Publications by authors named "Filip Raciborski"

58 Publications

Prevention of SARS-CoV-2 Infection Among Police Officers in Poland-Implications for Public Health Policies.

Int J Environ Res Public Health 2020 12 4;17(23). Epub 2020 Dec 4.

Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland.

Background: This study aimed to characterize sources of knowledge on the means of prevention of SARS-CoV-2 infections as well as to assess the methods of preventing SARS-CoV-2 infection among police employees in Poland and their potential impact on the risk of SARS-CoV-2 infection.

Methods: The study consisted of two phases: questionnaire and laboratory tests for SARS-CoV-2 infection. The questionnaire included 30 questions related to risk factors, knowledge about SARS-CoV-2, and methods of infection prevention.

Results: Data were obtained from 5082 police employees. The most common source of knowledge for a daily update on SARS-CoV-2 infection prevention was the Internet (42.6%), television (40.3%), and radio (39.7%). The most commonly used methods of SARS-CoV-2 infection included washing one's hands for at least 20 seconds (95.8%), wearing facemasks (82.9%), and physical distancing (74.9%). Results of IgG tests were lower in police units where the overall compliance with the preventive measures was higher ( < 0.01). Women were more likely to exercise SARS-CoV-2 infection prevention behaviors compared to men. Compliance with the recommended protective measures increased with age.

Conclusions: Lower anti-SARS-CoV-2 IgG seropositivity rates were observed in police units with better overall compliance with the preventive measures, suggesting the key importance of group rather than individual behaviors.
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http://dx.doi.org/10.3390/ijerph17239072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731213PMC
December 2020

Sensitisation to airborne allergens as a risk factor for allergic rhinitis and asthma in the Polish population.

Postepy Dermatol Alergol 2020 Oct 9;37(5):751-759. Epub 2019 Apr 9.

Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

Introduction: The patterns of sensitisation to airborne allergens and their association with allergic diseases have been analysed in different geographical regions.

Aim: To analyse the impact of sensitisation to airborne allergens on allergic rhinitis (AR) and asthma in different age groups of the Polish population.

Material And Methods: Completed questionnaires of 18,617 subjects (53.8% females), collected within the ECAP, a cross-sectional multicentre study, were analysed. Three groups of respondents were included: 6-7-year-olds (24.2%), 13-14-year-olds (25.4%), 20-44-year-olds (50.4%). The clinical part (an anamnesis, physical examination, spirometry, skin prick tests and an assay of major airborne allergen-specific IgE) was attended by 25.7% of the respondents.

Results: The AR was most strongly related to sensitisation to , with the highest odds ratios of 10 in two younger groups and of 16 for persistent AR in children. It was also the most important risk factor for allergic asthma, with odd ratios from 8.34 in children to 6.40 in adolescents. Sensitisation to grass pollen allergens was a major risk factor for both AR, with odds ratios from 9.16 in adults to 7.87 in adolescents, and asthma, with odds ratios from 6.16 in adolescents to 5.67 in adults.

Conclusions: AR and asthma shared common risk factors, independently of age. Sensitisation to airborne allergens was significantly associated with asthma and, even more strongly, with AR, across all age groups. The AR was the strongest risk factor for allergic asthma in the youngest group. Persistent AR increased asthma risk more than intermittent AR in all age groups.
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http://dx.doi.org/10.5114/ada.2019.84231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675083PMC
October 2020

The influence of socio-demographic characteristics on attitudes towards prophylactic vaccination in Poland.

Int J Occup Med Environ Health 2021 Jan 23;34(1):121-132. Epub 2020 Nov 23.

Medical University of Warsaw, Warsaw, Poland (Department of Prevention of Environmental Hazards and Allergology).

Objectives: A legally regulated program of mandatory vaccinations is in place in Poland. The number of vaccination refusals increased from 3437 to 48 609 in 2010-2019. The aim of the study was to determine the association of various socio-demographic factors with the attitudes of the residents of Poland to prophylactic vaccination.

Material And Methods: The study was based on a secondary statistical analysis of a representative sample of 977 adult residents of Poland (a cross-sectional questionnaire-based study). Data was purchased from the Public Opinion Research Center.

Results: The study group was characterized by a high level of acceptance of vaccinations. At the same time, nearly a third (31%) of the subjects agreed with the statement that vaccination is promoted mainly because this is in the interests of pharmaceutical companies, and more than a fifth (22%) of the respondents believed that vaccines for children can cause serious developmental disorders, including autism. A detailed multivariate analysis based on logistic regression revealed that being deeply religious (compared to being a non-believer) and living in a town with a population of 20 000-499 999 (compared to living in a rural area) were strongly associated with a very high acceptance of the anti-vaccination content. The opposite attitude was associated with having an average or good financial situation (compared to a poor financial situation), having completed vocational education (compared to primary education) and being ≥65 years old (as opposed to being <30 years old).

Conclusions: Most socio-economic factors analyzed did not influence the respondents' attitudes to prophylactic vaccination or showed little influence. Strong anti-vaccination beliefs were associated with being deeply religious and living in a town with a medium-size or small population. Int J Occup Med Environ Health. 2021;34(1):121-32.
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http://dx.doi.org/10.13075/ijomeh.1896.01671DOI Listing
January 2021

Trends in psoriatic arthritis epidemiology in Poland.

Rheumatol Int 2021 Jan 28;41(1):139-145. Epub 2020 Oct 28.

Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Warsaw, Poland.

Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis, usually seronegative and associated with psoriasis (Ps). The prevalence and incidence of psoriatic arthritis show strong ethnic and geographic variations. The aim of the study was to assess the epidemiological trends in psoriatic arthritis in Poland. The National Health Fund (NHF) database for the period 2008-2018 was analyzed. PsA was defined as ICD-10 codes L40.5, M07, M07.0, M07.1, M07.2 and M07.3, while psoriasis as ICD-10 codes L40 and L40.X (L40.0 to L40.9). A steady increase in the number of PsA patients (from 16,790 to 32,644) and in PsA recorded prevalence (from 38.47 per 100,000 in 2008 to 73.11 per 100,000 in 2018) was observed between 2008 and 2018. The PsA/Ps ratio increased to a similar extent (from 8.3 to 17.5%). The percentage of PsA patients receiving rehabilitation services remained constant throughout the observation period (mean: 17.35%; range 16.7-18.9%). The study showed a steady and continuous increase in PsA recorded prevalence. A simultaneous increase in the PsA/Ps ratio suggests that the main reason for the observed trend is greater disease detection .
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http://dx.doi.org/10.1007/s00296-020-04734-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806568PMC
January 2021

Prevalence of Current and Past SARS-CoV-2 Infections among Police Employees in Poland, June-July 2020.

