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1. The Influence of the Surgical Treatment Method on the Quality of Life of Women With Breast Cancer

Author

Magdalena Konieczny and Andrzej Fal

Subjects
breast cancer, quality of life, mastectomy, conserving therapy, reconstruction, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Medicine
Abstract

Objective:Breast cancer is the most common malignant neoplasm among women in Poland. The primary treatment for breast cancer is surgery. The choice of surgical treatment method can significantly affect the quality of life of women with breast cancer.Materials and Methods:Women treated surgically because of breast cancer were included. The quality of life was assessed by survey using the quality of live questionnaire (QLQ)-C30 and QLQ-BR23 (European Organization for the Research and Treatment of Cancer) questionnaires, taking into account the following factors: The method of surgery performed and comparing breast conserving therapy (BCT) with mastectomy, and breast reconstruction or the lack of it.Results:The study included 243 subjects. Women had a reduced overall quality of life (53.88 points out of 100), in particular emotional (59.77) and sexual (17.49) functioning, and a poor body image assessment (61.57). Patients after BCT functioned better in physical (p = 0.001) and sexual (p = 0.007) terms, and also experienced lower pain intensity (p = 0.003) and shoulder discomfort (p = 0.024). The quality of life was significantly higher (p = 0.003) in the opinion of women who underwent breast reconstructive surgery.Conclusion:The quality of life of women depends on the surgical treatment method used when treating breast cancer. For this reason, the choice of method, whenever possible, should promote breast protection or its postoperative reconstruction.

Published
2023
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2. Adult pneumococcal vaccination – new opportunities

Author

ERNEST KUCHAR, JOANNA CHOROSTOWSKA-WYNIMKO, LESZEK CZUPRYNIAK, ANDRZEJ FAL, ROBERT FLISIAK, ARTUR MAMCARZ, ANETA NITSCH-OSUCH, ANNA SKOCZYŃSKA, MARCIN STAJSZCZYK, JACEK WYSOCKI, MICHAŁ ABENDROT, DOMINIK GOLICKI, KATARZYNA JAŚKOWIAK, and ADAM ANTCZAK

Subjects
streptococcus pneumoniae, pneumococcal vaccines, adult., Medicine
Abstract

Pneumococcal infections (Streptococcus pneumoniae) remain a significant epidemiological problem globally. Although an invasive pneumo-coccal disease (IPD), which includes meningitis, sepsis and pneumonia with bacteremia, is the most severe form of pneumococcal infection, the main bur-den in terms of morbidity and mortality is associated with community-acquired pneumonia in the elderly. The epidemiology of infections caused by S. pneumoniae serotypes can change naturally in time and by universal vaccination implementation. The proportion of infections caused by serotypes not contained in any available vaccines is constantly increasing. These changes stimulate the development of new vaccines and ensure the broadest possible protection against S. pneumoniae infections. There is a need to raise awareness of the burden of pneumococcal disease in adults and the vaccines used for prophylaxis for pneumococcal infection. The article discusses the pneumococcal infection burden in the adult population and the factors that raise the risk of infections. We characterised available vaccines for adults, highlighting the significant differences between the conjugated and unconjugated polysaccharide vaccines. Current epidemiological data on pneumococcal infections in Europe and Poland is presented. The latest 20-valent pneumococcal conjugate vaccine (PCV20) is described, and the most recent Advisory Committee on Immunization Practices (ACIP) recommendations on primary prevention and the current implementation of vaccination against pneumococcal infections in the adult population in Poland are discussed.

Published
2023
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3. Pneumococcal vaccination among adults – updated Polish recommendations

Author

ERNEST KUCHAR, ADAM ANTCZAK, ANNA SKOCZYŃSKA, ANDRZEJ FAL, JACEK WYSOCKI, JOLANTA WALUSIAK-SKORUPA, MAŁGORZATA CZAJKOWSKA-MALINOWSKA, AGNIESZKA MASTALERZ-MIGAS, ROBERT FLISIAK, and ANETA NITSCH-OSUCH

Subjects
streptococcus pneumoniae, immunization, evidence-based medicine, communicable diseases, public health, aged., Medicine
Abstract

Diseases caused by Streptococcus pneumoniae (S. pneumoniae) can be either invasive or non-invasive. In adults, pneumococcal infections most often occur as pneumonia, one of the leading causes of hospitalisation in these patients in Poland. Multiple factors predispose patients to the severe course of pneumococcal disease, including age, comorbidities, immune disorders and unhealthy behaviours, whereas the accumulation of coexisting conditions leads to risk stacking. Therefore, prophylactic vaccinations should be the preferred form of protection against pneumococcal infections in adults, based on high vaccination effectiveness and a relatively low risk of adverse events. Importantly, the current recommendations need to be updated in the context of epidemiological changes and the registration of new conjugate vaccines. This publication aims to present the current knowledge on the prevention of pneumococcal disease among adults and establish practical recommendations on the appropriate immunisation schedules used in Poland.

Published
2022
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4. Frequency and Nuisance Level of Adverse Events in Individuals Receiving Homologous and Heterologous COVID-19 Booster Vaccine

Author

Piotr Rzymski, Dominika Sikora, Joanna Zeyland, Barbara Poniedziałek, Dorota Kiedik, Halina Falfushynska, and Andrzej Fal

Subjects
SARS-CoV-2, pandemic, mRNA vaccines, vector vaccines, massive vaccinations, immunology, Medicine
Abstract

This study aimed to compare the occurrence and nuisance of adverse events following administration of each COVID-19 vaccine dose between two groups: individuals given three doses of mRNA vaccine (homologous group, 3 × mRNA, n = 252) and those given two doses of adenoviral vector vaccine further boosted with mRNA vaccine (heterologous group, 2 × AZ + 1 × mRNA, n = 205). Although the studied groups differed significantly in the frequency and number of side effects after the first and second vaccine dose, no relevant differences were seen following the booster administration. Arm pain and fatigue were the most common effects, regardless of the vaccination group and vaccine dose. In the homologous group, female sex, lower BMI, and no history of regular influenza vaccination were associated with a higher frequency of side effects of a booster dose. In the heterologous group, the history of COVID-19 was associated with an increased number of side effects seen after a booster. In both groups, the number of side effects related to the first and second dose correlated with the number observed after administration of a booster dose. Individuals receiving a homologous booster reported a higher nuisance of side effects than the heterologous group. It was similar to the level reported after the second dose in both groups. The use of pharmaceuticals to counteract the side effects was more frequent after a first dose in the 2 × AZ + 1 × mRNA group, but higher after second dose in individuals receiving the 3 × mRNA vaccination scheme. The frequency of pharmaceutical use after a booster dose was similar in both groups (approx. 60%). Paracetamol was most frequently chosen, regardless of the group and vaccine dose. In addition, the vast majority of participants (93%) declared to accept future doses of the COVID-19 vaccine if their administration would be recommended. This study provides an overview of the response to homologous and heterologous mRNA vaccine booster dose that may be valuable in shaping accurate and honest communication with vaccinated individuals, especially in those regions which are yet to pursue booster strategies.

Published
2022
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6. Willingness to Receive the Booster COVID-19 Vaccine Dose in Poland

Author

Piotr Rzymski, Barbara Poniedziałek, and Andrzej Fal

Subjects
COVID-19 vaccine, booster dose, vaccine hesitancy, mRNA vaccines, vector vaccines, SARS-CoV-2, Medicine
Abstract

COVID-19 vaccinations are essential to mitigate the pandemic and prevent severe SARS-CoV-2 infections. However, the serum antibody levels in vaccinated individuals gradually decrease over time, while SARS-CoV-2 is undergoing an evolution toward more transmissible variants, such as B.1.617.2, ultimately increasing the risk of breakthrough infections and further virus spread. This cross-sectional online study of adult Poles (n = 2427) was conducted in September 2021 (before a general recommendation to administer a booster COVID-19 vaccine dose in Poland was issued) to assess the attitude of individuals who completed the current vaccination regime toward a potential booster dose of the COVID-19 vaccine and identify potential factors that may influence it. Overall, 71% of participants declared willingness to receive a booster COVID-19 dose, with a low median level of fear of receiving it of 1.0 (measured by the 10-point Likert-type scale), which was increased particularly in those having a worse experience (in terms of severity of side effects and associated fear) with past COVID-19 vaccination. The lowest frequency of willingness to receive a booster dose (26.7%) was seen in the group previously vaccinated with Ad26.COV2.S. The majority of individuals vaccinated previously with mRNA vaccines wished to receive the same vaccine, while in the case of AZD1222, such accordance was observed only in 9.1%. The main reasons against accepting a booster COVID-19 dose included the side effects experienced after previous doses, the opinion that further vaccination is unnecessary, and safety uncertainties. Women, older individuals (≥50 years), subjects with obesity, chronic diseases, and pre-vaccination and post-vaccination SARS-CoV-2 infections, and those with a history of vaccination against influenza were significantly more frequently willing to receive a booster COVID-19 dose. Moreover, the majority of immunosuppressed individuals (88%) were willing to receive an additional dose. The results emphasize some hesitancy toward potential further COVID-19 vaccination in the studied group of Poles and indicate the main groups to be targeted with effective science communication regarding the booster doses.

Published
2021
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7. COVID-19 Vaccine Boosters: The Good, the Bad, and the Ugly

Author

Piotr Rzymski, Carlos A. Camargo, Andrzej Fal, Robert Flisiak, Willis Gwenzi, Roya Kelishadi, Alexander Leemans, Juan J. Nieto, Ahmet Ozen, Matjaž Perc, Barbara Poniedziałek, Constantine Sedikides, Frank Sellke, Emilia C. Skirmuntt, Anzhela Stashchak, and Nima Rezaei

Subjects
immunology, pandemic, massive vaccinations, vaccine inequity, SARS-CoV-2, Medicine
Abstract

Pursuing vaccinations against COVID-19 brings hope to limit the spread of SARS-CoV-2 and remains the most rational decision under pandemic conditions. However, it does not come without challenges, including temporary shortages in vaccine doses, significant vaccine inequity, and questions regarding the durability of vaccine-induced immunity that remain unanswered. Moreover, SARS-CoV-2 has undergone evolution with the emergence of its novel variants, characterized by enhanced transmissibility and ability to at least partially evade neutralizing antibodies. At the same time, serum antibody levels start to wane within a few months after vaccination, ultimately increasing the risk of breakthrough infections. This article discusses whether the administration of booster doses of COVID-19 vaccines is urgently needed to control the pandemic. We conclude that, at present, optimizing the immunity level of wealthy populations cannot come at the expense of low-income regions that suffer from vaccine unavailability. Although the efficiency of vaccination in protecting from infection may decrease over time, current data show that efficacy against severe disease, hospitalization, and death remains at a high level. If vaccine coverage continues at extremely low levels in various regions, including African countries, SARS-CoV-2 may sooner or later evolve into variants better adapted to evade natural and vaccine-induced immunity, ultimately bringing a global threat that, of course, includes wealthy populations. We offer key recommendations to increase vaccination rates in low-income countries. The pandemic is, by definition, a major epidemiological event and requires looking beyond one’s immediate self-interest; otherwise, efforts to contain it will be futile.

