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Anna Breborowicz
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ABSTRACT: Antibiotics have significant role in the treatment of respiratory diseases. The main aim of their use is to treat infection, but anti-inflammatory properties of macrolides are also beneficial in selected diseases. The role of antibiotics in the therapy of asthma exacerbation can be neglected and should be limited to exceptional situations of bacterial infections which are very rare. During last few years the role of atypical infections in asthma inception, induction of exacerbation and modification of chronic course of disease has been discussed. Antibiotics play significant role in cystic fibrosis therapy. They are especially recommended during exacerbation, when new pathogens are revealed and in chronic Pseudomonas aeruginosa infection. This paper includes the principal rules of antibiotics therapy in patients with cystic fibrosis. The role of azithromycin in antiinflammatory therapy in this group of patients is also presented.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 05/2011; 30(179):349-51.
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Anna Breborowicz
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ABSTRACT: Broncholitis in infant is most commonly results from viral infection, typically RS virus will be responsible. Treatment is difficult due to limited efficacy of available methods of causal and symptomatic therapies. Therefore it is specially important to seek preventive measures. This is crucial in case of preterm infants, infants with broncho-pulmonary dysplasia, cystic fibrosis, hemodynamically significant congenital heart defects and immunodeficiencies who are likely to undergo a severe course of the disease. In the above mentioned cases the effects of passive immunotherapy of prophylaxis with initially intravenous anti RSV-immunoglobulin G, then intramuscular monoclonal antibody palivizumab have been assessed. Palivizumab is currently recommended by American Academy of Pediatrics for RSV infection prophylaxis with children at risk like infants with broncho-pulmonary dysplasia, preterm infants depending on gestational age and infant age in infection season as well as infants with hemodynamically significant congenital heart defects. So far there is no possibility to prevent infection within the whole population.
Przegla̧d lekarski 01/2011; 68(1):29-32.
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ABSTRACT: Most methods used for the assessment of severe steatorrhea in cystic fibrosis (CF) are sensitive. In fact, the tests show their usefulness in a borderline zone of the results. Yet, the existing data related to acid steatocrit (AS) are still contradictory. Therefore, in the present study we have aimed to assess CF patients without or with mild steatorhea (<10 g/day) and evaluate the applicability of AS in such a subset of patients.
In fifty-five CF patients, AS, fecal fat concentration (FFC) and fecal fat excretion (FFE) in 1-day stool collection were assessed from one to three times (149 samples). In 50 subjects, FFC, FFE, and AS were available for 3 subsequent days. It allowed for the calculations based upon 3-day fecal fat balance study.
The correlations between FFE/FFC and AS based upon 1-day stool collection, although statistically significant, were rather weak (r = 0.208, P < 0.011; r = 0.362, P < 0.000006, respectively). The correlations between FFE/FFC and AS based upon the 3-day stool collection, although stronger, did not show values a linear relationship (r = 0.394, P < 0.005; r = 0.454, P < 0.001, respectively). With no regard to the cut-off level for AS (10% and 20%), sensitivity, specificity, negative, and positive predictive values in the determination of abnormal FFC and FFE were not satisfactory. The flow charts describing the accuracy of AS to determine FFE and FC revealed a high level of uncertainty.
AS does not reflect in a reliable way FFE in CF patients without or mild steatorrhea. Its applicability in the assessment of FFC in such patients has therefore limited practical value.
Pediatric Pulmonology 02/2010; 45(3):249-54. · 2.53 Impact Factor
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Anna Breborowicz
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ABSTRACT: Genetic and environmental background of allergic disease has been suggested the option of allergy prevention by allergen avoidance. For many years this environmental manipulation has been commonly recommended as primary prevention, but it was not effective which was proved by general increasing trend in allergy prevalence. Prospective observation of birth cohort combined with well controlled intervention didn't confirm the usefulness of such intervention. Allergen elimination as an element of secondary and tertiary prevetion could be effective if it leads to true reduction of allegen concentration which seems very difficult. Allergen elimination using currently available methods is very expensive with little benefit. During last few years new opposite option of allergy prevention it means tolerance induction has been proposed. Till now traditional approach to allergy prevention is worldwide recommended.
Przegla̧d lekarski 01/2010; 67(1):51-3.
