[The problem of increased vitamin D3 level in a group of patients hospitalized in a geriatrics clinic]. / Problem podwyzszonego stezenia witaminy D3 w grupie pacjentów hospitalizowanych w klinice geriatrii.

BACKGROUND: Taking into account the multi-directional beneficial effects of vitamin D3 and its widespread deficiency, regular supplementation is recommended. However, more and more attention is being paid to the risk of overdose with supplemented vitamin D3 and the associated serious health consequences. MATERIAL AND METHODS: The concentration of 25-hydroxyvitamin D (25(OH)D) is a routine test recommended upon admission to the Geriatrics Clinic of Wroclaw Medical University. The aim of the study was to analyze the results from January 2018 to June 2023. Additionally, information on the reported symptoms, gender and age of people with an increased level of vitamin D3 was collected. RESULTS: Analyzing a group of 1400 patients, it was noted that within 5 years, vitamin D3 concentrations exceeding the recommended level were recorded in 7 patients, including 3 with toxic levels. All abnormal results occurred in women. The most frequently reported symptoms included general weakness, lower limbs and joint pain, sleep disorders, low mood. People with toxic concentrations reported dizziness. In seniors there is a gradual increase in vitamin D concentration and its deficiency is less common. Higher concentrations were recorded in the group of older seniors, and concentrations considered toxic occur in the population >74 years of age. Supplements and drugs with vitamin D are most often used without consulting a doctor, without determining the appropriate dose, or without assessing the concentration of 25(OH)D in the serum. CONCLUSIONS: To prevent vitamin D deficiency in seniors, doses >4000 IU daily are not recommended. It is advisable to check all medications and supplements taken at each doctor's visit in terms of duplicating treatment with vitamin D. It is advisable to assess the status of vitamin D supply the concentration of 25(OH)D in order to select the appropriate dose. Assessment of 1,25-dihydroxyvitamin D concentration is recommended in cases of vitamin D toxicity. Med Pr Work Health Saf. 2024;75(3).

[Problem of depression in patients with bronchial asthma]. / Problem depresji u chorych na astme oskrzelowa.

INTRODUCTION: The aim of this study was to evaluate the frequency of various degrees of depressive disorders in patients diagnosed with bronchial asthma of different degrees of severity. MATERIAL AND METHODS: The study involved 120 patients - 80 with bronchial asthma from mild to severe and various prevalence of the disease hospitalized in The Department of Internal Medicine, Geriatrics and Allergology, Medical University in Wroclaw, and 40 patients without chronic lung's disease as the control group. The methods included a structural interview, body examination and spirometry. The psychological status was assessed by Beck Depression Inventory (BDI). RESULTS: The level of negative mood state and depression was positively correlated with severity of bronchial asthma. Also relationship between the level of depression and male-gender was rather strong. CONCLUSIONS: It should be noted that the presence of negative mood state and depressive symptoms in patients suffered from bronchial asthma might be the problem in proper compliance and indicate that adequate treatment, when these psychopathological symptoms are diagnosed, should be implemented. It could suggest that depressive disorders are associated with worse asthma control and deterioration in quality of life.

[Efficacy and safety of specific immunotherapy of upper airways allergic diseases caused by allergy to mites]. / Skutecznosc i bezpieczenstwo doustnej immunoterapii swoistej alergicznych schorzen górnych dróg oddechowych w zwiazku z uczuleniem na roztocza.