Published
2021
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9. The Strategies to Support the COVID-19 Vaccination with Evidence-Based Communication and Tackling Misinformation

Author

Piotr Rzymski, Leszek Borkowski, Marcin Drąg, Robert Flisiak, Jacek Jemielity, Jacek Krajewski, Agnieszka Mastalerz-Migas, Andrzej Matyja, Krzysztof Pyrć, Krzysztof Simon, Michał Sutkowski, Jacek Wysocki, Joanna Zajkowska, and Andrzej Fal

Subjects
COVID-19, vaccine, science communication, vaccine hesitancy, misinformation, Medicine
Abstract

COVID-19 vaccinations are about to begin in various countries or are already ongoing. This is an unprecedented operation that is also met with a loud response from anti-vaccine communities—currently using all available channels to manipulate public opinion. At the same time, the strategy to educate on vaccinations, explain their mechanism of action, and build trust in science is subdued in different world parts. Such actions should go much beyond campaigns promoting the COVID-19 vaccines solely on the information provided by the health institutions and national authorities. In this paper, actions provided by independent expert groups needed to counteract the anti-vaccine propaganda and provide scientific-based information to the general public are offered. These actions encompass organizing groups continuously communicating science on COVID-19 vaccines to the general public; tracking and tackling emerging and circulating fake news; and equipping celebrities and politicians with scientific information to ensure the quality of messages they communicate, as well as public letters, and statements of support for vaccination by healthcare workers, recognized scientists, VIPs, and scientific societies; and no tolerance to false and manipulated claims on vaccination spread via traditional and social media as well as by health professionals, scientists, and academics. These activities should be promptly implemented worldwide, regardless of the current status and availability of the COVID-19 vaccine in a particular region. If we are about to control the pandemic for the sake of public benefit, it is high time to collectively speak out as academic and medical societies with support from decision-makers. Otherwise, the battle will be lost to those who stand against scientific evidence while offering no feasible solution to the problem.

Published
2021
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10. Vaccination of Ukrainian Refugees: Need for Urgent Action

Author

Piotr Rzymski, Halina Falfushynska, and Andrzej Fal

Subjects
Microbiology (medical), Refugees, Infectious Diseases, Vaccination, COVID-19, Humans, Child, Communicable Diseases, Poliomyelitis
Abstract

The unprovoked aggression of Russian military forces on Ukraine in February 2022 has caused a high influx of refugees, including children, to neighboring countries, particularly Poland. This caused additional pressures on the healthcare system and the need to meet challenges for public health, such as those related to infectious diseases. Here, we discuss the potential epidemiological risks associated with the war-induced influx of refugees (coronavirus disease 2019, measles, pertussis, tetanus, and poliomyelitis) and highlight the need for their swift management through institutional support, educational campaigns, counteracting antiscience misinformation, and pursuing vaccinations of refugees but also improving or maintaining good levels of immunization in populations of countries welcoming them. These are necessary actions to avoid overlapping of war and infectious diseases and associated public health challenges.

Published
2022
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12. Guidelines for preventing and treating vitamin D deficiency : a 2023 update in Poland

Author

Paweł Płudowski, Beata Kos-Kudła, Mieczysław Walczak, Andrzej Fal, Dorota Zozulińska-Ziółkiewicz, Piotr Sieroszewski, Jarosław Peregud-Pogorzelski, Ryszard Lauterbach, Tomasz Targowski, Andrzej Lewiński, Robert Spaczyński, Mirosław Wielgoś, Jarosław Pinkas, Teresa Jackowska, Ewa Helwich, Artur Mazur, Marek Ruchała, Arkadiusz Zygmunt, Mieczysław Szalecki, Artur Bossowski, Justyna Czech-Kowalska, Marek Wójcik, Beata Pyrżak, Michał A. Żmijewski, Paweł Abramowicz, Jerzy Konstantynowicz, Ewa Marcinowska-Suchowierska, Andrius Bleizgys, Spirydon N. Karras, William B. Grant, Carsten Carlberg, Stefan Pilz, Michael F. Holick, and Waldemar Misiorowski

Subjects
Nutrition and Dietetics, 25-hydroxyvitamin-D, calcifediol, cholecalciferol, general population guidelines, risk groups, vitamin D deficiency, Food Science
Abstract

Introduction: All epidemiological studies suggest that vitamin D deficiency is prevalent among the Polish general population. Since vitamin D deficiency was shown to be among the risk factors for many diseases and for all-cause mortality, concern about this problem led us to update the previous Polish recommendations. Methods: After reviewing the epidemiological evidence, case-control studies and randomized control trials (RCTs), a Polish multidisciplinary group formulated questions on the recommendations for prophylaxis and treatment of vitamin D deficiency both for the general population and for the risk groups of patients. The scientific evidence of pleiotropic effects of vitamin D as well as the results of panelists’ voting were reviewed and discussed. Thirty-four authors representing different areas of expertise prepared position statements. The consensus group, representing eight Polish/international medical societies and eight national specialist consultants, prepared the final Polish recommendations. Results: Based on networking discussions, the ranges of total serum 25-hydroxyvitamin D concentration indicating vitamin D deficiency [

Published
2023

13. Oral antiviral treatments for COVID-19: opportunities and challenges

Author

Laila Rahmah, Sunny O. Abarikwu, Amanuel Godana Arero, Mickael Essouma, Aliyu Tijani Jibril, Andrzej Fal, Robert Flisiak, Rangarirai Makuku, Leander Marquez, Kawthar Mohamed, Lamin Ndow, Dorota Zarębska-Michaluk, Nima Rezaei, and Piotr Rzymski

Subjects
Pharmacology, General Medicine
Abstract

The use of antiviral COVID-19 medications can successfully inhibit SARS-CoV-2 replication and prevent disease progression to a more severe form. However, the timing of antiviral treatment plays a crucial role in this regard. Oral antiviral drugs provide an opportunity to manage SARS-CoV-2 infection without a need for hospital admission, easing the general burden that COVID-19 can have on the healthcare system. This review paper (i) presents the potential pharmaceutical antiviral targets, including various host-based targets and viral-based targets, (ii) characterizes the first-generation anti-SARS-CoV-2 oral drugs (nirmatrelvir/ritonavir and molnupiravir), (iii) summarizes the clinical progress of other oral antivirals for use in COVID-19, (iv) discusses ethical issues in such clinical trials and (v) presents challenges associated with the use of oral antivirals in clinical practice. Oral COVID-19 antivirals represent a part of the strategy to adapt to long-term co-existence with SARS-CoV-2 in a manner that prevents healthcare from being overwhelmed. It is pivotal to ensure equal and fair global access to the currently available oral antivirals and those authorized in the future.

Published
2022

15. Związek pomiędzy typem alergenu a rozwojem choroby atopowej w grupie pacjentów leczonych w Klinice Pediatrii, Nefrologii i Alergologii Dziecięcej WIM w Warszawie

Author

Bolesław Kalicki, Anna Maślany, Agnieszka Rustecka, Anna Jung, Janusz Żuber, Małgorzata Placzyńska, and Andrzej Fal

Subjects
punktowe testy skórne, astma, alergiczny nieżyt nosa, atopowe zapalenie skóry, alergia, Medicine
Abstract

Punktowe testy skórne to jedna z najpowszechniej stosowanych metod diagnostycznych we współczesnej alergologii, dzięki niej rozpoznajemy alergię natychmiastową, IgE-zależną. Diagnostycznie alergeny są stosowane w postaci standaryzowanych roztworów. Oceniana jest średnica powstałych bąbli, a także ich wielkość wzglę- dem kontroli dodatniej i ujemnej. W prezentowanej pracy przedstawiono wyniki punktowych testów skórnych przeprowadzonych w grupie 225 dzieci z objawami alergii w postaci astmy, alergicznego nieżytu nosa (ANN) oraz atopowego zapalenia skóry (AZS). Oceniano związek pomiędzy typem alergenu a chorobą atopową oraz wiekiem dziecka. Najczęściej uczulającym alergenem w całej badanej grupie były roztocza kurzu domowego, stwierdzone u 81% pacjentów. Drugą co do częstości występowania alergię stanowiło uczulenie na pyłki traw (u 43%). W dalszej kolejności uczulały pyłki drzewa (33%) i alergeny sierści kota (27%). Kolejność ta zmienia się w poszczególnych grupach wiekowych. Dla najmłodszej grupy pacjentów najczęściej stwierdzanym alergenem były pleśnie (54,3%), rzadziej odnotowywano – w równym stopniu – roztocza kurzu domowego oraz alergeny traw (po 43,5%). W grupie między 5. a 12. rokiem życia dominującym alergenem były roztocza kurzu domowego (90,7%), następnie pleśnie (50,4%) i trawy (36%). U dzieci powyżej 12. roku życia również dominowały roztocza kurzu domowego (92%), rzadziej stwierdzano uczulenie – w równym stopniu – na trawy i pleśnie (po 58%). Najczęstszą manifestacją kliniczną był zespół współwystępowania astmy i ANN, rzadziej wystę- powały objawy astmy, a jeszcze rzadziej objawy ANN oraz zespół współwystępowania astmy i AZS. Najmniej liczną grupę stanowiły dzieci z objawami AZS. Rozkład najczęściej występujących alergenów w odniesieniu do manifestacji choroby atopowej wykazał, że wśród pacjentów z astmą oraz współistniejącymi astmą i ANN dominującą rolę odgrywają roztocza kurzu domowego. W grupie dzieci z ANN równie często obserwuje się też alergie na pyłki traw. Powyższe wyniki są zgodne z doniesieniami innych cytowanych autorów. Jednakże ze względu na specyfikę badanej grupy pacjentów można przypuszczać, że uzyskane wyniki mogą być nieco inne dla ogółu populacji dziecięcej..

Published
2011

16. Porównanie stężeń tlenku azotu w powietrzu wydychanym i pH kondensatu powietrza wydychanego u dzieci chorych na astmę i zdrowych

Author

Bolesław Kalicki, Ludmiła Bartoszewicz, Anna Jung, Janusz Żuber, Agnieszka Rustecka, and Andrzej Fal

Subjects
astma, kondensat powietrza wydychanego (KPW), tlenek azotu (NO), pH kondensatu powietrza wydychanego, zaostrzenie astmy, Medicine
Abstract

Istotą astmy jest proces zapalny toczący się w śluzówce drzewa oskrzelowego. Parametry oceniające nasilenie tego procesu stosowane do tej pory są mało obiektywne i trudne do uzyskania, zwłaszcza u dzieci. Możliwość rzetelnej oceny intensywności tego procesu wpłynęłaby na dokładniejszą diagnozę pacjenta i zobiektywizowałaby postępowanie lecznicze. W ostatnim okresie ukazało się wiele prac poświęconych poszukiwaniu takich narzędzi, które w łatwy, nieinwazyjny i tani sposób odzwierciedlą stan zapalny w układzie oddechowym. Za jeden z takich wykładników uznawany jest pomiar stężenia tlenku azotu (NO) w wydychanym powietrzu. Jego stężenie zależy od aktywności iNOS – enzymu aktywowanego między innymi przez czynniki zapalne. Oznacza się go metodami chemiluminescencyjnymi. Wzrost stężenia sugeruje nasilenie zapalenia oskrzeli. Innym markerem stanu zapalnego branym pod uwagę w wielu badaniach jest pH kondensatu powietrza wydychanego (KPW), który jest pochodną płynu pokrywającego powierzchnię pęcherzyków płucnych. Spośród wielu substancji w nim rozpuszczonych oznaczanie jego pH jest najłatwiejszą metodą analizy KPW. Zauważono, że pH tego płynu spada w chorobach przebiegających z nasileniem stanu zapalnego w płucach. Obie wymienione metody są stosunkowo tanie i proste do zastosowania (również w populacji dziecięcej). Celem niniejszego badania była ocena stężeń NO w powietrzu wydychanym i pH KPW u dzieci z rozpoznaną astmą w okresie zaostrzenia choroby i porównanie tych wyników z wartościami uzyskanymi w grupie dzieci zdrowych. Do badań włączono 26 dzieci w wieku od 8 do 17 lat. Pomiędzy obiema grupami dzieci – zdrowych i chorych, uzyskano statystycznie znamienną różnicę wyników zarówno stężenia NO w powietrzu wydychanym, jak i pH KPW. W przypadku zaostrzenia astmy stężenie NO rosło, a pH KPW malało, oba parametry korelowały ze sobą. Wyniki te pozostają w zgodzie z innymi badaniami posługującymi się tymi metodami do oceny stanu zapalnego w oskrzelach. Sugeruje to, że mogą stać się cennymi i powszechnie używanymi metodami oceny astmy.

