Special Issue "Community and Family-Focused Public Health and Sustainable Development"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editors

Prof. Dr. Wioletta Zukiewicz-Sobczak
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Guest Editor
State University of Applied Sciences in Kalisz, Nowy Świat 4, 62-800 Kalisz, Poland
Interests: food and nutrition; food production; health aspects in sustainable production
Special Issues and Collections in MDPI journals
Prof. Paulina Wojtyla-Buciora
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Guest Editor
State University of Applied Sciences, Kalisz Poland
Interests: health behaviour; adolescent health; public health
Dr. Izabela Rącka
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Guest Editor
State University of Applied Sciences, Kalisz Poland
Interests: housing market; urban renewal; public space; sustainable city development; real estate appraisal
Special Issues and Collections in MDPI journals
Prof. Andrzej Wojtyla
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Guest Editor
State University of Applied Sciences, Kalisz Poland
Interests: health inequalities; reproductive health; environmental and rural health; public health

Special Issue Information

Dear Colleagues,

The Special Issue “Community and Family-Focused Public Health and Sustainable Development” is part of the renowned International Journal of Environmental Research and Public Health. This Special Issue encompasses applications in novel aspects connected with sustainability issues in community and family-focused public health studies. Contributions with a significant impact on solving public health problems at the family and community level are particularly welcome. All types of scientific papers, including review articles, qualify for publication, as long as they fall under this Special Issue’s remit and are relevant to audiences worldwide. Currently, the term 'family health' is most commonly used in aspects of mother and child health, and reproductive health. It is rare for family health to include the family as an important context for health development, including all family members and the family’s social environment. We therefore particularly encourage authors of scientific research covering issues of the impact of the family and the environment in which the family lives and functions on its members’ health presently and in the future. In addition, we are especially interested in scientific reports on social, economic, and health inequalities in the context of achieving sustainable development goals.

Prof. Dr. Wioletta Zukiewicz-Sobczak
Prof. Paulina Wojtyla-Buciora
Dr. Izabela Rącka
Prof. Andrzej Wojtyla
Guest Editors

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Published Papers (25 papers)

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Article
Physical Activity and the Quality of Life of Female Students of Universities in Poland
Int. J. Environ. Res. Public Health 2021, 18(10), 5194; https://doi.org/10.3390/ijerph18105194 - 13 May 2021
Viewed by 425
Abstract
Physical activity increases human health potential and has an impact on achieving a higher quality of life in society. The aim of our research was to determine the relationship between a physically active lifestyle and the quality of life of female students in [...] Read more.
Physical activity increases human health potential and has an impact on achieving a higher quality of life in society. The aim of our research was to determine the relationship between a physically active lifestyle and the quality of life of female students in the context of demographic and social factors (major, age, marital status, professional activity). The research was conducted among a group of 285 women studying physical culture and social sciences in Poznań and Szczecin (Poland). Average age: 22.7 ± 4.90. The standardized World Health Organization Quality of Life—BREF (WHQOL-BREF) questionnaire was used to assess the quality of life of female students, and the original survey technique was used to study the lifestyle of people undertaking physical activity in the context of socio-demographic factors. Nonparametric statistics were applied in the analyses of the results. The effect size was calculated for each test: E2R for the Kruskal–Wallis H test, Glass rank biserial correlation (rg) for the Mann–Whitney U test, and Cramér′s V for the χ2 test. The value of p ≤0.05 was assumed to be a significant difference. In the study, it was shown that a higher overall quality of life and health satisfaction, as well as better results in the physical, psychological, and environmental domains, were achieved by female students who assessed their lifestyle as physically active in comparison to those physically inactive. Higher scores of overall quality of life and satisfaction with health were found among female students of physical education and people participating in physical recreation, who also achieved better results in the environmental domain. Female students aged 23–25 had a higher quality of life in the physical, psychological, and social domains. Having a partner or spouse had a positive effect on the quality of life of female students defined by the social domain. A higher overall quality of life and satisfaction with health were characteristic of people who were employed. In the search of factors positively influencing the quality of life of society, it seems necessary to promote a physically active lifestyle among students. The observed differences in the quality of life and health satisfaction of female students of selected majors require targeted programs and interventions that improve the quality of their lives at various stages of their studies. Such activities increase the health potential of the individual and society, not only in the biological, but also psychosocial dimension. Full article
Article
Morphological and Motor Fitness Determinants of Shotokan Karate Performance
Int. J. Environ. Res. Public Health 2021, 18(9), 4423; https://doi.org/10.3390/ijerph18094423 - 21 Apr 2021
Viewed by 600
Abstract
The achievement of high performance levels in a complex structured sport such as karate is determined by the competitor’s physical fitness, fighting technique, tactics and mental state. This study aimed to identify the most important determinants of top-level performance in karate. Methods: The [...] Read more.
The achievement of high performance levels in a complex structured sport such as karate is determined by the competitor’s physical fitness, fighting technique, tactics and mental state. This study aimed to identify the most important determinants of top-level performance in karate. Methods: The participants were 32 karate competitors (12 women and 20 men) aged 18–25 years. A series of tests measuring 11 anthropometric features was undertaken twice during a year, separated by a 6-week interval during a training camp at the Olympic Preparation Center in Walcz, Poland. Motor skills were measured with strength, speed, endurance, flexibility and reaction time tests. Special motor fitness was assessed with tests of karate technical skills. The results were subject to statistical analysis using multiple stepwise regression of the Polish Karate Federation ranking points as the dependent variable. Results: The multiple regression analysis revealed two main determinants of high scores in female and male karate competitors. In women, these were thigh circumference and the speed of the mawashi-geri-kick roundhouse technique (i.e., the maximum number of delivered kicks in 30 s), whilst for men they were the extent of the sideway leg swing to the highest possible height (yoko-geri) and general endurance assessed with the bent arm hang test. Conclusion: Karate training should account for the determinants of high-level competitive karate performance identified in this study. Strengthening the lower limbs, exercises increasing hip joint mobility, low position movements, performing leg techniques in various planes and applying external loads undoubtedly increase a karate athlete’s strength and lead to the development of a more extensive repertoire of karate leg techniques, especially at the highest-scoring head level (jodan). Full article
Article
Assessment of the Health Behaviours and Value-Based Health Analysis of People Aged 50+ Who Were Hospitalized Due to Cardiovascular Disease
Int. J. Environ. Res. Public Health 2021, 18(8), 4221; https://doi.org/10.3390/ijerph18084221 - 16 Apr 2021
Viewed by 499
Abstract
Introduction: The basic determinant of healthy behaviour—among other human behaviours—is the fact that it consistently affects health. Nowadays, health behaviour studies are considered to be an important method of measuring the health of a population. Objective: To assess the health behaviours and value-based [...] Read more.