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Piotr Brzyski,
Ewa Cichocka-Jarosz,
Beata Tobiasz-Adamczyk,
Grzegorz Lis,
Urszula Jedynak-Wasowicz,
Jacek Józef Pietrzyk,
Beata Ordyk,
Krzysztof Profus,
Joanna Lange,
Wioletta Zagórska,
Marek Kulus,
Ewa Swiebocka,
Maciej Kaczmarski,
Teresa Małaczyńska,
Barbara Klajna-Kraluk, Anna Breborowicz,
Zdzisława Kycler
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ABSTRACT: Aim of the study was to assess validity and reliability of adaptations of VQLQ for Polish children with Hymenoptera venom allergy and their parents. Sample under study consisted of 73 children aged up to 14 years, who were treated with specific venom immunotherapy (VIT) in 2008 in centres conducting this procedure in Poland, and their parents. Theoretical validity of the scales was assessed with exploratory factor analysis using principal component analysis method. Reliability of the scales was assessed in terms of internal consistency with Cronbach alpha coefficient. Results of analysis showed that both scales measure 4 dimension of quality of life and reliability of scales measuring particular dimensions is at least acceptable in case of scale for children, and high in case of scale for parents. Both adapted scales are valid and reliable tools measuring quality of life in children with Hymenoptera venom allergy and their parents' quality of life in the face of child's allergy.
Przegla̧d lekarski 01/2010; 67(12):1237-42.
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Ewa Cichocka-Jarosz,
Beata Tobiasz-Adamczyk,
Piotr Brzyski,
Grzegorz Lis,
Urszula Jedynak-Wasowicz,
Jacek J Pietrzyk,
Beata Ordyk,
Krzysztof Profus,
Joanna Lange,
Wioletta Zagórska,
Marek Kulus,
Ewa Swiebocka,
Maciej Kaczmarski,
Teresa Małaczyńska,
Olga Swidzicka, Anna Breborowicz,
Zdzisława Kycler
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ABSTRACT: Hymenoptera venom allergy, although rare in children, by its potential fatalities, leads to many psychosocial consequences, influencing quality of life of children and their parents. Aim of this paper is the estimation of health-related quality of life of venom allergic children treated with specific immunotherapy, and their parents. Assessment of factors influencing health-related quality of life levels was also performed.
Sample under study consisted of 73 children: mean age 10.6, SD 2, 4, treated because of Hymenoptera venom allergy in 5 clinical allergy centers in Poland. Data was collected using VQLQ questionnaire adapted for children and their parents. Determinants of quality of life were assessed with multivariate linear and logistic regression models. Analysis were done with SPSS 15 for Windows package.
Girls reported higher level of anxiety than boys (B = 0.47; 95% CI = (0.01; 0.94)). Level of caution in children increased along with increase of their anxiety against re-sting (B = 0.49; 95% CI = (0.27; 0.71)). Level of anxiety of children who were under treatment from 6 months to 2 years was lower than level of anxiety of parents of children treated shorter than 6 months (B = -1.21; 95% CI = (-2.16; -0.25)). The lowest level of caution was reported by parents of children aged 10 year or less (B = -0.86; 95% CI = (-1.67; -0.05)), while the highest was reported by parents of children aged 11 years (B = 0.86; 95% CI = (0.20; 1.53)) in comparison to parents of children aged 12 years or more. Parents' caution increased along with increase of their anxiety (B = 0.61; 95% CI = (0.40; 0.83)). Higher level of limitations was imposed by parents of children treated with rush or ultra rush method, in comparison to parents of children treated with conventional method (B = 1.27; 95% CI = (0.21; 2.33)). Levels of quality of life in children and their parents were strongly dependent in the same dimensions.
1. Levels of quality of life in particular dimension in children is related to level of the same dimension in parents. 2. Age of children influenced level of caution of their parents. 3. Treatment duration influenced level of anxiety of parents. 4. Safety feeling acquired by parents at the beginning of treatment improves their quality of life in all dimensions.
Przegla̧d lekarski 01/2010; 67(12):1243-8.
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Ewa Cichocka-Jarosz,
Piotr Brzyski,
Grzegorz Lis,
Urszula Jedynak-Wasowicz,
Jacek Józef Pietrzyk,
Joanna Lange,
Teresa Małaczyńska,
Barbara Kraluk,
Ewa Swiebocka, Anna Breborowicz,
Zdzisława Kycler,
Jolanta Pietraszek-Mamcarz,
Adam Poszwiński,
Grzegorz Gaszczyk
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ABSTRACT: Insect venom allergy requires a high level approach adequate to allergy intensity. In case of severe IgE-mediated sting reactions, in children older than five years, venom immunotherapy is a treatment of choice.