AIM OF THE STUDY: The aim of this study was to evaluate the efficacy and safety of 3 years oral specific immunotherapy in patients with perannial allergic rhinitis and bronchial asthma caused by allergy to mites. MATERIAL AND METHODS: Fifteen patients with allergic perannial rhinitis entered the study. Ten of them suffered also from bronchial asthma. During 3 years of therapy we have monitored the appearance of side effects, clinical parameters (symptoms degree and medication usage score) and immunological parameters (serum eosinophil cationic protein concentration and leukotriene C4 liberation by peripheral blood leukocytes upon in vitro specific allergens stimulation). RESULTS: We have not observed the appearance of any adverse event, so medication has been recognized as a safe. Moreover, we have observed a lot of positive therapeutical effects--the lowering of symptoms scores, accompanied by advantageous changes in immunological parameters. However, in spite of 3 years of therapy, many patients still reported the substantial clinical symptoms, accompanied by still elevated serum ECP concentration and relatively high leukotriene C4 liberation by peripheral blood leukocytes upon in vitro stimulation by specific allergens. CONCLUSION: Oral specific immunotherapy in the patients with allergic diseases of upper airways is a safe medication but leads only to moderate clinical efficacy accompanied by lowering serum ECP concentration and reducing of leukotrienes C4 liberation by peripheral blood leukocytes stimulated by specific allergens.

[Modern views on the role of neutrophil in the pathogenesis of bronchial asthma]. / Wspólczesne poglady na temat roli neutrofila w patogenezie astmy oskrzelowej.

In this study the authors presented modern views concerning neutrophil participation in allergic inflammation and some literature data suggesting the possibility of neutrophil specific activation by extrinsic allergens.

[Neutrophil myeloperoxidase release by selected extrinsic allergens]. / Uwalnianie mieloperoksydazy przez neutrofile pod wplywem wybranych alergenów zewnatrzpochodnych.

In this study the authors investigated myeloperoxidase release from peripheral blood neutrophils isolated from patients with allergic respiratory tract diseases and from healthy subjects, induced by selected extrinsic allergens. We have observed the same degree of myeloperoxidase release from neutrophils isolated from both patients with allergic respiratory tract diseases and healthy subjects after stimulation by selected allergens (Dermatophagoides pteronyssinus, Grass mix). Moreover, control allergens (to which allergic persons were not sensitized) also caused myeloperoxidase release from neutrophils isolated from patients with allergic diseases of the airways. The authors suggest that recently postulated hypothesis concerning participation of neutrophil in the pathogenesis of allergic reactions as the alternative target cell cannot be accepted in the light of these observations.

[Studies of the specificity of immediate allergic reactions to ampicillin]. / Badania nad swoistoscia natychmiastowych reakcji alergicznych wywolywanych przez ampicyline.

Ampicillin belongs to the drugs causing most frequently IgE-dependent allergic reactions, but the current specificity of these reactions is poorly known. Some experimental data suggest that the side chain of ampicillin may induce synthesis of drug-specific IgE antibodies. In our study we have decided to explain the specificity of ampicillin-induced allergic reactions type I appearing in patients after drug administration. Thirty-eight subjects developing an immediate response after administration of ampicillin entered the study. In all the patients skin tests with penicillin, ampicillin and amoxicillin determinants were performed. We have observed positive skin tests results with penicillin determinants in 23 subjects, in 32 subjects with ampicillin and in 17 cases with amoxicillin. Only in three persons the results were positive exclusively to ampicillin. The results of our study indicate that in the Polish population ampicillin induces an immediate IgE response with variable degree of cross-reactivity to other tested drugs, and selective response to ampicillin is uncommon.

Exercise-induced bronchospasm among athletes in Lower Silesia Province.

A few studies have reported data on the prevalence of exercise-induced bronchospasm in high school and university athletes. Recently published data suggest that exercise-induced bronchospasm may affect up to 39% of American university athletes. To date, no data describing this pathology in athletes from Central Europe have been published. The aim of the present study was to establish the prevalence of exercise-induced bronchospasm in pupils attending sports mastership classes in secondary school as well as students of the University of Physical Education in Wroclaw. The participants were 77 athletes (30 women and 47 men) aged 16-27 years (mean 17.3 years). Only one athlete (1.29%) diagnosed with atopic asthma before testing experienced a fall in forced expiratory volume in one second (12.9% FEV(1)) compared with baseline, which showed that the exercise test result was positive. From a clinical point of view, the ventilation disturbance was asymptomatic. In the other participants, there were slight but statistically significant rises in FEV(1) (P < 0.02). The results of our study indicate a very low prevalence of exercise-induced bronchospasm in the population of athletes examined.