Published
2009

17. Age, Cognitive Factors, and Acceptance of Living with the Disease in Rheumatoid Arthritis: The Short-Term Perspective

Author

Daniel Pankowski, Kinga Wytrychiewicz-Pankowska, Ewa Pisula, Andrzej Fal, Bartłomiej Kisiel, Ewa Kamińska, and Witold Tłustochowicz

Subjects
Arthritis, Rheumatoid, Cognition, Health, Toxicology and Mutagenesis, Chronic Disease, Public Health, Environmental and Occupational Health, Quality of Life, acceptance, rheumatoid arthritis, vascular diseases, diabetes, longitudinal study, Humans
Abstract

Rheumatoid arthritis is a chronic inflammatory disease leading to disability, reduced quality of life, and severe depressive symptoms. Theoretical models and research emphasize the importance of cognitive factors such as illness-related beliefs and cognitive appraisals in the process of adapting to life with a chronic disease. Objectives: The aim of this study was to analyze the role of age, disease duration, and cognitive factors in the level of acceptance of life with rheumatoid arthritis and determine the factors responsible for short-term (one week) changes without the use of interventions. We also assessed differences in predictors between rheumatoid arthritis, vascular diseases, and diabetes. Methods: Data were collected using a panel study. The first part of the analysis included 83 participants who declared a medical diagnosis of rheumatoid arthritis. In the second part of the analysis, in addition to people with rheumatoid arthritis (69 participants), two control groups were also included: diabetes (n = 26) and vascular disease (n = 26). The analysis examined basic sociodemographic and clinical data, cognitive appraisals, illness-related beliefs, and acceptance of living with the disease twice in one week. Results: The relationship between age and levels of acceptance of living with the disease was cubic, but the groups distinguished based on age and disease duration did not differ in terms of the analyzed variables. Cognitive appraisals (both baseline and changes over one week) were responsible for changes in acceptance of living with the disease, although other variables (sociodemographic, clinical, and illness-related beliefs) also played a role. The predictors of change in acceptance of living with the disease differed between analyzed diagnoses. Conclusions: Cognitive factors are an important aspect of the adaptation process to living with an illness. Potential clinical applications and future directions of research are discussed.

Published
2022

18. To aspirate or not to aspirate? Considerations for the COVID-19 vaccines

Author

Piotr Rzymski and Andrzej Fal

Subjects
Pharmacology, Myocarditis, COVID-19 Vaccines, Humans, COVID-19, General Medicine, RNA, Messenger, Pandemics
Abstract

Syringe aspiration when vaccinating intramuscularly was not recommended before the pandemic due to the lack of conclusive evidence that it provides any benefit. However, in vivo evidence suggests that intravenous injection of mRNA vaccine can potentially lead to myocarditis, while introducing adenoviral vector to bloodstream can possibly result in thrombocytopenia and coagulopathy. These rare reactions were recorded in humans following the administration of the COVID-19 vaccines. Although the syringe aspiration may increase the level of pain at the injection site, it represents a simple technique to decrease the risk of vaccine introduction into the vascular system and potentially decrease the risk of severe reactions to mRNA and adenoviral vaccines. We are of the opinion that this cannot be disregarded if one considers that the COVID-19 vaccines will continue to be administrated globally in the form of initial and booster doses. Therefore, the aspiration when giving mRNA and adenoviral vaccines appears to be fully in line with the precautionary principle.

Published
2022

19. Analiza przypadków klinicznych w alergologii. Leczenie farmakologiczne w praktyce polskich lekarzy

Author

Andrzej Bant, Zbigniew Bartuzi, Marcin Baut, Łukasz Błażowski, Anna Bodzenta-Łukaszyk, Andrzej Bożek, Olga Branicka, Wojciech Budny, Małgorzata Bulanda, Łukasz Cała, Andrzej Chciałowski, Ewa Cichocka-Jarosz, Ewa Czarnobilska, Klaudia Czyż, Andrzej Fal, Radosław Gawlik, Urszula Jedynak-Wąsowicz, Ewelina Kasprzyk-Wieczorkowska, Tomasz Kociniak, Małgorzata Korniluk, Jerzy Kruszewski, Edyta Krzych-Fałta, Marek Kulus, Maciej Kupczyk, Ryszard Kurzawa, Agnieszka Lis, Piotr Łacwik, Aleksandra Łata, Mateusz Łukaszyk, Małgorzata Maj, Marcin Moniuszko, Wojciech Naumnik, Marek Niedoszytko, Marita Nittner-Marszalska, Cezary Pałczyński, Katarzyna Przybyłowska, Marta Dorota Rachel, Barbara Rogala, Patrycja Rogowska, Lidia Rudnicka, Bolesław Samoliński, Roman Skiepko, Youssef Sleiman, Małgorzata Sokołowska-Wojdyło, Monika Świderska, Jowita Sroka-Tomaszewska, Magdalena Trzeciak, Marta Tykwińska, Natalia Ukleja-Sokołowska, Aleksandra Wilkowska, Oksana Wojas, Anna Zawadzka-Krajewska, and Zbigniew Samochocki

Published
2021
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20. COVID-19 i jego powikłania - przypadki kliniczne

Author

Katarzyna Plewka, Izabela Leśniak, Magdalena Żabicka, Krzysztof Kłos, Jezry Kruszewski, Anna Kiliszczyk, Stanisław Niemczyk, Andrzej Chciałowski, Wojciech Włodarczyk, Mirosław Dziekiewicz, Agnieszka Jurek, Jan Miklas, Grzegorz Spłocharski, Magdalena Mosakowska, Arkadiusz Lubas, Ewa Pietruszka, Renata Rożyńska, Katarzyna Lewandowska, Marcin Możański, Anna Rychlik, Elżbieta Wojtas-Maciejewska, Weronika Machura-Adamus, Michał Makowiecki, Agnieszka Bednarska, Andrzej Horban, Beata Wojtycha-Kwaśnica, Dominika Krogulec, Magdalena Suchacz, Marcin Paciorek, Justyna Kowalska, Natalia Celejewska-Wójcik, Karolina Górka, Kamil Polok, Krzysztof Sładek, Tomasz Stachura, Adam Stępień, Paulina Marcinek, Anna Piekarska, Anna Szymanek-Pasternak, Anna Nowicka, Justyna Janocha-Litwin, Monika Biernat, Tomasz Wróbel, Krzysztof Simon, Marta Kucharska, Sylwia Serafińska, Katarzyna Przybyłowska, and Andrzej Fal

Published
2021
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21. The Awareness of Risks Associated with OTC Drugs Available in Non-Pharmacy Outlets among Polish Patients—A Cross-Sectional Study

Author

Jacek Dulęba, Emilia Słodka, Jerzy Krysiński, Andrzej Fal, Piotr Merks, and Urszula Religioni

Subjects
medicine.medical_specialty, Otc drugs, Leadership and Management, Cross-sectional study, pharmacist, Pharmacist, lcsh:Medicine, Health Informatics, Pharmacy, non-pharmacy outlets, Improper storage, 030226 pharmacology & pharmacy, Article, OTC drugs, 03 medical and health sciences, 0302 clinical medicine, Health Information Management, Health care, Medicine, community pharmacy, 030212 general & internal medicine, Face validity, business.industry, Health Policy, lcsh:R, Purchasing, Family medicine, Poland, business
Abstract

Background: Many OTC drugs are available in non-pharmacy outlets, and as such the risk of overuse and/or improper use of this class of drugs is more likely. In light of this observation, our study was conducted with the aim of exploring opinions on non-pharmaceutical distribution among Polish patients. This study was a part of an informative project to educate patients about the possible risks associated with the use of OTC medicines. Methods: We conducted a cross-sectional study among Polish patients in which we used an authorial questionnaire, previously tested via content, face validity, and a pilot study. The questionnaire was distributed both electronically and in a traditional form. Results: ‘Time saving’ had a statistically significant role in the patient’s decision about purchasing drugs in a non-pharmacy outlet (p = 0.0052, R = 0.276994). The lack of a pharmacist’s consultation/advice (p = 0.0072, R = −0.3290490), improper storage (p = 0.0044, R = −0.238246), risk of overdose (p = 0.0125, R = −0.189564), and the risk of purchasing out-of-date drugs (p = 0.0125, R = −0.145411), as well as the risk of purchasing falsified drugs (p = 0.0265, R = −0.159428), were all associated with the patient’s non-willingness to purchase drugs in non-pharmacy outlets. Patients supported the idea of the elimination of non-pharmacy outlet distribution (p = 0.0074, R = −0.195932), they also emphasized that they are advocates of purchasing drugs only in community pharmacies (p = 0.0006, R = −0.238625). Conclusion: Patients are aware of the risks associated with buying drugs outside of community pharmacies. They perceived pharmacists as professional health care advisors and supported the fact that OTC drugs should be available only via pharmaceutical distribution.

Published
2021

22. Fe

Author

Krzysztof, Marycz, Paulina, Sobierajska, Rafał J, Wiglusz, Rafał, Idczak, Jean-Marie, Nedelec, Andrzej, Fal, and Katarzyna, Kornicka-Garbowska

Abstract

The presented study aimed to investigate the effects of FeMagnetic nanoparticles were prepared by a wet chemical co-precipitation process and analyzed using X-ray powder diffraction, high-resolution transmission electron microscope (HRTEM), dynamic light scattering (DLS), laser Doppler velocimetry, Raman and the Mössbauer spectroscopy. In vitro experiments were performed using MC3T3, 4B12 and RAW 264.7 cell lines. Cells were cultured in the presence of nanoparticles and with or without exposure to the magnetic field. Proteins were investigated with Western blotting and immunofluorescence and Western blot. Gene expression was analyzed with a quantitative real-time polymerase chain reaction.Obtained particles were in the nano-range (average size around 50 nm) and had a spherical-like morphology. The typical hydrodynamic size was in the range 178-202 nm and Zeta potential equaled -9.51 mV. Mössbauer spectrum corresponds to the FeFe