Identification of current practices applied to venom allergic children in Poland and their adherence to the international guidelines.
Questionnaire survey concerning diagnostic and treatment rules was carried out in 8 centres of pediatric allergology, based on a similar audit conducted in the United Kingdom [Diwakar L. et al. Clin Exp Allergy 2008, 38: 1651].
In 5 centres both RAST and SPT tests were used as the first line of investigation. Subsequently 6 centres performed IDT. In three centres baseline serum tryptase levels were estimated. In case of sensitization to both bee and wasp venom in a child with the history of severe systemic reaction, but uncertain culprit insect, specific venom immunotherapy with both venoms was practised by 2 centres. In systemic reaction and not-detectable IgE in 6 centres child was followed-up in 6-12 months. Antihistamine premedication concerned all children in 7 centres. Six-week interval between booster doses was applied in half of centres. A target dose equal 100 mcg was used in 7 centres. Similarly all centres practiced 3-5 five year period of VIT.
In Poland current practice with venom allergic children was conducted in congruence with most of the recommendations.
Przegla̧d lekarski 01/2010; 67(1):1-5.
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ABSTRACT: Increased serum leptin levels have been observed in asthmatic patients. Leptin, via proliferation and activation of Th2 cells, may induce inflammation in asthma. It has also been demonstrated that leptin mRNA expression and protein levels increase in response to inflammatory stimuli. We hypothesized that polymorphisms in the leptin receptor, leptin and ghrelin genes, may affect their expression and, therefore, be responsible for altered response to increased leptin levels observed in asthma. To our knowledge, there were no studies on a potential role of LEPR, LEP, and GHRL polymorphisms in asthma.
We analyzed 129 pediatric patients with asthma and 114 healthy children from the control group ranging from 6 to 18 years of age. The diagnosis of allergic asthma was based on clinical symptoms, the lung function test, and the positive skin prick test and/or increased immunoglobulin E (IgE) levels. Polymorphisms were genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Statistical analyses were performed with Statistica v.7.1 software (Statistica, StatSoft, Poland; available free at http://www.broad.mit.edu/mpg/haploview/index.php). Linkage disequilibrium analysis was performed with Haploview v.4.0.
We observed a statistically significant association of the 3'UTR A/G and the -2549A/G polymorphisms of the leptin gene with asthma. No association with asthma was observed for the K109R and the Q223R polymorphisms of the LEPR gene and the Met72Leu polymorphism of the ghrelin gene. In the analysis of body mass index (BMI) stratified by genotype, we found an association of the -2549A/G LEP, but not of LEPR and GHRL polymorphisms, with higher BMI values in asthmatic patients. We found suggestive evidence for linkage between the two polymorphisms of the LEPR gene (D' = 0.84 CI: 0.71-0.92; r(2) = 0.29) in linkage disequilibrium analysis: The GG haplotype was more frequent in the control healthy group (p = 0.057). No linkage disequilibrium was detected between LEP polymorphisms.
Polymorphisms of the leptin gene may be associated with asthma and higher BMI in asthmatic patients. Polymorphisms of the LEPR and GHRL seem unlikely to be associated with asthma or BMI in our sample. The results of haplotype analysis for the LEPR gene may suggest a protective role of the GG haplotype against asthma; however, studies on larger groups are necessary to confirm the observed trend towards association.
Journal of Asthma 03/2009; 46(1):53-8. · 1.52 Impact Factor
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ABSTRACT: The aim of this study was to analyze the possible association of A/T polymorphism of the CHRM2 gene with asthma, and pharmacogenetic analysis of the polymorphism with bronchodilator response to ipratropium bromide, an anticholinergic drug used in asthma.
Analysis was performed in a group of 113 children diagnosed with bronchial asthma, and in a group of 123 healthy children from a control group. Moreover, in the group of 32 asthmatic children without concurrent treatment with long-acting beta2-agonists, bronchodilator response to ipratropium bromide was evaluated by the spirometric lung function test. Genetic analysis was performed for A/T polymorphism (rs6962027) of the CHRM2 gene. Genotyping was done with the PCR-RFLP method. Statistical analysis was performed using Statistica v.7.1 software.
