INTRODUCTION Lowering exposure to dyslipidemias is one of the biggest challenges in cardiovascular disease prevention. OBJECTIVES The aim of the study was to describe the prevalence of dyslipidemias and treatment of hypercholesterolemia in Poland, and to assess changes since the period of 2003-2005. PATIENTS AND METHODS Two cross-sectional surveys of the random samples of the Polish population were performed in the years 2003-2005 (WOBASZ) and 2013-2014 (WOBASZ II). Interviews were carried out according to a standard questionnaire. Blood lipid levels were determined in a single laboratory in frozen samples using the enzymatic colorimetric method. RESULTS The analysis included 14151 participants aged 20-74 years (WOBASZ) and 5947 participants aged 20-99 years (WOBASZ II). In the 2013-2014 survey, hypercholesterolemia was found in 70.3% of men and 64.3% of women. Isolated hypertriglyceridemia was found in 5.6% of men and 2.4% of women. Isolated low levels of high-density lipoprotein cholesterol (HDL-C) were found in 5.1% of men and in 7.3% of women. The prevalence of hypercholesterolemia did not change significantly with regards to the 2003-2005 survey. An increase in the prevalence of hypertriglyceridemia was found in men (relative ratio [RR], 1.26; 95% confidence interval [CI], 1.03-1.55), and an increase in the prevalence of low HDL-C levels was observed in both sexes (men: RR, 2.26; 95% CI, 1.77-2.88; women: RR, 1.94; 95% CI, 1.61-2.33). There was an increase in the proportion of persons receiving high- or moderate-intensity statin therapy. However, 60,6% of persons with hypercholesterolemia were not aware of their condition, and only 6% were treated and achieved the treatment target. CONCLUSIONS There is an urgent need for more effective strategies for the prevention and management of dyslipidemias.

Background: After political transformation in 1989/1990, Poland experienced a general improvement in living conditions and quality of life, but the benefits did not extend evenly across all segments of the society. We hypothesized that the regional differences in mortality due to diseases of the respiratory system are related to socioeconomic status (SES) and its changes over time. Materials and methods: An ecological study was carried out in 66 sub-regions of Poland using the data from the period of 2010 to 2014. Age-standardized mortality rates (SMRs) were calculated separately for men and women in three age categories: ≥15, 25–64 years, and ≥65 years. An area-based SES index was derived from the characteristics of the sub-regions using the z-score method. Multiple weighted linear regression models were constructed to estimate a real socioeconomic gradient for mortality resulting from lung cancer and respiratory diseases. Results: In the regions studied, the SMRs for respiratory disease varied from 70/100,000 to 215/100,000 in men and from 18/100,000 to 53/100,000 in women. The SMRs for lung cancer varied from 36/100,000 to 110/100,000 among men and from 26/100,000 to 77/100,000 among women. After adjusting for the prevalence of smoking and environmental pollution, the SES index was found to be inversely associated with the SMR for lung cancer in each category of age among men, and in the age group of 25–64 years among women. An increase of the SES index between 2010 and 2014 was associated with a decrease of SMR for respiratory disease both in men and women, but this change was not significantly associated with the SMR for lung cancer. Conclusion: SES appears to be an important correlate of mortality from respiratory diseases and lung cancer at the population level, particularly in men. A lower SES was associated with greater mortality from lung cancer and respiratory diseases. An increase in SES over time was related to a decrease in mortality from respiratory disease, but not from lung cancer.

Objective: Previous studies have reported inverse associations between socioeconomic status (SES) and lung function, but less is known about whether pulmonary function is affected by SES changes. We aimed to describe the relationship of changes of SES between childhood and adulthood with pulmonary function.Design: Cross-sectional study.Participants: The study sample included 4104 men and women, aged 45–69 years, residents of Krakow, participating in the Polish part of the Health, Alcohol and Psychosocial Factors in Eastern Europe Project.Main outcome: Forced expiratory volume (FEV₁) and forced vital capacity (FVC) were assessed by the standardised spirometry procedure. Participants were classified into three categories of SES (low, moderate or high) based on information on parent’s education, housing standard during childhood, own education, employment status, household amenities and financial status.Results: The adjusted difference in mean FVC between persons with low and high adulthood SES was 100 mL (p=0.005) in men and 100 mL (p<0.001) in women; the differences in mean FEV₁were 103 mL (p<0.001) and 80 mL (p<0.001), respectively. Upward social mobility and moderate or high SES at both childhood and adulthood were related to significantly higher FEV₁and FVC compared with low SES at both childhood and adulthood or downward social mobility.Conclusions: Low SES over a life course was associated with the lowest lung function. Downward social mobility was associated with a poorer pulmonary function, while upward mobility or life course and moderate or high SES were associated with a better pulmonary function.

