Search

IntroductionDietary fiber is a key component of a healthy diet, associated with a reduced risk of cardiovascular disease, obesity, type 2 diabetes, certain cancers, chronic inflammation, or depression. The aim of the study was to perform an in-depth analysis of dietary fiber intake in the Polish population, taking account of the consumption of groups of products that are fiber sources and identify any age-related differences in the dietary fiber intake of the subjects.MethodsWe analyzed data obtained from two representative cross-sectional studies on the diet and nutritional status of adult Polish residents including the total of 4,000 individuals aged 19 years and more. Two 24-h recalls were used per individual to assess the diet using the computer-assisted personal interview (CAPI) technique. Total fiber content and fiber contained in cereal products, vegetables, fruits, legumes, nuts and seeds were calculated. Fiber intake was compared to the recommendations: 25 g/d for adults up to 65 years of age and 20 g/d for those aged 66 years and older. All statistical analyses, including the Pearson’s chi-squared test, the Student’s t-test, and the Analysis of Variance (ANOVA), were conducted using STATISTICA™ version 13.3, with the results being adjusted for demographic distribution biases to enhance the representativeness.ResultsThe average daily fiber intake was 17.83 ± 0.14 g/day (78% of the recommended intake), with 20.5% of respondents meeting the requirement. More men than women (27.05% vs. 14.3%;) met the requirement and men were characterized by a higher average intake (19.34 ± 0.20 g/day) than women (16.43 ± 0.19 g/day). The main fiber sources were cereals (44.1%), vegetables (23.6%), and fruits (16.0%). As regards men, the sources included refined bread (25.8%), vegetables (23.1%), and fruits (10.2%) and for women, they were vegetables (24.0%), fruits (17.2%), and refined bread (16.3%). Although refined bread is not recommended as a primary fiber source due to its lower fiber content compared to whole grain bread, its high consumption significantly contributed to the total fiber intake.ConclusionThe prevalence of widespread dietary fiber deficiency calls for the intensification of educational efforts that address the health advantages and sources of dietary fiber, as well as methods for its inclusion in daily meals.

Due to the scale of the phenomenon, food allergies constitute a significant health problem and significantly impair the quality of life of patients. Differential diagnostics, including skin tests, sIgE detection tests, basophil and mast cell activation tests as well as double-blind placebo-controlled food challenge tests, is the gold standard in the diagnosis of food allergies. Recently, increasing attention has been paid to the potential use of intranasal provocation tests in the diagnosis of food allergies. Allergen dose, protocol standardization, assessment of subjective complaints and objectivization of test results are important factors determining the applicability of provocation tests.

Objectives Vaccination skepticism and vaccination refusal both constitute global public health concerns. Systematic monitoring of public attitudes towards vaccination is crucial for maintaining a high vaccination coverage rate. The study aimed to identify and characterize homogenous social groups distinguished by attitudes toward preventive vaccinations. Material and Methods Between October and November of 2021, a nationwide representative cross-sectional survey was conducted on a representative sample of 1560 inhabitants of Poland aged 15–39 years. The study questionnaire included 60 questions on public attitudes towards vaccines, vaccination, and the COVID-19 pandemic. Factor analysis was applied to identify the main dimensions of vaccination attitudes. Results Factor analysis included 22 variables and yielded 3 factors or dimensions that accounted for 48.5% of the model’s variability. Young adults were assigned into 6 homogeneous groups based on these factors: 1) general trust in vaccination, 2) vaccine safety concerns, 3) trust in fake medical news regarding COVID-19 vaccination, and denying the COVID-19 pandemic. Groups I–IV differed by sociodemographic factors and vaccination coverage rates. Nearly 60% of the respondents expressed concern regarding various aspects of vaccination. Conclusions Most of Poland’s young adults lack clearly defined attitudes towards vaccination. Attitudes towards vaccination can be divided into 6 heterogeneous groups. Int J Occup Med Environ Health. 2023;36(2):214–28