J Clin Med 2020 Oct 11;9(10). Epub 2020 Oct 11.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland.

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine the prevalence of current and past SARS-CoV-2 infections among police employees.

Methods: This cross-sectional survey was undertaken among 5082 police employees from Mazowieckie Province, Poland. RT-PCR testing for current SARS-CoV-2 infection and serological tests (ELISA) for the presence of anti-SARS-CoV-2 IgM+IgA and IgG antibodies were performed.

Results: All RT-PCR tests were negative. The anti-SARS-CoV-2 IgM+IgA index was positive (>8) in 8.9% of participants, including 11.2% women and 7.7% men ( < 0.001). Equivocal IgM+IgA index (6-8) was found in 9.8% of participants, including 11.9% women and 8.7% men ( < 0.001). The IgG index was positive (>6) in 4.3% and equivocal (4-6) in 13.2% of participants. A higher odds of positive IgM+IgA index was found in women vs. men (OR: 1.742) and police officers vs. civilian employees (OR: 1.411). Participants aged ≥60 years had a higher odds of positive IgG index vs. those aged 20-29 years (OR: 3.309). Daily vaping also increased the odds of positive IgG index (OR: 2.058).

Conclusions: The majority of Polish police employees are seronegative for SARS-CoV-2 infection. Vaping and older age (≥60 years) were associated with a higher risk of SARS-CoV-2 infection.
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http://dx.doi.org/10.3390/jcm9103245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600317PMC
October 2020

Importance of food allergy and food intolerance in allergic multimorbidity.

Ann Agric Environ Med 2020 Sep 9;27(3):413-417. Epub 2020 Jun 9.

Department of Prevention of Environmental Hazards and Allergology, Medical University, Warsaw, Poland.

Introduction: Allergy affects approximately one-third of the world's population, and the rates are growing. In Europe, it has been noticed that the risk of asthma and allergy is lower in the rural as opposed to urban population. There is a tendency for several allergic diseases to be present in the same person at the same time.

Objective: The aim of the study was to verify the co-occurrence of allergic multimorbidity and food allergy and intolerance in a group of children.

Material And Methods: The multicentre cross-sectional study enrolled 1,008 children and adolescence aged 6-18 years (51.2% boys, 48.8% girls). The study comprised a questionnaire (respondents' declarations) and an outpatient examination (diagnostic examination followed by a medical diagnosis). The study was conducted as part of the 2016-2020 National Health Programme.

Results: In the study group, allergic rhinitis (AR) was present in 46.4%, bronchial asthma (BA) in 11.2% and atopic dermatitis (AD) in 6%. Allergic multimorbidity (simultaneous presence of 2 or more of the allergic diseases AR, BA and AD) was diagnosed in 9.7%. A single allergic disease (of the 3) was diagnosed in 43.4%. A diagnosis of food allergy and food intolerance was reported respectively at 29.6% and 14.3% participants with doctor-diagnosed allergic multimorbidity. Among those without any of the 3 allergic diseases, the percentage were 14.4% and 9.1%, respectively.

Conclusions: Food allergy or food intolerance was more common in subjects with allergic multimorbidity than in subjects diagnosed with one allergic disease or those free of allergic diseases.
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http://dx.doi.org/10.26444/aaem/123107DOI Listing
September 2020

Dynamics of the coronavirus disease 2019 outbreak in Poland: an epidemiological analysis of the first 2 months of the epidemic.

Pol Arch Intern Med 2020 08 10;130(7-8):615-621. Epub 2020 Jun 10.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland

Introduction: Coronavirus disease 2019 (COVID‑19) is an infectious disease caused by the novel severe acute respiratory syndrome coronavirus 2.

Objectives: Our aim was to present an epidemiological analysis of the first 2 months (March and April 2020) of the COVID‑19 epidemic in Poland.

Patients And Methods: This analysis was based on data from epidemiological reports collected between March 4 and April 30, 2020, by the Chief Sanitary Inspectorate. These epidemiological reports include data on sociodemographic characteristics of new laboratory‑confirmed COVID 19 cases, the number of COVID‑19-related deaths, the number of recovered COVID-19 patients as well as the number of laboratory tests performed.

Results: From March 4 to April 30, 2020, a total of 12 877 laboratory‑confirmed COVID 19 cases were registered in Poland (55.7% women; mean [SD] age, 50.6 [20.5] years). The RT‑ PCR test was performed in 338 000 patients. The notification rate for COVID‑19 was 33.2 per 100 000 inhabitants. One third of laboratory‑confirmed COVID 19 cases were among quarantined persons, 26.1% were related to the healthcare system (hospital or clinic), and 13.3% occurred in nursing homes. As of April 30, 2020, 644 COVID‑19-related deaths were registered in Poland (46.5% women). The death rate for the whole country was 1.7 per 100 000 inhabitants.

Conclusions: Our data showed higher notification rate for COVID‑19 among women than men, but men were more likely to die from COVID‑19. The notification rate for COVID-19 in Poland among women aged 45 to 54 years was 2‑fold higher than among men.
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http://dx.doi.org/10.20452/pamw.15430DOI Listing
August 2020

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice.

