Azacitidine for Relapse After Allogeneic Stem Cell Transplantation-Single-Center Study.

BACKGROUND: Relapse is the leading cause of treatment failure for myeloid malignancies treated with allogeneic hematopoietic stem cell transplantation. Treatment options are very limited and use of azacitidine is one of the available options. METHODS: This was a retrospective, single-institution study. Of 28 evaluated patients, 18 were males, and the median age was 60 years (range, 15-78). There were 15 patients with acute myeloid leukemia, 8 with myelodysplastic syndrome, 4 with chronic myelomonocytic leukemia, and 1 with primary myelofibrosis. Ten patients received azacitidine for overt relapse, 14 received it as a preemptive therapy, and 4 others received it as maintenance treatment after allo-hematopoietic cell transplant (HSCT). Eleven patients received a donor lymphocyte infusion (DLI). RESULTS: The patients received median 5 (1-9) cycles of azacitidine in preemptive and maintenance therapy and median 2.5 (1-9) cycles in patients with relapse. Thirty-nine percent of patients received DLIs. Median overall survival was 6.1 months (95% CI, 0.7-13) for relapse therapy vs 21.2 months (95% CI, 8.4-inf) for preemptive therapy. Among patients treated for relapse, 30% achieved temporary disease control and underwent the second allo-HSCT. A complete, cytogenetic remission was achieved in 50% of patients and stable minimal residual disease in 14% of patients in a group with preemptive therapy. Toxicity was considerable; neutropenia (71%), anemia (14%), thrombocytopenia (36%), and serious infections (36%) were observed in the preemptive setting. CONCLUSIONS: These data support the notion that azacitidine is best used as a preemptive therapy against relapse for patients after allo-HSCT performed for myeloid malignancy. Applying azacitidine as therapy for ongoing relapse after allo-HSCT may lead to stable disease and allow for better performance of the second allo-HSCT.

Morphological description of the alimentary tract of Geoicautricularia (Passerini, 1856) (Insecta, Hemiptera, Eriosomatinae).

Existing literature data report the lack of stomach and crenated intestine in the aphid species Geoicasetulosa (Passerini, 1860), a representative of subfamily Eriosomatinae. This odd anatomical feature seemed remarkable, due to the presence of fully developed intestine in closely related genera and mutualistic relationship with ants of this genus. The study aimed at repeated anatomical research of Geoicautricularia (Passerini 1856), in order to confirm what seemed to be a generic feature. Standard histological methods were applied, with addition of oblique light microscopy, fluorescence microscopy and confocal laser scanning microscopy. The results indicated the existence of a fully developed intestine, with broad sac-shaped stomach and loops of the crenated intestine. The general anatomy of the alimentary tract of G. utricularia resembles that of other representatives of the tribe Fordini. Also well-developed rectal gland is present, most probably playing a role in modifying the carbohydrate composition of excreted honeydew.

Valdensinia heterodoxa Peyronel as a New Pathogen of Blueberry in Poland.

Valdensia leaf blight on blueberry in Poland was reported in one commercial nursery plantation near Prazmów, Mazovia voivodship, where heavy defoliation was observed on cv. Bluecrop, grown in nursery pots, in August 2011. Older fruiting bushes were only slightly affected by the disease. Initial symptoms of the disease were small, oval to circular zonated necrosis surrounded with dark brown borders that enlarged on the leaves throughout the canopy. Multicellular, hyaline or light brown, star-shaped conidiospores were observed on the necrotic areas. The mean length of 50 conidiospores from the end of head to the end of arm apex was 307 to 348 µm (4). Eight single-spore isolates of the fungus were obtained. Single conidiospores were picked up from necrotic spots on leaves and transferred with sterile needle on potato dextrose agar (PDA) and incubated at 20°C under ambient light. After 10 days of incubation, total DNA was extracted. Amplification of the internal transcribed spacer (ITS) region of rDNA was done using primers ITS1F and ITS4A (1). PCRs were carried out as follows: initial denaturation at 94°C for 2 min, denaturation at 94°C for 1 min, annealing at 57°C for 1 min, extension at 72°C for 1 min, and final extension at 72°C for 5 min for 28 cycles (Applied Biosystems Veriti 96 Wel Thermal Cycler). Amplicons, which were approximately 520 bp, were sequenced and nucleotide sequences were analyzed by Clustal W2EBI. The sequences of all eight isolates showed 100% similarity to each other and were compared with sequences stored in GenBank using BLAST. Sequences were 525 bp long and showed 100% homology to Valdensinia heterodoxa Peyronel, Sclerotiniaceae (anamorph: Valdensia heterodoxa Peyronel) from Japan and Norway (Accession Nos. AB663682 and Z81447, respectively) (3). The sequence from one isolate was submitted to GenBank (Accession No. KF212190). To fulfill Koch's postulates, each of the eight isolates was used to inoculate 20 healthy young leaves of Vaccinium corymbosum L. cv. Bluecrop and bilberry (V. myrtillus L.) (10 leaves per plant). Mycelial plugs 5 mm in diameter were taken from PDA cultures, approximately 20 days old, and used as inoculum and placed in the center of each leaf and moistened with sterile distilled water. Mycelium-free plugs were used as control. Inoculated leaves were placed in plastic box and incubated at 20°C in laboratory for 5 days, at which time small necrotic lesions consistent with initial symptoms of the disease were observed. Isolates obtained from these symptoms were morphologically identical to those used for inoculation. Control leaves did not show any disease symptoms. Valdensia leaf blight occurrence may be attributed to rainy July and August 2011 and long presence of water on soil surface. In Poland, Valdensinia heterodoxa causes heavy defoliation of Vaccinium myrtillus in pine stands and is a common pathogen of some herbaceous plants (2). To our knowledge, this is the first report of Valdensia leaf blight on highbush blueberry in Poland. References: (1) I. Larena et al. 75:187, 1999. (2) W. Mulenko and S. Woodward. Mycologist 10:69, 1996. (3) S. Nekoduka et al. J. Gen. Plant Pathol. 78:151, 2012. (4) S. Zhao and S. F. Shamoun. Mycology 1:113, 2010.