Objectives The development of allergic conditions is largely dependent on the interactions between genetic (individual genetic predisposition) and environmental factors (exposure to risk factors). The aim of this study was an attempt to assess the influence of selected elements of the hygiene theory in the development of allergic diseases such as allergic rhinitis and asthma. Material and Methods The study group consisted of 5518 women and 3868 men. The method that was used was the European Community Respiratory Health Survey II and International Study of Asthma and Allergies in Childhood questionnaire validated and adapted to Central and Eastern European conditions. The project was conducted in 8 urban areas (Gdańsk, Wrocław, Poznań, Katowice, Kraków, Lublin, Białystok, Warsaw) and 1 rural area (Krasnystaw county). This study had 2 stages; the first stage involved grouping the 22 500 respondents based on their questionnaire responses with the use of a Personal Digital Assistant (PDA); the second stage involved 7000 subjects, who underwent additional assessments: skin prick tests (birch, grasses/cereals, Dermatophagoides pteronyssinus and Dermatophagoides farinae , molds [set I: Botrytis cinerea , Cladosporium herbarum , Alternaria tenuis , Curvularia lunata , Fusarium moniliforme , Helminthosporium ], molds [set II: Aspergillus fumigatus , Mucor mucedo , Penicillium notatum , Pullularia pullulans , Rhizopus nigricans , Serpula lacrymans ], cat, dog, molds Cladosporium herbarum , Alternaria tenuis ) and spirometry tests. Results The age at which children attend the nursery school is critical to the development of allergic diseases; in allergic rhinitis, the risk of an IgE-dependent reaction is 2 times higher in the second than in the first year of life (p = 0.00147, p < 0.05), while in asthma, having a large number of siblings increases the risk of developing obstructive disease by almost 6 times (p = 0.00316, p < 0.05).The age at which children attend the nursery school is critical to the development of allergic diseases; in allergic rhinitis, the risk of an IgE-dependent reaction is 2 times higher in the second than in the first year of life (p = 0.00147, p < 0.05), while in asthma, having a large number of siblings increases the risk of developing obstructive disease by almost 6 times (p = 0.00316, p < 0.05). Conclusions The hygiene theory is particularly applicable and can explain the relationship of selected habits in the development of allergic diseases. Int J Occup Med Environ Health. 2023;36(1):69–83

The global interest in allergic disease epidemiology in the 20th and 21st centuries is a result of their growing prevalence of unprecedented, pandemic proportions. According to the 2011 White Book on Allergy, the prevalence of allergic conditions rises dramatically worldwide, both in developed and developing countries, with the rates of asthma ranging from 1% to 20%, allergic rhinitis from 1% to 18%, and skin allergies from 2% to 10% in various populations. The growing prevalence of allergies is particularly noticeable in children, who have been affected most by this trend for the last two decades.

Abstract Background Allergies, including food allergies, are a considerable clinical and public-health problem. The introduced preventive measures and differential diagnostics, including oral food challenges, are the gold standard for determining further treatment planning. Case presentation We present a case of an 18-year-old girl with a cow’s milk allergy who underwent an oral food challenge (double blind oral food challenge). Such a challenge may be confounded by inducing a response from other systems and organs, which provides theoretical grounds for the use of other methods of assessing the body’s response to food allergens (response demonstrated by the upper respiratory tract). Based on this idea, in order to assess the degree of mucosal response, we used optical rhinometry as an objective method for nasal patency evaluation, as well as identification of tryptase level in nasal lavage fluid and exfoliative cytology of nasal mucosa. The results of these tests confirmed positive reaction of the nasal mucosa in the course of the oral allergen challenge. Conclusions The observed increase in the nasal mucosal reactivity that accompanies oral food challenges may suggest a potential for using food allergens in nasal allergen provocation testing in order to diagnose food allergies.

Objectives Tobacco use is one of the most serious public health problems. Each year, it contributes to preventable disability and death of 8 million people worldwide. The aim of the study was to determine the change in the prevalence of tobacco and e-cigarettes use among Polish adults in the years 2010–2019 and the potential impact of legislative interventions on tobacco consumption in Poland. Material and Methods The research was based on an analysis of secondary data obtained from a cross-sectional study as part of the public opinion monitoring in Poland. The study was carried out in 2 editions (2010 and 2019) on representative samples of approximately 1000 Polish residents >18 years of age. Results The proportion of traditional cigarette smokers decreased from 30.4% to 26.0% in the years 2010–2019 (p < 0.05). In the male group decreased from 40.3% to 31.0% (p < 0.001); among females, the values remained at the same level (21.3%). The greatest change in the percentage of current smokers was recorded in cities with ≥500 000 inhabitants (from 30.3% to 17.1%) and