Introduction: The basic determinant of healthy behaviour—among other human behaviours—is the fact that it consistently affects health. Nowadays, health behaviour studies are considered to be an important method of measuring the health of a population. Objective: To assess the health behaviours and value-based health analysis of people aged 50+ who were hospitalized due to cardiovascular disease, depending on the selected descriptive variables. Materials and methods: The study was conducted between April 2018 and December 2018 among 411 subjects aged 50+ who were hospitalized due to cardiovascular disease at the Independent Public Health Care Unit in Sanok (Podkarpackie voivodship in Poland). The method used in the study was a diagnostic survey. The study used the authors’ survey questionnaire and two standardized tests: Inventory of Health-Related Behaviour (IHB) and List of Health Criteria (LHC). A statistical analysis was carried out in the R program, version 3.5.1. The obtained results were subjected to thorough statistical analysis using the following tests: Student’s t, Mann–Whitney U, ANOVA, Kruskal–Wallis, Fisher’s Least Significant Difference (LSD), Pearson, and Spearman. Results: The strongest correlation between health status and health behaviours (according to the IHB questionnaire) was in the area of ‘health practices’, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. Based on the LHC questionnaire, the most important health criteria according to the subjects were ‘not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. A positive correlation was found in the group of respondents where the ‘preventive health behaviours’ were more intense; herein, the more important criterion for the respondents was ‘eating properly’. Conclusions: Respondents aged 50+ and hospitalized for cardiovascular diseases indicated (based on the IHB questionnaire) that health behaviours in the area of ‘health practices’ had the strongest correlation with their health, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. According to the respondents, the most important criteria determining health (according to the LHC questionnaire) included ’not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. Based on the information collected from the respondents, it was found that the most important criteria determining health depended on selected descriptive variables, such as age, gender, place of residence, education, and marital status. Full article
Article
Patterns of Alcohol Consumption in the PURE Poland Cohort Study and Their Relationship with Health Problems
Int. J. Environ. Res. Public Health 2021, 18(8), 4185; https://doi.org/10.3390/ijerph18084185 - 15 Apr 2021
Viewed by 515
Abstract
(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline [...] Read more.
(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline study in 2007–2010. The study group consisted of 2021 adult participants of urban and rural areas from the Lower Silesia voivodeship in Poland (747 men and 1274 women). (3) Results: In the overall study population, 67.3% were current drinkers, 10.3% were former drinkers, and 22.4% were abstainers. Current use of alcohol products was more prevalent in men (77.2%), people living in urban areas (73.0%), and people with a higher level of education (78.0%). The percentage of current drinkers decreased with increasing age (from 73.4% in 30- to 44-year-olds to 48.8% in participants aged 64 and more). The majority of participants (89.2%) declared a low level of alcohol intake. The chance of high level of intake of alcohol was four times higher in men than in women (OR 4.17; CI 1.64–10.6). The majority of participants (54.6%) declared most frequent consumption of low-alcohol drinks (beer, wine) and 21% declared most frequent consumption of spirits. Current drinkers had almost 1.5-fold higher odds of diabetes and cardiovascular diseases (CVD) than never drinkers (OR 1.49, CI 1.03–2.17; OR 1.66, CI 1.27–2.18, respectively). Former drinkers had higher odds for hypertension and CVD than never drinkers (1.73, CI 1.05–2.85; OR 1.76, CI 1.22–2.53, respectively). (4) Conclusions: In our cohort study, we observed several socio-demographic factors differentiating the patterns of alcohol consumption. The preventive programs should focus predominantly on men, people aged <45 years, and those with a higher level of education. Full article
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Article
Physical Activity and Quality of Life of University Students, Their Parents, and Grandparents in Poland—Selected Determinants
Int. J. Environ. Res. Public Health 2021, 18(8), 3871; https://doi.org/10.3390/ijerph18083871 - 07 Apr 2021
Viewed by 476
Abstract
Physical activity is one of the factors conditioning human health. Research shows a positive impact of regular physical activity on the quality of human life. The aim of the study was to determine the relationship between the physical activity of university students, their [...] Read more.
Physical activity is one of the factors conditioning human health. Research shows a positive impact of regular physical activity on the quality of human life. The aim of the study was to determine the relationship between the physical activity of university students, their parents, and their grandparents, and the overall quality of their lives in individual domains (physical, mental, social, environmental), as well as the perceived state of health in relation to selected determinants. The research included 1001 participants, including 253 students related to physical culture and health promotion studying at the University of Szczecin (faculties: physical education, tourism and recreation, public health, sports diagnostics), and their 336 parents and 412 grandparents. Purposive sampling was used to outline the determinants of quality of life and family factors in physical activity. The diagnostic survey was carried out based on the standardized WHOQOL-BREF (World Health Organization Quality of Life) questionnaire. Statistically significant differences were shown in the studied generations regarding the assessment of quality of life and satisfaction with health in the physical, psychological, social, and environmental domains. The oldest generation gave the lowest assessment of quality of life and was the least satisfied with their health regarding particular domains. Female students were more satisfied with their health compared to grandmothers and grandfathers, whereas male students compared to mothers and fathers. Fathers achieved the highest scores in the psychological and social domains, but, in case of the latter, differences were found between mothers’ and fathers’ assessments. Intergenerational differences were found in quality of life and the assessment of health status. Current participation in broadly understood physical culture was often a result of positive attitudes towards physical education and doing sport in the past, which meant higher scores in the physical domain each time. The study demonstrated that taking up physical activity impacted the quality of life and assessment of health in the past and currently. Full article
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Article
A Pilot Study of Influence of Endurance Training on the Prooxidative and Antioxidant Status of Women after Breast Cancer
Int. J. Environ. Res. Public Health 2021, 18(6), 2822; https://doi.org/10.3390/ijerph18062822 - 10 Mar 2021
Viewed by 611
Abstract
The objective of this study was to assess the effect of 8-week long endurance training on the prooxidative–antioxidative status of plasma in women treated for breast cancer. The participants of the study were 12 women after radical mastectomy aged 45 to 56 years [...] Read more.
