Co-occurrence of otitis media with effusion and another environment-dependent disease (selected allergic conditions).

Introduction: Otitis media eith effusion (OME) is an inflammatory condition of the middle ear that involves accumulation of sterile fluid or effusion in the tympanic cavity with the tympanic membrane intact. The pathophysiology of OME is undoubtedly multifactorial. Aim: To assess the co-occurrence of OME, allergic rhinitis, and asthma. Material and methods: The study involved a group of 18,617 subjects aged 6-7 years, 13-14 years, or 20-44 years. ECRHS and ISAAC questionnaires, validated and adopted for Polish conditions, were used in the study. Results: OME increases the risk of developing allergic rhinitis by nearly two-fold (OR = 2.07, 95% CI: 1.738-2.479 in 6-7-year-olds; OR = 1.61, 95% CI: 1.299-1.995 in 13-14-year-olds, and OR = 1.55, 95% CI: 1.262-1.83 in 20-44-year-olds). Protective factors against otitis media with effusion include the number of siblings (the more children in the family, the higher the risk of chronic OM; OR = 2.00, 95% CI: 1.15-1.346) and consumption of dairy products rich in lactic acid bacteria. Conclusions: OME significantly more often co-exists with other conditions, particularly allergic rhinitis.

Trends in Hospitalization Duration for Rare Diseases: A Retrospective Analysis of Sarcoidosis, Still's Disease, and Systemic Sclerosis in Poland (2009-2018).

BACKGROUND A rare disease is a health condition that rarely occurs in the population. It is estimated that up to 400 million people around the world suffer from a rare disease. This retrospective study aimed to investigate factors associated with length of hospitalization in 78 626 patients with sarcoidosis, 3294 patients with adults-onset Still's disease, and 35 549 patients with systemic sclerosis between 2009 and 2018 using data from the National Institute of Public Health in Poland. MATERIAL AND METHODS In this population-based study, we analyzed hospital discharge records of first-time and subsequent hospitalizations. To perform the statistical analyses, R software was used. RESULTS The average length of hospitalization over the selected period in the diseases was 5.39 days for sarcoidosis, 6.22 days for scleroderma, and 7.44 days for Still's disease, and was shorter for each of the diseases analyzed compared with the length of hospitalization for second and subsequent stays. There were no substantial differences in length of hospitalization between males and females. The average length of hospitalization increased with each additional comorbidity. CONCLUSIONS The study showed that hospitalizations for selected rare diseases do not cause a significant burden on the healthcare system. The results also showed that advanced age and comorbidities are important factors determining the length of hospitalization. The average length of hospital stay for selected rare diseases in Poland is not longer than the European Union (EU) average, so it can be assumed that the process of inpatient treatment in Poland is optimal.

Nutrition-related mobile applications - Should they be used for dietary prevention and treatment of cardiovascular diseases?

BACKGROUND AND AIMS: There is no prior research on the usefulness that popular nutrition-related mobile applications would have in assessing fatty acids intake. In this study, we examine these applications through their utilization in the assessment of consumption of saturated (SFAs) and polyunsaturated (PUFAs) fatty acids against the Polish reference method (RM, Dieta 6.0). This report does also include the information about monounsaturated fatty acids and cholesterol intake. METHODS AND RESULTS: SFAs and PUFAs intake was assessed using two-day dietary recalls obtained from 120 individuals by 3 selected mobile applications (App1 = Yazio, App2 = MyFitnessPal, App3 = Fitatu) and compared with RM. Despite strong (SFAs by App1 and App3) and moderate (SFAs by App2 and PUFAs by App1, App2, App3) correlations with RM, Bland-Altman analyses showed relevant biases and wide range between limits of agreement. Considering SFAs and MUFAs intake, App1 had the best agreement. App1 had high sensitivity (94.6%) in recognition of subjects with SFAs intake >10% with moderate specificity (67.9%), while App2 had poor sensitivity (27.2%) and high specificity (100%). App3 showed moderate sensitivity and specificity (77.2% and 75%, respectively). CONCLUSIONS: Mobile applications are not accurate tools in SFAs and PUFAs assessment when compared to the RM. Nonetheless, their ability to recognize SFAs intake >10% energy intake may suggest that further development of mobile applications could potentially become an attractive tool in clinical practice.