Thanks to their valuable assessment possibilities (subjective complaints and changes in nasal patency during the examination), nasal provocation tests may serve as an alternative tool for oral food challenges in the future. However, this test requires successive attempts to regulate its methodology in order to develop a standardized lyophilisate form and determine the threshold dose for a positive result. The study objective was to present the methodological foundation for nasal food allergen provocation tests induced by freeze-dried powdered chicken egg whites. A control group of 25 individuals with no history of allergy to chicken eggs or any other allergy was included in the study. Optical rhinometry and visual analog scales were used to assess the response of nasal mucosa to local allergen challenges. Minor variations in nasal flows, as measured by optical rhinometry, were observed in the provocation tests. The mean optical density measurements (as measured regardless of the allergen dose used) varied from positive to negative values and vice versa, e.g., amounting to 0.018 OD (standard deviation 0.095) at 15 min and −0.011 OD (standard deviation 0.090) at 30 min. No significant differences were observed concerning the perceived nasal discomfort using the visual analog scale. Due to the absence of nasal mucosal reactivity, nasal challenge is an excellent methodological tool for implementing food allergen tests.

Acoustic rhinometry is an objective nasal patency assessment technique. Its cognitive value means that it plays a major role in the nasal allergen provocation test. The optimisation of the measured values and the interpretation of the results of the test-based values are critical. When the assessment is based on the minimal cross-sectional areas, the volumes for the different segments of the rhinometric curve indicate changes in nasal patency in the nasal allergen provocation test. It seems that the points on the rhinometric curve which correspond to the different waves for the nasal cavity accurately reflect the level of response of the mucous membrane of the nasal cavity to an allergen.

Introduction The primary prevention is intended to prevent the development of diseases, secondary prevention aims to limit disease progression, and tertiary prevention involves reducing disease-associated symptoms. The purpose of this study was to assess the use of selected forms of secondary prevention by patients diagnosed with perennial allergic rhinitis. Moreover, this paper presents the ways in which the adopted organizational solutions could be utilized as part of coordinated healthcare to benefit patients with perennial allergies. Material and methods The study population comprised 18,617 respondents, 4783 of whom (including patients allergic to Dermatophagoides pteronyssinus and Dermatophagoides farinae) were qualified to undergo a medical examination. The study used ECRHS and ISAAC questionnaires adapted for Europe. Results Nearly 20% of patients diagnosed with chronic allergic rhinitis used preventive measures against house dust mites; this is in contrast with 13% in the control group (p = 1.358e-07). The secondary preventive measures most commonly used in the study group were, in descending order of frequency, mattress protectors and anti-dust-mite spray. Undertaking preventive measures was most common among study participants with higher education and residents of large cities. Conclusions The proportion of patients diagnosed with a dust-mite allergy, who undertook preventive measures against perennial allergic rhinitis, was relatively low. Building, maintaining, and continual strengthening the doctors’ relationship with chronic allergy patients may shift the nature of healthcare services more towards preventive measures, for the implementation of which the patient will be co-responsible under the coordinated healthcare system.

Local allergic rhinitis (LAR) is a specific phenotype of allergic rhinitis. One characteristic feature of LAR is a medical history indicative of an allergic disease, negative skin-prick test results, undetectable levels of specific IgE, and a positive allergen-specific nasal provocation test. This paper presents a case of a patient with LAR and underlying house dust mite allergy, who was ultimately diagnosed >10 years after the onset of his first symptoms. Currently, there are only pharmacological treatments available for LAR. However, some studies show encouraging results with the use of allergen-specific immunotherapy in LAR, which offer hope for a future use of this causative treatment in LAR patients. Int J Occup Med Environ Health. 2020;33(2):241–6

Sarcopenia in the elderly population is a public health challenge, and there are few data on its prevalence in Europe. In this study, we investigated the prevalence of sarcopenia in the elderly Polish population and its association with the level of obesity and co-existing diseases. We conducted a population-based cross-sectional study involving 823 men and 1177 women aged 65 years and older, randomly selected from the population living in the territory of the Republic of Poland between 2017 and 2020. We analyzed the results of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Risk of sarcopenia was assessed with the simple questionnaire to rapidly diagnose sarcopenia (SARC-F), and sarcopenic obesity risk was defined as the combination of anthropometry and SARC-F results. In addition, we collected disease data with an author questionnaire. The prevalence of risk of sarcopenia was 18.6% (22.3% in women and 13.2% in men), and its incidence significantly increased with age in both sexes. The risk of sarcopenic obesity was more common in women than in men, and it was higher in the older age group, except for sarcopenic obesity diagnosed by the WHR criteria. The group of elderly with concomitant diseases had a higher risk of developing sarcopenia, which emphasizes the need to monitor sarcopenia when concomitant diseases are diagnosed. In both groups, risk of sarcopenia was associated with motor and respiratory system diseases, type 2 diabetes, and neurological diseases. This study highlights that the risk of sarcopenia in the elderly population affects women to a greater extent than men. It is important to identify the elderly at risk of sarcopenia in routine clinical practice to develop long-term prevention strategies.