Maternal allergy as a potential source of variability of exhaled nitric oxide in children non-sensitized to common domestic allergens.

The goal of the study is to evaluate the importance of maternal atopy as a potential biological source of variability of exhaled FeNO values in healthy children who were non-asthmatic and non-sensitized to common domestic allergens. The study sample consisted of 61 seven-year old children. Fractional exhaled nitric oxide (FeNO) has been measured by NObreath (Bedfont portable device). Children with reported maternal atopy had significantly higher mean FeNO values (geometric mean =10.7 ppb; 95%CI: 6.7-17.1 ppb) than those who denied it (geometric mean =5.2 ppb 95%CI: 3.9-6.9 ppb) (p=0.010). Neither the correlation between FeNO values and gender, respiratory and eczema symptoms, nor ETS exposure in the prenatal and postnatal period or body mass of children were significant. We also found no significant association of FeNO values with the amount of common domestic allergens measured in the households. The results of the ROC analysis suggested 11 ppb as the cut-off point for FeNO to distinguish groups of healthy children with and without maternal atopy. In conclusion, our study provided some evidence suggesting that maternal atopy may affect FeNO level in children independently of asthma and sensitization status to common domestic allergens. The data should be considered in the interpretation of FeNO levels in clinical practice and setting up FeNO screening criteria for identification of eosinophilic airway inflammation.

Wheezing and asthma may be enhanced by broad spectrum antibiotics used in early childhood. Concept and results of a pharmacoepidemiology study.

UNLABELLED: One of the mechanisms supposed to explain the increasing prevalence of asthma, among children in particular, is the use of antibiotics because they may modify natural microbial exposure and development of the immune system in early childhood. The aim of this study is to investigate the association between the use of various classes of antibiotics (penicillin, cephalosporin and macrolide derivatives) in early childhood and the medical diagnosis of asthma or wheezing reported by mothers over the follow-up after adjustment for potential confounders and respiratory infections. In a population-based sample of 5-year-olds, a part of the ongoing birth cohort study, the standardized interviews on health outcomes, potential confounders (child's gender, maternal atopy, parity, prenatal and postnatal environmental tobacco smoke) and the use of antibiotics were gathered from mothers of 310 children. While the overall use of antibiotics during the early childhood was insignificantly associated with asthma (adjusted OR = 1.65, 95%CI: 0.93 - 2.93), the risk estimates were significant both for macrolide antibiotics (adjusted OR=2.14, 95%CI: 1.16-3.95) and cephalosporins (OR=1.98, 95%CI: 1.14-3.37). The significant excess in IRR (incident risk ratio) of wheezing episodes was related only to the use of macrolide antibiotics (adjusted IRR=1.91, 95%CI: 1.12-3.27). The use of other classes of antibiotics was found not to be associated with the medical diagnosis of asthma or wheezing episodes recorded in the study period. CONCLUSION: as early childhood use of broad spectrum antibiotics is associated with an increased risk of developing asthma in 5-year-olds, it may be hypothesized that the antibiotic- related suppression of allergic inflammatory responses in the course of treatment may later lead to greater than before atopic immune response in Th2 children or an impairment of Th1 immune responses in early childhood.

Impact of excessive gestational weight gain in non-smoking mothers on body fatness in infancy and early childhood. Prospective prebirth cohort study in Cracow.

