Prevalence and potential risk factors of urticaria in the Polish population of children and adolescents.

INTRODUCTION: Urticaria is a frequent, mast cell driven disease of great social significance as it may lead to disablement, impair quality of life and affect performance at work and school. AIM: A study on the prevalence and potential risk factors for acute and chronic urticaria in the population of children and adolescents living in Krakow, one of the major cities in Poland. MATERIAL AND METHODS: In this paper we present a study on the prevalence and potential risk factors of acute and chronic urticaria in the population of children aged 7-8 years old and adolescents aged 16-17 years old living in Krakow, one of the major cities in Poland. The relation of urticaria prevalence and exposure to polluted air was also investigated. In the period of 3 years between 2016 and 2018 we enrolled 17082 participants (9287 children and 7795 adolescents). RESULTS: Lifetime occurrence of at least one episode of urticaria was reported by 3.3% of respondents (3.6% in the children group and 2.8% in adolescents). The most frequently mentioned causative agent was medicines in children and food in adolescents. Chronic urticaria occurred in 2.1% of children and 1.1% of adolescents. We found no relationship between the volume of traffic and the distance of residence from the high-traffic street to the frequency of urticaria. CONCLUSIONS: A higher incidence of urticaria in the younger age group may suggest an upward trend in the incidence of this disease in the near future. The incidence of chronic urticaria in children turned out to be higher than in the European population. As our research results show, the incidence of urticaria in children and adolescents does not depend on exposure to polluted air.

The effects of air pollution on the development of allergic diseases.

During the past years, air pollution created by humans has become a major problem increasing the public awareness. The incidence of allergic disease is high and continues to increase in populations of urban areas of Westernized countries throughout the world. The aim of this article is to summarize current knowledge of the effects of air pollution on the development of allergic diseases. In the paper the effect of outdoor and indoor air pollution is described with potential and proven mechanisms of action on the development of allergic diseases.

[Clinical symptoms of the allergic rhinitis and coexisting cross reactions in patients treated with the birch and/or grasses allergens against a background of the pollen exposure].

During specific immunotherapy (SIT) it is recommended to monitor the patient symptoms in relation to the exposure of allergen which the patient is treated. The aim of the study was to analyze the clinical symptoms of allergic rhinitis (AR) and cross reactivity in patients undergoing specific immunotherapy using pollen allergens (SIT) (birch and/or grasses) against the pollen exposure in 2014-2016. The study group, consisted of patients with pollen allergy, treated by SIT with birch and grasses allergens, who showed oral allergy symptoms. Patients of the control group were sensitive to birch and/or grasses allergens and they were not treated with SIT. The analyses were based on the results of questionnaires and patient symptom diaries. Timing of the pollen seasons of birch and grasses were similar, however the significantly higher concentration of birch pollen was found in 2014 and 2016, comparing to 2015. The strongest relationship between the pollen concentration and symptoms severity was revealed in the study group in patients desensitized by combined vaccine (birch/grasses), while in the control group, in patients sensitive to both taxa. In 35.3% of patients in the study group, a significant decrease in symptoms after foods was found, especially in patients desensitized with mixed vaccine (birch, grasses) after consumption of vegetables and in patients desensitized with grasses allergens after the fruits and nuts. SIT has a significant impact on the symptoms score reduction, which could be modified by the changeable seasonal pollen exposure.

Growing problem of allergy in population of children and adolescents living in Polish cities.

Allergy is a worldwide medical problem and prevalence of allergic diseases is on the rise. In the study a population of 7494 children and adolescents living in Cracow responded to a questionnaire based on the ISAAC study complemented with questions concerning food allergy. 49.1% of respondents reported symptoms suggestive of allergic disease. 52.7% of them (25.9% of respondents in total) had not received any treatment despite the reported symptoms. The most frequently reported allergic disease was allergic rhinitis followed by atopic dermatitis, asthma, food allergy and allergic contact dermatitis. In the adolescents group allergic rhinitis was followed by asthma. 487 voluntary applicants were further analysed in order to confirm specific allergic disease. Given the final diagnosis, allergic rhinitis was also the most common disease. Interestingly in both categories (preliminary and final diagnoses) we noticed that it is substantially more frequent in the older group which in our opinion can be linked to the impact of polluted urban environment but there is a need for further research in this area.