Screening for SARS-CoV-2 Infection in Students at the Medical University of Warsaw, Poland Between November 15 and December 10, 2021 Using a Single Lateral Flow Test, the Panbio™ COVID-19 Ag Rapid Test.

BACKGROUND Education was significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus. Online learning affects the quality of learning as well as the mental health status of students. Regular screening for COVID-19 may be crucial to provide practical classes during the pandemic. The present study aimed to analyze the usefulness of rapid antigen tests for on-campus COVID-19 screening in real-life conditions at a medical university in Poland. MATERIAL AND METHODS This screening study was carried out among students attending practical classes at the Medical University of Warsaw, Poland between November 15 and December 10, 2021, during which a series of rapid antigen tests (Panbio™ COVID-19 Ag Rapid Test Device, nasal) were performed by healthcare professionals (nurses). Out of 104 student groups selected for the study (n=1847 students), 423 individuals from 63 student groups were tested at least once (22.9% response rate). A total of 2295 samples were collected. RESULTS Among the participants, 3.4% (n=15) had positive test results. Out of 15 COVID-19 cases, 14 were vaccinated. At least 1 positive COVID-19 case was detected in 8 student groups. In 3 student groups, we observed ≥2 infections that occurred at intervals, which may suggest student-to-student SARS-CoV-2 transmission. CONCLUSIONS This study produced real-world data from a COVID-19 screening study and confirmed the usefulness of the rapid antigen test (Panbio™ COVID-19 Ag Rapid Test Device nasal) for on-campus COVID-19 screening prior to practical classes. Maintaining a high percentage of participants is crucial to ensuring the effectiveness of on-campus COVID-19 screening.

Changes in the cross-sections of the nasal cavity assessed by acoustic rhinometry in the study population as a guideline for attempts to standardize nasal provocation tests.

Introduction: A specific difficulty in the standardization of nasal allergen challenge tests as measured by acoustic rhinometry is the lack of reference values measured according to dependent changes, for example height and weight/height- or weight-dependent changes. Human growth and development rates and other changes the human body undergoes throughout the lifetime depend closely on the environment, sex, and race. Aim: To assess selected anthropometric (body weight and height) and rhinometric (nasal cross-sectional areas) measurements concerning subject age and sex. Material and methods: The study was conducted in 633 subjects selected in multistage, stratified sampling (324 females and 309 males). Body weight and height were measured with a sliding weight scale and height measure. Nasal cavity cross-sectional areas were measured via acoustic rhinometry. Results: We observed parallel increases in the evaluated anthropometric measurements and nasal cavity cross-sectional areas both in males and females aged ≤ 14 years, with the two sexes starting to differ significantly in terms of those measurements over the age of 14 (p < 0.0001; p < 0.000001). The evaluated rhinometric measurements showed a greater correlation with height than with body weight. The time of the most diversified and dynamic changes in anthropomorphic measurements was the age of > 12 years: with boys demonstrating significantly higher mean values of height and body weight than girls. Conclusions: Height showed a better correlation with rhinometric measurements (cross-sectional area of the nasal cavity) in younger subjects (at their age of development) than in older ones.

Optical rhinometry in assessing the nasal mucosa reaction during nasal allergen provocation testing.

Introduction: Optical rhinometry is a newly standardized technique for assessing nasal obstruction in nasal allergen provocation testing. It is one of the few techniques that accurately determine the beginning of an allergic reaction as it measures optical density, which is consistent with the degree of response. Aim: To evaluate the usefulness of optical rhinometry in nasal allergen provocation testing. Material and methods: The study population was a group of 45 subjects (25 diagnosed with an allergy to common environmental allergens and 20 controls). Nasal allergen provocation testing was conducted with the use of Dermatophagoides pteronyssinus and Dermatophagoides farina (5,000 SBU/ml). Results: The onset of the nasal mucosa allergen response in the form of nasal obstruction was observed at 10.40 min. The subsequent reaction developed rapidly, with only 53 s from the initial stage of nasal obstruction to complete obstruction (optical density 0.4552). Conclusions: Due to its informative potential, optical rhinometry is a valuable tool in assessing the nasal mucosal response to topical allergen application.

Place of residence, gender, month of birth and age influence on the concentration of specific IgE antibodies in serum. The Epidemiology of Allergic Diseases in Poland (ECAP survey): part three.