Published
2020

23. Benralizumab for the Prevention of COPD Exacerbations

Author

Criner, G. J., Celli, B. R., Brightling, C. E., Agusti, A., Papi, A., Singh, D., Sin, D. D., Vogelmeier, C. F., Sciurba, F. C., Bafadhel, M., Backer, V., Kato, M., Ramirez-Venegas, A., Wei, Y. -F., Bjermer, L., Shih, V. H., Jison, M., O'Quinn, S., Makulova, N., Newbold, P., Goldman, M., Martin, U. J., GALATHEA Study Investigators, TERRANOVA Study Investigators, Otto, Burghuber, Bernhard, Forstner, Gerhard, Köberl, Bernd, Lamprecht, Judith, Löffler-Ragg, Horst, Olschewski, Michael, Studnicka, Francois, Beaucage, Guy, Chouinard, Anthony, Dechant, Anthony, Dowell, Jacques, Hebert, Sohail, Khattak, Kieran, Killian, William, Killorn, Andy, Lam, Francois, Maltais, Darcy, Marciniuk, Lyle, Melenka, Bonavuth, Pek, Jeremy, Road, Donald, Sin, Alain, Vaugeois, Brandie, Walker, Tomas, Dvorak, Stanislav, Holub, Otakar, Hokynar, Vitezslav, Kolek, Daniela, Kopecka, Jan, Krepelka, Jaroslav, Mares, Josef, Veverka, Vladimir, Zindr, Sabine, Ballenberger, Rolf, Dichmann, Christian, Geßner, Margret, Jandl, Claus, Keller, Joachim, Kirschner, Marc, Kornmann, Petra, Mikloweit, Ingomar, Naudts, Axel, Overlack, Isabelle, Schenkenberger, Volker, Schlegel, Lutz Von Versen, Claus Franz Vogelmeier, Stefan, Zielen, István, Albert, Beatrix, Bálint, Mária Csilla Hangonyi, Teréz, Kecskés, Anikó, Kurucz, Balázs, Medgyasszay, Lajos, Molnár, János, Mucsi, Márta, Papp, Magdolna, Póczi, Éva, Radeczky, Zsolt Pápai Székely, Csilla, Szabó, Gyöngyi, Szabó, Melinda, Szabó, Alfredo Antonio Chetta, Giuseppe Di Maria, Giulio, Donazzan, Federica, Meloni, Elisabetta, Pace, Pierluigi, Paggiaro, Alberto, Papi, Ricciardolo, Fabio Luigi Massimo, Antonio, Spanevello, Fumiaki, Aoki, Ryosuke, Eda, Takeo, Endo, Yasushi, Fukushima, Kenichi, Gemba, Naoki, Hagimoto, Hiromasa, Harada, Yasuko, Harada, Norihiko, Hata, Osamu, Hataji, Nobuo, Hatakeyama, Takahiko, Horiguchi, Gen, Ideura, Motoyasu, Iikura, Azusa, Ikegami, Shirou, Imokawa, Yoshikazu, Inoue, Takeshi, Isobe, Ryoji, Ito, Susumu, Iwata, Tadashi, Kamei, Motokazu, Kato, Hideki, Katsura, Yuji, Kawarada, Norio, Kihara, Masaharu, Kinoshita, Takashi, Kinoshita, Tomoo, Kishaba, Hideo, Kita, Arihiro, Kiyosue, Shigeru, Komatsu, Kazuki, Konishi, Sekiya, Koyama, Makoto, Kudo, Kazuhiko, Machida, Hironi, Makita, Hiroto, Matsuse, Naoki, Miyazawa, Hiroyuki, Nakamura, Yuji, Nakatani, Kazuyuki, Nishimura, Takashi, Nishimura, Junichi, Ogawa, Hiroyuki, Ohbayashi, Tetsuro, Ohdaira, Tsukasa, Ohnishi, Kazuhiko, Oki, Masahiko, Saito, Kenji, Sakamoto, Osamu, Sakamoto, Hisakuni, Sekino, Noriharu, Shijubo, Masaharu, Shinkai, Hideo, Soto, Yoshitaka, Sugawara, Noriaki, Suko, Hisaho, Takahashi, Masamitsu, Takahashi, Tsuneyuki, Takahashi, Hiroshi, Tanaka, Hiroyuki, Taniguchi, Tadayuki, Terada, Takao, Tochigi, Kazuyo, Tohyama, Hirokazu, Tokuyasu, Keisuke, Tomii, Tomomasa, Tsuboi, Mitsuyoshi, Utsugi, Katsumaru, Yamamoto, Michiko, Yamamoto, Shuichi, Yano, Makoto, Yoshida, Frank, Custers, Richard, Dekhuijzen, Remco, Djamin, Jan Willem Van Dan Berg, Lowie, Vanfleteren, Pascal, Wielders, Bogusława, Cimoszko, Anna, Doboszyńska, Andrzej, Dyczek, Andrzej, Fal, Krystyna, Folcik, Łukasz, Goliński, Marek, Jutel, Andrzej, Kolczyński, Piotr, Kuna, Ewa, Łączyńska, Wojciech, Machowiak, Maciej, Marczak, Joanna, Markiewicz, Janusz, Milanowski, Grzegorz, Mincewicz, Maria, Nittner-Marszalska, Wojciech, Papiewski, Małgorzata, Pawlukiewicz, Witold, Pomiećko, Barbara, Rewerska, Cezary, Rybacki, Wojciech, Skucha, Ewa, Trębas-Pietraś, Ewa, Uhryn, Małgorzata, Żurowska-Gębala, Laurentia, Andrei, Traian, Mihaescu, Stefan, Mihaicuta, Eniko Vera Pall, Ioan, Petrui, Angelica, Savu, Claudia, Toma, Ana, Trailescu, Vladimir, Abrosimov, Nataliya, Astafyeva, Evgenyi, Bazdyrev, Nadezhda, Berdnikova, Laura, Bolieva, Ekaterina, Bukreeva, Valery, Chistyakov, Anna, Galustyan, Halida, Gantseva, Svetlana, Goncharova, Sergey, Grigoriev, Galina, Ignatova, Inna, Ilyashevich, Nadezhda, Izmozherova, Magomed, Kamalov, Yaroslava, Khovaeva, Natalia, Kuzubova, Lyudmila, Kvitkova, Liudmila, Lenskaya, Igor, Leshchenko, Olga, Magnitskaya, Boris, Molotilov, Artem, Molotkov, Svetlana, Myasoedova, Sergey, Nedogoda, Vladimir, Nosov, Marina, Osipenko, Andrey, Peskov, Veronika, Popova, Oksana, Ratushnay, Irina, Ryzhova, Olga, Shangina, Natalia, Shaporova, Evgeny, Shmelev, Lybov, Shpagina, Alexander, Shutkin, Yuri, Shvarts, Mikhail, Smirnov, Irina, Stitsenko, Maksim, Vasilev, Arkadiy, Vertkin, Elena, Vishneva, Alexander, Vizel, Anna, Zateyschikova, Mohamed, Abdool-Gaffar, Ismail, Abdullah, Axel, Bruning, Nyda, Fourie, Michael, Greenblatt, Mohammed, Tayob, Venter, K, An Soo Jang, Kwan Ho Lee, Sang Haak Lee, Sook Young Lee, Suk Joong Yong, Kwang Ha Yoo, Soo Taek Uh, Ramón Agüero Balbín, David Ramos Barbón, Álvar Agustí García-Navarro, José Luis Velasco Garrido, Sergi Pascual Guardia, Eduard Monso Molas, Luis De Teresa Parreño, Borja García-Cosio Piqueras, German Peces-Barba Romero, Myriam Calle Rubio, Fernando Sánchez-Toril López, Alicia Marín Tapia, Heidi Martin Braschler, Martin, Brutsche, Michael, Grob, Jörg, Leuppi, Daiana, Stolz, Alexander, Turk, Nawar, Bakerley, Mona, Bafadhel, Christopher, Brightling, Rekha, Chaudhuri, Gourab, Choudhury, Graham, Devereux, Imran, Hussain, Kai, Lee, William, Macnee, Ravindran, Mahadeva, Matthew, Masoli, Monica, Nordstrom, Manish, Patel, Allan, Reid, Dinesh, Saralaya, Tariq, Sethi, Sukh Dave Singh, Anthony, G de Soyza, Tom, Wilkinson, Alice, Turner, Helen, Ward, Chandar, Abboy, Ivan, Ackerman, Idalia, Acosta, Arun, Adlakha, Bassil, Aish, Mohamed, Ali, Charles, Andrews, Robby, Ayoub, Anil, Badhwar, Dennis, Bassetti, Sherif El Bayadi, Richard, Beasley, Shashi, Bellam, Jonathan, Bernstein, Maria, Blahey, Scott, Bloom, Eugene, Bleecker, Wesley, Bray, Johnathan, Brewer, Robert, Buynak, William, Calhoun, Edward, Campbell, Anthony, Captain, Birjis, Chinoy, Kenneth, Chinsky, Geoffrey, Chupp, Arsenio, Columbie, Clinton, Corder, Gerard, Criner, Humberto, Cruz, Edward, Cullen, Kevin, Deboer, Michael, Denenberg, Mark, Dransfield, Leonard, Dunn, Miles, Elmore, David, Erb, Faisal, Fakih, Gary, Ferguson, Charles, Fogarty, Mark, Freed, Stephen, Fritz, David, Fuentes, Shariar, Cohen-Gadol, Robert, Garver, John, Given, Luis Ramos Gonez, Raul Ebran Gonzalez, Robert, Gordon, Gregory, Gottschlich, Donald, Graham, David, Grant, Gary, Greenwald, James, Greenwald, Kenneth, Haft, Gregory, Hammond, Nadia, Hansel, Jeffrey, Harris, Humberto, Hernandez, Marvin, Heuer, Albrecht, Heyder, David, Hill, Willis, Holloway, Octavian, Ioachimescu, Richard, Jackson, Ajay, Jain, Nan, Jiang, Thomas, Kaelin, Adolfo, Kaplan, Mitchell, Kaye, Akram, Khan, Yekaterina, Khronusova, Ryan, Klein, Joel, Kline, Firas, Koura, Ritsu, Kuno, Ware, Kuschner, Jean Claude Labissiere, David Laman Jr, John, Lee, Mitchell, Lee, Lawrence, Levinson, Njira, Lugogo, Mador, M, Nathaniel, Marchetti, Rafael, Martinez, Richard, Martinez, Peter, Mattar, David, Maybee, Dennis, Mcgraw, Michael, Mcguire, Curtis, Mello, Aaron, Milstone, John, Mitchell, Wendy, Moore, Timothy, Moriarty, Cheta, Nand, Brooke, Nevins, Ikeadi, Ndukwu, Rachel, Nisbet, David, Nyanjom, Maria, Nualart, Thomas, O'Brien, Mikhail, Palatnik, Gnyandev, Patel, Amit, Patel, Guido, Perez, Christopher, Perry, Michael, Pfeffer, Krishna, Pudi, Marina, Raikhel, Murali, Ramaswamy, Joe, Ramsdell, Donato, Ricci, Gary, Richmond, Eugene, Ryan, Fadi, Saba, Boris, Sagalovich, C Andrew Schroeder, Timothy, Scialla, Frank, Sciurba, Amit, Shah, Nirav, Shah, Zeeshan, Shaikh, Akhtar, Siddiqui, Barry, Sigal, Thomas, Siler, Howard, Silverboard, William, Sims, Clyde, Southwell, Selwyn, Spangenthal, Peruvemba, Sriram, James, Stocks, Tony, Su, John, Suen, Robert, Sussman, Horia, Tatu, Antonio, Terrelonge, Alan, Thomas, Mario, Torres, Rodolfo, Trejo, Miguel, Trevino, Banks, Turner, Manuel, Villareal, Janine, Vintch, Neal, Warshoff, Jan, Westerman, Philip, Wexler, Thomas, Yunger, Amir, Zeki, Mariano Fernandez Acquier, Norma, Aramayo, German, Arce, Juan, Belloni, Víctor, Cambursano, Carlos De La Vega, Fernando Rodriguez Chariarse, Pedro, Elias, Marcelo, Fernández, Ana, Lopez, Andrea, Medina, María, Otaola, Maria Salazan Saez, Maria De Salvo, Fernando, Scherbovsky, Ana, Stok, Jorge, Taborda, Alberto, Tolcachier, Fernando, Verra, Carlos, Victorio, Rita Gisela Delgado Vizcarra, Philip, Bardin, Peter, Bremner, Martin, Phillips, John, Upham, Peter, Wark, Antoine, Bolly, Alain, Delobbe, Peter, Driesen, Eduard, Janssens, Wim, Janssens, Olivier, Michel, Bernard, Vandooren, Martti, Antila, Jussara, Fiterman, Carlos, Fritscher, Jorge, Hetzel, Jose, Jardim, Waldo De Mattos, Rafael, Martins, Maria Eunice De Oliveira, Andreia, Pez, Maria, Sales, Rafael, Stelmach, Priscila, Wolff, Svetla, Andreeva, Reneta, Antonova, Ana, Dancheva, Yuliya, Ivanova, Slavcho, Ivanov, Hristo, Metev, Iveta, Naydenova, Tatyana, Petkova, Galina, Petrova, Kostadinka, Sotirova, Mariyana, Stoyanova, Rumen, Tiholov, Iliyana, Valkanova, Oleg, Yakov, Rosa, Feijoo, Juana, Pavie, Patricia, Schönffeldt, Absalon, Silva, Victor, Martinez, David, Espinosa, Alejandro, Londono, Dora, Molina, Gonzalo, Prada, Andrés, Rico, Gregorio Sanchez Vallejo, Alvaro, Urbina, Ana, Vanegas, Maria, Villegas, Josip, Aralica, Gordana, Stjepanovic, Vibeke, Backer, Uffe, Bødtger, Christian, Meyer, Læge Sven Nielsen, Anders Loekke Ottesen, Ingrid, Titlestad, Nathalie, Bautin, Arnaud, Bourdin, Pascal, Chanez, Francis, Couturaud, Antoine, Cuvelier, Gilles, Devouassoux, Pierre-Olivier, Girodet, Jean-François, Muir, Jean-Louis, Pépin, Alain, Proust, Azzedine, Yaici, Yochai, Adir, Gershon, Fink, Zvi, Fridlender, Gabriel, Izbicki, Mordechai, Kramer, Yehuda, Schwartz, Juan Moreno Hoyos Abril, Ricardo Campos Cerda, Efraín Montaño Gonzalez, Ricardo Ramirez Terrones, Rodolfo Posadas Valay, Alejandra, Ramirez-Venegas, Paul, Dawkins, Syed, Hussain, Benedict, Brockway, John, Richmond, Colin, Helm, Catherina, Chang, Jørn, Ahlqvist, Terje, Tollåli, Tadeusz, Tomala, Socorro, Castro, William, Chavez, Octavio, Cubas, Rolando, Estrella, Efrain, Felix, Ronal, Gamarra, Alfredo, Guerreros, Alberto, Matsuno, Danilo, Salazar, Miguel, Tsukayama, Albert Albay Jr, Teresita, Aquino, Tito, Atienza, Joven Roque Gonong, Ronnie, Samoro, Joel, Santiaguel, Beata, Asankowicz-Bargiel, Ewa, Pisarczyk-Bogacka, Renata, Bijata-Bronisz, Marta, Chełmińska, Małgorzata, Dobryniewska, Anna, Olech-Cudzik, Tomasz, Fijołek, Krzysztof, Filipek, Agata, Kot, Bożena, Kucińska, Krzysztof, Lis, Elżbieta, Rybicka-Liszewska, Marzenna, Tarnowska-Matusiak, Robert, Mróz, Piotr, Napora, Wojciech, Naumnik, Artur, Niemiec, Władysław, Pierzchała, Grzegorz, Przybylski, Katarzyna, Styka, Danuta, Wrońska, Branislava, Milenkovic, Dobrivoje, Novkovic, Matijaz, Flezar, Niksa, Segota, Snezana Ulcar Kostic, Albert, Klobucar, Leif, Bjermer, Dan, Curiac, Christer, Janson, Pekka, Koskinen, Lundback, Bo, Åke, Olsson, Shih-Lung, Cheng, Ming-Lin, Ho, Jeng-Yuan, Hsu, Wu-Huei, Hsu, Ping-Hung, Kuo, Chin-Chou, Wang, Yu-Feng, Wei, Kuang-Yao, Yang, Watchara, Boonsawat, Somchai, Chantarothorn, Warangkana, Keeratichananont, Kittipong, Maneechotesuwan, Kanok, Pipatvech, Piamlarp, Sangsayunh, Sibel, Arinc, Sermin, Borekci, Arzu Kaner Erturk, Filiz, Kosar, Hakan, Gunen, Ismail, Hanta, Pinar Akin Kabalak, Tunc Alp Demir, Sibel, Nayci, Serir Aktogu Ozkan, Abdullah, Sayiner, Esra, Uzaslan, Viktor, Blazhko, Volodymyr, Gavrysyuk, Olena, Golub, Liudmyla, Iashyna, Tetiana, Ilashchuk, Volodymyr, Koshlia, Olena, Krakhmalova, Vitali, Kryvenko, Lesia, Kuryk, Olena, Levchenko, Yuriy, Mostovoy, Mykola, Ostrovskyy, Tetyana, Pertseva, Olena, Piura, Nadiya, Rudnytska, Ganna, Stupnytska, Nataliia, Velychko, Oleh, Yakovenko, Lilia Rodriguez Ables, Roger, Abrahams, Jose, Alvarez, Fernando, Arencibia, Chander, Arora, Samir, Arora, Francis, Averill, Kwabena, Ayesu, Stephen, Basheda, Steven, Bauer, Jose, Bautista, Matthew, Beacom, Hernando, Bernal, Subodh, Bhuchar, J'Cinda, Bitters, John, Burk, Elizabeth, Burkett, James, Cain, Robert, Call, Christopher, Chappel, Bartolome, Celli, Tom, Christensen, Jeremy, Cole, Jerome, Daniel, Nguyen, Dang, Enrique, Davis, Samuel, Deleon, Robert, Deluca, Ernesto, Diaz, Anthony, Dimarco, Calvin, Dixon, Ankur, Doshi, Hugh, Durrence, Alain, Eid, John, Elsen, Herbon, Fleming, May, Flores, Scott, Franczek, Gregory, Funk, Stuart, Garay, Bernard, Garcia, Joseph, Graif, Carl, Griffin, Yamirka Duardo Guerra, David, Headley, Mitzie, Hewitt, Susan, Hole, Robert, Holladay, Ira, Horowitz, Yu-Luen, Hsu, Jonathan, Ilowite, Stephen, Jones, Ravindra, Kashyap, Edward, Kerwin, Ahtaram, Khan, Nicole, Kimzey, James, Krainson, Flory, Kreutter, Kannappan, Krishnaswamy, Shahrukh, Kureishy, Albert, Lai, Alex, Lechin, Daria, Lee, Marcus, Lee, Williams, Leeds, Joseph, Lillo, Edward, Lisberg, Lawrence, Madoff, Narendra, Maheskwari, Mujibur, Majumder, Sashi, Makam, Douglas, Mapel, Matthew, Mardiney, Jennifer, Martin, Isaac, Melamed, Elvin, Mendez, Stuart, Millstone, Joseph, Montes, Lee, Morrow, Frank, Murphy, Dany, Obeid, France, Occy, Godson, Oguchi, Juan, Ortiz, Francisco, Padron, Ward, Paine, James, Pearle, Enrique, Pelayo, Vandely, Perez, David, Pham, Carlos, Piniella, Kevin, Pritchett, Padmashri, Rastogi, Stephen, Ryan, Syed, Rehman, Jackson, Rhudy, Eustace, Riley, James, Riser, Clifford, Risk, Emory, Robinette, Christopher, Roney, Gary, Ruoff, David, Russian, Mercedes, Samson, Jay, Sandberg, Jose, Santiago, William, Sargeant, Alan, Schecter, Jeffrey, Scott, Ilia, Segal, Sudhir, Sehgal, Frederic, Seifer, Sudhir, Sekhsaria, Richard, Sellman, Paul, Shapero, Jeffrey, Shea, Lawrence, Sher, John, Sibille, Jawed, Siddiqui, Toniya, Singh, Deren, Sinkowitz, Denise, Smyth, Daniel, Soteres, Daniel, Sousa, Ralph, Steele, Thomas, Stern, Jose, Suarez, Sever, Surdulescu, Ricardo, Tan, Tonny, Tanus, Raymond, Tidman, Aurelio, Torres-Consuegra, Barry, Troyan, John, Updegrove, Sanjay, Vadgama, Armando, Pineda-Velez, Eduardo, Viera, Andrew, Wachtel, Ralph, Wade, Jimin, Wang, Dave, Webster, Paul, Weinberg, Terry, Wells, Jeffrey, White, Bram, Wieskopf, Hugh, Windom, Patrick, Wright, David, Wyatt, Bassam, Yousef, Zahid, Zafar, Chau, Ngo, Huong, Le, Lan, Nguyen, Thanh, Nguyen, Nhung, Nguyen, SALAS, Danielle, Temple