[Oral allergy syndrome in patients with pollen allergy]. / Zespól alergii jamy ustnej u pacjentów z alergia pylkowa.

The symptoms of pollen allergy in the European population occur in a period of increased pollen precipitation, and take the form of allergic rhinitis and conjunctivitis, bronchial asthma, contact urticaria, and food allergy. Diagnosis in addition to medical history, takes into account the positive results of skin tests and elevated allergen-specific IgE antibodies (specific IgE) in serum. These studies are considered to be objective diagnostic tests confirming the diagnosis of pollen allergy. Not in every case there is a correspondence of symptoms and results of diagnostic tests, which puts into question the accuracy of the diagnosis of pollen allergy. The aim of this study was to test the characteristics of patients with oral allergy syndrome on the background of all patients with pollen allergy and evaluation of the diagnostic value of history, skin tests and specific IgE levels in the diagnosis of patients with pollen allergy and oral allergy syndrome. A retrospective analysis of the cases of 85 patients with a diagnosis of pollen allergy and the 30 patients with OAS was performed. In our study the most common sensitizing allergen in patients with OAS was birch pollen, while patients showing no symptoms of OAS were equally sensitive to timothy and birch pollen. The main food responsible for the presence of the OAS in the mechanism of cross-allergy to pollen was an apple. Among patients with OAS we did not show significantly higher incidence of polyvalent allergies. It was shown, however, that there is a tendency that the maximum concentration of allergen-specific IgE causing clinically significant symptoms, ie in line with the pollen season, is higher in the OAS patients than in the absence of OAS. Further research is needed using new diagnostic methods, which would predict future symptoms after eating certain foods in particularly endangered patients with pollen allergy.

The Prevalence of Atopic Dermatitis and Food Allergy in Children Living in an Urban Agglomeration-Is There a Current Relationship?

Atopic dermatitis (AD) prevalence in Poland is more frequent in individuals who live in a city. There are more studies demonstrating that long-term exposure to air pollutants is an independent risk factor for developing AD. The aim of the study was to assess the epidemiology of AD and food allergy (FA) in school children and adolescents living in Krakow, and to find a potential relationship between the incidence of atopic dermatitis with exposure to polluted air. In this paper, we presented the incidence of AD and FA between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged 7-8 and adolescents aged 16-17 from the population of children and youth in Krakow. We correlated it with annual mean concentrations of PM10 and PM2.5, which indicated a gradual improvement in the air quality in Krakow. As our research results show that the prevalence of atopic dermatitis decreased with food allergy prevalence depending on the age group. We can suspect that this is the result of children growing out of a food allergy. It may be also influenced by more consequential eating habits in a group of adolescents and the elimination of allergenic foods from the diet. The decreasing incidence of atopic dermatitis appears to be also related to improvement in air quality.

Symmetry Control of Unconventional Spin-Orbit Torques in IrO2.

Spin-orbit torques generated by a spin current are key to magnetic switching in spintronic applications. The polarization of the spin current dictates the direction of switching required for energy-efficient devices. Conventionally, the polarizations of these spin currents are restricted to be along a certain direction due to the symmetry of the material allowing only for efficient in-plane magnetic switching. Unconventional spin-orbit torques arising from novel spin current polarizations, however, have the potential to switch other magnetization orientations such as perpendicular magnetic anisotropy, which is desired for higher density spintronic-based memory devices. Here, it is demonstrated that low crystalline symmetry is not required for unconventional spin-orbit torques and can be generated in a nonmagnetic high symmetry material, iridium dioxide (IrO2 ), using epitaxial design. It is shown that by reducing the relative crystalline symmetry with respect to the growth direction large unconventional spin currents can be generated and hence spin-orbit torques. Furthermore, the spin polarizations detected in (001), (110), and (111) oriented IrO2 thin films are compared to show which crystal symmetries restrict unconventional spin transport. Understanding and tuning unconventional spin transport generation in high symmetry materials can provide a new route towards energy-efficient magnetic switching in spintronic devices.