Authors:
Jean Bousquet Josep M Anto Claus Bachert Tari Haahtela Torsten Zuberbier Wienczyslawa Czarlewski Anna Bedbrook Sinthia Bosnic-Anticevich G Walter Canonica Victoria Cardona Elisio Costa Alvaro A Cruz Marina Erhola Wytske J Fokkens Joao A Fonseca Maddalena Illario Juan-Carlos Ivancevich Marek Jutel Ludger Klimek Piotr Kuna Violeta Kvedariene Ltt Le Désirée E Larenas-Linnemann Daniel Laune Olga M Lourenço Erik Melén Joaquim Mullol Marek Niedoszytko Mikaëla Odemyr Yoshitaka Okamoto Nikos G Papadopoulos Vincenzo Patella Oliver Pfaar Nhân Pham-Thi Christine Rolland Boleslaw Samolinski Aziz Sheikh Mikhail Sofiev Charlotte Suppli Ulrik Ana Todo-Bom Peter-Valentin Tomazic Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Maria-Teresa Ventura Samantha Walker Sian Williams Arzu Yorgancioglu Ioana Agache Cezmi A Akdis Rute Almeida Ignacio J Ansotegui Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagaña Eric D Bateman Annabelle Bédard Martin Bedolla-Barajas Sven Becker Kazi S Bennoor Samuel Benveniste Karl C Bergmann Michael Bewick Slawomir Bialek Nils E Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Matteo Bonini Philippe Bonniaud Isabelle Bosse Jacques Bouchard Louis-Philippe Boulet Rodolphe Bourret Koen Boussery Fluvio Braido Vitalis Briedis Andrew Briggs Christopher E Brightling Jan Brozek Guy Brusselle Luisa Brussino Roland Buhl Roland Buonaiuto Moises A Calderon Paulo Camargos Thierry Camuzat Luis Caraballo Ana-Maria Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Niels H Chavannes Ekaterine Chkhartishvili Derek K Chu Cemal Cingi Jaime Correia de Sousa David J Costa Anne-Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejan Dokic Yves Dauvilliers Giulia De Feo Govert De Vries Philippe Devillier Stefania Di Capua Gerard Dray Ruta Dubakiene Stephen R Durham Mark Dykewicz Motohiro Ebisawa Mina Gaga Yehia El-Gamal Enrico Heffler Regina Emuzyte John Farrell Jean-Luc Fauquert Alessandro Fiocchi Antje Fink-Wagner Jean-François Fontaine José M Fuentes Perez Bilun Gemicioğlu Amiran Gamkrelidze Judith Garcia-Aymerich Philippe Gevaert René Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam Yunuen R Huerta Villalobos Marc Humbert Guido Iaccarino Despo Ierodiakonou Tomohisa Iinuma Ewa Jassem Guy Joos Ki-Suck Jung Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Musa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Rostislav Kouznetsov Marek L Kowalski Vicky Kritikos Inger Kull Stefania La Grutta Lisa Leonardini Henrik Ljungberg Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Catarina Lopes-Pereira Claudia C Loureiro Renaud Louis Alpana Mair Bassam Mahboub Michaël Makris Joao Malva Patrick Manning Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Pedro Carreiro-Martins Mika Makela Eve Mathieu-Dupas Marcus Maurer Esteban De Manuel Keenoy Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Yann Micheli Neven Miculinic Florin Mihaltan Branislava Milenkovic Dimitirios I Mitsias Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralph Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leyla Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Björn Nordlund Ettore Novellino Dieudonné Nyembue Robyn O'Hehir Ken Ohta Kimi Okubo Gabrielle L Onorato Valentina Orlando Solange Ouedraogo Julia Palamarchuk Isabella Pali-Schöll Peter Panzner Hae-Sim Park Gianni Passalacqua Jean-Louis Pépin Ema Paulino Ruby Pawankar Jim Phillips Robert Picard Hilary Pinnock Davor Plavec Todor A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Fotis Psarros Benoit Pugin Francesca Puggioni Pablo Quinones-Delgado Filip Raciborski Rojin Rajabian-Söderlund Frederico S Regateiro Sietze Reitsma Daniela Rivero-Yeverino Graham Roberts Nicolas Roche Erendira Rodriguez-Zagal Christine Rolland Regina E Roller-Wirnsberger Nelson Rosario Antonino Romano Menachem Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Joaquin Sastre Glenis K Scadding Sophie Scheire Peter Schmid-Grendelmeier Holger J Schünemann Faradiba Sarquis Serpa Mohamed Shamji Juan-Carlos Sisul Mikhail Sofiev Dirceu Solé David Somekh Talant Sooronbaev Milan Sova François Spertini Otto Spranger Cristiana Stellato Rafael Stelmach Michel Thibaudon Teresa To Mondher Toumi Omar Usmani Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Marilyn Urrutia Pereira Rianne van der Kleij Michiel Van Eerd Olivier Vandenplas Tuula Vasankari Antonio Vaz Carneiro Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Yun Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Osman M Yusuf Heather J Zar Stéphane Zeng Mario E Zernotti Luo Zhang Nan Shan Zhong Mihaela Zidarn

Allergy 2021 01 23;76(1):168-190. Epub 2020 Oct 23.

University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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http://dx.doi.org/10.1111/all.14422DOI Listing
January 2021

Epidemiological Analysis of the First 1389 Cases of COVID-19 in Poland: A Preliminary Report.

Med Sci Monit 2020 May 7;26:e924702. Epub 2020 May 7.

School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland.

BACKGROUND The World Health Organization has declared COVID-19 a global pandemic. This paper presents an epidemiological analysis of the first phase of the COVID-19 epidemic in Poland. MATERIAL AND METHODS This cross-sectional study was carried out between 3 and 27 March 2020 on a sample of 1389 laboratory-confirmed COVID-19 cases in Poland. Data were obtained from epidemiological reports collected by the Chief Sanitary Inspectorate. Analysis includes the number of COVID-19 cases, number of deaths, number of hospitalizations, number of people quarantined, and number of laboratory tests performed. RESULTS The first case was confirmed on 4 March 2020. Over 24 days after the first case, the total number of confirmed infections rose to 1389 (34,000 laboratory tests were performed). The highest incidence rates (over 5 per 100,000) were observed in the 2 central administrative regions (Mazowieckie and Łódzkie) and in the south-western region of Dolnośląskie, which borders the Czech Republic and Germany. Based on available data about age and sex, a clearly higher incidence was observed in the 20-29 years (4.0 per 100,000), 40-49 years (4.1 per 100,000), and 50-59 years (4.3 per 100,000) age groups. In the period analyzed (24 days), there were 16 confirmed deaths (average age 65.5 years; 81.2% males). CONCLUSIONS The proportion of women and men with confirmed COVID-19 infection was similar to the sex ratio in the general population. Infections were relatively less common in those aged under 20 years. The largest numbers of confirmed cases were detected in 3 of the 4 largest cities, each of which has an international airport.
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http://dx.doi.org/10.12659/MSM.924702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233008PMC
May 2020

Public Health Interventions to Mitigate Early Spread of SARS-CoV-2 in Poland.

Med Sci Monit 2020 Apr 13;26:e924730. Epub 2020 Apr 13.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

This study aimed (1) to present public health interventions to mitigate the early spread of SARS-CoV-2 implemented in Poland between January 9 and March 29, 2020, and (2) to analyze the potential impact of these regulations on the early phase of the COVID-19 outbreak in Poland. All legal regulations published in the Journal of Laws between January 9 and March 29, 2020, were analyzed. Out of 406 legal regulations identified, 56 were related to the COVID-19 outbreak. Moreover, the official announcements published on the governmental websites dedicated to the coronavirus and health issues were analyzed. On March 4, Poland reported the first laboratory-confirmed COVID-19 case. On March 9, Poland introduced border sanitary control. Six days after the first laboratory-confirmed COVID-19 case, all mass events in Poland were banned. All schools and universities were closed 8 days after the first COVID-19 case. All gastronomic facilities and sport and entertainment services were limited starting on March 14. Eleven days after the first COVID-19 case, controls at all Polish borders were introduced, and a ban on entry into Poland by foreigners (with some exemptions) was implemented. Starting on March 15, all citizens returning from abroad had to undergo compulsory 14 days self-quarantine. On March 20, a state of epidemic was announced, which resulted in new social distancing measures starting on March 25. In Poland, compared to other European countries, far-reaching solutions were implemented relatively early to reduce the spread of infection.
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http://dx.doi.org/10.12659/MSM.924730DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174894PMC
April 2020

Epidemiology and direct costs of atopic dermatitis in Poland based on the National Health Fund register (2008-2017).