Eosinophilic esophagitis is a newly described entity of increasing incidence. Previously thought to be a variation of gastroesophageal reflux disease, now it becomes well known among gastroenterologists, allergologists, paediatricians and pathologists. Aetiology of the disease is strongly correlated with atopic and allergic disorders but exact pathogenesis and cellular mechanisms of inflammatory process in the esophagus are still unknown. Diagnostic criteria have been described but diagnostic tools are still in the research and improvement phase. Clinical manifestation varies considerably between age groups, which causes a delay in the course of diagnosis due to improperly recognized symptoms. Since eosinophilic esophagitis is a chronic disease without a tendency to be self-limiting, delayed diagnosis may lead to complications associated with oesophageal tissue remodelling. Some forms of treatment are approved and of great therapeutical value, nevertheless clinical trials of new medications provide new possibilities. Therefore, many questions regarding eosinophilic esophagitis arise and are still unanswered.

It is estimated that every third person living in Europe suffers from allergic diseases. Allergies are a growing health problem in Poland where 40% of the population have allergy symptoms, including 12% afflicted with asthma. The actual cost of allergic diseases is difficult to estimate due to the lack or incompleteness of the relevant data. The aim of this review is to present estimates of the indirect costs of allergic diseases in Poland and globally, using asthma, allergic rhinitis and atopic dermatitis as examples. The analysis also includes the impact of allergic diseases on the costs to the social welfare system and employers. The literature review of the indirect costs of allergic diseases shows that the indirect costs of a disease, which substantially exceed the direct costs, increase with the disease activity and severity. Interestingly, some studies have found that the indirect costs of lost productivity due to hours missed from work to take care of a sick child could be threefold higher than those of absence due to a worker’s own illness. The indirect costs of a disease can be significantly reduced by early diagnosis and appropriate treatment. Int J Occup Med Environ Health. 2019;32(3):281–90

Abstract Background Links between multimorbidity of allergic diseases and allergen sensitization are still under debate, especially in adults. This study aimed to establish a relationship between polysensitization and allergic multimorbidity in children and adults and the allergens involved in multimorbidity. Material and method A cross-sectional multicentre study enrolled children aged 6–7 and 13–14 years and adults aged 20–44 years from a Polish national cohort. The diagnosis of allergic diseases was made by a physician. Skin prick tests to 13 allergens and serum IgE levels to 4 allergens were tested. Results Among the 3856 participants, single disease (asthma, allergic rhinitis or atopic dermatitis) was diagnosed in 27.7% subjects and allergic multimorbidity in 9.3%. Allergic multimorbidity occurred more commonly in children than in adults (p

Obesity is one of the important risk factors for a severe course of COVID-19. Maintaining a healthy body weight through diet and physical activity is a reasonable approach to preventing a SARS-CoV-2 infection or in alleviating its course. The goal of the study was to determine the influence of obesity on nutrition and physical activity during the COVID-19 pandemic. A total of 964 respondents, including 227 individuals with a body mass index (BMI) ≥30 kg/m2 were evaluated in this study. In the case of 482 respondents, including 105 individuals (21.8%) with BMI ≥ 30 kg/m2, the data were collected during the pandemic period from 1 June to 31 August 2020. The remaining 482 individuals were the “pre-pandemic” group, selected via propensity score matching (PSM) out of the 723 National Health Program study participants whose data was collected in 2017–2019. The evaluated dietary health factors were quantitatively similar in patients with BMI of either 2 or ≥30 kg/m2 and showed no significant changes during the pandemic. The diets of those who suffered from obesity prior to the pandemic showed the evaluated unhealthy nutritional factors to be less pronounced in comparison with those of individuals with BMI < 30 kg/m2. During the pandemic, the BMI ≥ 30 kg/m2 group showed a significant increase in the overall calorie intake (by 319 kcal; p = 0.001) and an increased consumption of total carbohydrates 299.3 ± 83.8 vs. 252.0 ± 101.5; p = 0.000), sucrose (51.7 ± 30.0 vs. 71.6 ± 49.9; p = 0.000), plant protein (26.3 ± 12.1 vs. 29.3 ± 8.3; p = 0.040), total fat (73.1 ± 42.6 vs. 84.9 ± 29.6; p = 0.011) and saturated fatty acids (29.5 ± 16.4 vs. 34.3 ± 13.9; p = 0.014) in comparison with the pre-pandemic period. The energy and nutritional value of the diets of BMI < 30 kg/m2 individuals did not change between the pre-pandemic and pandemic period. Before the pandemic, the level of leisure physical activity of the BMI ≥ 30 kg/m2 group was significantly lower than of those with BMI < 30 kg/m2. Such differences were not observed in the levels of physical activity at work or school. The pandemic did not alter the amount of physical activity either during leisure time or at work/school in individuals with BMI ≥ 30 kg/m2. However, respondents without obesity exercised significantly less during the pandemic than before. In conclusion, the pandemic altered the diets and levels of physical activity in the Polish population, with dietary changes observed in individuals with BMI ≥ 30 kg/m2 and changes in physical activity observed in those with BMI < 30 kg/m2.