Autonomic nervous system activity in constipation-predominant irritable bowel syndrome patients.

BACKGROUND: The main mechanism underlying irritable bowel syndrome is currently believed to be a dysfunction of the brain-gut axis. Autonomic nervous system dysfunction can contribute to development of irritable bowel syndrome symptoms by disturbing visceral sensations. MATERIAL/METHODS: Thirty patients with a diagnosis of constipation-predominant irritable bowel syndrome and 30 healthy volunteers were included in the study. Resting and functional autonomic nervous system tests and percutaneous electrogastrography were performed. Plasma adrenalin, noradrenalin, insulin, ghrelin and cholecystokinin activity was analyzed. RESULTS: Increased sympathetic activation with disturbed parasympathetic function was demonstrated. Patients had substantially higher plasma catecholamine concentration, which confirms sympathetic overbalance. Hyperinsulinemia may explain sympathetic predominance followed by gastric and intestinal motility deceleration. Abnormal, reduced ghrelin and cholecystokinin titre may disturb brain-gut axis functioning and may be responsible for gastric motility deceleration. In electrogastrography, distinctly lower values of fasting normogastria percentage and dominant power were observed. Patients had substantially lower slow wave coupling percentage both in fasting and postprandial periods, which negatively correlated with plasma catecholamines level. Gastric myoelectrical activity disturbances may result from lack of sympatho-parasympathetic equilibrium. CONCLUSIONS: Central sympathetic influence within the brain-gut axis is most probably responsible for myoelectrical activity disturbances in irritable bowel syndrome patients.

Gastric dysfunction in dialysed patients with chronic renal failure.

BACKGROUND: Gastric motor functions are disturbed in patients with chronic renal failure (CRF). The aim of this study was to find the relationship between GI symptoms, gastric myoelectrical activity and regulatory peptides (gastrin, motilin, VIP, CCK) in patients with CRF treated with hemodialyses (HD) and peritoneal dialyses (CAPD). METHODS: Gastric myoelectric activity was evaluated with cutaneously recorded electrogastrographs (EGGs) measurement in: group A: 23 pts with CRF treated with CAPD, group B: 21 pts treated with HD and group C: 48 matched healthy controls. GI symptoms severity was quantified with specially designed questionnaire. The laboratory evaluation of plasma parameters, such as: gastrin, motilin, VIP and CCK was performed. RESULTS: The patients with CRF treated with CAPD and HD showed a significantly lower percentage of normal 2-4 cpm wave's rhythm in both fasting (65.3 +/- 29.3% vs 43.5 +/- 35.9% vs 86.4 +/- 10.2%) and fed conditions (72.7 +/- 34.2% vs 69.5 +/- 22.1% vs 89.3 +/- 9.5%) in comparison to controls. In the fasting state, none of the healthy controls had an abnormal EGG, whereas the 27 patients with CRF (61.3%) had an abnormal EGG. In the fed state the 18 patients with CRF (40.9%). No significant increase of the dominant power (PDP) after meal in CRF patients was observed. The plasma concentrations of gastrin, CCK were increased in fasted and fed CRF patients, whereas VIP and motilin only in fed state. CONCLUSIONS: The patients with CRF showed impaired gastric myoelectrical activity in response to food and high levels of GI hormones. Gastric dysmotility and high peptides appears to be partially responsible for GI symptoms.

Trends in the Epidemiology of Allergic Diseases of the Airways in Children Growing Up in an Urban Agglomeration.