Postepy Dermatol Alergol 2019 Dec 19;36(6):727-733. Epub 2018 Oct 19.

Faculty of Health Sciences, Medical University of Lodz, Lodz, Poland.

Introduction: Epidemiological data indicate significant differences in atopic dermatitis (AD) prevalence between countries.

Aim: The purpose of this study is to (i) analyse the recorded prevalence of atopic dermatitis (diagnoses of AD reported to the Polish National Health Fund (NHF)) and to (ii) estimate direct costs of medical care for AD incurred by the NHF.

Material And Methods: The analysis was based on data reported to the database of the public payer (NHF). The prevalence rates were calculated using the NHF data and population estimates were obtained from the Central Statistical Office of Poland (GUS).

Results: In 2017, the annual prevalence rate of AD in the Polish population was 32.5 per 10,000 inhabitants (34.7/10,000 for women and 30.1/10,000 for men). The highest prevalence was observed in the youngest age groups (300/10,000 in children up to 4 years of age and 141/10,000 in 5-9-year-olds). The prevalence rate decreased with age and AD was the least prevalent in patients over 85 years of age (4/10,000). In 2008-2017, NHF expenditure on AD treatment varied between PLN 19.9 million (EUR 5.6 million) in 2008 and PLN 28.4 million (EUR 6.5 million) in 2016.

Conclusions: The prevalence rates of AD in Poland estimated on the basis of NHF data are significantly lower than those reported in previous epidemiological studies conducted in Poland and worldwide. This may indicate that the prevalence of AD in the Polish population is underestimated or that there are no adequate disease control measures in patients with a confirmed diagnosis.
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http://dx.doi.org/10.5114/ada.2018.79099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986289PMC
December 2019

Dietary supplements: a great menace of our time or golden remedy? A cross-sectional study amongschool-aged children.

Postepy Dermatol Alergol 2019 Dec 30;36(6):681-686. Epub 2019 Dec 30.

Department of Paediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.

Introduction: Dietary supplements (DS) are commonly used as a remedy for various health issues as they are widely advertised and available.

Aim: This study aimed to evaluate the prevalence of DS use among school-aged children in Warsaw, the capital city of Poland. Additionally, we evaluated the parents' motivations for DS administration, the frequency of the use of specific compounds and the influence of child's history of allergy on DS use.

Material And Methods: Children aged 6-7 years who attended the first grade of primary schools in Warsaw were included into the study. Forty-two out of 170 primary schools in Warsaw were randomly selected of which 38 agreed to participate. The research tool was a self-administered questionnaire.

Results: Half of the studied children received DS in the previous 6 months. Fatty acids were the most commonly administered DS (49.8%). The most common reason for administering DS was prevention of diseases (69.1%). The total household income correlated positively with the DS use. History of food allergy was one of the factors which increased the risk of DS use, whereas diagnosis of asthma did not correlate with a higher frequency of DS use.

Conclusions: This study shows the need to educate patients about medical indications for DS use and expected benefits in the specific indications.
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http://dx.doi.org/10.5114/ada.2019.91418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986285PMC
December 2019

Prevalence of axial spondyloarthritis in Poland.

Rheumatol Int 2020 Feb 4;40(2):323-330. Epub 2019 Dec 4.

Satellite Campus in Warsaw, University of Humanities and Economics in Lodz, Łódź, Poland.

The prevalence of axial spondyloarthritis (axSpA) in the published data varies significantly. Two types of axSpA can be distinguished depending upon the presence of abnormalities consistent with sacroiliitis on plain radiography: ankylosing spondylitis (AS) and nonradiographic axial SpA (nr-axSpA). The aim of this study is to perform a retrospective analysis of axSpA prevalence in Poland in the years 2008-2017. The National Health Fund (NHF) database for the period 2008-2017 was analysed. Data of all patients with the ICD-10 codes M46 (M46.1, M46.8, M46.9) or M45 (further named other inflammatory spondylopathies-OIS and AS, respectively) as the main or co-existing diagnosis were extracted and analysed. The AS prevalence was stable during the period under examination amounting to approximately 0.083%, while the OIS prevalence increased from 0.036 to 0.059%. For both men and women, the AS prevalence increased with age, reaching a maximum around the age of 70; however, in men, a marked increase in prevalence was observed earlier as compared to women (20-24 vs. 40-44 years, respectively). The OIS prevalence also increased with age; however, the maximum was reached earlier as in case of AS. Moreover, a sharp increase in OIS prevalence occurred earlier than in AS (15-19 years) with no difference between sexes. In Poland, approximately 0.1% of the population suffers from AS-the prevalence remained stable over the last decade. The prevalence of OIS increased markedly over the studied period which presumably reflects an increasing prevalence of nr-axSpA as the effect of the introduction of ASAS classification criteria for axSpA.
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http://dx.doi.org/10.1007/s00296-019-04482-7DOI Listing
February 2020

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases.