Depression is a heterogeneous and etiologically complex psychiatric syndrome thatshows a strong sexual dimorphism and often impacts people with a low socioeconomic status (SES). The aim of the study was to estimate the occurrence of depression symptoms in a local community with a high deprivation rate, the example being the inhabitants of the JanówLubelski County in eastern Poland. A cross-sectional study was carried out on 3752 people aged between 35 and 64. The prevalence of depression symptoms was assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. In the screening for depression symptoms in the entire population we studied, the risk of depression symptoms was 16.1% (n = 605), with women having a significantly higher mean score than men (p < 0.001). Significant predictors associated with the achievement of 10 points and more in the PHQ-9 assessment in the case of women and men were: living alone, education and having comorbidities. Moreover, female participants living in rural areas were significantly more likely to exhibit depression symptoms, whereas smoking was a significant predictor of depressive symptoms in men. It was observed that in the case of obese women, the chance of being in the higher category of the PHQ-9 assessment was 1.41 times higher than in women with normal body weight. However, in the case of men, an increase in age by one year increased the chance of being in a higher category by 1.02 times. Moreover, the odds of falling into a higher category, as assessed by the PHQ-9 questionnaire, among men who drink alcohol more than once a week was 1.7 times higher than in men who do not drink or consume alcohol occasionally. Summarising the results of studies conducted in a local community characterised by a high deprivation rate, socioeconomic and health variables related to SES significantly impacted the incidence of depression, but they differ in terms of gender.

Background For research with human participants to be ethical, risk must be in a favorable balance with potential benefits. Little is known about the risk/benefit ratio for pediatric cancer phase II trials testing targeted therapies. Objective Our aim was to conduct a systematic review of preliminary efficacy and safety profiles of phase II targeted therapy clinical trials in pediatric oncology. Methods Our protocol was prospectively registered in PROSPERO (CRD42020146491). We searched EMBASE and PubMed for phase II pediatric cancer trials testing targeted agents. We included solid and hematological malignancy studies published between 1 January, 2015 and 27 February, 2020. We measured risk using drug-related grade 3 or higher adverse events, and benefit by response rates. When possible, data were meta-analyzed. All statistical tests were two-sided. Results We identified 34 clinical trials (1202 patients) that met our eligibility criteria. The pooled overall response rate was 24.4% (95% confidence interval [CI] 14.5–34.2) and was lower in solid tumors, 6.4% (95% CI 3.2–9.6), compared with hematological malignancies, 55.1% (95% CI 35.9–74.3); p < 0.001. The overall fatal drug-related (grade 5) adverse event rate was 1.6% (95% CI 0.6–2.5), and the average drug-related grade 3/4 adverse event rate per person was 0.66 (95% CI 0.55–0.78). Conclusions We provide an estimate for the risks and benefits of participation in pediatric phase II cancer trials. These data may be used as an empirical basis for informed communication about benefits and burdens in pediatric oncology research.

Background: Umbrella clinical trials in precision oncology are designed to tailor therapies to the specific genetic changes within a tumor. Little is known about the risk/benefit ratio for umbrella clinical trials. The aim of our systematic review with meta-analysis was to evaluate the efficacy and safety profiles in cancer umbrella trials testing targeted drugs or a combination of targeted therapy with chemotherapy. Methods: Our study was prospectively registered in PROSPERO (CRD42020171494). We searched Embase and PubMed for cancer umbrella trials testing targeted agents or a combination of targeted therapies with chemotherapy. We included solid tumor studies published between 1 January 2006 and 7 October 2019. We measured the risk using drug-related grade 3 or higher adverse events (AEs), and the benefit by objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). When possible, data were meta-analyzed. Results: Of the 6207 records identified, we included 31 sub-trials or arms of nine umbrella trials (N = 1637). The pooled overall ORR was 17.7% (95% confidence interval [CI] 9.5–25.9). The ORR for targeted therapies in the experimental arms was significantly lower than the ORR for a combination of targeted therapy drugs with chemotherapy: 13.3% vs 39.0%; p = 0.005. The median PFS was 2.4 months (95% CI 1.9–2.9), and the median OS was 7.1 months (95% CI 6.1–8.4). The overall drug-related death rate (drug-related grade 5 AEs rate) was 0.8% (95% CI 0.3–1.4), and the average drug-related grade 3/4 AE rate per person was 0.45 (95% CI 0.40–0.50). Conclusions: Our findings suggest that, on average, one in five cancer patients in umbrella trials published between 1 January 2006 and 7 October 2019 responded to a given therapy, while one in 125 died due to drug toxicity. Our findings do not support the expectation of increased patient benefit in cancer umbrella trials. Further studies should investigate whether umbrella trial design and the precision oncology approach improve patient outcomes.