Introduction A growing number of epidemiological studies suggest that paracetamol, which is commonly used in children, may be a risk factor for asthma, allergic rhinitis, and atopic eczema. Objective The aim of this study was to determine and characterize the correlation between paracetamol use and asthma, allergic rhinitis, and atopic eczema symptoms in the Polish population. Material and methods The study is part of the ECAP project involving the use of the ISAAC and ECRHS questionnaires. Completed questionnaires of 18,617 subjects, including 10,011 (53.8%) females, were analyzed. Children aged 6–7 (n=4,510), adolescents aged 13–14 (n=4,721), and adults aged 20–44 (n=9,386) constituted 24.2%, 25.4%, and 50.4% of respondents, respectively. Study subjects lived in 8 major urban centres and one rural area. The frequency of paracetamol use during the previous 12 months and symptoms of asthma, allergic rhinitis, and atopic eczema during that period were analyzed. Results The use of paracetamol was associated with a significant dose-dependent increase in the risk of asthma symptoms in all evaluated age groups. This was demonstrated via odds ratios (OR) for developing asthma symptoms, including wheezing or whistling in the chest in 6–7-year-olds and exercise-induced shortness of breath in 13–14-year-olds and adults, depending on the frequency of paracetamol use in the previous 12 months, compared to no paracetamol intake during that period. Conclusions The use of paracetamol in the last 12 months was associated with a significant dose-dependent increase in the risk of rhinitis and skin allergy symptoms, as demonstrated by the odds ratio. Therefore, frequent paracetamol use may be a risk factor for symptoms of asthma, rhinitis, and skin allergy in the Polish population.

The paper presents the designs and methods of a cross-sectional study of two groups of randomly selected Polish inhabitants aged 19–64, and 65 and over, carried out as part of the National Health Program. The aim of the study was to illustrate the current health situation of the respondents in terms of nutrition and physical activity level. The quantitative and qualitative methods were used. The Computer Assisted Personal Interview technique was used. The dietary research was carried out through repeated interviews about the frequency of food consumption, and about what food had been consumed in the previous 24 h. In addition to the questionnaire studies, anthropometric data, blood pressure and the level of physical activity were measured. During the COVID-19 pandemic, some methods were modified according to hygiene rules. The Computer Assisted Telephone Interview technique was used to collect the data, and the anthropometric data were obtained via measurements made by the respondents themselves based on detailed instructions. The results will be used to present representative data for the Polish population, describing a wide range of eating behaviours and other lifestyle elements, food and nutrition knowledge, dietary supplement use, the occurrence of diet-related diseases, nutritional status and, in the seniors group, the risk of sarcopenia.

Introduction: Nasal provocation testing involves an allergen-specific local reaction of the nasal mucosa to the administered allergen. Aim: To determine the most objective nasal occlusion assessment technique that could be used in nasal provocation testing. Material and methods : A total of 60 subjects, including 30 patients diagnosed with allergy to common environmental allergens and 30 healthy subjects were enrolled into the study. The method used in the study was a nasal provocation test with an allergen, with a standard dose of a control solution and an allergen (5,000 SBU/ml) administered using a calibrated atomizer into both nostrils at room temperature. Early-phase nasal mucosa response in the early phase of the allergic reaction was assessed via acoustic rhinometry, optical rhinometry, nitric oxide in nasal air, and tryptase levels in the nasal lavage fluid. Results : In estimating the homogeneity of the average values, the Levene’s test was used and receiver operating characteristic curves were plotted for all the methods used for assessing the nasal provocation test with an allergen. Statistically significant results were defined for p < 0.05. Of all the objective assessment techniques, the most sensitive and characteristic ones were the optical rhinometry techniques (specificity = 1, sensitivity = 1, AUC = 1, PPV = 1, NPV = 1). Conclusions : The techniques used showed significant differences between the group of patients with allergic rhinitis and the control group. Of all the objective assessment techniques, those most sensitive and characteristic were the optical rhinometry.