The objective of this study was to assess the effect of 8-week long endurance training on the prooxidative–antioxidative status of plasma in women treated for breast cancer. The participants of the study were 12 women after radical mastectomy aged 45 to 56 years (M = 50.6 ± 2.9 years), who had undergone full cancer treatment, on average more than 5 years after the treatment (M = 5.9 ± 0.9 years). Body mass components were measured twice using the method of bioelectric impedance analysis. In order to optimize training loads and to assess the level of exercise tolerance of the participants, the group was subject to an ergospirometric exercise test twice, before (1st) and after (2nd) the completion of the training cycle. The blood was also taken twice for biochemical analyses. Statistically significant differences were noted in the maximum exercise load, the level of which increased in the second test (p < 0.05). No change was observed in the level of antioxidative potential, i.e., the content of some variables, ferric reducing ability of plasma (FRAP), urea, total phenolics, thiobarbituric acid reactive substances (TBARS), and in the blood indices of the body’s nutritional status during the project (total protein, albumin. Endurance training caused an increase in exercise tolerance and did not cause an aggravation of oxidative stress in women undergoing breast cancer treatment. Full article
Article
Obesity and Chosen Non-Communicable Diseases in PURE Poland Cohort Study
Int. J. Environ. Res. Public Health 2021, 18(5), 2701; https://doi.org/10.3390/ijerph18052701 - 08 Mar 2021
Viewed by 586
Abstract
Introduction: Obesity has been associated with a higher risk of morbidity, disability, and death. The objective of this study was to assess the prevalence of obesity and chosen non-communicable diseases (NCDs) in the PURE Poland cohort study. Material and Methods: The study covers [...] Read more.
Introduction: Obesity has been associated with a higher risk of morbidity, disability, and death. The objective of this study was to assess the prevalence of obesity and chosen non-communicable diseases (NCDs) in the PURE Poland cohort study. Material and Methods: The study covers a group of 2035 people (1281 women and 754 men), who live in urban and rural areas of Lower Silesian voivodeship. The baseline study was conducted between 2007–2010. The data on demographic status and history of diseases were collected using questionnaires. The anthropometric parameters, blood pressure, blood lipids, and glucose level were measured. Results: Normal body weight was observed in 28.1% of participants, whereas overweight and obesity were observed in 40.1% and 31.1% of participants, respectively. Moreover, there was a significant difference in the body weight between genders. Prevalence of obesity was similar in men and women (31.0% and 31.1%, respectively). Obesity was more prevalent in rural vs. urban residents (38.5% and 26.0%, respectively). In a logistic regression analysis, the odds for obesity was two-fold higher in participants aged >64 years and rural inhabitants (OR 1.91; 95% CI 1.36–2.70; OR 1.79; 95% CI 1.48–2.16, respectively). Participants with obesity had 2.5-fold higher odds for diabetes and hypertension and two-fold higher odds for CHD in comparison with non-obese individuals (OR 2.74; 95% CI 2.01–3.73, OR 2.54; 95% CI 2.03–3.17, OR 1.88; 95% CI 1.26–2.80, respectively). Conclusions: Taken together, the prevalence of obesity was associated with particular socio-demographic factors (age, place of residence, and level of education) as well as diabetes, hypertension, and coronary heart disease. Full article
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Article
MALDI-TOF Protein Profiling Reflects Changes in Type 1 Diabetes Patients Depending on the Increased Amount of Adipose Tissue, Poor Control of Diabetes and the Presence of Chronic Complications
Int. J. Environ. Res. Public Health 2021, 18(5), 2263; https://doi.org/10.3390/ijerph18052263 - 25 Feb 2021
Viewed by 700
Abstract
Introduction: Protein profiling allows the determination of the presence of proteins marking various stages of the disease, and differentiates between people at risk of various diseases. In type 1 diabetes, protein profiling had been previously used to find blood markers other than islet [...] Read more.
Introduction: Protein profiling allows the determination of the presence of proteins marking various stages of the disease, and differentiates between people at risk of various diseases. In type 1 diabetes, protein profiling had been previously used to find blood markers other than islet autoantibodies to indicate the pancreatic beta cell destruction process and to reflect the progression of type 1 diabetes mellitus (T1DM). However, T1DM is an auto-immune disease and its clinical presentation changes in time of its duration. The aim of the study: To find differences in protein profiles in patients with type 1 diabetes according to diabetes control (HbA1c > 7%) and with presence of diabetic complications or obesity. It may help to identify subgroups of patients who may need a better clinical supervision and individualized treatment. Material and methods: A group of 103 patients with auto-immunologically confirmed T1DM, and meeting the following inclusion criteria: Caucasian race, duration of diabetes >5 years, were used in the study. Criteria of exclusion: past or present cancer (treated with chemo-/radiotherapy), diseases of the liver (ALT > 3 × ULN) except for people with simple hepatic steatosis, chronic renal disease (eGFR < 30 mL/1.73 m2/min), and acute inflammation (CRP > 5 mg/dL). The study group was divided in terms of the presence of chronic complications, obesity, or poor metabolic control (HbA1c > 7%). Protein profiling was completed by using the MALDI-TOF MS (matrix-assisted laser desorption/ionization-time of flight mass spectrometry) analyzer. Results: Differentiating proteins were identified in all of the groups. The groups burdened with complications, obesity, and poor metabolic control were characterized by increased levels of fibrinogen, complement C4 and C3. Conclusion: The groups of type 1 diabetes patients burdened with complications, obesity, and poor metabolic control were characterized by increased levels of fibrinogen, complement C4 and C3. Further detailed studies are necessary to determine more subtle changes in the proteomic profile of patients with type 1 diabetes. Full article
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Article
A Spatio-Temporal Analysis of the Health Situation in Poland Based on Functional Discriminant Coordinates
Int. J. Environ. Res. Public Health 2021, 18(3), 1109; https://doi.org/10.3390/ijerph18031109 - 27 Jan 2021
Viewed by 558
Abstract
The aim of this study was to investigate if the provinces of Poland are homogeneous in terms of the observed spatio-temporal data characterizing the health situation of their inhabitants. The health situation is understood as a set of selected factors influencing inhabitants’ health [...] Read more.