No association of A/T polymorphism was found with asthma (p=0.865 for genotypes and p=0.782 for alleles). In the pharmacogenetic analysis, it was observed that patients carrying TT genotype of CHRM2 gene polymorphism demonstrated significantly poorer response to anticholinergic drug as compared to the patients with other genotypes for this polymorphism (p=0.035).
We found that TT genotype in the CHRM2 gene was associated with poor bronchodilator response in asthmatic patients. The results should be analyzed carefully considering the small sample size and should be confirmed by other research groups.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2009; 77(1):5-10.
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Anna Breborowicz
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ABSTRACT: Lower respiratory tract infections are serious health problem in pediatric population. The prevalence of infections is the highest in the youngest group and typical bacteria is the most common cause of diseases in this group. The role of atypical pathogens is on the rise in older patients. The choice of therapy depends on ethiology The article is focused on the role of azithromycin showing the benefits of such therapy.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 12/2008; 25(149):420-2.
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ABSTRACT: Asthma is a disease with a complex pathogenesis. Obesity seems to be crucial risk factor for the development and worse clinical outcome of the disease. The aim of the study was to assess the relation between the body weight and the severity of asthma and preliminary analysis of factors influencing nutritional status among asthmatic children.
Complete data have been available for 101 children with mild persistent, moderate persistent and severe persistent asthma. The questionnaires have been completed according to the physical and spirometric examination, analysis of medical documentation and anamnesis. Weight and height were measured in all children. To estimate the body mass index (BMI) values we used Body Mass Index Percentile Charts for Age. The control group consisted of 45 healthy school children.
Mean BMI percentile for age in asthmatic children did not significantly differ from healthy children (53.4 +/- 32.3 and 59.5 +/- 30.5 respectively). Higher BMI percentiles for the age were observed among boys in comparison to girls (p =0.018). We did not find statistically significant relation between values of BMI percentiles and severity of asthma, although higher BMI values in boys with severe persistent asthma were noticed. Body mass index percentiles did not correlate with time of treatment and the doses of inhaled corticosteroids. Food allergy and atopic dermatitis in the past influenced BMI values.
Mean BMI percentile for age in asthmatic children did not significantly differ from healthy children. The correlation between BMI values and severity of asthma and treatment with inhaled corticosteroids were not found.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2008; 76(2):88-95.
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ABSTRACT: FYN is nonreceptor tyrosine kinase that represents the earliest detectable signaling response after antigen-activated inflammatory cells. Studies in animal models of allergic asthma have shown that inhibitors of tyrosine kinases exert an anti-inflammatory effect. In the FYN gene, several polymorphisms have been described. There have, however, been no studies analyzing the impact of FYN gene polymorphisms on the course and severity of asthma. The aim of this study was to analyze the possible relationship between three polymorphisms (-93A/G, Intron10+37C/T and Ex12+894T/G) in the FYN gene and asthma.
We analyzed 120 pediatric asthmatic patients aged from 6 to 18 years. The diagnosis of allergic asthma was based on clinical manifestation, lung function test and positive skin prick tests and/or an increased IgE level. The control group consisted of 187 healthy subjects. The polymorphisms were genotyped with use of the PCR-RFLP method.
We observed an association of the -93A/G polymorphism and the presence of asthma (p = 0.014 for genotypes and p = 0.019 for alleles) and in the subgroup of 55 patients with severe asthma (p = 0.042 for genotypes and p = 0.021 for alleles). We also found an association of the Ex12+894T/G polymorphism in the whole group analyzed (p = 0.067 for genotypes and p = 0.024 for alleles), but not in the subgroup with severe asthma. For the Intron10+37T/C polymorphism, we did not find a significant difference between the whole group of asthmatic patients and the control group nor between the subgroup with severe asthma and the control group. In the linkage disequilibrium analysis, we observed a modest linkage between -93A/G and Intron10+37T/C polymorphisms (lod = 18.7, D' = 0.62, 95% CI: 0.51-0.71, r2 = 0.29); however, it was not strong enough to generate any haplotypes.
The results may suggest a relationship between the FYN polymorphisms and allergic asthma.