Authors:
J Jean Bousquet Holger J Schünemann Alkis Togias Marina Erhola Peter W Hellings Torsten Zuberbier Ioana Agache Ignacio J Ansotegui Josep M Anto Claus Bachert Sven Becker Martin Bedolla-Barajas Michael Bewick Sinthia Bosnic-Anticevich Isabelle Bosse Louis P Boulet Jean Marc Bourrez Guy Brusselle Niels Chavannes Elisio Costa Alvaro A Cruz Wienczyslawa Czarlewski Wytske J Fokkens Joao A Fonseca Mina Gaga Tari Haahtela Maddalena Illario Ludger Klimek Piotr Kuna Violeta Kvedariene L T T Le Desiree Larenas-Linnemann Daniel Laune Olga M Lourenço Enrica Menditto Joaquin Mullol Yashitaka Okamoto Nikos Papadopoulos Nhân Pham-Thi Robert Picard Hilary Pinnock Nicolas Roche Regina E Roller-Wirnsberger Christine Rolland Boleslaw Samolinski Aziz Sheikh Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Tuula Vasankari Maria-Teresa Ventura Samantha Walker Sian Williams Cezmi A Akdis Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagana Eric Bateman Anna Bedbrook K S Bennoor Samuel Benveniste Karl C Bergmann Slawomir Bialek Nils Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Mateo Bonini Philippe Bonniaud Jacques Bouchard Vitalis Briedis Christofer E Brightling Jan Brozek Roland Buhl Roland Buonaiuto Giorgo W Canonica Victoria Cardona Ana M Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Eka Chkhartishvili Derek K Chu Cemal Cingi Elaine Colgan Jaime Correia de Sousa Anne Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejand Dokic Yves Dauvilliers Antoni Dedeu Giulia De Feo Philippe Devillier Stefania Di Capua Marc Dykewickz Ruta Dubakiene Motohiro Ebisawa Yaya El-Gamal Esben Eller Regina Emuzyte John Farrell Antjie Fink-Wagner Alessandro Fiocchi Jean F Fontaine Bilun Gemicioğlu Peter Schmid-Grendelmeir Amiran Gamkrelidze Judith Garcia-Aymerich Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam John O'B Hourihane Marc Humbert Guido Iaccarino Despo Ierodiakonou Maddalena Illario Juan C Ivancevich Guy Joos Ki-Suck Jung Marek Jutel Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Mussa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Marek L Kowalski Vicky Kritikos Inger Kull Lisa Leonardini Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Claudia C Loureiro Renaud Louis Alpana Mair Gert Marien Bassam Mahboub Joao Malva Patrick Manning Esteban De Manuel Keenoy Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Eve Mathieu-Dupas Poalo M Matricardi Eric Melén Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Neven Miculinic Florin Mihaltan Branislava Milenkovic Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralf Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leila Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Enrico Novellino Dieudonné Nyembue Robin O'Hehir Ken Ohta Kimi Okubo Gabrielle Onorato Solange Ouedraogo Isabella Pali-Schöll Susanna Palkonen Peter Panzner Hae-Sim Park Jean-Louis Pépin Ana-Maria Pereira Oliver Pfaar Ema Paulino Jim Phillips Robert Picard Davor Plavec Ted A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Benoit Pugin Filip Raciborski Rojin Rajabian-Söderlund Sietze Reitsma Xavier Rodo Antonino Romano Nelson Rosario Menahenm Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Juan-Carlos Sisul Dirceu Solé David Somekh Talant Sooronbaev Milan Sova Otto Spranger Cristina Stellato Rafael Stelmach Charlotte Suppli Ulrik Michel Thibaudon Teresa To Ana Todo-Bom Peter V Tomazic Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Rianne van der Kleij Olivier Vandenplas Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Y Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Arzu Yorgancioglu Osman M Yusuf Heahter J Zar Stéphane Zeng Mario Zernotti Luo Zhang Nan S Zhong Mihaela Zidarn

Clin Transl Allergy 2019 9;9:44. Epub 2019 Sep 9.

260University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.

Main Body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.

Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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http://dx.doi.org/10.1186/s13601-019-0279-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734297PMC
September 2019

The indirect costs of allergic diseases.

Int J Occup Med Environ Health 2019 Jun 30;32(3):281-290. Epub 2019 May 30.

Medical University of Warsaw, Warsaw, Poland (Department of the Prevention of Environmental Hazards and Allergology).

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.
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http://dx.doi.org/10.13075/ijomeh.1896.01275DOI Listing
June 2019

Comorbidity burden and clinical characteristics of patients with difficult-to-control rheumatoid arthritis.

Clin Rheumatol 2019 Sep 10;38(9):2473-2481. Epub 2019 May 10.

Rheumatology and Autoimmune Diseases Department, Silesian Rheumatology Center, Ustron, Poland.

Introduction: Difficult-to-treat rheumatoid arthritis (RA) is a significant clinical problem despite no clear definition. We aimed to provide clinical characteristics and associated comorbidities of RA patients in relation to disease control.

Methods: RA characteristics and physician-recorded comorbidities were analyzed in a sample of 1937 RA patients. Patients treated for RA for 5.2 y (IQR, 2.1-11.3) were classified as difficult-to-control when presenting with DAS28-ESR > 3.2 despite previous use of at least 2 csDMARDs. A comparison of demographic and RA-related characteristics between difficult-to-treat and low disease activity patients (DAS28-ESR ≤ 3.2) was performed. Comorbidity burden was assessed by calculating Rheumatic Diseases Comorbidity Index (RDCI). Logistic regression model was constructed for difficult-to-control disease.

Results: Hypertension (46.9% (95%CI, 44.7-49.2)), coronary artery disease (CAD) (18.5% (95%CI, 16.8-20.3)), and diabetes (14.4% (95%CI, 12.9-16.0)) were the most prevalent conditions in RA patients. When compared with the adequate control group, difficult-to-control patients were increasingly burdened with hypertension (52.7% (95%CI, 47.5-57.8) vs. 42.0% (95%CI, 36.6-47.6); p = 0.006), cardiovascular diseases (24.2% (95%CI, 20.1-28.9) vs. 11.1% (95%CI, 8.0-15.1); p < 0.001), respiratory system diseases (7.0% (95%CI, 4.8-10.2) vs. 3.3% (95%CI, 1.8-5.9); p = 0.03) and gastroduodenal ulcers (2.3% (95%CI, 1.2-4.4) vs. 0.3% (95%CI, 0.1-1.8); p = 0.04). Patients with higher RDCI had lower chance to obtain low disease activity (OR 0.69 (95%CI, 0.61-0.79); p < 0.001). In multivariate analysis, RDCI was independently associated with difficult-to-control disease (OR 1.46 (95%CI, 1.21-1.76); p < 0.001).

Conclusions: RA patients suffer from a variety of comorbidities. Cardiovascular and respiratory system diseases occur twice as often in difficult-to-control patients. RDCI may provide a valuable tool in evaluating a risk for difficult-to-control RA. Key Points • Hypertension, coronary artery disease and diabetes are the most prevalent comorbidities in rheumatoid arthritis. • Cardiovascular and respiratory tract diseases as well as gastroduodenal ulcers are more common among difficult-to-control patients, when compared with subjects with adequately controlled RA. • Rheumatic Diseases Comorbidity Index is an independent predictor for difficult-to-control RA.
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http://dx.doi.org/10.1007/s10067-019-04579-1DOI Listing
September 2019

Dissociating polysensitization and multimorbidity in children and adults from a Polish general population cohort.

Clin Transl Allergy 2019 11;9. Epub 2019 Feb 11.

1Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

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 < 0.01). Asthma or atopic dermatitis alone were not associated with polysensitization. Rhinitis and multimorbidity were associated with polysensitization. Allergic multimorbidity occurred in 2.2% of participants with negative skin prick tests, 9.8% of those with one positive prick test (SPT ≥ 3 mm) and 20.6% of polysensitized ones (p < 0.001). There was an increasing risk of multimorbidity depending on the number of positive prick tests for both SPT ≥ 3 mm (OR 9.6-16.5) and SPT ≥ 6 mm (OR 5.9-13.7). A statistically significant relationship was found between allergic multimorbidity and sensitization to cat and mite allergens.