University [Philadelphia], Pennsylvania Commonwealth System of Higher Education (PCSHE), Harvard Medical School [Boston] (HMS), University of Leicester, University of Barcelona, Università degli Studi di Ferrara = University of Ferrara (UniFE), University of Manchester [Manchester], St. Paul’s Hospital - University of British Columbia [Vancouver, BC, Canada] (SPH-UBC), Philipps Universität Marburg = Philipps University of Marburg, University of Pittsburgh School of Medicine, University of Oxford, Bispebjerg University Hospital [Copenhagen, Denmark] (BUH), Kishiwada City Hospital [Osaka, Japan] (KCH), Instituto Nacional de Enfermedades Respiratorias [México, Mexico], I-Shou University [Kaohsiung, Taiwan] (ISU), Lund University [Lund], AstraZeneca [Gaithersburg, MD, USA] (AZ), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), and Otto Burghuber, Bernhard Forstner, Gerhard Köberl, Bernd Lamprecht, Judith Löffler-Ragg, Horst Olschewski, Michael Studnicka, Francois Beaucage, Guy Chouinard, Anthony Dechant, Anthony Dowell, Jacques Hebert, Sohail Khattak, Kieran Killian, William Killorn, Andy Lam, Francois Maltais, Darcy Marciniuk, Lyle Melenka, Bonavuth Pek, Jeremy Road, Donald Sin, Alain Vaugeois, Brandie Walker, Tomas Dvorak, Stanislav Holub, Otakar Hokynar, Vitezslav Kolek, Daniela Kopecka, Jan Krepelka, Jaroslav Mares, Josef Veverka, Vladimir Zindr, Sabine Ballenberger, Rolf Dichmann, Christian Geßner, Margret Jandl, Claus Keller, Joachim Kirschner, Marc Kornmann, Petra Mikloweit, Ingomar Naudts, Axel Overlack, Isabelle Schenkenberger, Volker Schlegel, Lutz Von Versen, Claus Franz Vogelmeier, Stefan Zielen, István Albert, Beatrix Bálint, Mária Csilla Hangonyi, Teréz Kecskés, Anikó Kurucz, Balázs Medgyasszay, Lajos Molnár, János Mucsi, Márta Papp, Magdolna Póczi, Éva Radeczky, Zsolt Pápai Székely, Csilla Szabó, Gyöngyi Szabó, Melinda Szabó, Alfredo Antonio Chetta, Giuseppe Di Maria, Giulio Donazzan, Federica Meloni, Elisabetta Pace, Pierluigi Paggiaro, Alberto Papi, Fabio Luigi, Massimo Ricciardolo, Antonio Spanevello, Fumiaki Aoki, Ryosuke Eda, Takeo Endo, Yasushi Fukushima, Kenichi Gemba, Naoki Hagimoto, Hiromasa Harada, Yasuko Harada, Norihiko Hata, Osamu Hataji, Nobuo Hatakeyama, Takahiko Horiguchi, Gen Ideura, Motoyasu Iikura, Azusa Ikegami, Shirou Imokawa, Yoshikazu Inoue, Takeshi Isobe, Ryoji Ito, Susumu Iwata, Tadashi Kamei, Motokazu Kato, Hideki Katsura, Yuji Kawarada, Norio Kihara, Masaharu Kinoshita, Takashi Kinoshita, Tomoo Kishaba, Hideo Kita, Arihiro Kiyosue, Shigeru Komatsu, Kazuki Konishi, Sekiya Koyama, Makoto Kudo, Kazuhiko Machida, Hironi Makita, Hiroto Matsuse, Naoki Miyazawa, Hiroyuki Nakamura, Yuji Nakatani, Kazuyuki Nishimura, Takashi Nishimura, Junichi Ogawa, Hiroyuki Ohbayashi, Tetsuro Ohdaira, Tsukasa Ohnishi, Kazuhiko Oki, Masahiko Saito, Kenji Sakamoto, Osamu Sakamoto, Hisakuni Sekino, Noriharu Shijubo, Masaharu Shinkai, Hideo Soto, Yoshitaka Sugawara, Noriaki Suko, Hisaho Takahashi, Masamitsu Takahashi, Tsuneyuki Takahashi, Hiroshi Tanaka, Hiroyuki Taniguchi, Tadayuki Terada, Takao Tochigi, Kazuyo Tohyama, Hirokazu Tokuyasu, Keisuke Tomii, Tomomasa Tsuboi, Mitsuyoshi Utsugi, Katsumaru Yamamoto, Michiko Yamamoto, Shuichi Yano, Makoto Yoshida, Frank Custers, Richard Dekhuijzen, Remco Djamin, Jan Willem Van Dan Berg, Lowie Vanfleteren, Pascal Wielders, Bogusława Cimoszko, Anna Doboszyńska, Andrzej Dyczek, Andrzej Fal, Krystyna Folcik, Łukasz Goliński, Marek Jutel, Andrzej Kolczyński, Piotr Kuna, Ewa Łączyńska, Wojciech Machowiak, Maciej Marczak, Joanna Markiewicz, Janusz Milanowski, Grzegorz Mincewicz, Maria Nittner-Marszalska, Wojciech Papiewski, Małgorzata Pawlukiewicz, Witold Pomiećko, Barbara Rewerska, Cezary Rybacki, Wojciech Skucha, Ewa Trębas-Pietraś, Ewa Uhryn, Małgorzata Żurowska-Gębala, Laurentia Andrei, Traian Mihaescu, Stefan Mihaicuta, Eniko Vera Pall, Ioan Petrui, Angelica Savu, Claudia Toma, Ana Trailescu, Vladimir Abrosimov, Nataliya Astafyeva, Evgenyi Bazdyrev, Nadezhda Berdnikova, Laura Bolieva, Ekaterina Bukreeva, Valery Chistyakov, Anna Galustyan, Halida Gantseva, Svetlana Goncharova, Sergey Grigoriev, Galina Ignatova, Inna Ilyashevich, Nadezhda Izmozherova, Magomed Kamalov, Yaroslava Khovaeva, Natalia Kuzubova, Lyudmila Kvitkova, Liudmila Lenskaya, Igor Leshchenko, Olga Magnitskaya, Boris Molotilov, Artem Molotkov, Svetlana Myasoedova, Sergey Nedogoda, Vladimir Nosov, Marina Osipenko, Andrey Peskov, Veronika Popova, Oksana Ratushnay, Irina Ryzhova, Olga Shangina, Natalia Shaporova, Evgeny Shmelev, Lybov Shpagina, Alexander Shutkin, Yuri Shvarts, Mikhail Smirnov, Irina Stitsenko, Maksim Vasilev, Arkadiy Vertkin, Elena Vishneva, Alexander Vizel, Anna Zateyschikova, Mohamed Abdool-Gaffar, Ismail Abdullah, Axel Bruning, Nyda Fourie, Michael Greenblatt, Mohammed Tayob, K Venter, An Soo Jang, Kwan Ho Lee, Sang Haak Lee, Sook Young Lee, Suk Joong Yong, Kwang Ha Yoo, Soo Taek Uh, Ramón Agüero Balbín, David Ramos Barbón, Álvar Agustí García-Navarro, José Luis Velasco Garrido, Sergi Pascual Guardia, Eduard Monso Molas, Luis De Teresa Parreño, Borja García-Cosio Piqueras, German Peces-Barba Romero, Myriam Calle Rubio, Fernando Sánchez-Toril López, Alicia Marín Tapia, Heidi Martin Braschler, Martin Brutsche, Michael Grob, Jörg Leuppi, Daiana Stolz, Alexander Turk, Nawar Bakerley, Mona Bafadhel, Christopher Brightling, Rekha Chaudhuri, Gourab Choudhury, Graham Devereux, Imran Hussain, Kai Lee, William MacNee, Ravindran Mahadeva, Matthew Masoli, Monica Nordstrom, Manish Patel, Allan Reid, Dinesh Saralaya, Tariq Sethi, Sukh Dave Singh, Anthony G de Soyza, Tom Wilkinson, Alice Turner, Helen Ward, Chandar Abboy, Ivan Ackerman, Idalia Acosta, Arun Adlakha, Bassil Aish, Mohamed Ali, Charles Andrews, Robby Ayoub, Anil Badhwar, Dennis Bassetti, Sherif El Bayadi, Richard Beasley, Shashi Bellam, Jonathan Bernstein, Maria Blahey, Scott Bloom, Eugene Bleecker, Wesley Bray, Johnathan Brewer, Robert Buynak, William Calhoun, Edward Campbell, Anthony Captain, Birjis Chinoy, Kenneth Chinsky, Geoffrey Chupp, Arsenio Columbie, Clinton Corder, Gerard Criner, Humberto Cruz, Edward Cullen, Kevin Deboer, Michael Denenberg, Mark Dransfield, Leonard Dunn, Miles Elmore, David Erb, Faisal Fakih, Gary Ferguson, Charles Fogarty, Mark Freed, Stephen Fritz, David Fuentes, Shariar Cohen-Gadol, Robert Garver, John Given, Luis Ramos Gonez, Raul Ebran Gonzalez, Robert Gordon, Gregory Gottschlich, Donald Graham, David Grant, Gary Greenwald, James Greenwald, Kenneth Haft, Gregory Hammond, Nadia Hansel, Jeffrey Harris, Humberto Hernandez, Marvin Heuer, Albrecht Heyder, David Hill, Willis Holloway, Octavian Ioachimescu, Richard Jackson, Ajay Jain, Nan Jiang, Thomas Kaelin, Adolfo Kaplan, Mitchell Kaye, Akram Khan, Yekaterina Khronusova, Ryan Klein, Joel Kline, Firas Koura, Ritsu Kuno, Ware Kuschner, Jean Claude Labissiere, David Laman Jr, John Lee, Mitchell Lee, Lawrence Levinson, Njira Lugogo, M Mador, Nathaniel Marchetti, Rafael Martinez, Richard Martinez, Peter Mattar, David Maybee, Dennis McGraw, Michael McGuire, Curtis Mello, Aaron Milstone, John Mitchell, Wendy Moore, Timothy Moriarty, Cheta Nand, Brooke Nevins, Ikeadi Ndukwu, Rachel Nisbet, David Nyanjom, Maria Nualart, Thomas O'Brien, Mikhail Palatnik, Gnyandev Patel, Amit Patel, Guido Perez, Christopher Perry, Michael Pfeffer, Krishna Pudi, Marina Raikhel, Murali Ramaswamy, Joe Ramsdell, Donato Ricci, Gary Richmond, Eugene Ryan, Fadi Saba, Boris Sagalovich, C Andrew Schroeder, Timothy Scialla, Frank Sciurba, Amit Shah, Nirav Shah, Zeeshan Shaikh, Akhtar Siddiqui, Barry Sigal, Thomas Siler, Howard Silverboard, William Sims, Clyde Southwell, Selwyn Spangenthal, Peruvemba Sriram, James Stocks, Tony Su, John Suen, Robert Sussman, Horia Tatu, Antonio Terrelonge, Alan Thomas, Mario Torres, Rodolfo Trejo, Miguel Trevino, Banks Turner, Manuel Villareal, Janine Vintch, Neal Warshoff, Jan Westerman, Philip Wexler, Thomas Yunger, Amir Zeki, Mariano Fernandez Acquier, Norma Aramayo, German Arce, Juan Belloni, Víctor Cambursano, Carlos De La Vega, Fernando Rodriguez Chariarse, Pedro Elias, Marcelo Fernández, Ana Lopez, Andrea Medina, María Otaola, Maria Salazan Saez, Maria De Salvo, Fernando Scherbovsky, Ana Stok, Jorge Taborda, Alberto Tolcachier, Fernando Verra, Carlos Victorio, Rita Gisela Delgado Vizcarra, Philip Bardin, Peter Bremner, Martin Phillips, John Upham, Peter Wark, Antoine Bolly, Alain Delobbe, Peter Driesen, Eduard Janssens, Wim Janssens, Olivier Michel, Bernard Vandooren, Martti Antila, Jussara Fiterman, Carlos Fritscher, Jorge Hetzel, Jose Jardim, Waldo De Mattos, Rafael Martins, Maria Eunice De Oliveira, Andreia Pez, Maria Sales, Rafael Stelmach, Priscila Wolff, Svetla Andreeva, Reneta Antonova, Ana Dancheva, Yuliya Ivanova, Slavcho Ivanov, Hristo Metev, Iveta Naydenova, Tatyana Petkova, Galina Petrova, Kostadinka Sotirova, Mariyana Stoyanova, Rumen Tiholov, Iliyana Valkanova, Oleg Yakov, Rosa Feijoo, Juana Pavie, Patricia Schönffeldt, Absalon Silva, Victor Martinez, David Espinosa, Alejandro Londono, Dora Molina, Gonzalo Prada, Andrés Rico, Gregorio Sanchez Vallejo, Alvaro Urbina, Ana Vanegas, Maria Villegas, Josip Aralica, Gordana Stjepanovic, Vibeke Backer, Uffe Bødtger, Christian Meyer, Læge Sven Nielsen, Anders Loekke Ottesen, Ingrid Titlestad, Nathalie Bautin, Arnaud Bourdin, Pascal Chanez, Francis Couturaud, Antoine Cuvelier, Gilles Devouassoux, Pierre-Olivier Girodet, Jean-François Muir, Jean-Louis Pépin, Alain Proust, Azzedine Yaici, Yochai Adir, Gershon Fink, Zvi Fridlender, Gabriel Izbicki, Mordechai Kramer, Yehuda Schwartz, Juan Moreno Hoyos Abril, Ricardo Campos Cerda, Efraín Montaño Gonzalez, Ricardo Ramirez Terrones, Rodolfo Posadas Valay, Alejandra Ramirez-Venegas, Paul Dawkins, Syed Hussain, Benedict Brockway, John Richmond, Colin Helm, Catherina Chang, Jørn Ahlqvist, Terje Tollåli, Tadeusz Tomala, Socorro Castro, William Chavez, Octavio Cubas, Rolando Estrella, Efrain Felix, Ronal Gamarra, Alfredo Guerreros, Alberto Matsuno, Danilo Salazar, Miguel Tsukayama, Albert Albay Jr, Teresita Aquino, Tito Atienza, Joven Roque Gonong, Ronnie Samoro, Joel Santiaguel, Beata Asankowicz-Bargiel, Ewa Pisarczyk-Bogacka, Renata Bijata-Bronisz, Marta Chełmińska, Małgorzata Dobryniewska, Anna Olech-Cudzik, Tomasz Fijołek, Krzysztof Filipek, Agata Kot, Bożena Kucińska, Krzysztof Lis, Elżbieta Rybicka-Liszewska, Marzenna Tarnowska-Matusiak, Robert Mróz, Piotr Napora, Wojciech Naumnik, Artur Niemiec, Władysław Pierzchała, Grzegorz Przybylski, Katarzyna Styka, Danuta Wrońska, Branislava Milenkovic, Dobrivoje Novkovic, Matijaz Flezar, Niksa Segota, Snezana Ulcar Kostic, Albert Klobucar, Leif Bjermer, Dan Curiac, Christer Janson, Pekka Koskinen, Bo Lundback, Åke Olsson, Shih-Lung Cheng, Ming-Lin Ho, Jeng-Yuan Hsu, Wu-Huei Hsu, Ping-Hung Kuo, Chin-Chou Wang, Yu-Feng Wei, Kuang-Yao Yang, Watchara Boonsawat, Somchai Chantarothorn, Warangkana Keeratichananont, Kittipong Maneechotesuwan, Kanok Pipatvech, Piamlarp Sangsayunh, Sibel Arinc, Sermin Borekci, Arzu Kaner Erturk, Filiz Kosar, Hakan Gunen, Ismail Hanta, Pinar Akin Kabalak, Tunc Alp Demir, Sibel Nayci, Serir Aktogu Ozkan, Abdullah Sayiner, Esra Uzaslan, Viktor Blazhko, Volodymyr Gavrysyuk, Olena Golub, Liudmyla Iashyna, Tetiana Ilashchuk, Volodymyr Koshlia, Olena Krakhmalova, Vitali Kryvenko, Lesia Kuryk, Olena Levchenko, Yuriy Mostovoy, Mykola Ostrovskyy, Tetyana Pertseva, Olena Piura, Nadiya Rudnytska, Ganna Stupnytska, Nataliia Velychko, Oleh Yakovenko, Lilia Rodriguez Ables, Roger Abrahams, Bassil Aish, Jose Alvarez, Fernando Arencibia, Chander Arora, Samir Arora, Francis Averill, Kwabena Ayesu, Stephen Basheda, Steven Bauer, Jose Bautista, Matthew Beacom, Richard Beasley, Hernando Bernal, Subodh Bhuchar, J'Cinda Bitters, John Burk, Elizabeth Burkett, James Cain, Robert Call, Christopher Chappel, Bartolome Celli, Tom Christensen, Jeremy Cole, Jerome Daniel, Nguyen Dang, Enrique Davis, Samuel Deleon, Robert DeLuca, Ernesto Diaz, Anthony DiMarco, Calvin Dixon, Ankur Doshi, Hugh Durrence, Alain Eid, John Elsen, Herbon Fleming, May Flores, Charles Fogarty, Scott Franczek, Stephen Fritz, Gregory Funk, Stuart Garay, Bernard Garcia, Luis Ramos Gonez, Gregory Gottschlich, Joseph Graif, Carl Griffin, Yamirka Duardo Guerra, David Headley, Mitzie Hewitt, Susan Hole, Robert Holladay, Ira Horowitz, Yu-Luen Hsu, Jonathan Ilowite, Stephen Jones, Ravindra Kashyap, Edward Kerwin, Ahtaram Khan, Nicole Kimzey, James Krainson, Flory Kreutter, Kannappan Krishnaswamy, Shahrukh Kureishy, Albert Lai, Alex Lechin, Daria Lee, Marcus Lee, Williams Leeds, Joseph Lillo, Edward Lisberg, Lawrence Madoff, Narendra Maheskwari, Mujibur Majumder, Sashi Makam, Douglas Mapel, Matthew Mardiney, Jennifer Martin, David Maybee, Isaac Melamed, Elvin Mendez, Stuart Millstone, Joseph Montes, Lee Morrow, Frank Murphy, Dany Obeid, France Occy, Godson Oguchi, Juan Ortiz, Francisco Padron, Ward Paine, James Pearle, Enrique Pelayo, Vandely Perez, David Pham, Carlos Piniella, Kevin Pritchett, Padmashri Rastogi, Stephen Ryan, Syed Rehman, Jackson Rhudy, Eustace Riley, James Riser, Clifford Risk, Emory Robinette, Christopher Roney, Gary Ruoff, David Russian, Mercedes Samson, Jay Sandberg, Jose Santiago, William Sargeant, Alan Schecter, Frank Sciurba, Jeffrey Scott, Ilia Segal, Sudhir Sehgal, Frederic Seifer, Sudhir Sekhsaria, Richard Sellman, Paul Shapero, Jeffrey Shea, Lawrence Sher, John Sibille, Jawed Siddiqui, William Sims, Toniya Singh, Deren Sinkowitz, Denise Smyth, Daniel Soteres, Daniel Sousa, Ralph Steele, Thomas Stern, Jose Suarez, Sever Surdulescu, Ricardo Tan, Tonny Tanus, Raymond Tidman, Aurelio Torres-Consuegra, Barry Troyan, John Updegrove, Sanjay Vadgama, Armando Pineda-Velez, Eduardo Viera, Andrew Wachtel, Ralph Wade, Jimin Wang, Dave Webster, Paul Weinberg, Terry Wells, Jeffrey White, Bram Wieskopf, Hugh Windom, Patrick Wright, David Wyatt, Bassam Yousef, Zahid Zafar, Chau Ngo, Huong Le, Lan Nguyen, Thanh Nguyen, Nhung Nguyen