The aim of this study was to investigate if the provinces of Poland are homogeneous in terms of the observed spatio-temporal data characterizing the health situation of their inhabitants. The health situation is understood as a set of selected factors influencing inhabitants’ health and the healthcare system in their area of residence. So far, studies concerning the health situation of selected territorial units have been based on data relating to a specific year rather than longer periods. The task of assessing province homogeneity was carried out in two stages. In stage one, the original spatio-temporal data space (space of multivariate time series) was transformed into a functional discriminant coordinates space. The resulting functional discriminant coordinates are synthetic measures of the health situation of inhabitants of particular provinces. These measures contain complete information regarding 8 diagnostic variables examined over a period of 6 years. In the second stage, the Ward method, commonly used in cluster analysis, was applied in order to identify groups of homogeneous provinces in the space of functional discriminant coordinates. Sixteen provinces were divided into four clusters. The homogeneity of the clusters was confirmed by the multivariate functional coefficient of variation. Full article
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Article
Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women—The Results of the Polish National Survey
Int. J. Environ. Res. Public Health 2021, 18(2), 560; https://doi.org/10.3390/ijerph18020560 - 11 Jan 2021
Viewed by 729
Abstract
Obesity and diabetes increase the risk of complications during gestation and at delivery. The aim of this study was to compare the perinatal outcomes in the populations of diabetic and obese Polish women, based on the results of a national survey performed in [...] Read more.
Obesity and diabetes increase the risk of complications during gestation and at delivery. The aim of this study was to compare the perinatal outcomes in the populations of diabetic and obese Polish women, based on the results of a national survey performed in years 2012 and 2017, as well as to determine the risk factors of the gestational diabetes mellitus (GDM). Questionnaires from 6276 women were collected. Obese women constituted 5.5% and 7.5% of study population in years 2012 and 2017, respectively. Among women whose pregnancies were complicated by diabetes mellitus, GDM constituted the most common type of glucose intolerance during both time periods (2012: 89% vs. 2017: 85.6%). In the group of obese women an insignificant increase in the rate of induced deliveries was noted (2012: 9.9% vs. 2017: 11.7%), whereas the fetal birth-weight decreased significantly (2012: 3565 g vs. 2017: 3405 g, p < 0.05). In the group of diabetic pregnant women the percentage of cesarean sections, labour inductions and fetal birth defects was characterized by an insignificant upward trend. Risk of GDM was significantly increased in women aged over 35 years—(2012: OR 1.9 (95% CI: 1.1–2.9) and 2017: OR = 2.1 (95% CI: 1.5–2.9), p < 0.05—, as well as in overweight women—2012: OR 1.8 (95% CI: 1.2–2.7) and 2017: OR 2.6 (95% CI: 1.9–3.4), p < 0.05—during both analysed time periods. Based on the study results, it is necessary to develop population-based programmes to prevent obesity and to introduce and enforce the rules of appropriate screening for glucose tolerance disorders during pregnancy. Full article
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Article
MALDI-MSI—A Step Forward in Overcoming the Diagnostic Challenges in Ovarian Tumors
Int. J. Environ. Res. Public Health 2020, 17(20), 7564; https://doi.org/10.3390/ijerph17207564 - 18 Oct 2020
Cited by 2 | Viewed by 785
Abstract
This study presents the use of matrix-assisted laser desorption and ionization mass spectrometry imaging (MALDI-MSI) directly on the tissue of two ovarian tumors that often present a diagnostic challenge, a low-grade serous borderline ovarian tumor and ovarian fibrothecoma. Different spatial distribution of m/z [...] Read more.
This study presents the use of matrix-assisted laser desorption and ionization mass spectrometry imaging (MALDI-MSI) directly on the tissue of two ovarian tumors that often present a diagnostic challenge, a low-grade serous borderline ovarian tumor and ovarian fibrothecoma. Different spatial distribution of m/z values within the tissue samples was observed, and regiospecific peaks were identified. Among the 106 peaks in the borderline ovarian tumor five, regiospecific peaks (m/z: 2861.35; 2775.79; 3368.34; 3438.43; 4936.37) were selected using FlexImaging software. Subsequently, the distribution of those selected peaks was visualized on the fibrothecoma tissue section, which demonstrated the differences in the tissue homo-/heterogeneous structure of both tumors. The comparison with the histopathological staining of the ovarian borderline tumor tissue section, obtained during serial sectioning, showed a close correlation of the molecular map with the morphological and histopathological features of the tissue and allowed the identification of different tissue types within the sample. This study highlights the potential significance of MSI in enabling morphological characterization of ovarian tumors as well as correct diagnosis and further prognosis than thus far seen in the literature. Osteopontin, tropomyosin and orosomucoid are only a couple of the molecules investigated using MALDI-MSI in ovarian cancer research. This study, in line with the available literature, proves the potential of MALDI-MSI to overcome the current limitations of classic histopathological examination giving a more in-depth insight into the tissue structure and thus lead to the more accurate differential diagnosis of ovarian tumors, especially in the most challenging cases. Full article
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Article
Sustainable Development of Polish Macroregions—Study by Means of the Kernel Discriminant Coordinates Method
Int. J. Environ. Res. Public Health 2020, 17(19), 7021; https://doi.org/10.3390/ijerph17197021 - 25 Sep 2020
Cited by 2 | Viewed by 565
Abstract
The aim of this study was to investigate if the macroregions of Poland are homogeneous in terms of the observed spatio-temporal data characterizing their sustainable development. So far, works related to the sustainable development of selected territorial units have been based on data [...] Read more.
