The lipophilic character of quercetin suggests that it can cross enterocyte membranes via simple diffusion. Therefore, it should be more bioavailable than its glucosides, which require preliminary hydrolysis or active transport for absorption. However, the published human studies show that quercetin is less bioavailable than its glucosides. Assuming that low bioavailability of quercetin aglycone provided to humans as a pure substance is the result of its low solubility in the digestive tract, we studied its bioavailability from dietary sources in which quercetin was dispersed in the food matrix. In a randomized crossover study, 9 volunteers took a single dose of either shallot flesh (99.2% quercetin glucosides and 0.8% quercetin aglycone) or dry shallot skin (83.3% quercetin aglycone and 16.7% quercetin glucosides), providing 1.4 mg quercetin per kg of body weight. Blood samples were collected before and after consumption of shallot preparations. Plasma quercetin was measured on HPLC with electrochemical detection after plasma enzymatic treatment. The maximum plasma quercetin concentration of 1.02 +/- 0.13 micromol/L was reached at 2.33 +/- 0.50 h after shallot flesh consumption compared with 3.95 +/- 0.62 micromol/L at 2.78 +/- 0.15 h after dry skin consumption. The area under the concentration-time curve after dry skin consumption was 47.23 +/- 7.53 micromol x h(-1) x L(-1) and was significantly higher than that after shallot flesh intake (22.23 +/- 2.32 micromol x h(-1) x L(-1)). When provided along with dietary sources, quercetin aglycone is more bioavailable than its glucosides in humans. Results point to the food matrix as a key factor.

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BackgroundThe homeless constitute a subpopulation particularly exposed to atmospheric conditions, which, in the temperate climate zone, can result in both cold and heat stress leading to the increased mortality hazard. Environmental conditions have become a significant independent risk factor for mortality from specific causes, including circulatory or respiratory diseases. It is known that this group is particularly prone to some addictions, has a shorter life span, its members often die of different causes than those of the general population and may be especially vulnerable to the influence of weather conditions.Materials and methodsThe retrospective analysis is based on data concerning 615 homeless people, out of which 176 died in the analyzed period (2010–2016). Data for the study was collected in the city of Olsztyn, located in north-east Poland, temperate climatic zone of transitional type. To characterize weather conditions, meteorological data including daily minimum and maximum temperatures and the Universal Thermal Climate Index (UTCI) were used.ResultsThe average life span of a homeless person was shorter by about 17.5 years than that recorded for the general population. The average age at death of a homeless male was 56.27 years old (SD 10.38), and 52.00 years old (SD 9.85) of a homeless female. The most frequent causes of death were circulatory system diseases (33.80%). A large number of deaths were attributable to smoking (47.18%), whereas a small number was caused by infectious diseases, while a relatively large proportion of deaths were due to tuberculosis (2.15%). Most deaths occurred in the conditions of cold stress (of different intensity). Deaths caused by hypothermia were thirteen-fold more frequently recorded among the homeless than for the general population. A relative risk of death for a homeless person even in moderate cold stress conditions is higher (RR = 1.84) than in thermoneutral conditions.ConclusionsOur results indicate excessive mortality among the homeless as well as the weak and rather typical influence of atmospheric conditions on mortality rates in this subpopulation, except for a greater risk of cold related deaths than in the general population. UTCI may serve as a useful tool to predict death risk in this group of people.

AbstractTuberculosis (TB) is a disease particularly affecting the poorest socioeconomic groups. One such group in Central Europe are the homeless. We developed a prevention programme that targets, among others, homeless individuals in Warmia and Mazury Province (in the northeast of Poland). We investigated 121 homeless persons. We performed surveys, X-rays and microbiological tests of the sputum for TB. Five cases of pulmonary TB were found. The prevalence of TB in this community was estimated at 4132 per 100,000 (4.13%). Efficient TB control justifies continued prevention programmes aimed at the systematic monitoring of the homeless population.

AbstractLung cancer is rated with the highest incidence and mortality every year compared with other forms of cancer, therefore early detection and diagnosis is essential. Artificial Neural Networks (ANNs) are “artificial intelligence” software which have been used to assess a few prognostic situations. In this study, a database containing 193 patients from Diagnostic and Monitoring of Tuberculosis and Illness of Lungs Ward in Kuyavia and Pomerania Centre of the Pulmonology (Bydgoszcz, Poland) was analysed using ANNs. Each patient was described using 48 factors (i.e. age, sex, data of patient history, results from medical examinations etc.) and, as an output value, the expected presence of lung cancer was established. All 48 features were retrospectively collected and the database was divided into a training set (n=97), testing set (n=48) and a validating set (n=48). The best prediction score of the ANN model (MLP 48-9-2) was above 0.99 of the area under a receiver operator characteristic (ROC) curve. The ANNs were able to correctly classify 47 out of 48 test cases. These data suggest that Artificial Neural Networks can be used in prognosis of lung cancer and could help the physician in diagnosis of patients with the suspicion of lung cancer.

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Background and ObjectivesThe ways in which homeless individuals cope with stress may differ from those relied upon by the members of the general population and these differences may either be the result or the cause of their living conditions. The aim of the study was to determine the preferred coping style among the homeless and its relationship with alcohol dependence.MethodsThe study included 78 homeless individuals and involved the collection of demographic, sociological, psychological and medical data from each participant. Coping styles relied upon when dealing with stressful situations were assessed using a Polish adaptation of the Coping Inventory for Stressful Situations. Alcohol dependence was assessed using the Michigan Alcoholism Screening Test (MAST) and a quantitative analysis of alcohol consumption.ResultsMen accounted for 91.93% of the study population. Nearly 75% of the subjects met the alcohol dependence criterion. Significant relationships were observed between the individual's age, preferred coping style and alcohol consumption level. As an individual’s age increased, the use of emotion-oriented coping styles decreased, while an increase in alcohol consumption was associated with a more frequent use of emotion- and avoidance-oriented strategies.ConclusionsThe findings of this study, similarly to those of many other studies of homeless individuals but investigating other areas (e.g. epidemiology of tuberculosis and traumatic injuries), are an exaggerated representation of associations observed in the general population. The results describe a group of people living on the margins of the society, often suffering from extremely advanced alcoholism, with clear evident psychodegradation. The presence of specific ways of coping with stress related to excessive alcohol consumption in this group of individuals may interfere with active participation in support programmes provided for the homeless and may further exacerbate their problems.

Background: The COVID-19 pandemic affected the functioning of healthcare systems (HSs) in a way that was difficult to foresee earlier. It quickened the introduction of e-medicine, and changed the manner and number of services provided in the open medical setting. Aim: To assess variations in the consultation rate of patients in primary healthcare centers (PHCs) in consecutive months of the pandemic. Method: Data collected from two PHCs located in Olsztyn (Poland) were analyzed retrospectively. Collectively, these two centers provide care for approximately 20,000 inhabitants and perform approximately 100,000 medical services annually. The analysis was based on data covering the period April–July of the years 2010–2020, consisting in total of 337,510 medical services records. Results: A large, statistically significant decrease in the consultation rate (consultation rate understood as the number of individuals seeking consultation in relation to the number of people under care in a given time period) was revealed in each age group in the initial phase of the pandemic. In consecutive months, the approximated consultation rate achieved mean long-term values. Conclusions. The largest reduction in the consultation rate was revealed in the youngest age group, with the smallest occurring in the oldest. In the group of patients older than 65 years of age, the consultation rate after 3 months of the pandemic was the same as before the outbreak. Variations in the consultation rate were independent of the epidemiological situation. During the study, we observed an increased level of the administrative and paperwork activities carried out by PHC physicians.