose was to evaluate the prevalence of different regions for the highest pressure on the sole and its association with selected factors among patients with diabetes. Medical records of nonulcer patients were retrospectively analysed. The relationship between pressure patterns on the sole obtained during a pedobarographic test as a semiquantitative assessment with colourful print analysis and neuropathy, gender, age, and BMI was searched. The most common location of the highest pressure was the central part of the forefoot. No association was found between the different highest pressure regions and age, sensory neuropathy, calluses, and foot deformities. The highest pressure on the lateral part of the foot and midfoot was observed more often in females and in patients with a BMI≥35. The prevalence of the highest pressure on the forefoot was more common in patients with a BMI<35. Conclusions. The most frequent regions of the highest pressure on the sole in patients with diabetes were the central part of the forefoot (2-3 metatarsal heads) with no simple relationship to the assessed variables other than BMI<35. Female gender and higher BMI seem to be responsible for shifting the place of the highest pressure to other places of the foot.

Background. The aim of the study was to answer the question whether chronic periodontitis (CP) in patients with essential hypertension is associated wi

Epidemiological data on obesity are needed, particularly in patients with type 2 diabetes mellitus (T2DM) and high cardiovascular (CV) risk. We used the baseline data of liraglutide effect and action in diabetes: evaluation of CV outcome results—A long term Evaluation (LEADER) (a clinical trial to assess the CV safety of liraglutide) to investigate: (i) prevalence of overweight and obesity; (ii) relationship of the major cardiometabolic risk factors with anthropometric measures of adiposity [body mass index (BMI) and waist circumference (WC)]; and (iii) cardiometabolic treatment intensity in relation to BMI and WC. LEADER enrolled two distinct populations of high-risk patients with T2DM in 32 countries: (1) aged ≥50 years with prior CV disease; (2) aged ≥60 years with one or more CV risk factors. Associations of metabolic variables, demographic variables and treatment intensity with anthropometric measurements (BMI and WC) were explored using regression models (ClinicalTrials.gov identifier: NCT01179048). Mean BMI was 32.5 ± 6.3 kg/m2 and only 9.1 % had BMI <25 kg/m2. The prevalence of healthy WC was also extremely low (6.4 % according to International Joint Interim Statement for the Harmonization of the Metabolic Syndrome criteria). Obesity was associated with being younger, female, previous smoker, Caucasian, American, with shorter diabetes duration, uncontrolled blood pressure (BP), antihypertensive agents, insulin plus oral antihyperglycaemic treatment, higher levels of triglycerides and lower levels of high-density lipoprotein cholesterol. Overweight and obesity are prevalent in high CV risk patients with T2DM. BMI and WC are related to the major cardiometabolic risk factors. Furthermore, treatment intensity, such as insulin, statins or oral antihypertensive drugs, is higher in those who are overweight or obese; while BP and lipid control in these patients are remarkably suboptimal. LEADER confers a unique opportunity to explore the longitudinal effect of weight on CV risk factors and hard endpoints.