Conclusions: Multimorbidity is associated with polysensitization especially in children compared with adults in Polish population cohort. New insights into single disease patterns were found: bronchial asthma is the strongest risk factor for the development of multimorbidity in comparison with allergic rhinitis and atopic dermatitis.
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http://dx.doi.org/10.1186/s13601-019-0246-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369558PMC
February 2019

Prevalence and clinical characteristics of rheumatoid arthritis in Poland: a nationwide study.

Arch Med Sci 2019 Jan 13;15(1):134-140. Epub 2017 Dec 13.

Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland.

Introduction: There are no reliable data regarding the prevalence of rheumatoid arthritis (RA) in Poland.

Material And Methods: The first stage was a face-to-face survey on a nationwide representative sample of 3000 people, which identified respondents with a physician-confirmed diagnosis of RA. The second stage was a survey of RA patients, which characterized the disease course and treatment. It was evaluated by analysis of a representative group of 1957 RA patients in routine clinical practice.

Results: The overall RA prevalence in Poland was 0.9% (95% CI: 0.6-1.2%), 1.06% for women, 0.74% for men. Seventy-eight percent were female, mean age was 56 and mean disease duration 7 years. Younger patients (< 50) remained professionally active in 90% of cases. Thirty percent of patients were diagnosed within 3 months of the first RA symptoms, while for 17% it took more than 1 year. Fifty-six percent of newly diagnosed patients were characterized by high disease activity (DAS-28 > 5.1). Presently, low disease activity (DAS-28 < 3.2) was found in 38.5% of patients. In Poland, 94% of patients have been treated with non-steroid anti-inflammatory drugs, almost 80% with glucocorticoids. Meanwhile, methotrexate, as an anchor drug in Poland, has been used by 80% of patients, biological agents by 2.94% of patients.

Conclusions: This is the first cross-sectional population-based epidemiological study regarding prevalence of RA in the adult Polish population. The results demonstrate a high prevalence, falling within the upper boundary estimates for Europe. Despite ongoing treatment, the majority still have moderate to high disease activity, and the use of biological therapies is low.
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http://dx.doi.org/10.5114/aoms.2017.71371DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348369PMC
January 2019

The importance of specific IgE antibodies in epidemiology of allergic rhinitis and asthma - the Epidemiology of Allergic Diseases in Poland (ECAP) survey: part one. Influence of allergy risk factors on concentration of specific IgE antibodies in serum.

Postepy Dermatol Alergol 2018 Oct 19;35(5):520-526. Epub 2018 Jul 19.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

Introduction: Specific immunoglobulins E (sIgE) are important parameters to estimate severity of allergic diseases.

Aim: To determine the influence of allergy risk factors on the concentration of specific IgE antibodies in serum.

Material And Methods: The concentration of sIgE antibodies against allergens , cat dander, timothy grass, were determined in serum of 4077 respondents randomly selected from 9 regions (ECAP study). The positive results of sIgE (≥ 0.35 IU/ml) were correlated to answers in questionnaires ECRHSII and ISAAC.

Results: sIgE are more frequently detected in respondents declaring an allergic disease of a father than of a mother ( < 0.05, < 0.01). An early beginning to attend school, kindergarten or nursery increases the frequency of sIgE detection ( < 0.05). If the number of children who slept in the same room as a respondent before the respondent was five years old, was lower, sIgE antibodies are more frequently detected ( < 0.05). Relating to: 1) all 4 allergens, sIgE are the most frequently detected in respondents declaring absence of a carpet/rug at home ( < 0.05), 2) cat dander - less frequently detected in respondents who have a cat at home at the age of 1-4 years ( < 0.005).

Conclusions: Carpets/rugs capture a portion of mite, epidermal, mould allergens located at home, wherefore absence of a carpet or rug causes greater stimulation of an immune system by these allergens; as a consequence, IgE antibodies are the most frequently detected in respondents. Household contacts of the respondents, at the age of 1-4 years, with cats induced partial immune tolerance to cat dander.
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http://dx.doi.org/10.5114/pdia.2017.70894DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232542PMC
October 2018

The nationwide program of allergic disease prevention as an implementation of GARD guidelines in Poland.

J Thorac Dis 2018 Sep;10(9):5595-5604

Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

Background: In 2006, the Global Alliance against Chronic Respiratory Diseases (GARD) was established. The GARD strategy is based mainly on activities aimed at implementing preventive tasks at a local and global level. In Poland, the National Health Program (NHP) is the strategic document describing the tasks of governmental and local administration in the field of public health. One of the activities under the NHP is a project to carry out mass allergy screening (of children and adolescents at school age) and to organize an information and education campaign.

Methods: In 2017-2018, the screening will cover a group of at least 10,000 children and adolescents at school age (6-18 years of age) in 10 of 16 voivodships in Poland. In the study, the e-health tool for early pre-medical risk assessment of allergic diseases was used. The algorithm determines the risk of bronchial asthma (BA) and allergic rhinitis (AR) based on a series of 38 questions on the symptoms of allergic diseases. In order to assess the effectiveness of the screening test (algorithm) a validation study was carried out before screening. Moreover, the algorithm was calibrated on the basis of the obtained results. The screening is accompanied by a nationwide information and education campaign carried out by means of new media.

Results: A total of 1,008 children and adolescents participated in the validation study. In outpatient examination AR was diagnosed in 46.4% and BA in 11.2%. In the case of AR, the sensitivity of the calibrated version of the algorithm was 0.852 and the specificity was 0.840. In the case of BA, it was 0.841 and 0.912, respectively. In 2017, 1,512 people used the screening tool, of which 1,472 respondents went through all stages of the assessment. BA positive AR result (probably sick) was found in 19.5% of respondents and BA in 8.4%.

Conclusions: The use of e-health tools in mass screening and new media to conduct information and education campaigns allows for the reduction of costs and for efficient implementation of activities. It is important to popularize the use of this type of solutions both at national and local level.
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http://dx.doi.org/10.21037/jtd.2018.08.97DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196193PMC
September 2018

Effect of indoor air quality on the natural history of asthma in an urban population in Poland.

Allergy Asthma Proc 2018 Nov;39(6):e64-e70

From the Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Pol.