Introduction: Specific immunoglobulins E (sIgE) are important parameters to estimate the severity of allergic diseases. Aim: To determine the influence of gender, age and place of residence on the concentration of specific IgE antibodies in serum. Material and methods: The concentration of sIgE antibodies against allergens of Dermatophagoides pteronyssinus, cat dander, timothy grass, Alternaria alternata were determined in serum of 4077 respondents randomly selected from 8 regions (ECAP study). The positive results of sIgE (≥ 0.35 IU/ml) were correlated with answers to ECAP questionnaires. Results: IgE antibodies are less frequently detected in respondents living in the country (p < 0.05 to p < 0.005); and they are less frequently detected in respondents living in cities of hardly industrialised regions than in respondents living in cities of industrialised regions (D. pteronyssinus p < 0.05, cat dander p < 0.01). IgE antibodies are more frequently detected in men (p < 0.005 to p < 0.001). IgE antibodies are more frequently detected in respondents born in May-July (timothy grass p < 0.005, Alternaria alternata p < 0.005) and less frequently detected in respondents born in August-October (timothy grass p < 0.005, Alternaria alternata p < 0.05). Conclusions: Characteristics of the urban environment, non-specific factors and gender affect the concentration of specific IgE antibodies in serum. Influence of seasonal allergens within the first months of life and/or in the course of the foetal period alters the production of specific IgE antibodies.

Recorded prevalence of nasal polyps increases with age.

INTRODUCTION: Nasal polyps are a multifactorial inflammatory condition of the upper airways. Nasal polyps typically affect middle-aged and elderly patients, average age at diagnosis is 40 to 60, and men are affected more commonly than women. AIM: To analyse the reported prevalence of nasal polyps in the Polish population, including demographics and co-morbidities, and to estimate the costs of outpatient and hospital (inpatient) services financed by the National Health Fund. MATERIAL AND METHODS: Statistical analysis of data extracted from the National Health Fund (NHF) registers for 2008-2018. RESULTS: In 2018, the recorded prevalence of nasal polyps in Poland was 52.0/10,000 population (0.52%), amounting to 64.6/10,000 (0.65%) in men and 40.2/10,000 (0.40) in women. Nasal polyps were much more frequent in patients aged 55-59 (98.1/10000) and 75-79 years (98.7/10,000). Among men, the highest prevalence was found in the 75-79 age group (164.3/10,000 population), and among women in the 55-59 age group (75.1/10,000). In 2018, the Polish NHF spent PLN 17.2 million (equivalent to EUR 4.0 million/USD 4.7 million) on health services related to the diagnosis of nasal polyps. Hospital services accounted for 77.4% of the total cost. CONCLUSIONS: Nasal polyps are more than one and a half times as prevalent in men than in women. The recorded prevalence of nasal polyps increases with age, with the rates peaking in those between 75 and 79 years old, and is more often in urban than rural areas.

Stimulation of an immune system by different types of allergens causes seasonal (late spring and summer) factors to increase probability of allergic rhinitis symptoms. The Epidemiology of Allergic Diseases in Poland (ECAP) survey: part two.

INTRODUCTION: Specific immunoglobulins E (sIgE) are important parameters to estimate severity of allergic diseases. AIM: To determine the relationship between the concentration of sIgE antibodies in serum and clinical outcome of allergic diseases. MATERIAL AND METHODS: The concentration of sIgE antibodies against allergens Dermatophagoides pteronyssinus, cat dander, Timothy grass, Alternaria alternata were determined in serum of 4077 respondents randomly selected from 9 regions (ECAP study). Positive results of sIgE (≥ 0.35 IU/ml) were correlated with answers in ECRHSII and ISAAC questionnaires. RESULTS: IgE antibodies are more frequently detected in respondents aged over 4 years when they had their first attack of asthma (cat dander p < 0.05, Timothy grass p < 0.05). IgE antibodies are less frequently detected in respondents aged over 29 years when they had the first allergic rhinitis symptoms as compared to respondents aged 0-19 years when they had the first allergic rhinitis symptoms (p < 0.05 to p < 0.001). Among respondents showing allergic rhinitis symptoms, IgE antibodies are more frequently detected in respondents showing those symptoms from May to August (p < 0.05 to p < 0.005). CONCLUSIONS: The first attack of asthma appears later mainly in patients whose immune systems are more strongly stimulated by allergens. Development of allergic rhinitis in patients aged over 29 years presumably needs weaker stimulation of their immune systems by allergens than in patients aged 0-19 years. Stimulation of an immune system by different types of allergens modifies its response in such a way that seasonal (late spring and summer) factors increase probability of allergic rhinitis symptoms.