Subjects
Male, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Anti-asthmatic Agent, law.invention, Pulmonary Disease, Chronic Obstructive, Leukocyte Count, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, Monoclonal, Receptors, Medicine, Anti-Asthmatic Agents, 030212 general & internal medicine, Humanized, COPD Exacerbations, benralizumab, clinical trials, COPD, Subcutaneous, General Medicine, Middle Aged, anti–IL-5Rα, Benralizumab, Pulmonary Disease, Chronic Obstructive/drug therapy, [SDV] Life Sciences [q-bio], Female, Antibodies, Monoclonal, Humanized/administration & dosage, Chronic Obstructive, Benralizumab COPD exacerbations, Injections, Subcutaneous, Socio-culturale, Aged, Antibodies, Monoclonal, Humanized, Double-Blind Method, Eosinophils, Humans, Patient Acuity, Receptors, Interleukin-5, Antibodies, chronic obstructive pulmonary disease, Injections, Pulmonary Disease, 03 medical and health sciences, Phase III, Anti-Asthmatic Agents/administration & dosage, In patient, business.industry, Eosinophils/metabolism, medicine.disease, Clinical trial, Receptors, Interleukin-5/antagonists & inhibitors, chemistry, Multicenter study, randomized controlled trial, Immunology, Interleukin-5, business
Abstract

