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Human papillomavirus (HPV) leads to diseases of the skin and mucous membranes of the anogenital and upper gastrointestinal tract, especially neoplasia. HPV vaccinations effectively protect against the development of HPV-related diseases. However, despite the wide availability of vaccination for patients, only a few percent of Polish children are vaccinated. The reasons for this are certainly complex. Therefore, the aim of the study was to evaluate gynecologists' and general practitioners' knowledge, awareness and attitudes towards HPV vaccination and analyze their opinions about the interest in HPV vaccinations among children and parents. An anonymous, voluntary, cross-sectional survey study was conducted among 300 Polish gynecologists and general practitioners. Participants were from a diverse group with a wide range of work experience and different workplaces. Most of the respondents (83%), especially the gynecologists (p = 0.03), declared informing and discussing with parents the HPV-related diseases and prevention methods. Only 8% of the participants reported a negative reaction from parents when talking about HPV vaccines. However, in practice, physicians very rarely recommend this vaccine. HPV vaccination was recommended more often by female physicians (p = 0.03), general practitioners (p < 0.001), physicians working over five years (p < 0.001), doctors who regularly vaccinated themselves against influenza (p = 0.01) and those who vaccinated their children against HPV (p =0.001). The availability of educational materials for parents and/or patients encouraged physicians to provide this information (p < 0.001). Polish gynecologists and general practitioners declared a positive attitude regarding HPV vaccines; however, they rarely recommended this vaccine. Physicians who vaccinate themselves against influenza and their own children against HPV are more likely to provide information and encourage HPV vaccination in others. Additionally, the availability of educational material for parents and adolescents plays an essential role in the popularization of this vaccination. Knowledge alone is not enough for physicians to recommend the vaccination to patients.

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Purpose: Human papillomavirus (HPV) vaccination can prevent more than 90% of cancers caused by HPV. However, they are still not common in Poland. The aim of the study was to evaluate Polish youths' knowledge of HPV vaccine and sexually transmitted diseases (STD). Methods: The cross-sectional study was performed with the use of an anonymous and voluntary survey distributed among 610 graduate high-school students, and 491 (81%) responded. Results: Only 24% were aware of potential oncological risk of HPV infection. Nearly all responders indicated HIV/AIDS as STD, while only 14% indicated HPV as well. In the opinion of 94% participants, vaccines are effective and safe, however, only 8% of girls and 5% of boys claimed that they were vaccinated against HPV. Simultaneously, 43% declared the will to vaccinate their own child in the future. As a barrier in performing HPV vaccinations, participants indicated first of all lack of enough knowledge (64%) and lack of awareness of the need to be vaccinated (51%). The main sources of knowledge about health were internet (93%) and school (67%). Only 10% of the participants had discussed the HPV and vaccine with a doctor. These adolescents had more knowledge about cervical cancer (P = 0.0002) and its relation to HPV infection (P = 0.0001). Conclusions: Polish adolescents present positive attitude toward HPV vaccines but their knowledge is still unsatisfactory. Schools and professional health providers should pay more attention to patient's education as well as developing online campaigns.

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Background: Human papillomavirus (HPV) vaccinations are rare among Polish children, and the reasons are scant. The objective was to evaluate the knowledge, attitude and awareness of parents about HPV vaccination to investigate reasons for low HPV vaccination coverage. Methods: 387 parents of children hospitalized at the Children's Hospital were asked to participate in an anonymous and voluntary survey study. Three hundred and two surveys were returned. Results: Only 54% of participants have heard about HPV, while 26% know that it is a sexually transmitted disease. According to 71% of responders, vaccines are generally effective, and 63% claim that they are safe. However, only 5% of daughters and 4% of sons are vaccinated against HPV. A total of 25% of parents spoke with their doctor about HPV-related diseases and prevention methods. A higher level of education (p = 0.01), knowledge of sexually transmitted diseases (p < 0.0001), perceiving vaccination as an effective and safe prophylactic method (p < 0.0001), and conversations with a doctor (p < 0.0001) are strong motivators to vaccinate children against HPV. This decision is free of religious beliefs, origin, age, gender and the number of children. Conclusions: Polish parents have a positive attitude towards vaccination. They recognize the limitations of their knowledge and express a desire to further it. Educational activity is an important element of physicians' work.