The aim of this study was to investigate if the macroregions of Poland are homogeneous in terms of the observed spatio-temporal data characterizing their sustainable development. So far, works related to the sustainable development of selected territorial units have been based on data relating to a specific year rather than many years. The solution to the problem of macroregion homogeneity goes through two stages. In step one, the original spatio-temporal data space (matrix space) was transformed into a kernel discriminant coordinates space. The obtained kernel discriminant coordinates function as synthetic measures of the level of sustainable development of Polish macroregions. These measures contain complete information on the values of 27 diagnostic features examined over 15 years. In the second step, cluster analysis was used in order to identify groups of homogeneous macroregions in the space of kernel discriminant coordinates. The agglomeration method and the Ward method were chosen as commonly used methods. By means of both methods, three super macroregions composed of homogeneous macroregions were identified. Within the kernel discriminant coordinates, the differentiating power of a selected set of 27 features characterizing the sustainable development of macroregions was also assessed. To this end, five different and most commonly used methods of discriminant analysis were used to test the correctness of the classification. Depending on the method, the classification errors amounted to zero or were close to zero, which proves a well-chosen set of diagnostic features. Although the data relate only to a specific country (Poland), the presented statistical methodology is universal and can be applied to any territorial unit and spatial-temporal dynamic data. Full article
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Article
Prenatal Fine Particulate Matter (PM2.5) Exposure and Pregnancy Outcomes—Analysis of Term Pregnancies in Poland
Int. J. Environ. Res. Public Health 2020, 17(16), 5820; https://doi.org/10.3390/ijerph17165820 - 11 Aug 2020
Viewed by 762
Abstract
Air pollution is currently one of the greatest threats to global health. Polish cities are among the most heavily polluted in Europe. Due to air pollution 43,100 people die prematurely in Poland every year. However, these data do not take into account the [...] Read more.
Air pollution is currently one of the greatest threats to global health. Polish cities are among the most heavily polluted in Europe. Due to air pollution 43,100 people die prematurely in Poland every year. However, these data do not take into account the health consequences of air pollution for unborn children. Thus, the aim of this study was to evaluate the effects of the fine particulate matter air pollution (less than 2.5 μm in diameter) on pregnancy outcomes. An analysis of pregnant women and their children was made using a questionnaire survey from a nationwide study conducted in 2017. Questionnaires from 1095 pregnant women and data from their medical records were collected. An analysis of air pollution in Poland was conducted using the air quality database maintained by the Chief Inspectorate for Environmental Protection in Poland. A higher concentration of PM2.5 was associated with a decrease in birth weight and a higher risk of low birthweight (i.e., <2500 g). We also observed lower APGAR scores. Thus, all possible efforts to reduce air pollution are critically needed. Full article
Article
Changes in Knowledge about Umbilical Cord Blood Banking and Genetic Tests among Pregnant Women from Polish Urban and Rural Areas between 2010–2012 and 2017
Int. J. Environ. Res. Public Health 2020, 17(16), 5744; https://doi.org/10.3390/ijerph17165744 - 08 Aug 2020
Cited by 1 | Viewed by 759
Abstract
The aim of this study was to evaluate knowledge of umbilical cord blood (UBC) banking and prenatal genetic diagnosis among pregnant women from rural and urban areas, and how this knowledge changed within a five-year period. A survey by questionnaire was conducted between [...] Read more.
The aim of this study was to evaluate knowledge of umbilical cord blood (UBC) banking and prenatal genetic diagnosis among pregnant women from rural and urban areas, and how this knowledge changed within a five-year period. A survey by questionnaire was conducted between 2010 and 2012, and in 2017 in public hospitals; the study population comprised 6128 women, with 2797 patients from the years 2010–2012 and 3331 from the year 2017. 41% of the studied population declared that they were living in rural areas. In the 2010–2012 period, fewer women from rural areas knew about UBC banking. In 2017 that same relative difference in knowledge persisted, but the percentage of women who now knew about this procedure rose significantly in both studied groups. Prenatal diagnosis was more familiar for urban inhabitants both in 2010 and 2017 but as with the UBC data, a trend of growing awareness was also seen in pregnant women from rural areas. Knowledge of new techniques such as UBC banking and genetic tests has grown among pregnant women during the time frame of our study, but there is still a need to emphasize the benefits of these two possibilities to pregnant women, especially among rural inhabitants. Full article
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Article
How to Screen Suitable Service Improve Community Health Care Services by University Students in Taiwan
Int. J. Environ. Res. Public Health 2020, 17(15), 5402; https://doi.org/10.3390/ijerph17155402 - 27 Jul 2020
Cited by 2 | Viewed by 805
Abstract
Engaging in social contributions to enhance social participation and attending community experiential service learning or internship courses have become an essential learning experience for university students. On the basis of postmodern education theories, this study adopted images and oral accounts involving personal experiences [...] Read more.