BACKGROUND: The efficacy and safety of benralizumab, an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody, for the prevention of exacerbations in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) are not known.METHODS: In the GALATHEA and TERRANOVA trials, we enrolled patients with COPD (at a ratio of approximately 2:1 on the basis of eosinophil count [≥220 per cubic millimeter vs. RESULTS: In GALATHEA, the estimates of the annualized exacerbation rate were 1.19 per year (95% confidence interval [CI], 1.04 to 1.36) in the 30-mg benralizumab group, 1.03 per year (95% CI, 0.90 to 1.19) in the 100-mg benralizumab group, and 1.24 per year (95% CI, 1.08 to 1.42) in the placebo group; the rate ratio as compared with placebo was 0.96 for 30 mg of benralizumab (P = 0.65) and 0.83 for 100 mg of benralizumab (P = 0.05). In TERRANOVA, the estimates of the annualized exacerbation rate for 10 mg, 30 mg, and 100 mg of benralizumab and for placebo were 0.99 per year (95% CI, 0.87 to 1.13), 1.21 per year (95% CI, 1.08 to 1.37), 1.09 per year (95% CI, 0.96 to 1.23), and 1.17 per year (95% CI, 1.04 to 1.32), respectively; the corresponding rate ratios were 0.85 (P = 0.06), 1.04 (P = 0.66), and 0.93 (P = 0.40). At 56 weeks, none of the annualized COPD exacerbation rate ratios for any dose of benralizumab as compared with placebo reached significance in either trial. Types and frequencies of adverse events were similar with benralizumab and placebo.CONCLUSIONS: Add-on benralizumab was not associated with a lower annualized rate of COPD exacerbations than placebo among patients with moderate to very severe COPD, a history of frequent moderate or severe exacerbations, and blood eosinophil counts of 220 per cubic millimeter or greater (Funded by AstraZeneca [GALATHEA and TERRANOVA] and Kyowa Hakko Kirin [GALATHEA]; GALATHEA and TERRANOVA ClinicalTrials.gov numbers, NCT02138916 and NCT02155660.).

Published
2019
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24. Bromek Aklidyny w Leczeniu POChP—Opinia Interdyscyplinarnej Grupy Roboczej

Author

Piotr Kuna, Halina Batura-Gabryel, Andrzej Fal, Ewa Jassem, Krzysztof Filipiak, Marcin Michalak, Piotr Radziszewski, Kazimierz Wardyn, and Katarzyna Życińska

Subjects
Pulmonary and Respiratory Medicine
Abstract

Według ostatniej definicji Global Initiative For Chronic Obstructive Lung Disease i Polskiego Towarzystwa Chorób Płuc (GOLD/PTChP) prze-wlekła obturacyjna choroba płuc (POChP) jest chorobą, której można zapobiec i którą można leczyć [...]

Published
2014
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25. Drobne drogi oddechowe w chorobach obturacyjnych płuc

Author

Andrzej Fal, Ewa Niżankowska-Mogilnicka, Paweł Śliwiński, Andrzej Emeryk, Adam Antczak, and Jerzy Kruszewski

Subjects
Pulmonary and Respiratory Medicine
Abstract

Określenie drobne drogi oddechowe (DDO) dotyczy oskrzeli poniżej 7. generacji, o średnicy mniejszej niż 2 mm. W artykule przedstawiono dowody, że ta część drzewa oskrzelowego charakteryzuje się pewnymi odmiennymi cechami zarówno w kontekście budowy, fizjologii, jak i patofizjologii. Szczególnie ważną funkcję odgrywają DDO w chorobach obturacyjnych układu oddechowego. U zdrowych osób opór DDO nie jest większy niż 10% całkowitego oporu dróg oddechowych, natomiast u pacjentów chorych na choroby obturacyjne, poprzez nałożenie się elementu zapalnego i skurczowego ich opór może stanowić nawet 60% oporu całkowitego. Zmiany w DDO w astmie oskrzelowej i przewlekłej obturacyjnej chorobie płuc (POChP) są odpowiedzialne także za powstawanie tak zwanej pułapki powietrznej, szczególnie w POChP. Nie ma obecnie doskonałych metod diagnostyki DDO, w zależności od doświadczeń własnych w różnych ośrodkach przeprowadza się tomografię komputerową wysokiej rozdzielczości, badanie pletyzmograficzne całego ciała (stosunku objętości zalegającej/całkowitej ilości zawartego w płucach powietrza [RV/TLC] lub innych parametrów). Pewne nadzieje wiąże się obecnie z połączeniem oscylometrii impulsacyjnej, testu wypłukiwania azotu w jednym wydechu i pomiaru wydychanego tlenku azotu(eNO). Ze względu na coraz szerszą wiedzę o istotnej roli DDO w patofizjologii chorób obturacyjnych, stworzono superdrobne aerozole, których cząstki zarówno teoretycznie, jak i praktycznie (doświadczenia na impaktorze kaskadowym, skany ozonowe po inhalacjach) mogą wnikać do tej części dróg oddechowych. Autorzy przedstawiają wybrane badania z dwiema grupami leków—agonistami receptora b2-adrenergicznego (BA) i wziewnymi glikokortykosteroidami (wGKS). W przypadku tych pierwszych nie udowodniono, że tak głęboka depozycja w drogach oddechowych przekłada się na poprawę efektu klinicznego. Natomiast w przypadku wGKS, głęboka depozycja ultradrobnego aerozolu powoduje możliwość zmniejszenia dawki leku (nawet ponad dwukrotnej) przy utrzymaniu tego samego efektu terapeutycznego (poprawa indeksu terapeutycznego). Reasumując, DDO wydają się być miejscem podstawowych procesów w rozwoju chorób obturacyjnych i w związku z tym celem potencjalnych terapii.

Published
2012
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26. Wskazówki Polskiego Towarzystwa Chorób Płuc dotyczące metod pozyskiwania, opracowywania oraz oceny płynu z płukania oskrzelowo-pęcherzykowego (BAL)

Author

Andrzej Chciałowski, Joanna Chorostowska-Wynimko, Andrzej Fal, Robert Pawłowicz, and Joanna Domagała-Kulawik

Subjects
Pulmonary and Respiratory Medicine
Abstract

Płukanie oskrzelowo-pęcherzykowe (BAL, bronchoalveolar lavage) nadal zajmuje bardzo istotną po-zycję w diagnostyce pierwotnych chorób płuc o różnym podłożu: infekcyjnych, śródmiąższowych, no-wotworowych oraz patologii płucnych występujących w przebiegu innych schorzeń, w tym układowych [...]