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Persistent infection with oncogenic Human papillomavirus (HPV) types can lead to neoplasms involving urogenital and laryngeal tumors, which account for approximately 5% of all cancers worldwidely. Effective measures to reduce the morbidity and mortality associated with HPV cancers are regular examinations including the Papanicolaou test and preventive vaccination. However, despite the registration of the first HPV vaccine already in 2006, there is still huge disparity in the vaccination coverage between countries. In Poland, vaccination coverage is still very low in comparison to other European Union countries (only a few percent). Constraints exist on the part of the state and health system organizations, as well as in the attitudes of health professionals and parents. One of the primary factors influencing the decision to vaccinate against HPV is the presence of the vaccine in The National Immunization Program, while often with financial support. Formalization of vaccination also forces physicians to be more attentive to informing and recommending immunization, increasing their level of education. The role of medical workers is crucial from a social point of view. For parents, an adequate discussion with the physician is a vital factor influencing HPV vaccination decisions. At the same time, health care workers express the need to change their work organization due to insufficient time for health promotion and prophylaxis during visits. A thorough understanding of the barriers can allow for the development of effective strategies to increase vaccination coverage.

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PURPOSE: To investigate the association of galectin-3 (Gal-3) and soluble ST2 (sST2) and their follow-up changes with the development of heart failure (HF) and echocardiographic parameters of HF (ejection fraction, atrial and ventricular size, left ventricular hypertrophy, e', and E/e') in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). METHODS: A prospective, observational study, BIOSTRAT (Biomarkers for Risk Stratification After STEMI), enrolled 117 patients between October 2014 and April 2017. Gal-3 and sST2 serum collection and echocardiography were performed twice (during index hospitalization and on a control visit at one-year follow-up). The primary endpoint was HF onset at one-year follow-up. Secondary assessments included associations of biomarker concentration with echocardiographic indices of systolic and diastolic dysfunction at baseline and at one year. RESULTS: Mean baseline concentrations of Gal-3 and sST2 (7.5 and 26.4 ng/mL, respectively) were significantly increased at one-year follow-up (8.5 ng/mL and p < 0.001 and 31.4 ng/mL and p = 0.001, respectively). Patients who reached the primary endpoint (50 patients (48%)) had significantly higher baseline concentrations of both biomarkers and a higher Gal-3 level at one year compared to patients who did not. Both Gal-3 and sST2 were predictors of the primary endpoint in univariate logistic regression analysis, but only Gal-3 remained significant in multivariate analysis. There was no clear association between both biomarkers and echocardiographic parameters. CONCLUSIONS: Baseline, but not one-year, changes of Gal-3 and sST2 concentrations may be useful for risk stratification after STEMI. However, only Gal-3 was the independent predictor of HF development at one-year observation. This trial is registered with NCT03735719.

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INTRODUCTION: Galectin­3 (Gal­3) and soluble interleukin-1 receptor-like 1 (sST2) have known prognostic value in already diagnosed heart failure (HF). OBJECTIVES: To investigate the association of Gal­3 and sST2 with prognosis in patients with ST­segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). PATIENTS AND METHODS: The analysis was based on data collected in a prospective observational BIOSTRAT (Biomarkers for Risk Stratification After STEMI; ClinicalTrials.gov identifier, NCT03735719) study. Analysis included 117 patients with first­time STEMI treated with pPCI. Serum for Gal­3 and sST2 was sampled 72 to 96 hours after admission due to STEMI. The patients were followed for the primary endpoint (cardiovascular [CV] death or HF hospitalization at 1 year). RESULTS: Both biomarkers correlated with N­terminal pro­B­type natriuretic peptide (NT­proBNP); Gal­3 correlated with older age. Data on the primary endpoint were available for 104 patients (89%). At 1­year follow­up, 9 patients (8.7%) reached the primary endpoint. In univariate Cox proportional hazards regression analysis, both Gal­3 and sST2 as continuous variables, as well as their newly­established cutoffs (≥9.57 ng/ml for Gal­3 and ≥45.99 ng/ml for sST2, based on the Youden index) were predictors of the primary endpoint, and of HF hospitalizations alone. Gal­3 also predicted CV death. After adjustment for age and NT­proBNP, Gal­3 and sST2 remained predictors of the primary endpoint in multivariate models. CONCLUSIONS: In patients with first­time STEMI treated with pPCI, baseline Gal­3 and sST2 predicted the composite of CV death and HF hospitalization at 1 year. Both biomarkers may play an important role in CV risk stratification after STEMI, although Gal­3 may be considered preferable.

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We present a case report of a 70-year-old female patient with a history of right hip dysplasia and total hip arthroplasty complicated by chronic periprosthetic hipction. Failure of oral antibiotic treatment was an indication for implant removal. A computed tomography scan performed during qualification for reimplantation revealed massive bone defects in the pelvis. A three-dimensional printed patient-specific anatomical model of the pelvis helped to determine the precise position and cup size in preoperative planning and prepare a patient-matched acetabulum. The custom-made endoprosthesis was implanted during revision arthroplasty.

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