International Archives of Allergy and Immunology 02/2008; 145(1):43-7. · 2.40 Impact Factor
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ABSTRACT: A number of previous studies have suggested that adrenal suppression occurs in asthmatic children treated with high-doses of inhaled glucocorticoids (IGC). This study was designed to determine the frequency of adrenal suppression in children with severe asthma treated with recommended doses of IGC: namely 500-1,000 microg/day of fluticasone propionate or the equivalent of budesonide (1,000-2,000 microg/day) for a period of at least 12 months.
Early morning cortisol (F) and ACTH serum levels were measured in 27 severe asthmatics aged 6-16 years old. The children underwent a low dose ACTH test (1 microg/1.73 m2) with a parallel glucose measurement. Twenty-four hour urine collection was performed before examination for free F (UfF) and creatinine levels. There were no clinical manifestations of adrenal hypofunction in the analyzed children.
Of the 27 patients, 22 had normal basal and post-stimulatory levels of F and normal UfF, and the other five (18.5%) had basal serum F levels of <400 nmol/l. Four of the five also had normal post-stimulatory levels of F and normal UfF. One child had a subnormal peak F value of 484 nmol/l during the ACTH test. None of the patients had a suppressed serum ACTH level, but an elevated ACTH level was found in four children. This study provided biochemical evidence of suboptimal adrenal function in one child in the examined group (3.7%) and a good response to stimulation in all the others, even in those with slightly reduced basal cortisol levels.
This study showed that the use of fluticasone in doses of up to 1,000 microg/day (or the equivalent of budesonide) as long-term treatment of children with severe asthma did not substantially affect their adrenal function.
Journal of pediatric endocrinology & metabolism: JPEM 07/2007; 20(7):781-9. · 0.88 Impact Factor
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ABSTRACT: Brain-derived neurotrophic factor (BDNF) has been described to modulate airway hyper-responsiveness and inflammation and was involved in late allergic reaction in asthma and higher levels of circulating BDNF were present in allergic asthmatics. In BDNF gene, Val66Met and C-270T polymorphisms were described. There were, however, very few studies analyzing BDNF gene polymorphisms in asthma. The aim of this study was to analyze the possible relationship between these two polymorphisms in the BDNF gene and asthma. Fifty-six pediatric asthmatic patients were analyzed, aged from 6 to 18. The diagnosis of atopic asthma was based on clinical manifestation, lung function test and increased immunoglobulin E level, and/or positive skin prick tests. The control group consisted of 109 healthy subjects. The polymorphisms were genotyped with the use of polymerase chain reaction-restriction fragment length polymorphism method. We did not observe an association of Val/Met polymorphism and the presence of asthma. However, we observed that Val allele is much more frequent in the male group of asthmatic patients (p = 0.06). For -270C/T polymorphism, we found significant differences between asthmatic patients and the control group (p = 0.041 for genotypes and p = 0.005 for alleles). The results may suggest a relationship between the BDNF gene and asthma and male gender of asthmatic children.
Pediatric Allergy and Immunology 07/2007; 18(4):293-7. · 2.46 Impact Factor
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Anna Breborowicz
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ABSTRACT: The choice of diagnostic and therapeutic options in infant with recurrent wheezing remains difficult. Number of episodes, severity of respiratory symptoms and co-morbidities should be analyzed. Viral infections are the risk factors of recurrent wheezing. Atopy predispose to asthma development. Most studies focus on assessment of efficacy of inhaled glucocorticoids, antileukotriens and cromones. Inhaled steroids are considered as the most effective. The initiation of therapy is recommended in children with at least 3-4 episodes or after one, but severe exacerbation. The treatment with inhaled steroids decrease symptoms, but has no influence on natural course of disease.
Przegla̧d lekarski 02/2007; 64 Suppl 3:109-11.