The relationship between nasal polyps, bronchial asthma, allergic rhinitis, atopic dermatitis, and non-allergic rhinitis.

INTRODUCTION: Nasal polyps are frequently associated with bronchial asthma and rhinitis. The chronic nature of the symptoms, the high post-treatment recurrence rates, as well as various comorbidities, constitute key factors that significantly affect the quality of life of patients diagnosed with this condition. AIM: The purpose of the study was to estimate the prevalence of nasal polyps in the examined population and to assess the possible associative occurrence of nasal polyps (NP) with bronchial asthma (BA), allergic (AR) and non-allergic rhinitis (NAR), and atopic dermatitis (AD). MATERIAL AND METHODS: The ECRHS II and ISAAC questionnaires of the study group of 18,458 individuals, including 4,473 6-7-year-olds (24.2%), 4,675 13-14-year-olds (25.4%), and 9,310 20-44-year-olds (50.4%) were performed. RESULTS: The prevalence of nasal polyps in the examined group was 1.1%, reported by a total of 204 individuals. Nasal polyps were reported more frequently among urban residents (191 (1.1%)) than rural residents (13 (0.6%)). Our study demonstrated a correlation between the presence of nasal polyps and asthma, as well as allergic and non-allergic rhinitis The greatest risk factor for NP in the evaluated subpopulation with multiple allergic conditions was the co-existence of non-allergic rhinitis and atopic dermatitis (OR = 6.09; 95% CI: 3.4-10.93). CONCLUSIONS: Nasal polyps are relatively rare in the evaluated Polish population. Nonetheless, we believe their co-occurrence with non-allergic rhinitis, allergic rhinitis, bronchial asthma, and atopic dermatitis to be of significant importance, as it illustrates the phenomenon of multimorbidity of inflammatory conditions affecting the upper and lower respiratory tract.

Survey participations rates reporting ­ toward standardization in epidemiological studies

Participation rates are recognized as key indicators of the quality of the data collected during a survey. This is particularly important in epidemiological studies where the findings are extrapolated from the study sample to the general population. The response rate is very frequently selected as the key indicator of the overall quality of the data collected but the literature search shows that there are many different ways to calculate it. Only the use of the whole set of participation rates allows assessment of both the quality of the survey (the quality of the data collected) and the reliability of the fieldwork. Standardization of the methods for calculating participation rates seems to be a prerequisite for a reliable comparison of the quality of population surveys.

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

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, p = 2.00 × 10-16) or father (OR = 2.20; 95% CI: 1.96-2.47; p = 2.00 × 10-16) 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; p = 1.69 × 10-5) or paternal (OR = 1.94; 95% CI: 1.42-2.66; p = 3.61 × 10-5) 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; p = 0.04) than vaginal delivery (OR = 0.88; 95% CI: 0.78-0.99; p = 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.

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.

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 Dermatophagoides pteronyssinus, cat dander, timothy grass, Alternaria alternata 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 (D. pteronyssinus p < 0.05, A. alternata p < 0.01). An early beginning to attend school, kindergarten or nursery increases the frequency of sIgE detection (p < 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 (p < 0.05). Relating to: 1) all 4 allergens, sIgE are the most frequently detected in respondents declaring absence of a carpet/rug at home (p < 0.05), 2) cat dander - less frequently detected in respondents who have a cat at home at the age of 1-4 years (p < 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.

Social implications of rheumatic diseases.