Indoor air pollution may have an impact on asthma. To evaluate the influence of indoor air pollution on the natural history of asthma. Data collection by using the European Community Respiratory Health Survey and International Study of Asthma and Allergies in Childhood standardized questionnaire (N = 18,617) and medical examinations (N = 4783) in selected Polish regions was used. Statistical analysis was performed by using the χ² test. A value of p < 0.05 was considered statistically significant. Questionnaire results demonstrated that people who used the central heating system were less likely to declare the occurrence of asthma (odds ratio [OR] 0.84) and were corroborated with clinical findings of moderate asthma (OR 0.35). Symptomatic asthma occurred more frequently in people who used a solid-fuel heating device (OR 1.36) and electric heaters (OR 1.54). The use of cooking appliances with municipal natural gas (OR 1.77) and gas storage tanks (OR 2.03) was correlated with more frequent declarations of asthma. Symptomatic asthma was more common among people who smoked for at least 1 year (OR 2.26) and those who smoked over the course of the preceding month (OR 1.60). Passive exposure to tobacco smoke provided for a 1.5-fold increase in the incidence of symptomatic asthma (OR 1.53), regardless of the time of exposure. Both active and passive tobacco smoke exposure as well as the use of certain types of heating and cooking appliances have a significant impact on the incidence of asthma and the intensification of its symptoms in rooms with limited air exchange. Highlights of the study included the following: (1) central heating had an amelioratory effect on asthma, (2) heating technologies used at home had a significant impact on the incidence of asthma, and (3) devices used for cooking (municipal and cylinder gas stoves) played an important role in the intensification of asthma symptoms.
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http://dx.doi.org/10.2500/aap.2018.39.4176DOI Listing
November 2018

The prevalence of depression and insomnia symptoms among patients with rheumatoid arthritis and osteoarthritis in Poland: a case control study.

Psychol Health Med 2019 03 4;24(3):333-343. Epub 2018 Oct 4.

a Clinic of Early Arthritis , National Institute of Geriatrics, Rheumatology and Rehabilitation , Warsaw , Poland.

The objective of the study was to assess the prevalence of symptoms of depression and insomnia among patients with rheumatoid arthritis and osteoarthritis in comparison with individuals without chronic diseases. The study was carried out at National Institute of Geriatrics, Rheumatology and Rehabilitation, included 229 persons. The participants were divided into the following groups: group I - 120 patients with rheumatoid arthritis, group II - 58 patients with osteoarthritis, group III - 51 healthy individuals no confirmed depression (control group). Symptoms of depression were confirmed by a multiple-choice self-reported Beck Depression Inventory questionnaire. Symptoms of depression confirmed with depression inventory≥ 10 occurred as follows: patients with rheumatoid arthritis - 75.83%, patients with osteoarthritis - 50%, control group - 23.53% (p<0.0001), with the prevalence of insomnia (AIS≥6) at: 71%, 32% and 33%, respectively (p<0.001). In group I mean values of FIRST and AIS were 23.06 and 8.36 respectively, with group II: 21.71 and 7.84, respectively. In all subjects with AIS≥6, the depression inventory was statistically significantly (p<0.005) higher than in the subjects with AIS<6 (respectively: 17.02 vs 12.13; 15.6 vs 8.05; 5.45 vs 1.81). Patients with rheumatoid arthritis find it difficult to cope with stress. Insomnia as a reaction to stress occurs more often in this group.
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http://dx.doi.org/10.1080/13548506.2018.1529325DOI Listing
March 2019

The association between paracetamol use and the risk of asthma, rhinitis and eczema in the Polish population.

Ann Agric Environ Med 2018 Sep 17;25(3):428-432. Epub 2018 Apr 17.

Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

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.
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http://dx.doi.org/10.26444/aaem/86336DOI Listing
September 2018

New laws to reduce tobacco smoking changed attitudes to the problem, but not the percentage of smokers.

Ann Agric Environ Med 2017 Aug 28;25(3):546-551. Epub 2017 Aug 28.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Poland.

Introduction: The epidemic of tobacco smoking remains one of the most important challenges in public health. It is associated with premature death. For this reason, the Act of 9 November 1995 on the Protection of Public Health against the Effects of Use of Tobacco and Tobacco Products, as amended on 15 November 2010, implemented significant additional restrictions on smoking in public places.

Objective: The objective of this study is evaluation of the impact of smoking regulations on social behaviour and attitude to the legal forms of tobacco control, due to the new smoke-free policy.

Material And Methods: A secondary statistical analysis of third party data was used in the study. The material was obtained from the Public Opinion Research Centre. Polls are conducted among representative samples of about 1,000 adult inhabitants of Poland. The studies on cigarette smoking were carried out in 3 editions (2010, 2011, 2012).

Results: The collected data on tobacco smoking before and after implementation of the Act show that the number of smokers remained at a comparable level - about 30% (p=0.891). Between 2010-2012, an increase was observed in the percentage of people supporting the smoking ban in public places. The total number of people who definitely or rather supported the smoking ban increased from 75.6% in 2010 to 85.0% in 2012 (p<0.001).

Conclusions: The restrictive smoking ban in public places implemented in 2010 did not have an impact on the number of smokers in the studied time interval, although an increase in the number of people supporting the smoking ban in public places was observed.
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http://dx.doi.org/10.26444/aaem/76703DOI Listing
August 2017

Factors of depression among patients with rheumatoid arthritis.

Reumatologia 2018 31;56(4):219-227. Epub 2018 Aug 31.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Poland.

Objectives: The aim of this study was to assess the correlation between symptoms of depression and the course and clinical picture of rheumatoid arthritis (RA).

Material And Methods: 120 patients with RA were included in the study: 104 (87%) female patients and 16 (13%) male patients. All studied patients completed the following questionnaires: Beck Depression Inventory (BDI), Ford Insomnia Response to Stress Test (FIRST), Athens Insomnia Scale (AIS) and Health Assessment Questionnaire (HAQ). The serum levels of IL-1β, TNF-α, and IL-6 were measured using standard ELISA assays at the time of the first questionnaire assessment.

Results: Symptoms of depression were found in 91 patients (76%), including 79 (87%) women and 12 (13%) men. There were no significant differences between the prevalence of depression in women and men ( = 0.93). Symptoms of depression occurred more often in patients who were professionally inactive, compared with the professionally active patients ( = 0.04). Significant correlations was demonstrated between the value of BDI and the patient's pain assessed by the visual analogue scale (VAS) value ( = 0.36), the disease activity assessed by the patient and the physician evaluated in millimetres on the VAS scale ( = 0.38 and = 0.30, respectively), the number of painful and swollen joints ( = 0.22 and = 0.26, respectively), DAS28 ( = 0.31) as well as the Health Assessment Questionnaire (HAQ) value ( = 0.46). Longer duration of the disease was observed in patients with symptoms of depression ( = 0.02). Also a significant difference in the assessment of BDI between patients treated with biological drugs and those receiving no such treatment was observed ( = 0.042).