The prevalence of asthma and allergies among children has become an increasing problem in the last few decades. Data on the population of children and adolescents, especially living in polluted cities, are limited and based on studies carried out in small groups. In our study, we analyzed the incidence of asthma and allergic rhinitis between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged seven to eight and adolescents aged 16-17, which allowed us to assess the frequency of allergic diseases in the population of children and youth in Krakow. More than 40% of respondents reported allergic symptoms, and nearly 50% of them were not diagnosed and treated. In the group of seven- and eight-year-olds with a positive history of allergies, 52% had allergic rhinitis and 9.1% had asthma. In the group of 16-17-year-olds, allergic rhinitis was diagnosed in 35.8%, while asthma was found in 4.9% of cases. The results obtained over the course of 10 years has shown the reduction in the frequency of asthma (from 22% in the case of asthma in both age groups) and allergic rhinitis cases (from 63.9% in adolescents). In our opinion, this can be considered a positive effect of the preventive measures taken in Kraków after 2010. Although there is still a higher incidence of allergic diseases among children and young people living in urban areas compared to rural areas, the trend apparently has reversed for some diseases.

The Influence of Air Pollution on the Development of Allergic Inflammation in the Airways in Krakow's Atopic and Non-Atopic Residents.

Until now, the simultaneous influence of air pollution assessed by measuring the objective marker of exposition (1-hydroxypirene, 1-OHP) and atopy on the development of allergic airway diseases has not been studied. The aim of this study was to determine the pathomechanism of the allergic response to PM2.5 in atopic and non-atopic patients. We investigated the changes in peripheral blood basophil activity of patients after stimulation with the birch pollen allergen alone, the allergen combined with PM2.5 (BP), PM2.5 alone, a concentration of 1-OHP in urine, and a distance of residence from the main road in 30 persons. Activation by dust alone was positive for all concentrations in 83% of atopic and 75% of non-atopic assays. In the group of people with atopy, the simultaneous activation of BP gave a higher percentage of active basophils compared to the sum of activation with dust and birch pollen alone (B + P) for all concentrations. The difference between BP and B + P was 117.5 (p = 0.02) at a PM concentration of 100 µg. Such a relationship was not observed in the control group. The correlation coefficient between the distance of residence from major roads and urinary 1-OHP was 0.62. A Pearson correlation analysis of quantitative variables was performed, and positive correlation results were obtained in the atopy group between BP and 1-OH-P. Exposure to birch pollen and PM2.5 has a synergistic effect in sensitized individuals. The higher the exposure to pollutants, the higher the synergistic basophil response to the allergen and PM in atopic patients.

Comparison of cardiac and gastric responses to vagal stimulation in hypertensive women.

BACKGROUND: The aim was to evaluate the interactions between the effects of vagal stimulation by sham feeding (nonbaroreflex) and deep breathing (baroreflex) on heart rate variability (HRV) and gastric myoelectrical activity (GMA) in pre- and postmenopausal women with essential hypertension. MATERIAL/METHODS: One hundred five post- and premenopausal women with hypertension and 60 premenopausal normotensive women were observed. The study protocol consisted of 5 min of resting HRV followed by 5 min of deep breathing (DB), then 6 min of sham feeding (SF) with 30-min electrogastrography (EGG) before and after SF. The fasting plasma level of noradrenalin was measured. RESULTS: The HRV parameter values at rest in the hypertensive group were half those in the control group (p<0.05). There were notably higher HRV parameter values in the premenopausal women. Plasma noradrenalin level was higher in the postmenopausal women (p=0.0009). The effect of DB was similar before and after menopause; however, HRV parameters in response to DB were lower in the hypertensive women than in the controls (p<0.05). In the controls there was a marked increase in the main HRV parameters in response to DB. In fasting electrogastrography the lowest normogastria percentage was observed in the postmenopausal women. EGG showed that only SF significantly affected the period dominant power (PDP) in all groups and the bradygastria percentage in the postmenopausal women. CONCLUSIONS: This study suggests that the interactions that occur between the effects of non-baroreflex and baroreflex vagal stimulation in hypertensive women may contribute to gastric motility disorders and dyspeptic symptoms.