Engaging in social contributions to enhance social participation and attending community experiential service learning or internship courses have become an essential learning experience for university students. On the basis of postmodern education theories, this study adopted images and oral accounts involving personal experiences to construct a postmodern education research scheme by using the method of collaborative ethnography. This study selected and performed the following services: filming a community documentary, administering community health dance classes, and archiving community cultural artifacts in databases. Interviews were also administered to facilitate implementation of the actual services. Community health services commonly seen in Taiwan and abroad were compiled, and the resources required for each service were examined. Subsequently, factor analysis was performed to explore the characteristic of these services in order to recommend feasible services for university students to undertake. The results indicated that the eight resources required for the 59 common community health services were (1) a designated space or venue, (2) materials, (3) monetary resources, (4) human resources, (5) expertise, (6) professional equipment, (7) patience, and (8) empathy. The results revealed three principal components, namely labor services, high-resource services, and professional services, for a total explanatory power of 67.99%; the individual explanatory power of these components accounted for 25.04%, 21.81%, and 21.15%, respectively. Next, community health care services suitable for university students to perform were selected and implemented, and these services were well received. The study results indicated that community and environmental justice can be realized by identifying with the value of community health services and promoting postmodern education theories and social norms. The research results are suitable for implementation after the COVID-19 pandemic. Full article
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Article
Alterations in Serum-Free Amino Acid Profiles in Childhood Asthma
Int. J. Environ. Res. Public Health 2020, 17(13), 4758; https://doi.org/10.3390/ijerph17134758 - 02 Jul 2020
Viewed by 700
Abstract
Asthma often begins in childhood, although making an early diagnosis is difficult. Clinical manifestations, the exclusion of other causes of bronchial obstruction, and responsiveness to anti-inflammatory therapy are the main tool of diagnosis. However, novel, precise, and functional biochemical markers are needed in [...] Read more.
Asthma often begins in childhood, although making an early diagnosis is difficult. Clinical manifestations, the exclusion of other causes of bronchial obstruction, and responsiveness to anti-inflammatory therapy are the main tool of diagnosis. However, novel, precise, and functional biochemical markers are needed in the differentiation of asthma phenotypes, endotypes, and creating personalized therapy. The aim of the study was to search for metabolomic-based asthma biomarkers among free amino acids (AAs). A wide panel of serum-free AAs in asthmatic children, covering both proteinogenic and non-proteinogenic AAs, were analyzed. The examination included two groups of individuals between 3 and 18 years old: asthmatic children and the control group consisted of children with neither asthma nor allergies. High-performance liquid chromatography combined with tandem mass spectrometry (LC-MS/MS technique) was used for AA measurements. The data were analyzed by applying uni- and multivariate statistical tests. The obtained results indicate the decreased serum concentration of taurine, L-valine, DL-β-aminoisobutyric acid, and increased levels of ƴ-amino-n-butyric acid and L-arginine in asthmatic children when compared to controls. The altered concentration of these AAs can testify to their role in the pathogenesis of childhood asthma. The authors’ results should contribute to the future introduction of new diagnostic markers into clinical practice. Full article
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Article
Bone Metabolism in Patients Treated for Depression
Int. J. Environ. Res. Public Health 2020, 17(13), 4756; https://doi.org/10.3390/ijerph17134756 - 02 Jul 2020
Viewed by 622
Abstract
Background: Depression and osteoporosis are severe public health problems. There are conflicting findings regarding the influence of depression on bone metabolism. The aim of the presented study was to compare bone turnover markers and vitamin D levels between patients treated for depression and [...] Read more.
Background: Depression and osteoporosis are severe public health problems. There are conflicting findings regarding the influence of depression on bone metabolism. The aim of the presented study was to compare bone turnover markers and vitamin D levels between patients treated for depression and healthy controls. Patients and Methods: We determined a concentration of osteocalcin, carboxy-terminal telopeptide of type I collagen (β-CTX), 25-hydroxyvitamin D (25OHD) and 1,25(OH)2D3 in 99 patients, aged 46.9 ± 11 years, treated for depression, as well as in 45 healthy subjects. Depressive status was determined with the Hamilton Depression Scale (HDRS). Results: In patients treated for depression, we demonstrated significantly lower osteocalcin concentrations (p < 0.03) and higher concentration of β-CTX (result on the border of significance; p = 0.08). Those relationship were stronger in women. The level of 25OHD and 1,25(OH)2D3 did not differ significantly between the examined groups. We observed a negative correlation between the 25OHD and HDRS score after treatment in all patients treated for depression and in subgroups of women and subjects with recurrent depression. Conclusions: Our results indicate that depression is related to disturbances in bone metabolism, especially in women and patients with recurrent depression, suggesting its role in context of osteoporosis development. Full article
Article
Cervical Cancer Mortality in East-Central European Countries
Int. J. Environ. Res. Public Health 2020, 17(13), 4639; https://doi.org/10.3390/ijerph17134639 - 28 Jun 2020
Viewed by 566
Abstract
Changes that took place in Europe in the early 1990s had an impact on health-associated issues. They were an impulse for the changes in healthcare systems and, consequently, also for the changes in cancer control programmes. Those changes also had an effect on [...] Read more.
Changes that took place in Europe in the early 1990s had an impact on health-associated issues. They were an impulse for the changes in healthcare systems and, consequently, also for the changes in cancer control programmes. Those changes also had an effect on mortality rates due to cervical cancer (CC). Therefore, the aim of this study is to analyse CC mortality trends in east-central Europe after 1990. Data on deaths due to CC were retrieved from the WHO Mortality Database. Trends in east-central European countries between 1990 and 2017 were assessed using Joinpoint Regression Program software. CC mortality decreased in the majority of analysed countries. However, an increase was observed in Latvia and Bulgaria. Despite decreasing mortality in the majority of the analysed countries, significant differences were observed. In order to improve the epidemiological situation, effective early detection programmes for cervical cancer ought to be rearranged and based not only on pap smears but also on molecular methods, as well as on introducing widespread programmes of vaccination against HPV. Full article
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Article
Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland
Int. J. Environ. Res. Public Health 2020, 17(12), 4395; https://doi.org/10.3390/ijerph17124395 - 18 Jun 2020
Cited by 3 | Viewed by 877
Abstract
The aim of this study was to evaluate the knowledge regarding a healthy lifestyle and prophylaxis during pregnancy among women from rural and urban areas and how this changed within a 5-year period. Analyses of the population of pregnant women in Poland were [...] Read more.