Conclusions: Professional inactivity and longer disease duration are important factors influencing symptoms of depression in patients with RA. Higher values of HAQ increase the probability of the occurrence of depression symptoms. The use of biological drugs that reduce the level of proinflammatory cytokines may have a positive effect on reducing the severity of depressive symptoms.
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http://dx.doi.org/10.5114/reum.2018.77973DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142018PMC
August 2018

The effect of selected risk factors, including the mode of delivery, on the development of allergic rhinitis and bronchial asthma.

Postepy Dermatol Alergol 2018 Jun 18;35(3):267-273. Epub 2018 Jun 18.

Unit of Environmental Hazard Prevention and Allergology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland.

Introduction: Cesarean section affects the process of colonization by bacteria transferred from the mother's skin and hospital bacteria, which in turn contributes to development of allergic conditions.

Aim: To assess selected risk factors, including the mode of delivery, parity, and the role of genetic factors for the development of allergic rhinitis and bronchial asthma.

Material And Methods: The study was conducted in 18,617 respondents aged 6-7, 13-14, and 20-44 years who completed the ECRHS II and ISSAC questionnaires. Thirty percent of the study population underwent complementary assessments in the form of skin-prick tests, serum IgE levels, lung function tests, and peak nasal inspiratory flow (PNIF). The study is a part of the Epidemiology of Allergic Disorders in Poland (ECAP) study conducted in 8 areas in Poland (Warsaw, Lublin, Bialystok, Gdansk, Poznan, Wroclaw, Katowice, Krakow, and two rural areas - Zamosc and Krasnystaw counties).

Results: Respondents diagnosed with allergic rhinitis were at a significantly higher risk of inheriting the allergic condition if their mother (OR = 2.17; 95% CI: 1.98-2.39, = 2.00 × 10) or father (OR = 2.20; 95% CI: 1.96-2.47; = 2.00 × 10) suffers from this allergy. Conversely, in the group diagnosed with bronchial asthma, the highest risk of an inherited allergy was observed in situations where maternal (OR = 2.00; 95% CI: 1.57-2.55; = 1.69 × 10) or paternal (OR = 1.94; 95% CI: 1.42-2.66; = 3.61 × 10) grandparent was affected. Moreover, the risk of developing allergic rhinitis depended on the mode of delivery: i.e. it was higher for a Cesarean section (OR = 1.20; 95% CI: 1.01-1.43; = 0.04) than vaginal delivery (OR = 0.88; 95% CI: 0.78-0.99; = 0.03). The higher the number of siblings, the lower the risk of allergic rhinitis.

Conclusions: Allergy risk factors, especially those predisposing to allergic rhinitis, include not only genetic factors but also the mode of delivery: vaginal delivery or Cesarean section.
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http://dx.doi.org/10.5114/ada.2018.76222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041717PMC
June 2018

Extent of protective or allergy-inducing effects in cats and dogs.

Ann Agric Environ Med 2018 Jun 15;25(2):268-273. Epub 2017 Dec 15.

Department of Environmental Hazard Prevention and Allergology, Faculty of Health Science, Medical University, Warsaw, Poland.

Objective: The study aimed to assess the effect of fur-bearing pets, including cats and dogs, on the health of individuals with allergic conditions.

Material And Methods: The study group comprised 18,617 individuals (16,562 from urban and 2,055 from rural areas). The tool used in the study was the European Community Respiratory Health Survey (ECRHS) and International Study of Asthma and Allergies in Childhood (ISAAC) study questionnaire, adapted to European conditions (Middle and Eastern Europe) and used as part of the study Implementation of a System for the Prevention and Early Detection of Allergic Diseases in Poland.

Results: The factors determining the keeping of fur-bearing pets in a household included a larger living space and the number of cigarettes smoked, which were observed especially in urban settings. The keeping of fur-bearing animals in rural areas acts preventively against allergic conditions, while in urban areas, these animals were a factor clearly aggravating symptoms of bronchial asthma - the risk of cough (OR 1.921; CI 10-3.36; P=0.02) and wheezing (OR 2.60; CI 1.22-5.54; P=0.01).

Conclusions: Fur-bearing animals kept in rural settings exhibit preventive effects on the development of allergies; whereas in urban areas they exacerbate allergic symptoms, especially the symptoms of bronchial asthma.
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http://dx.doi.org/10.26444/aaem/80596DOI Listing
June 2018

The impact of nutrition and generally available products such as nicotine and alcohol on rheumatoid arthritis - review of the literature.

Reumatologia 2018 9;56(2):121-127. Epub 2018 May 9.

Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.

Nutrition habits and diet may influence disease development and course. There are no specific recommendations related to rheumatic diseases for a diet that would facilitate treatment. However, some research results suggest that various nutrients may affect the health of patients, especially in the case of inflammatory rheumatic disease such as rheumatoid arthritis (RA). Scientists have been trying to find a relation between inflammatory rheumatic diseases and diet but have never come up with any firm conclusions that would help in determining the model of a diet for such patients. Nevertheless, there are some consistent results that refer to the influence of nutritional behaviours on symptoms of RA. The article presents a review of the research showing that certain nutrients may be beneficial for the course of disease among some RA patients.
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http://dx.doi.org/10.5114/reum.2018.75524DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974635PMC
May 2018

Epidemiology of urticaria in Poland - nationally representative survey results.

Postepy Dermatol Alergol 2018 Feb 20;35(1):67-73. Epub 2018 Feb 20.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

Introduction: The prevalence of urticaria is 15-20%. Women are twice as likely to be affected.

Aim: To present the epidemiology of urticaria and angioedema in Poland.

Material And Methods: A questionnaire-based survey was conducted on a representative group of 4,897 individuals, aged 15-74 years.

Results: A total of 11.2% of respondents reported at least one episode of urticaria symptoms in their life, and the frequency was higher in females (OR = 1.46; < 0.001). Single episodes accounted for 34.8%, while repeated episodes accounted for 65.2%. Acute urticaria was observed in 10.6% (more frequent in females; OR = 1.41; < 0.001), chronic in 0.6%. Median age of the first episode was 15 years. Angioedema was observed in 3.2%. The last episode of urticaria symptoms and/or angioedema occurred within the previous week in 0.7% of subjects, the last month in 1%, and the last year in 2.2%. 8.8% had experienced urticaria symptoms or angioedema over 1 year prior to the survey. The impact of urticaria symptoms on patients' daily activities was rated with 3.8 points on a scale of 0-10. In addition, chronic urticaria was rated 6.5, and acute urticaria 3.6. Angioedema and urticaria had a negative impact of 5.7 points.

Conclusions: Urticaria and angioedema are serious health problems in Poland, although their prevalence is below the mean rate for the global population. Females are more likely to suffer from these diseases. People affected by urticaria most frequently report contact with plants and substances, insect bites/stings, and food as the provoking factors.
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http://dx.doi.org/10.5114/ada.2018.73165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872247PMC
February 2018