[Gastric motility disorders in patients after pancreatoduodenectomy]. / Zaburzenia motoryki zoladka u pacjentów po pankreatoduodenektomii.

The aim of the study was to evaluate effect of pancreatoduodenectomy on the gastric motility in patients with pancreatic carcinoma. In the patients with cancer pancreatoduodenectomy causes disorders of gastric myoelectric activity, gastric motility and autonomic nervous system function. Gastroparesis after surgery seems to depend on specific abnormalities in neurohormonal interaction of the GI tract.

[Influence of vagal stimulation by deep breathing and sham feeding on autonomic system response in healthy women]. / Wplyw pobudzenia nerwu blednego przez glebokie oddychanie i rzekome karmienie na odpowiedz ukladu autonomicznego u kobiet.

Sham feeding (SF) opposite to deep breathing (DB) is not standard method for testing autonomic nervous system but is widely used for parasympathetic stimulation of gastrointestinal secretion and motility. Differences in vagal autonomic system response induced by both methods resulted from different localization of receptors and cortical and spinal autonomic centers.

Myoelectric and autonomic nervous system activity in patients with irritable bowel syndrome.

Explanation of the main causes of symptoms and dysfunctions in the FGIDs is focused on visceral hypersensitivity. Sympathetic stimulation increases sensitivity of visceral receptors. Thus overall influences of the autonomic nervous system are important not only in regulation of secretion and motility of the gastrointestinal tract but also in visceral sensation. The aim of this study was to evaluate gastric motility disturbances and changes in the autonomic nervous system (ANS) activity in irritable bowel syndrome patients (IBS). Our results show changes of the autonomic system activity in patients with IBS: decreased parasympathetic and increased sympathetic activity. The patients with autonomic dysfunction had also high percentage of dysrrhythmia time. We conclude that dyspeptic symptoms in patients with autonomic dysfunction are caused mostly by high adrenergic drive resulting in dysrrhythmias and decrease in the EGG amplitude.

[Percutaneous nephrolithotripsy efficacy assessement in nephrolithiasis treatment]. / Ocena skutecznosci leczenia kamicy nerkowej metoda przezskórnej nefrolitotrypsji.

PCNL is an up-to-date endoscopic method of nephrolithiasis treatment, characterized by high efficacy and low invasiveness. In this study we analyze our own experiences in nephrolithiasis treatment. In St. Luke Hospital, Tarnow PCNL has been the leading method of treatment of kidney stones since 1997. Low incidence of complications allows to choose this procedure in more than 90% of nephrolithiasis patients.

Antibody reactivity in patients with IgE-mediated wheat allergy to various subunits and fractions of gluten and non-gluten proteins from ω-gliadin-free wheat genotypes.

[b]Abstract Introduction and objective[/b]. Gluten proteins (gliadins and glutenins) are polymorphic wheat storage proteins of allergenic properties. Significant differences in chemical composition between both protein groups allow to expect highly specific immunological response of individual subunits and fractions in reactions with IgE sera of people allergic to wheat. The aim of these studies was to identify and characterize the most allergenic gluten proteins (GP) and nongluten proteins (NGP) occurred in two closely related wheat hybrid genotypes. [b]Materials and method.[/b] 3xC and 3xN wheat hybrids, which differ strongly in regard of gliadin composition, were analyzed. Seven people manifesting different symptoms of wheat allergy donated sera for the experiment. The technique of immunoblotting after SDS-PAGE was used for identification of allergenic subunits and fractions among GP and NGP. Immunologically active protein bands were visualized by chemiluminescence. [b]Results[/b]. Great variation of immunodetection spectra was observed. Results of immunoblotting showed LMW glutenins to be of highest, gliadins of medium, while NGP of lowest allergenicity for selected patients. The 43-kDa and 47-kDa LMW glutenin subunits, 40-kDa and 43-kDa γ-gliadin fractions and 49-kDa NGP can be considered as the most immunoreactive among all protein bands [b]separated by SDS-PAGE. CONCLUSION: [/b] The observed differentiation of immunodetection spectra allows to model highly specific IgE-binding profiles of allergenic wheat proteins attributed to individual patients with symptoms of gluten intolerance. Highly immunoreactive subunits and fractions among GP and NGP were identified. The observed immunoreactivity of 49 kDa NGP is worth to emphasize, as it has never been reported as wheat allergenic protein before.