Introduction: Poland’s transition into the stage of intensive population aging imposes changes in demand for different forms of care (including long-term). The proportion of dependent persons (requiring care) in the population continues to increase. The number of people aged 80 and above (in 2013 – 1.48 million) will double by 2050 and reach 3.54 million. The research objective was to gain knowledge on the supply and demand of different institutionalized forms of care services from the healthcare system perspective. Material and methods: A computer-assisted personal interview (CAPI) survey was carried out on a Poland-wide quota sample of health care and nursing centres operating within the healthcare system. The respondent group consisted of 96 directors of health care facilities. Results: In the opinion of more than a half of surveyed directors, supply of health care and nursing centres in their region is insufficient in terms of the needs of both patients and elderly people. In the context of patients, the deficit is observed primarily in health care and treatment centres, long-term nursing care and health care institutions, whereas for the elderly people the main concern is availability of nursing care, day care or social aid centres. More than half of surveyed institutions admit patients requiring care on an ongoing basis; however, in the case of health care and treatment centres more than a year-long waiting time proved to be a frequent phenomenon. In the opinion of the surveyed directors, the key factors influencing the number of available places and waiting time are insufficient financing and personnel deficit. Conclusions : Introduction of multiple changes to the operation of the care system in Poland is necessary in order to improve its availability, effectiveness and quality. Achievement of this objective requires implementation of a cohesive and integrated system dedicated to monitoring and diagnosing both the supply and demand for different forms of care.

SLIT ( sublingual immunotherapy ) induces allergen-specific immune tolerance by sublingual administration of a gradually increasing dose of an allergen. The mechanism of SLIT is comparable to those during SCIT (subcutaneous immunotherapy), with the exception of local oral dendritic cells, pre-programmed to elicit tolerance. In the SLIT dose, to achieve the same efficacy as in SCIT, it should be 50–100 times higher with better safety profile. The highest quality evidence supporting the efficacy of SLIT lasting 1 – 3 years has been provided by the large scale double-blind, placebo-controlled (DBPC) trials for grass pollen extracts, both in children and adults with allergic rhinitis. Current indications for SLIT are allergic rhinitis (and conjunctivitis) in both children and adults sensitized to pollen allergens (trees, grass, Parietaria ), house dust mites ( Dermatophagoides pteronyssinus, Dermatophagoides farinae ), cat fur, as well as mild to moderate controlled atopic asthma in children sensitized to house dust mites. There are positive findings for both asthma and new sensitization prevention. Severe adverse events, including anaphylaxis, are very rare, and no fatalities have been reported. Local adverse reactions develop in up to 70 – 80% of patients. Risk factors for SLIT adverse events have not been clearly identified. Risk factors of non-adherence to treatment might be dependent on the patient, disease treatment, physician-patient relationship, and variables in the health care system organization.

The paradigm of how we manage allergic rhinitis is shifting with a growing understanding that it is a complex process, requiring a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Community pharmacists are the most accessible healthcare professionals to the public and allergic rhinitis is one of the most common diseases managed by pharmacists. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines developed over the past 20 years have improved the care of allergic rhinitis patients through an evidence-based, integrated care approach. In this paper, we propose an integrated approach to allergic rhinitis management in community pharmacy following the 2019 ARIA in the pharmacy guidelines.

The T allele of rs7927894 (at 11q13.5) was associated with atopic dermatitis and other allergic diseases. Our purpose was to replicate the association with allergic phenotypes and explore the role of rs7927894 in predisposing to persistent allergic rhinitis and atopic asthma. We also wanted to explore if other SNPs at 11q13.5 contributed to effect of rs7927894. We studied patients with atopic dermatitis (N = 270), atopic asthma (N = 486), persistent allergic rhinitis (N = 589) and controls matched for age, sex and region (N = 540, N = 372 and N = 1178, respectively). We found that rs7927894 T was associated with atopic dermatitis (OR = 1.39, CI: 1.12-1.73, P = 0.003) and independently with persistent allergic rhinitis (OR = 1.24, CI:1.07-1.43, P = 0.0043, Pcorrected = 0.013) but not atopic asthma. Analysis of additional tagging SNPs (rs7930763, rs2513517, rs7125552) showed that effect of rs7927894 T was limited to haplotypes encoding G at rs7125552. In conclusion, rs7927894 T is associated not only with atopic dermatitis but also persistent allergic rhinitis. Since these effects are haplotype dependent rs7927894 alone does not account for the association between 11q13.5 and atopic dermatitis/persistent allergic rhinitis.

