The normal range and the decision interval.

The concept of the decision interval which replaces the normal range in medical decision-making in the contemporary setting of evidence- and procedure-based medicine is presented. The definition and some properties of the decision interval are discussed.

Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study-Study Rationale and Protocol.

Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD) and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design.

Indicator-based assessment of environmental hazards and health effects in the industrial cities of upper Silesia, Poland.

Using an indicator-based approach, we assessed environmental hazards and related health effects in populations of industrial cities with more than 100,000 inhabitants in Upper Silesia, Poland, and analyzed the relationship between environment and health. We adopted the method developed by Dutkiewicz et al. for assessing large geographic areas.

Percutaneous absorption studies after forty years.

The authors review the development of ways to study percuatneous absorption of chemicals and summarize the current status of investigations in this area.

Background on the system of integral evaluation of human exposure to toxic substances in the work and municipal environments.

Exposure to toxic chemicals in the work, natural and home environments is recognised as combined exposure. The system of integral evaluation of human exposure should take account of all toxic substances occurring in all environmental media (air, water, soil and food), and all routes through which they enter the human body. To provide the integral evaluation it is necessary to develop different exposure scenarios based on dose intake or derived values.

The influence of exogenous antioxidants and physical exercise on some parameters associated with production and removal of free radicals.

Metabolic processes generate chemically active forms of oxygen, among which a prominent role is played by the superoxide ion. Cells are equipped with defence systems against the effects of superoxide radicals, superoxide dismutase is the most important one. The organism depends on the delivery of exogenous antioxidants, like selenium, vitamins E and C.

Evaluation of regional environmental and health hazards by applying synthetic measures.

Large geographical areas, urban and rural regions of 49 voivodships in Poland, were evaluated from the point of view of existing environmental and health hazards caused by chemical contamination of the environment. Using routine sources of information, we selected four health-related environmental indicators and eight environmental-related health indicators. All indicator values were normalized and then aggregated to synthetic measures of environmental and health hazards, using the taxonometric method.

Environmental determinants of selected family-oriented health indicators.

Based on the levels of environmental contamination and degradation, synthetic measures of environmental hazards in urban and rural regions in Poland were developed. At the same time, negative family health indicators associated with environmental contamination were determined. These indicators included: low birth weight, fraction of deaths with low birth weight, excessive male and female mortality in the 30-64 age group.

A mathematical model for the estimation of nickel internal dose in populations under occupational and environmental exposure.

Using the results of own investigations as well as available literature data an attempt was made to develop a mathematical model for the estimation of nickel internal dose on the basis of nickel concentration in urine.

Selected aspects of the population health status in ecological hazard areas in comparison with ecologically "clean area". III. localisation of urban regions with high mortality from all and from the circulatory system diseases.

Territorial localisation of urban regions with particularly high mortality from all diseases and from diseases of the circulatory system in males and females was the aim of the study. Altogether 177 urban regions within ecological hazard areas (EHAs) and 76 urban regions within reference area (RA) were subjected to evaluation. In the group of urban regions in which mortality rate from all diseases exceeded the value of arithmetic mean + 1/2 of standard deviation, 32 urban regions of EHA and 12 of them with RA were selected for assessing male mortality and 44 and 7, respectively, for assessing female mortality.

Selected aspects of the population health status in ecological hazard areas in comparison with ecologically "clean" area. I. Methodology for analysing health status based on the routine data collection system.

A proposal for an integrated system of analysis of complex health problems in ecological hazard areas in comparison with reference least polluted area is presented. The proposed procedure can be used in identifying priorities in health promotion.

Spatial distribution of negative health indices in ecological hazard areas in Poland.

Spatial distribution of negative health indices (relative risk, synthetic measure) was demonstrated in 27 ecological hazard areas (EHAs) in Poland. For comparison reference areas were selected. The health indices were used for developing a general index of harmfulness characteristic for individual EHA.

Selected aspects of the population health status in ecological hazard areas in comparison with ecologically "clean" area. II. Assessment of spatial distribution of mortality.

On the basis of age adjusted rates of mortality from all diseases and from diseases of the circulatory system in female and male populations living in ecological hazard areas and in ecologically "clean" area, the distributions of the rate values were assessed. In the regions under consideration, urban and rural regions were distinguished. The goodness of fit of the empirical distribution to the normal one was assessed using the following statistical parameters: arithmetic mean, mode, median, standard deviation, coefficient of variation, coefficient of asymmetry, difference between the third and the first quartiles, as well as the Chi2 and lambda-Kolmogorow-Smirnow tests, maximum difference between cumulative distribution functions and standard deviation of differences between empirical and theoretical frequencies.