The aim of this study was to evaluate the knowledge regarding a healthy lifestyle and prophylaxis during pregnancy among women from rural and urban areas and how this changed within a 5-year period. Analyses of the population of pregnant women in Poland were made using a questionnaire survey. The survey was conducted in the years 2010–2012 and 2017. Questionnaires from 6128 pregnant women were collected. The statistical analyses were conducted using IBM SPSS. The examined population was comprised of 41% women from rural areas and 59% women from urban areas. Alcohol consumption was lower among women from rural areas than among urban inhabitants in 2010–2012; in 2017 a trend of even lower consumption was observed. Folic acid supplementation was more broadly developed in the urban population; however, in 2017, higher percentage rates of both populations admitted taking folates before pregnancy. More women in urban than in rural areas performed physical activity during pregnancy, but the differences decreased in 2017. Knowledge of a healthy lifestyle and prophylaxis during pregnancy increased regardless of place of residence; however, the most evident change could be observed among women from rural areas. Full article
Article
The Quality of Life of Seniors Hospitalized Due to Cardiovascular Diseases in Poland
Int. J. Environ. Res. Public Health 2020, 17(10), 3721; https://doi.org/10.3390/ijerph17103721 - 25 May 2020
Cited by 1 | Viewed by 835
Abstract
Introduction: In the light of the increased ageing of the world population, social policy needs to be focused on actions aimed at improving the quality of life of older people. Objective: The main objective of this study was to assess the quality of [...] Read more.
Introduction: In the light of the increased ageing of the world population, social policy needs to be focused on actions aimed at improving the quality of life of older people. Objective: The main objective of this study was to assess the quality of life in a population of seniors hospitalized due to cardiovascular disease. Materials and methods: The study included 408 elderly patients hospitalized for cardiovascular diseases in the Poddębickie Centrum Zdrowia Hospital in Poddębice, Łódzkie voivodship, Poland. The study used two survey questionnaires: the author’s survey questionnaire and the standardized SF36v2 Questionnaire. Statistical analysis of the obtained test results was carried out in the R program, version 3.5.1. Results: Having analyzed the health status of the study group, it was found that the largest group of subjects (84.07%) were treated due to hypertension. Among the ailments that hindered daily functioning, the respondents indicated primarily poor eyesight (53.68%). Patients assessed their own health as ‘mediocre’ (average) (58.58%). The analysis of the study results from the SF36v2 Questionnaire showed that the highest quality of life was in the limited activity due to emotional problems (RE) dimension, social functioning (SF), and physical functioning (PF); the weakest scores were observed in vitality (VT), general health perception (GH), and health transition (HT) dimensions. Conclusions: The significant demographic, social and socio-medical factors that determined respondents’ quality of life were: age, gender, marital status, education and health situation. The analysis of quality of life according to the SF36v2 Questionnaire showed that the study group functioned better in the mental dimension (MCS—mental component summary, overall mental health) than in the physical one (PCS—physical component summary, total physical health). Full article
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Article
Exposure to Environmental Tobacco Smoke (ETS) among Employees of Hospitality Venues in the Light of Changes in Anti-Tobacco Legislation in Poland
Int. J. Environ. Res. Public Health 2020, 17(10), 3691; https://doi.org/10.3390/ijerph17103691 - 23 May 2020
Viewed by 836
Abstract
Introduction: Numerous studies conducted in Europe and worldwide have indicated that employees of hospitality venues are the most exposed professional group to environmental tobacco smoke (ETS) in the workplace. The purpose of this study was to assess the exposure of employees of hospitality [...] Read more.
Introduction: Numerous studies conducted in Europe and worldwide have indicated that employees of hospitality venues are the most exposed professional group to environmental tobacco smoke (ETS) in the workplace. The purpose of this study was to assess the exposure of employees of hospitality venues to ETS in the light of changes in anti-tobacco legislation in Poland. Materials and methods: The study consisted of two stages. The first stage was conducted in 2010, while the second in 2015. The study was conducted among employees of 300 randomly selected hospitality venues in the city of Łódź (Poland). In total, 2607 questionnaires were analysed. The study used two survey questionnaires created and recommended by the Institute for Global Tobacco Control to study exposure to ETS. Statistical analysis was made with Statistica 13.1 PL (StatSoft, Poland). Results: In the group of all nonsmoking employees, individuals exposed to ETS at work in 2010 accounted for 72.6%; while in 2015 it was 51.8%. Factors affecting exposure to ETS in the workplace included, among others: age, marital status, education, position held, presence of a smoking room on the premises, and noncompliance with the provisions of the anti-tobacco laws. Conclusions: The prevalence of tobacco smoking among employees of hospitality venues decreased in 2010–2015, however, it remained high. More than half of nonsmoking employees were exposed to ETS at work. Full article
Article
In-Vitro Growth Inhibition of Bacterial Pathogens by Probiotics and a Synbiotic: Product Composition Matters
Int. J. Environ. Res. Public Health 2020, 17(9), 3332; https://doi.org/10.3390/ijerph17093332 - 11 May 2020
Cited by 4 | Viewed by 1085
Abstract
A variety of activities potentially contribute to the beneficial effects of probiotic bacteria observed in humans. Among these is a direct inhibition of the growth of pathogenic bacteria in the gut. The present study characterizes head-to-head the in-vitro pathogen growth inhibition of clinically [...] Read more.
A variety of activities potentially contribute to the beneficial effects of probiotic bacteria observed in humans. Among these is a direct inhibition of the growth of pathogenic bacteria in the gut. The present study characterizes head-to-head the in-vitro pathogen growth inhibition of clinically relevant infectious bacterial strains by different types of probiotics and a synbiotic. In-vitro growth inhibition of Escherichia (E.) coli EPEC, Shigella (Sh.) sonnei, Salmonella (S.) typhimurium, Klebsiella (K.) pneumoniae and Clostridioides (C.) difficile were determined. Investigated products were a yeast mono strain probiotic containing Saccharomyces (Sac.) boulardii, bacterial mono strain probiotics containing either Lactobacillus (L.) rhamnosus GG or L. reuteri DSM 17938, a multi strain probiotic containing three L. rhamnosus strains (E/N, Oxy, Pen), and a multi strain synbiotic containing nine different probiotic bacterial strains and the prebiotic fructooligosaccharides (FOS). Inhibition of pathogens was moderate by Sac. boulardii and L. rhamnosus GG, medium by L. reuteri DSM 17938 and the L. rhamnosus E/N, Oxy, Pen mixture and strong by the multi strain synbiotic. Head-to-head in-vitro pathogen growth inhibition experiments can be used to differentiate products from different categories containing probiotic microorganisms and can support the selection process of products for further clinical evaluation. Full article
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Article
Association between Living with Children and the Health and Health Behavior of Women and Men. Are There Differences by Age? Results of the “German Health Update” (GEDA) Study
Int. J. Environ. Res. Public Health 2020, 17(9), 3180; https://doi.org/10.3390/ijerph17093180 - 02 May 2020
Viewed by 1031
Abstract
Does the health of women and men living with and without minor children differ, and are age differences evident in the association? For self-rated general health, depression, back pain, overweight, smoking and sporting inactivity, the GEDA data 2009–2012 (18–54 years, n = 39,096) [...] Read more.