Microsporidial infections may be asymptomatic in immunocompetent hosts, but can be severe and disseminated in HIV/AIDS patients, children, the elderly, or in immunocompromised individuals, including those with primary or medically-induced immunodeficiencies. 209 faecal samples were collected from 80 clinical patients, with or without abdominal symptoms, and tested for the presence of the parasites. Microsporidia were found in 10 of the 80 patients (12.5%) using trichrom staining of faecal smears and/or PCR. [i]Encephalitozoon[/i] intestinalis and 1 unidentified species were identified in 2 of the 32 children with primary immunodeficiencies (6%), presenting with diarrhoea, including one co-infection with [i]Cryptosporidium meleagridis[/i]. In the group of patients with medically-induced immunosuppression (transplant recipients), 8 of the 48 patients (17%) were tested positive for microsporidia. Thus, these pathogens should be taken into account when the other etiological agents cannot be found in diarrheic patients with PIDs or undergoing immunosuppressive treatment before or after transplantation. This article presents the results of the first epidemiological study on the ccurrence and prevalence of microsporidia in patients with primary and secondary immunodeficiency in Poland.

Background. Bilateral nasal allergen provocation usually produces more pronounced obstruction of one nasal passage. It was found that this could be related to the stage of the nasal cycle before the provocation. objective. To discover whether the stage of the nasal cycle is decisive for asymmetry in congestive response observed during bilateral allergen nasal provocation. methods. Two bilateral nasal allergen provocations were performed in a group of 26 pollen-sensitive volunteers. Acoustic rhinometry measurements were taken during the nasal cycle, and then after the provocation. A cross-sectional area at the level of the inferior turbinate (CSA-2) was measured. Consecutive challenges were performed in the opposite phase of the nasal cycle: the side which had been wide just before the first challenge, was narrow before the second provocation. results. Asymmetry in CSA-2 reduction between the nasal passages was observed in most cases. Significant difference was observed between mean CSA-2 reduction rate (reactivity) of the side that responded with greater congestion, and the opposite side. No significant difference was found in mean CSA-2 reduction rate between the side which was narrow, and the side which was wide before provocation. conclusions. Asymmetry of congestive response during bilateral nasal allergen provocation is not dependent on the stage of the nasal cycle preceding the challenge.

Following publication of the original article [1], the authors reported that one of the authors’ name was spelled incorrectly.

The aim of the study was to assess the safety of nasal allergen challenge, and the use of certain parameters applied in assessing the condition of the respiratory system. We enrolled 30 patients diagnosed with allergy to common environmental allergens and 30 healthy controls. The safety of nasal challenge tests with an allergen was assessed by measuring the concentration of exhaled nitric oxide from the lower respiratory tract (eNO) and forced expiratory volume in one second (FEV1) in a spirometry test. In the early phase of the allergic reaction, extra-nasal symptoms were observed, namely cough and breathlessness. These measured symptoms using the VAS scale, were far more frequent in the patients diagnosed with perennial allergic rhinitis. The eNO and FEV1 values in the spirometry test did not show any statistically significant changes. No correlation was observed between the breathlessness and cough complaints to the eNO concentration levels (cough: r=0.019, p=0.921; breathlessness: r=-0.088, p=0.644) nor the FEV1 level (cough: r=0.002, p=0.983; breathlessness: r=-0.072, p=0.751) in the spirometry test. In the early phase of the allergic reaction, nasal allergen challenge do not cause any significant changes in the lower airways, as measured with the use of certain parameters applied in assessing the function of the lower airways’ function.

The purpose of this study was to assess the effect of preventive immunization on the incidence of allergies in Poland.18617 (53.8% female, 24.2% 6-7 years old, 25.4% 13-14 years old, 50.4% 20–44 years old) were selected by stratified cluster sampling method in 8 cities and 1 rural area. 4783 of whom underwent objective outpatient screening assessments. Study subjects were evaluated for any association between preventive immunization against rubella, measles, typhoid fever, smallpox and incidence of atopic dermatitis, allergic rhinitis, and asthma.There was no increased risk of allergy incidence in the majority of vaccinated subjects against rubella, measles, typhoid fever, or smallpox (OR from 0.42 (ppppp=0.005), varicella (OR=1.18; p=0.003); rhinitis and AR following vaccination against measles (respectively OR=1.22; pp=0.0002). No higher risk of allergic diseases was demonstrated in vaccinated individuals diagnosed by doctor in an outpatient setting.These data do not demonstrate a causal relationship between vaccinations and allergic conditions.