Published
2011
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27. Miejsce leukotrienów w patofizjologii astmy oskrzelowej. Konieczność leczenia przeciwleukotrienowego

Author

Andrzej Fal and Agnieszka Kopeć

Subjects
Pulmonary and Respiratory Medicine
Abstract

Astma jest przewlekłą chorobą zapalną dróg oddechowych, w której uczestniczy wiele komórek zapalnych i mediatorów. Obecnie rekomenduje się wziewne glikokortykosteroidy, jako najbardziej skuteczne leki przeciwzapalne dostępne w leczeniu astmy. Niektórzy pacjenci nie osiągają jednak kontroli choroby, mimo stosowania dużych dawek wziewnych glikokortykosteroidów w monoterapii lub skojarzeniu z długodziałającymi beta2-mimetykami. W przebiegu zapalenia astmatycznego ulegają aktywacji różne szlaki komórkowe. Szczególnie ważna jest ścieżka prowadząca do syntezy leukotrienów. Leukotrieny, takie jak leukotrien C4, D4, E4 (zwane leukotrienami cysteinylowymi), są znane z silnego działania prozapalnego oraz kurczącego oskrzela. Leukotrieny zwiększają przepuszczalność naczyń krwionośnych i produkcję śluzu w oskrzelach oraz mogą przyczyniać się do niekorzystnej przebudowy oskrzeli (remodelingu). Ich działanie chemotaktyczne na różne komórki zapalne (eozynofile, mastocyty, neutrofile) przyczynia się do podtrzymywania przewlekłego zapalenia w drogach oddechowych. Te biologiczne działania leukotrienów wskazują na ich ważną rolę w patogenezie astmy. Chociaż wziewne glikokortykosteroidy hamują wiele składowych zapalenia astmatycznego, to nie wpływają one na syntezę leukotrienów. W związku z tym dodatkowa terapia za pomocą antagonistów leukotrienów może okazać się korzystna dla tej grupy astmatyków. Dobrze udokumentowano działanie przeciwzapalne i bronchoprotekcyjne antyleukotrienów. Są one szczególnie skuteczne u pacjentów z astmą aspirynową i tych ze współistniejącym alergicznym nieżytem nosa. Leki antyleukotrienowe są także stosowane w zapobieganiu skurczowi oskrzeli wywołanym wysiłkiem i zimnym powietrzem. Mniej skuteczne w monoterapii, jako terapia dodana do wziewnych glikokortykosteroidów, poprawiają kontrolę astmy, powodując zmniejszenie liczby zaostrzeń choroby, zużycia krótkodziałających beta2-mimetyków oraz poprawę funkcji płuc. Artykuł podsumowuje obecną wiedzę na temat roli leukotrienów w patogenezie astmy oraz aspektów klinicznych terapii lekami antyleukotrienowymi.

Published
2010
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29. Differential Regulation of Epithelial-Derived C-C Chemokine Expression by IL-4 and the Glucocorticoid Budesonide

Author

Stellato, C., Matsukura, S., Andrzej Fal, White, J., Beck, L. A., Proud, D., and Schleimer, R. P.

Subjects
Chemokine CCL11, Tumor Necrosis Factor-alpha, Administration, Topical, Chemotactic Factors, Eosinophil, Immunology, Anti-Inflammatory Agents, Dose-Response Relationship, Immunologic, Epithelial Cells, Cell Line, Monocyte Chemoattractant Proteins, Interferon-gamma, Kinetics, Gene Expression Regulation, Chemokines, CC, Cytokines, Humans, Immunology and Allergy, Interleukin-4, RNA, Messenger, Budesonide, Promoter Regions, Genetic, Chemokine CCL5, Glucocorticoids, Cells, Cultured
Abstract

Airway epithelial cells are a rich source of eosinophil-selective C-C chemokines. We investigated whether cytokines and the topical glucocorticoid budesonide differentially regulate RANTES, monocyte chemoattractant protein-4 (MCP-4), and eotaxin mRNA and protein expression in the human bronchial epithelial cell line BEAS-2B and in primary human bronchial epithelial cells by Northern blot analysis and ELISAs. Eotaxin and MCP-4 mRNA expression induced by TNF-α alone or in combination with IFN-γ was near-maximal after 1 h, peaked at 4 and 8 h, respectively, remained unchanged up to 24 h, and was protein synthesis independent. In contrast, RANTES mRNA was detectable only after 2 h and slowly increased to a peak at 24 h, and was protein synthesis dependent. Induction of eotaxin and MCP-4 mRNA showed a 10- to 100-fold greater sensitivity to TNF-α compared with RANTES mRNA. IL-4 and IFN-γ had selective effects on chemokine expression; IL-4 selectively up-regulated the expression of eotaxin and MCP-4 and potentiated TNF-α-induced eotaxin, while IFN-γ markedly potentiated only the TNF-α-induced expression of RANTES. Although budesonide inhibited the expression of chemokine mRNA to a variable extent, it effectively inhibited production of eotaxin and RANTES protein. Budesonide inhibited both RANTES- and eotaxin promoter-driven reporter gene activity. Budesonide also selectively accelerated the decay of eotaxin and MCP-4 mRNA. These results point to IL-4 as a possible mediator by which Th2 cells may induce selective production of C-C chemokines from epithelium and indicate that glucocorticoid inhibit chemokine expression through multiple mechanisms of action.

Published
1999
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30. An Attempt to Estimate Parameters Useful for Establishing a Normal Range for Peak Nasal Inspiratory Flow

Author

Anna Dor-Wojnarowska, Marek Rabski, Andrzej Fal, Jerzy Liebhart, Bernard Panaszek, and Bolesław Samoliński

Subjects
Pulmonary and Respiratory Medicine, PNIF, reference values, nasal obstruction
Abstract

Introduction: Measurement of peak nasal inspiratory flow (PNIF) has gained wide acceptance among clinicians due to its simplicity. Unfortunately, due to the lack of reference values, a single measurement does not provide any relevant information on the degree of nasal obstruction. We have therefore attempted to evaluate parameters that would be useful for establishing reference ranges for PNIF. Material and methods: The study was a part of an epidemiological study ECAP (Epidemiologia Chorób Alergicznych w Polsce [The Epidemiology of Allergic Diseases in Poland]). Inhabitants of Wrocław, Poland, aged 6–7, 13–14 and 20–45 years were randomly selected for the study. All the subjects had their medical history taken and their PNIF measured (using an In-Check inspiratory flow meter manufactured by Clement-Clark). Patients with a diagnosis of rhinitis and/or asthma were excluded from the study. In each subject, the highest of the five measurements (PNIF MAX) was included in the analysis. Results: A total of 221 healthy individuals were enrolled in the study. PNIF MAX differed significantly between females and males. A significant correlation was observed between height and PNIF MAX, although no such correlation was found between age and PNIF MAX. For this reason, in order to establish a reference range for PNIF, a regression equation that included sex and height was analysed. The following relationship was arrived at: PNIF MAX = −137.7 − 22.5x + 1.7y, where x is the sex (1 for females and 0 for males) and y is the height. The coefficient of determination (R2) for this relationship was 0.45, which means that the regression equation explains about 45% of the observed variability of PNIF MAX. Conclusions: We found that PNIF MAX correlated with sex and height and that it did not correlate with age. The difficulties in establishing normal ranges for PNIF are most likely due to the differences in nasal anatomy between the subjects.

Published
2011
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31. [Evaluation of effectiveness and safety of three year immunotherapy with mixed grass pollen allergens]

Author

Gietkiewicz K, Andrzej Fal, and Małolepszy J

Subjects
Adult, Male, Vaccines, Vaccines, Synthetic, Adolescent, Plant Extracts, Rhinitis, Allergic, Seasonal, Allergens, Antigens, Plant, Middle Aged, Treatment Outcome, Desensitization, Immunologic, Humans, Pollen, Female
Abstract

Specific immunotherapy (SIT) is probably the only causative treatment in allergic diseases including pollinosis. It is capable of changing the natural history of the disease.Present study has been designed to estimate the effectiveness and safety of multi-seasonal immunotherapy with grass-pollen-allergoid-containing vaccines.Twenty seven patients with pollinosis entered the study. They were randomly assigned to two groups receiving two different but absolutely comparable vaccines (Allergovit, Pollinex). Cards of patient's self-evaluation (including nasal, eye and bronchial symptoms) as well as anti-allergic drug consumption were evaluated.Significant amelioration of symptoms was noticed already after first season of SIT 3.4 +/- 0.29 vs 7.54 +/- 0.35 points before SIT (control)(p0.05). The respective value after third SIT was 2.1 +/- 0.26 (p0.001). Also anti-allergic drug consumption felt from 2.12 +/- 0.12 points before SIT to 0.86 +/- 0.11 and 0.37 +/- 0.11 after first and third SIT, respectively (p0.001 and p0.00005). Few side reactions were observed, only one mild systemic reaction.Our study confirms that pre-seasonal SIT is a clinically effective and safe therapeutic method in patients with pollinosis. It's effect seems to be time-related.

Published
2002

32. [Chylomicronemia syndrome in 45 years old man]

Author

Obojski A, Chmielowicz B, Andrzej Fal, and Małolepszy J

Subjects
Diagnosis, Differential, Male, Chest Pain, Hyperlipoproteinemias, Lipoproteins, Chylomicrons, Humans, Syndrome, Middle Aged
Abstract

The case of chylomicronemia syndrome in 45 year old man, previously misdiagnosed as hypercholesterolemia is described. Secondary causes of hyperlipoproteinemia were excluded. No symptoms, characteristic of familial lipoprotein lipase deficiency were observed. We concluded that the diagnosis of hyperlipoproteinemia has to be based on determination of all plasma lipids concentrations (total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol). Otherwise a false diagnosis is quite possible. In rare cases additional laboratory tests are needed.

Published
2002

38. The relationship between the type of allergen and the development of atopic disease in the group of patients treated at the Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine in Warsaw,Zwia̧zek pomiȩdzy typem alergenu a rozwojem choroby atopowej w grupie pacjentów leczonych w Klinice Pediatrii, Nefrologii i Alergologii Dzieciȩcej WIM w Warszawie

Author

Kalicki, B., Maślany, A., Rustecka, A., Jung, A., Zuber, J., Placzyńska, M., and Andrzej Fal

44. [Influence of long-term low molecular weight heparin nebulization on selected clinical parameters and course of allergic inflammation in patients with bronchial asthma]

Author

Andrzej Fal, Miecielica J, Krasnowska M, Medrala W, Kuryszko J, and Małolepszy J

Subjects
Adult, Male, Biopsy, Nebulizers and Vaporizers, Bronchi, Heparin, Low-Molecular-Weight, Middle Aged, Asthma, Respiratory Function Tests, Administration, Inhalation, Bronchoscopy, Humans, Female, Bronchitis, Bronchoalveolar Lavage Fluid
Abstract

Bronchial asthma is a chronic condition with an inflammatory background--allergic inflammation. In recent years several observations have been published documenting activity of low molecular weight heparin (LMWH) in chronic inflammatory diseases of respiratory tract. This study was set up to evaluate the effect of nebulized LMWH on spirometric parameters and selected markers of allergic inflammation in bronchial asthma. Twenty patients diagnosed with mild or moderate asthma entered the study. At the beginning and at the end of the experiment every patient underwent bronchoscopy with BAL and in 15 of them bronchial biopsy was performed. Blood was drawn for ECP evaluation. LMWH was administered in nebulization in a dose 5000 U Xa/day for two weeks. BALf cellularity was evaluated as well as BALf IL-5 concentration. Further ELAM-1 and VCAM-1 expression in bronchial mucosa was examined in immunohistochemistry. We demonstrated that heparin treatment significantly enhanced FEV1 from 76.02 +/- 21.7% nominate value before to 92.4 +/- 21.8% after treatment (p0.005). Cellular profile of BALf changed, showing significant drop in percentages of eosinophils--from 7% to 6% (p0.05), macrophages--38 to 32% (p0.05) and neutrophils--32 to 28% (p0.05). Surprisingly we did not notice any change in ECP concentration in blood serum or IL-5 in BALf. Also adhesion molecules expression in bronchial mucosa remained unchanged. We conclude that chronic LMWH nebulization is a valuable treatment ameliorating asthmatic condition clearly due to anti-inflammatory properties of heparin. Both dose of LMWH used and the time of therapy have to be further investigated in order to develop treatment able to influence more of the elements of allergic inflammation.

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