Does the health of women and men living with and without minor children differ, and are age differences evident in the association? For self-rated general health, depression, back pain, overweight, smoking and sporting inactivity, the GEDA data 2009–2012 (18–54 years, n = 39,096) were used to calculate prevalence for women and men stratified by parental status (living with children: yes/no) and age. Moreover, we calculated odds ratios and predictive margins, performing logistic regressions with interaction terms of parental status and age. Women and men aged 45–54 living with children are healthier than those not living with children. Parents aged 18–24 smoke more frequently and do less sport; young mothers are also more likely to be overweight and suffer from back pain than women not living with children. In multivariable analysis, the interaction of living with children and age is significant for all outcomes (except depression and back pain in men). Living with children is an important social determinant of health, highly dependent on age. It is to be discussed whether the bio-psycho-social situation has an influence on becoming a parent, or whether parenthood in different phases of life strains or enhances health. Full article
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Review

Jump to: Research, Other

Review
Adenomyosis and Infertility—Review of Medical and Surgical Approaches
Int. J. Environ. Res. Public Health 2021, 18(3), 1235; https://doi.org/10.3390/ijerph18031235 - 30 Jan 2021
Viewed by 914
Abstract
The aim of this review is to clarify the relative association between adenomyosis and infertility and the possible treatment for an infertile patient. Although adenomyosis is detected more often in women of late reproductive age, its influence on pregnancy rates is important, especially [...] Read more.
The aim of this review is to clarify the relative association between adenomyosis and infertility and the possible treatment for an infertile patient. Although adenomyosis is detected more often in women of late reproductive age, its influence on pregnancy rates is important, especially considering the tendency to delay pregnancy among women in developed countries. In this article, we present a critical analysis of the literature data concerning the impact of adenomyosis on fertility. The possible effects of treatment on the pregnancy rate will also be discussed. We conducted a literature search; publications from Pubmed, Embase and Cochrane databases published from 1982 to 2019 were retrieved using terms ’adenomyosis and infertility’ and ’adenomyosis and pregnancy outcomes’, extensively studied in the aspects of diagnosis, pathogenesis of infertility and possible treatment methods. Molecular studies have given deep insight into the pathogenesis of adenomyosis in the recent few years, but there is a huge discrepancy between in vitro studies and praxis. Oral contraceptive pills, anti-prostaglandins, oral or parenteral progestins, danazol and gonadotrophin-releasing hormone (GnRH) analogues have all been used to control menstrual pain and menorrhagia in women with adenomyosis, but they temporarily suppress the menstrual cycle. Additionally, endometrial ablation and hysterectomy used to alleviate pain caused by adenomyosis exclude pregnancy planning. The development of imaging techniques—ultrasound and MRI—enables the diagnosis of adenomyosis with very high accuracy nowadays, but the methods of treatment mentioned above have not given satisfactory results in women planning pregnancy. For these patients, the high-intensity-focused ultrasound method (HIFU) and combined treatment before assisted reproductive techniques can prove beneficial in adenomyosis patients. Full article
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Other

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Case Report
CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report
Int. J. Environ. Res. Public Health 2020, 17(12), 4397; https://doi.org/10.3390/ijerph17124397 - 18 Jun 2020
Viewed by 1107
Abstract
Background: Many studies show the occurrence of several multiple endocrine neoplasia syndromes caused by different mutations, for example, in MEN1 and RET genes. Nevertheless, there are less common mutations causing multiple endocrine glands tumors. Examples of such mutations are CHEK2 gene mutations, causing [...] Read more.
Background: Many studies show the occurrence of several multiple endocrine neoplasia syndromes caused by different mutations, for example, in MEN1 and RET genes. Nevertheless, there are less common mutations causing multiple endocrine glands tumors. Examples of such mutations are CHEK2 gene mutations, causing breast, kidney, gastric, colorectal, prostate, lung, ovarian, and thyroid cancers. Case description: In 2005, a 30-year-old woman was admitted to the hospital due to uncontrolled hypertension and obesity. Performed tests have shown ACTH (adrenocorticotropic hormone)—independent micronodular adrenal hyperplasia (AIMAH) as a cause. In 2010, the further diagnostic analysis revealed Cushing’s disease caused by ACTH-secreting pituitary microadenoma. Additionally, in 2011, the patient underwent the strumectomy of multinodular struma. Papillary thyroid carcinoma was found in the excised tissue. In 2018, transvaginal ultrasonography revealed a tumor of the right ovary. After a performed hysterectomy with bilateral salpingo-oophorectomy, the histopathology result has shown female adnexal tumors of probable Wolffian origin (FATWO) located in the broad ligament of the uterus. Due to the history of multiglandular diseases, the patient was referred to genetic testing. We found a positive pathogenic mutation in CHEK2-suppressor gene involved in DNA repair, cell cycle arrest, and apoptosis in response to DNA damage. Conclusion: CHEK2 variants may predispose to a range of endocrine glands tumors, including those identified in our patient. Multiple endocrine glands tumors, as in the presented patient, are a serious problem of public health, due to numerous hospitalizations and necessary repeated surgical treatments. Moreover, the association between CHEK2 and ovarian cancer can be a serious problem with reproductive health. Full article
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