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ABSTRACT: The introduction of inhaled corticosteroids (ICS) has been a milestone in asthma therapy. According to current guidelines ICS are the first line drug in chronic anti-inflammatory therapy. The purpose of first part of this publication is to present updated knowledge on mechanisms of anti-inflammatory action as well as some pharmacokinetics and pharmacodynamics data about commonly used ICS, especially fluticasone propionate (FP) and two others: budesonide (BUD), beclomethasone dipropionate (BDP). Some differences between mentioned drugs have been found concerning systemic activity and safety of therapy. Fluticasone propionate is twice as active as the BUD and BDP. First results of therapy are seen 1-2 week after administration. Fluticasone propionate, more lipophilic than other steroids, has also high glucocorticoid receptor affinity and specificity, high topical anti-inflammatory activity and low systemic bioavailability. Systemic availability of FP depends on absorption from respiratory system. Oral bioavailability can be neglected because of almost total inactivation in liver during first pass. Fluticasone propionate has some features of dissociated steroids which means predominance of transrepression over transactivation--beneficial from safety point of view. Clinical efficacy of FP in chronic asthma therapy in children was confirmed in many studies. It significantly reduces the symptoms and exacerbations of asthma. There is a close correlation between FP use and lung function tests. The therapy with FP decreases bronchial hyperreactivity and the use of systemic steroids and rescue medication. The beneficial action of fluticasone propionate in asthma is due its anti-inflammatory properties within the airways (decreasing levels of direct and indirect markers of airways inflammations are observed).
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 02/2004; 17 Suppl 2:5-10.
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ABSTRACT: Inhaled administration of glucocorticoid doesn't mean lack of systemic effects of drug. Bioavailability of steroid depends on oral absorption and absorption from respiratory system. In case of fluticasone propionate (FP) swallowed dose can be neglected because almost total (>99%) inactivation in liver during first pass. In second part of paper the most important safety parameters of therapy with FP are discussed, it means; influence on hypothalamic-pituitary-adrenal axis, growth and bone metabolism. Interpretation of potential side effects should differentiate between abnormal value of laboratory test and clinically important symptoms. Adrenal suppression depends on dose of FP and was found even after low dose (about 200 microg per day), but clinical value of this findings is unknown. Prolonged administration of high doses can suppress hypothalamic-pituitary-adrenal axis; exceptionally, it can induce adrenal insufficiency. Recommended doses of FP given 1 to 2 years doesn't cause growth retardation. Long term studies on influence of drug on final height are needed. FP as other inhaled corticosteroids, may transiently alter bone metabolism. Till now there are no evidences that this drug, when prescribed appropriately in standard doses for asthma control, may decrease the bone mineral density or induce osteoporosis and may increase the risk of bone fractures in asthmatic children. Effective asthma control achieved with FP therapy permits normal activity and development of asthmatic children which prevails over exceptionally noticed side effects.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 02/2004; 17 Suppl 2:11-8.
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ABSTRACT: The aim of study was to assess the prevalence of symptoms and diagnosis of allergic rhinitis (AR) and allergic rhinitis and conjunctivitis (ARC) in school children in 1994/95 and 2001/02.
Standardized ISAAC questionnaire was used for assessment population of school children 6-7 yrs of age and 13-14 yrs of age in Kraków and Poznań.
The prevalence of AR ever symptoms increased significantly in group 6-7 yrs of age from 28.5% to 33.6% in Kraków and from 13.0% to 31.3% in Poznań. The similar rise was found in group 13-14 yrs of age in Kraków from 26.1% to 41.1%, in Poznań from 19.0% to 39.6%. In both age groups and both centers the number of children with established AR diagnosis increased: in group 6-7 yrs of age in Kraków from 15.3% to 21.1%, in Poznań from 5.0% to 19.5%; in group 13-14 yrs of age in Kraków from 19.7% to 29.9%, in Poznań from 12.0% to 32.6%. Analysis of AR and ARC current symptoms (in the last year) confirmed significant increasing prevalence in both age groups, too.
The prevalence of AR and ARC diagnosis and symptoms increased significantly during last 7 years.
Otolaryngologia polska. The Polish otolaryngology 02/2004; 58(6):1103-9.
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Anna Breborowicz
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ABSTRACT: In this paper general characteristic of the growing process of children is described. Various factors may modify this process including genetic predisposition, environmental factors, diseases, diet, and drugs. Asthmatic children present growth retardation, however without significant influence on final height. Low and moderate doses of inhaled glycocorticosteroids have no significant effects on growth. The results of short, medium and long term studies are discussed.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2003; 14(84):627-30.
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Anna Breborowicz
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ABSTRACT: Specific immunotherapy is the only method of causal therapy of allergic diseases. The general principles of this type of intervention are described, including indications, contraindications, efficacy and safety. Attention is paid to the recommended age range of patients, type of hypersensitivity and clinical manifestations that justify undertaking of such intervention. Specific immunotherapy should be supervised by a specialist.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2003; 14(84):692-4.