Social consequences of a disease constitute limitations in performing roles relating to working life as well as family and social life caused by the disease, mainly chronic. The aim of the study was to analyze the social consequences of rheumatic diseases in the aspect of disability pensions with respect to incapacity for work and quality of life. The occurrence of rheumatic diseases is related not only to increased risk of different types of organic changes, but above all disability. In Europe almost 50% of persons suffering from diseases of the musculoskeletal system who are currently unemployed were breadwinners. Nearly 60% of them received legal disability status. The loss of work ability is, among other things, the consequence of progressive disability. In Europe 40% of persons suffering from rheumatoid arthritis (RA) had to stop working due to the disease. Most of the persons diagnosed with RA were of working age. It results in the decrease in the quality of life as well as economic difficulties (decreased incomes and increased disease-related costs). In Poland the results of the analysis of the Social Insurance Institution (ZUS) of first-time disability recognition issued for the purpose of disability pensions in 2014 showed that the incapacity for work was caused by diseases relating to general health condition (65.5%). Diseases of the musculoskeletal system were the cause of partial inability to work of 21.6% of persons who received a disability pension for the first time (as many as 5,349 certificates were issued). Early diagnosis and implementation of effective treatment are the necessary conditions for a patient to sustain activity, both professional and social, which is of crucial importance to reduce the negative effects of the disease.

Current nutritional status of patients with rheumatic diseases in the population of Poland.

THE AIM OF THE STUDY: The aim of the study was to evaluate the current state of nutrition of patients with rheumatic diseases in the Polish population. MATERIAL AND METHODS: An anonymous questionnaire study was carried out among the patients of the Institute of Rheumatology in Warsaw in the fourth quarter of 2012. Five hundred questionnaires were distributed, and 397 questionnaires were collected and accepted for further analysis (response rate = 79%). RESULTS: Overweight or obesity was present in more than half (53%) of the patients (overweight in 30.5% of respondents, obesity in 22.6%). Among obese subjects, 43% of men and 37% of women in the study think that their diet is correct. Sixty-eight percent of respondents declared that they do not follow any special diet and only 18% declared that they follow a diet with a reduced quantity of monosaccharides (no sweets). A milk-free diet was followed by 7% of respondents, a meat-free diet by 6%, and a fruit-and-vegetable diet by 5%. Dietary supplements were regularly used by 26.7% of respondents, whereas 33.8% did not use them at all. The average assessment of physical aptitude (Health Assessment Questionnaire - HAQ) in the group of respondents was 0.71. No statistically significant differences were found between higher level of disability (e.g. HAQ ≥ 1) and the type of diet followed (p = 0.678) or body mass index (BMI) value (p = 0.864) in relation to persons with the value of HAQ < 1. CONCLUSIONS: More than half of patients suffering from rheumatic diseases are overweight or obese, which corresponds to the body weight profile of the population of Poland. Most patients diagnosed with rheumatic diseases do not follow any special diet. In spite of the frequent use of dietary supplements, the patients do not consult a doctor or a dietician about it. The type of diet and BMI value do not differ according to the level of disability.

Atopic dermatitis is a serious health problem in Poland. Epidemiology studies based on the ECAP study.

INTRODUCTION: Global epidemiological studies have revealed considerable geographical differences in prevalence of atopic dermatitis (AD). AIM: To present the epidemiology of AD, risk factors and co-occurrence of allergic diseases in the Polish population. MATERIAL AND METHODS: The present paper is a part of the Epidemiology of Allergic Disorders in Poland study. We studied 22 703 participants by ECRHS/ISAAC questionnaire; 18 617 (53.8% female, 24.2% 6-7 y.o., 25.4% 13-14 y.o., 50.4% 20-44 y.o.) completed questionnaires were accepted. Four thousand seven hundred and eighty-three participants (25.7%) have undergone a medical examination. RESULTS: Atopic dermatitis was diagnosed in 3.91% (6-7 y.o. 5.34%, 13-14 y.o. 4.3%, adults 3.02%), more often in females (OR = 1.52; 95% CI: 0.56-0.77), in the cities (OR = 2.23; 95% CI: 1.61-3.09), in mothers (OR = 2.07; 95% CI: 1.72-2.48) and fathers (OR = 2.00; 95% CI: 1.61-2.49) with atopy, higher education (OR = 1.61; 95% CI: 1.11-2.32) and economic status (OR = 1.35; 95% CI: 1.04-1.74). The highest prevalence was found in Katowice (4.89%) and lowest in rural areas (1.9%). Coexisting AD and allergic rhinitis (AR) was found in 26.17%, AR and asthma in 9.09% and AD, AR and asthma in 14.6%. Atopic dermatitis was diagnosed by allergologists in 6.5% (6-7 y.o. 8.7%, 13-14 y.o. 9.0%, adults 3.6%). Most diagnoses were made in Poznan (16.76%) and smallest in rural area (3.67%). 78.8% of subjects were diagnosed with AD for the first time although they had earlier experienced its symptoms. CONCLUSIONS: Atopic dermatitis prevalence in Poland is below the mean rate for Europe, but the risk factor profile is similar to other countries. Atopic dermatitis is more frequent in well-educated females with atopic parents and high socioeconomic status and who live in a city.

