Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the proximal femur. The alterations in the blood supply may occur following a traumatic event or result from a non-traumatic cause. Femoral neck fracture and hip dislocation and associated surgical procedures, corticosteroid therapy, and alcohol abuse frequently lead to AVN development. Type of fracture (displaced or undisplaced) and time between injury and surgery are the most critical factors in assessing the risk of developing AVN. Diagnosis of AVN can be established based on patients’ complaints, medical history, and radiographic findings. There is no consensus on the treatment of patients with AVN to date. Non-surgical methods are dedicated to patients in the early pre-collapse stages of the disease and consist of pharmacotherapy and physiotherapy. Surgery is recommended for patients with advanced disease.

IntroductionThe COVID-19 pandemic has significant socio-economic implications for numerous industries, including healthcare. Disruptions of essential health services were reported by nearly all countries around the world. A detailed assessment of the healthcare uptake is necessary to estimate the potential health effects of the COVID-19 pandemic on the population. This study aimed to assess the prevalence of barriers to accessing health services during the COVID-19 pandemic in Poland as well as to identify factors associated with the disturbed access to healthcare during the pandemic.MethodsThis cross-sectional survey was carried out among Internet users in Poland using the computer-assisted web interview technique. Data were collected between October and December 2021. The questionnaire included 32 questions on sociodemographic characteristics, the COVID-19 pandemic, health status, daily habits as well as the use of healthcare during the COVID-19 pandemic.ResultsData were obtained from 102928 adults, the mean age was 48.0 ± 14.2 years, and 57.2% were females. Most of the respondents had visited a doctor during the past 12 months (70.4%). Almost half of adults in Poland (49.7%) reported barriers to access health services in the past 12 months. Out of 51,105 respondents who had experienced barriers to accessing health services during the COVID-19 pandemic, only 54.3% had visited a doctor in the past 12 months. Long waiting time (39.5%) and temporary closure of healthcare facilities/transformation into a COVID-19 dedicated center (28.8%) were the most common barriers indicated by the respondents. In multivariable logistic regression, female gender, age 18–49 years, lack of higher education, living in cities between 51,000 and 200,000 residents or above 500,000 residents, and having at least one chronic disease were significantly (p < 0.05) associated with higher odds of experiencing barriers to accessing health services during the COVID-19 pandemic.ConclusionsThis study confirmed that the COVID-19 pandemic has worsened access to health services in Poland. During the pandemic, new barriers to accessing health services, such as the temporary closure of healthcare facilities for non-COVID patients were revealed. Findings from this study provided patients' perspectives on barriers to accessing health services in Poland that may be used by policymakers to reduce health inequalities.

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The objective of this study was to evaluate the association between breastfeeding duration and child neurodevelopment based on the Polish Mother and Child Cohort Study. Material and Methods: The current analysis included 501 mother-child pairs. The analysis evaluating the association between the length of breastfeeding and child neurodevelopment considered the following variables: maternal age and body mass index, weight gain during pregnancy, parental level of education, marital status, socioeconomic status, child gender, birthweight, type of delivery, preterm delivery, pre-and postnatal exposure to tobacco constituents and child day care attendance. Psychomotor development was assessed in 1-year-olds on the Bayley Scales of Infant and Toddler Development. Results: The length of breastfeeding correlated positively with maternal age at delivery (ρ = 0.13), maternal and paternal level of education (ρ = 0.2 and ρ = 0.14 respectively), birthweight (ρ = 0.1) and marital status (ρ = 0.16) (p < 0.05). A negative correlation between the length of breastfeeding and maternal smoking status during the first year after delivery (ρ =-0.19) and weight gain during pregnancy (r =-0.1) was observed (p < 0.05). The association between the duration of breastfeeding and child development was not statistically significant in the model with the inclusion of confounding variables. A significant association between language development and maternal level of education (p = 0.004), gender of the child (p = 0.0007) and maternal weight gain during pregnancy (p = 0.01) was found. A negative association between cognitive development and maternal salivary cotinine during pregnancy (p = 0.03) and a negative association between motor development and maternal smoking status during the first year after delivery (p = 0.007) were also found. Conclusions: This study found no significant association between the duration of breastfeeding and child development after adjustment for confounders.

Introduction. Physical activity is one of the basic needs of people throughout their lives. Physical activity prevents many diseases, including cardiovascular diseases, which have the highest mortality rate, both among urban and rural populations in Poland. The average life expectancy in Poland and the European Union is increasing. The proportion of children and adolescents under the age of 20 is decreasing slowly but steadily, while the proportion of older people (aged 65+) in the total population is gradually increasing. According to the forecast of the Central Statistical Office, the percentage of older people increased rapidly after 2010, and will reach 22.3% in 2030. The number of the elderly will increase from 5,134,000 in 2007 to 8,195,000 in 2030. The health situation of Poles is less favourable compared to other European Union states. The most common health risks are: nicotine, drug addiction, alcoholism and obesity. One of the causes of obesity is an unhealthy lifestyle. Lifestyle is a basic determinant of human health. Objective. The aim of this study is to present research results based on a literature review on the importance of physical activity for human health as an element of organizing and managing the lifestyle of urban and rural populations. Conclusions. Comprehensive measures should be taken to increase public health awareness and promote health education, especially among school-age children and youths, and to provide appropriate sports infrastructure in particularly neglected rural areas.