Plasma prekallikrein levels in patients with hepatocellular carcinoma and liver cirrhosis: a pilot study.

The concentration of plasma prekallikrein (PK) in five patients with hepatocellular carcinoma (HCC) has been measured and related to levels in 18 patients with liver cirrhosis (LC) and 30 healthy subjects. It was found that the mean PK level was significantly increased in patients with HCC, while patients with LC demonstrated lower concentrations, as compared with healthy subjects. The results indicate that PK might be useful in screening cirrhotic patients for HCC.

Development of the aggregation model of adverse environmental and health effects for evaluation of large areas of ecological hazard.

The model of aggregation of 12 parameters describing the environmental and health effects in areas of ecological hazard has been elaborated. The values of particular indices create the characteristic profile useful for selection of dominant environmental problems. The general index of hazard is suitable for establishing priorities among ecological hazard areas.

Health risk assessment in children exposed to lead compounds in the vicinity of mine-smelter plant "Orzeł Biały".

Investigations of environmental exposure to lead were performed in 1028 children from a very polluted industrial region affected by emissions from the lead mine and smelter plant "Orzeł Biały". A group of 629 children was used as the reference population from non-polluted parts of Poland. The lead blood concentrations in exposed groups of children were considerably higher than in the reference group and 26% of younger children and 11% of older children exceeded the safe limit value of 20 micrograms/dl.

[Reference levels of lead in children from clean regions of Poland].

Following the determination of blood lead levels in children of 8-10 age group, living in selected clean regions of Poland, a statistical analysis of results was carried out. On the basis of this analysis reference values were proposed. The values are characteristic for the whole area of Poland and they should be applied in all studies pertaining to the assessment of exposure to lead among children.

[Lead in the environment of Poland].

Lead belongs to those elements which have a great variety of applications in the up-to-date technology. In the form of waste products or automotive wastes it has been brought into a global circulation. The authors attempt to present harmful effects of this "environmental poison" on individual media and human population in Poland.

[Chief toxic effects associated with environmental pollution in Poland based on health status indices of the general population].

Poor health status of general population in Poland together with existing trends were discussed on the basis of health indices and in comparison with other European countries. Examples of health effects related to environmental pollution in Poland were presented, and some vital preventive activities for improving the situation were proposed.

Identification and evaluation of nickel intake sources.

The level of nickel in a full-day diet, drinking water and complementary liquids was measured in groups of persons occupationally and environmentally exposed to this element. Both adults and children (in preschool and school age) living in industrial and recreation areas were considered. Concentrations of nickel in the occupational and ambient air were also taken into account.

Caffeine reduces the hepatotoxicity of paracetamol in mice.

Paracetamol causes extensive liver damage when taken in overdose quantities; however, it is less hepatotoxic when administered in combination with caffeine. The present work in mice was undertaken to study the effect of caffeine on mortality rates and biochemical and histological parameters of liver damage after administration of toxic doses of paracetamol. It was found that caffeine markedly increased the survival rate after administration of a dose of paracetamol that was lethal to 50% and 100% of mice, reduced liver damage as assessed by serum glutamic pyruvic and glutamic oxaloacetic transaminase activities, partially prevented the depletion of reduced glutathione and reduced histological changes to the liver accompanying paracetamol intoxication.

Essential phospholipids modify immunological functions and reduce experimental atherosclerosis in rabbits.

Atherosclerosis was induced in male mongrel rabbits with a high-fat diet and the influence of essential phospholipids (EPL) on plaque formation, parameters of lipid metabolism and immunological functions was studied. When EPL were added to the high-fat diet there was a significant reduction in the area of atherosclerotic involvement of the aorta. The serum concentration of lipids decreased, often to normal values, and cholesterol esterified with polyunsaturated fatty acids appeared.

The preservation of mitochondrial functions in extracellular environments.

Mitochondria are labile objects when isolated from mammalian organs and may undergo rapid changes (aging) in vitro. This work attempts to examine conditions which retard such changes. Isolated rat heart mitochondria were incubated for 180 min in the presence of various substances whose properties might influence the aging process as expressed by changes in oxygen consumption rates.