Hospitalizations of patients with sarcoidosis before and during the COVID-19 pandemic in Poland.

INTRODUCTION: Sarcoidosis is a multisystemic granulomatous disease that mostly affects the lungs and lymphatic system. Due to its rarity and variable clinical course, analyses of factors related to sarcoidosis should be based on large databases and long observation periods. OBJECTIVES: The aim of this study was to determine the characteristics of patients with sarcoidosis hospitalized in Poland over a long period (2016-2021). PATIENTS AND METHODS: We conducted a retrospective study using hospital discharge records compiled by the National Institute of Public Health NIH - National Research Institute. We analyzed the records of patients with sarcoidosis from the entire Polish population at their first hospitalization. RESULTS: We identified a total of 15 548 first-time hospitalizations for sarcoidosis. The mean annual disease incidence was 6.8 cases per 100 000. The mean (SD) age of the patients was 45.8 (13.6) years, and it was lower in men than in women (42.9 [12.5] vs 49.8 [14.2] years; P <0.001). There were significantly more hospitalizations among city dwellers (62.3% vs 37.3% for rural residents; P <0.001). At the beginning of the COVID­19 pandemic in Poland there was a decrease in the number of hospitalizations for sarcoidosis, followed by an increase in the subsequent year. The all­cause in­hospital death rate was significantly higher during the COVID­19 pandemic, as compared with the period before the pandemic (7.2 vs 2.3 per 1000; P <0.001). CONCLUSIONS: Health care changes related to the outbreak of the COVID­19 pandemic may have increased the health debt for inpatient sarcoidosis treatment. The occurrence of sarcoidosis in Poland may be related to demographic and territorial factors.

A national registry-based study on uptake of the first dose of MMR vaccine in 380 administrative regions in Poland, 2013-2016-2020.

INTRODUCTION AND OBJECTIVE: Regular monitoring of the measles, mumps, and rubella (MMR) vaccine uptake quickly exposes immunity gaps in the population. In Poland, the first dose of the MMR vaccine is mandatory for children between 13 and 15 months of life. This study aimed to assess the uptake of the first dose of MMR vaccine in 380 administrative counties in Poland in 2020, as well as to analyze the MMR vaccine uptake trends in 2013-2016-2020. MATERIAL AND METHODS: This study is an epidemiological retrospective national registry-based analysis. Data on mandatory childhood vaccinations in all 380 counties in Poland were collected from the epidemiological reports of the State Sanitary Inspectorate territorial representatives. MMR vaccine uptake was calculated as the percentage of children who received the first dose of MRR vaccine to all children subject to mandatory vaccination in the county. RESULTS: The uptake of the first dose of MMR vaccine decreased from 99.4% in 2013, to 95.5% in 2016 and 91.9% in 2020. In 2013, 93.2% of countys MMR vaccine uptake level reached the herd immunity level, followed by 77.1% of counties in 2016 and only 38.3% of countys in 2020. In 2020, two counties reached complete (100%) MMR vaccine uptake, and the lowest MMR vaccine uptake was 63.88%. Of the 380 counties in Poland, in 226 (61.1%) the MMR vaccine uptake level was lower than the herd immunity level, and a downward trend was observed. MMR vaccine uptake decreased with an increased number of residents in a county (r= -0.35; p<0.001). CONCLUSIONS: This study revealed that in 61% of administrative regions in Poland, the MMR vaccine uptake was below the herd immunity level. Regional differences in the MMR vaccine uptake were observed. A significant decrease in MMR vaccine uptake between 2013 - 2020 poses a risk of measles outbreaks.

The multidimensional nature of attitudes towards preventive vaccinations - a cross-sectional survey among Poles aged 15-39 years.

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

Nasal mucosal reactivity assessment via a double-blind placebo-controlled food challenge with cow's milk allergens.

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