Instytut Reumatologii im. prof. dr hab. med. Eleonory Reicher pełnijednocześnie funkcję szpitala świadczącego wysoko specjalistyczneusługi medyczne, jak i instytutu badawczego zajmującegosię problematyką chorób reumatycznych. W 2010 r. w Instytuciehospitalizowano 9128 pacjentów (72% stanowiły kobiety) i udzielonoponad 27 500 porad specjalistycznych (80% stanowiły kobiety)(ryc. 1, ryc. 3, tab. I). Najwięcej hospitalizacji wykonano w KliniceReumatologii Wieku Rozwojowego, tj. 28% wszystkichhospitalizacji zrealizowanych w Instytucie Reumatologii. KlinikaReumatologii Wieku Rozwojowego różni się znacznie od pozostałychklinik Instytutu Reumatologii, biorąc pod uwagę następująceparametry: średni czas hospitalizacji (8 – dni Instytut Reumatologii,4 dni – Klinika Reumatologii Wieku Rozwojowego) (ryc. 2),odsetek pacjentów z województwa mazowieckiego (78% – InstytutReumatologii, 69% – Klinika Reumatologii Wieku Rozwojowego).Największą grupę chorych hospitalizowanych w InstytucieReumatologii stanowiły osoby cierpiące na choroby zapalne,tj. reumatoidalne zapalenie stawów (27,5% wszystkich pacjentów),układowe choroby tkanki łącznej (16,5% wszystkich pacjentów),młodzieńcze zapalenia stawów, głównie idiopatyczne (14%wszystkich pacjentów) (tab. II i III). Mediana wieku pacjentów hos -pitalizowanych w Instytucie Reumatologii wynosiła 49 lat.Najstarsi pacjenci byli leczeni w Klinice Rehabilitacji (mediana65 lat), a najmłodsi w Klinice Reumatologii Wieku Rozwojowego(mediana 14 lat) (ryc. 4). Poradnie specjalistyczne Instytutu Reumatologiiprzyjęły 8831 pacjentów w trakcie 27 512 wizyt. Oznaczato, że statystyczny pacjent w 2010 r. odbył nieco ponad 3 wizyty lekarskie (ryc. 5, tab. IV). Najliczniejszą grupą osób korzystającychz porady specjalistycznej byli pacjenci w wieku 55–69 lat (ryc. 6).Znacząca ich większość (niemal 93%) mieszkała na terenie województwamazowieckiego.

BACKGROUND: FLG null variants of which 2282del4 and R501X are the most frequent in Caucasians are established risk factors for atopic dermatitis (AD) with an effect probably mediated through impairment of epidermal barrier. Among subjects with AD FLG defects are also consistently associated with asthma and allergic rhinitis (AR) but it is less clear to what extent these associations are also present independently from skin disease. The aim of the present study was to evaluate the role of 2282del4 and R501X in predisposing to these allergic phenotypes in a Polish population. METHODOLOGY: 2282del4 and R501X were typed among 3,802 participants of the Epidemiology of Allergic Diseases in Poland (ECAP) survey, a cross-sectional population-based study using ECRHS II and ISAAC questionnaires, and ambulatory examination. PRINCIPAL FINDINGS: The FLG null variants were associated with AD (OR = 2.01, CI: 1.20-3.36, P = 0.007), allergic rhinitis (in particular persistent form, OR = 1.69, CI:1.12-2.54, P = 0.011), and asthma (in particular atopic asthma, OR = 2.22, CI:1.24-3.96, P = 0.006). Association with atopic asthma (but not persistent allergic rhinitis) was also present in the absence of AD, (OR = 2.02, CI: 1.07-3.81, P = 0.027) as well as in the absence of AD and history of broadly defined inflammatory skin disease (OR = 2.30, CI: 1.07-4.93, P = 0.03). Association to atopic asthma would have not been found if diagnosis was made by questionnaire only (OR = 1.15, CI: 0.58-2.32, P = 0.8). We did not observe an association between FLG variants and allergic sensitizations (P = 0.8) or total IgE. (P = 0.6). CONCLUSIONS/SIGNIFICANCE: In a Polish population FLG 2282del4 and R501X carriage increases risk for development of AD and atopic asthma (also in the absence of AD or history thereof). This suggests that interventions aimed at restoring epidermal barrier may have a general role in asthma prophylaxis/treatment.