[The autonomic nervous system function in benign prostatic hyperplasia]. / Ocena funkcji autonomicznego ukladu nerwowego w lagodnym przeroscie gruczolu krokowego.

BPH is responsible for lower urinary tract symptoms (LUTS). Pathogenesis of prostatic overgrowth is multifactorial. It has been suggested that the autonomic nervous system (ANS) may also be involved. The aim of the study was to evaluate the role of the ANS activity in pathogenesis of BPH. The study was done in 13 men with LUTS secondary to BPH. ANS activity was assessed based on heart rate variability (HRV) measurement in resting conditions and after simulation with deep breathing (DB test) and the tilt test. LUTS (with IPSS scale), quality of life, waist-hip ratio and objective measures of benign prostatic hyperplasia (BPH), were evaluated. Correlation for LF/HF ratio vs. BPH variables was calculated. Results of the study showed sympathetic overactivity and impaired parasympathetic response to stimulation in both DB and tilt test.

Antral gastric motility impairement and autonomic nervous system dysfunction in patients with pancreatic cancer (preliminary results).

The aim of the study was to evaluate the influence of pancreatic carcinoma on gastric motility and autonomic system activity in patients before surgery. Patients with histologically confirmed pancreatic cancer were studied. Our results show that gastric dysrrhythmias are continuously present in patients with pancreatic cancer both with and without gastric emptying delay. Antral distribution of meal suggests the presence of impaired proximal gastric response to meal due to diminished autonomic nervous system function and impaired myoelectric gastric activity in patients with pancreatic cancer.

Comparison of the basophil activation test versus the nasal provocation test in establishing eligibility for specific immunotherapy.

INTRODUCTION    Allergic rhinitis (AR) is the most common atopic disease. Specific immunotherapy (SIT) is the only effective treatment method for AR. In uncertain diagnostic cases, before establishing eligibility for SIT, nasal provocation tests (NPTs) should be performed. However, there are numerous contraindications to performing NPTs, and there is ongoing search for an alternative in vitro method. OBJECTIVES    The aim of the study was to determine whether a specific in vitro provocation, that is, the basophil activation test (BAT), may replace a specific in vivo provocation, that is, the NPT, in establishing patient's eligibility for SIT. PATIENTS AND METHODS    The study included 30 patients with AR caused by allergy to house dust mite or birch pollen, referred for SIT. The assessment of basophil activation by measuring CD63 antigen expression was performed using the Flow2 CAST test. Basophils were stimulated with allergen preparation (concentrations of 5000, 500, and 50 standardized biological units) used in NPTs. BAT results were expressed as stimulation index (SI) and basophil reactivity (BR). RESULTS    Allergen concentrations of 500 and 50 SBU proved to be appropriate for basophil stimulation. Median SI and BR were higher for positive NPT results than for negative NPT results (P <0.001). Sensitivity for SI and BR was in the range from 83% to 100%; specificity, from 78% to 89%; positive predictive value, from 75% to 87%; and negative predictive value, from 89% to 100%. We observed a high correlation of the analyzed parameters for the allergen concentrations of 500 and 50 SBU (range, 0.58-0.74; P <0.05). CONCLUSIONS    If there are contraindications to performing the NPT, BAT may be regarded as an alternative in establishing patients' eligibility for SIT. The optimal concentrations of allergen preparations are 500 and 50 SBU. Both SI and BR are good indicators of basophil activation.