Gestational weight gain (GWG) is important for health policy as it may be associated with overweight epidemics in childhood and adolescence. The purpose of the study was to perform the risk assessment of joint effects of the excessive GWG and the pregravid maternal BMI on overweight in infancy and childhood. The observations were collected in the ongoing prospective birth cohort study of 482 non-smoking mothers and their newborns in Cracow inner city area. At 5 years of age the subsample of 312 infants were reexamined in order to assess their nutritional status. Body fatness was assessed by means of the weight/length ratio (WLR) in neonates and weight/height ratio (WHR) in 5-year-olds since they showed the strongest correlation with subcutaneous fat mass of young children. In the statistical analysis the binary regression models were applied to identify predictors of overweight. The excessive GWG (>18 kg) increased more than twofold the adjusted relative risk (RR) of neonatal fatness (R=2.7; 95% CI 2.0-3.7) and was also a significant independent risk factor for postnatal body fatness at 5 years of age (RR=2.0; 95% CI: 1.3-3.3). The results confirmed earlier findings that pregravid overweight increased not only the relative risk of neonatal fatness (RR=2.9; 95% CI: 2.2-3.9) but also overweight in early childhood (RR=2.7; 95% CI: 1.7-4.4). The conclusion is that excessive GWG may be a risk factor for overweight in early childhood and should be a focus of public health policy.

First Report of Microcyclosporella mali Causing Sooty Blotch and Flyspeck Disease on Plum in Poland.

Sooty blotch and flyspeck (SBFS), a disease caused by a complex of fungi, results in substantial economic losses for commercial growers of scab-resistant apple (Malus × domestica Borkh.) cultivars in Poland. However, many species causing SBFS in Poland are unidentified and sources of inoculum are uncertain. In August 2009, signs of SBFS were noted on fruit of plum (Prunus domestica L., cvs. Sweet Common Prune and Oullins Golden Gage) in orchards near Mostki in central Poland. Colonies consisted of olive green-to-black mycelial mats with few sclerotium-like bodies; infections ranged in severity from scattered spots to nearly complete coverage of the fruit surface. Ten of these colonies were isolated on potato dextrose agar (PDA). After 10 days of incubation at 22°C, total DNA was extracted; amplification of the internal transcribed spacer (ITS) region of rDNA utilized primers ITS1 and ITS4 (1). Nucleotide sequences were analyzed by ClustalW and compared with sequences in GenBank using BLAST. Sequences showed 99 to 100% homology to Microcyclosporella mali (2), which was formerly assigned as Pseudocercosporella sp. (1). Sequences from five isolates were submitted to GenBank (Accession Nos. HM101275, HM101276, HM101277, HM101278, and HM101279). Morphological characteristics-conidiogenous cells integrated, sympodial and polyblastic; conidial scars nonthickened and inconspicuous; conidia hyaline, subcylindric, narrow, straight or very slightly curved, truncate at the base and obtuse at the apex, often catenulate in simple or branched chains, with one (commonly) to five septa (12.5 × 2.6 to 50.7 × 4.0 µm)-were consistent with descriptions of M. mali (2). To fulfill Koch's postulates, each of the 10 isolates was used to inoculate three healthy apple fruit (cv. Golden Delicious) that had been previously washed under tap water and disinfested with 70% ethanol. After fruit were swabbed with cotton plugs that had been saturated with a suspension of spores in sterile distilled water (SDW), inoculated fruit were placed on filter paper that had been moistened with SDW, then sealed in foil bags and incubated at 22°C. When bags were removed 5 weeks later, dark colonies had appeared on the fruit. Isolates obtained from these colonies were morphologically identical to those used for inoculation. Control (SDW-inoculated and noninoculated) fruit that were incubated in the same manner developed no colonies. To our knowledge, this is the first report of SBFS on plum caused by M. mali in Poland; it had previously been noted as part of the SBFS complex on apple in Germany and Slovenia (2) and on apple and plum in the United States (3). References: (1) J. C. Batzer et al. Mycologia 97:1268, 2005. (2) J. Frank et al. Persoonia 24:93, 2010. (3) J. Latinovic et al. Plant Dis. 91:1685, 2007.

Extracts of retina and brain that excite afferent fibers innervating hair cells contain a compound related to hydroxyphenylglycine-N-carbamoyl.

To identify new neurotransmitter and modulator candidates that might be important in transmission from sensory hair cells to afferent nerves, we examined extracts of neural tissue for compounds that excite afferent fibers innervating hair cells. Here, we describe the extraction and purification from retina and brain of a potent, unstable, excitatory compound with pharmacological activity similar to glutamate on afferent fibers innervating hair cells. This compound, however, was clearly distinguished from glutamate, other common amino acids, and known endogenous glutamate-receptor agonists. After derivatization and analysis by gas chromatography-mass spectrometry, the major compound found in highly purified neuroactive chromatographic fractions had the same gas chromatographic elution time and mass spectrum as the compound formed by derivatization of L-p-hydroxyphenylglycine-N-carbamoyl. Hydroxyphenylglycine-N-carbamoyl, however, did not copurify with the neuroactive compound and was not neuroactive. We thus hypothesize that the detected compound was produced from a precursor, structurally related to L-p-hydroxyphenylglycine-N-carbamoyl, that was a major component of the neuroactive chromatographic fractions. Because several compounds related to hydroxyphenylglycine are known to act on glutamate receptors, such a compound is an interesting candidate to be an endogenous glutamate-receptor ligand in the mammalian nervous system.

Virulence factors and in vitro adherence of Enterococcus strains to urinary catheters.

The ability to adhere in vitro to urinary catheters and the presence of enterococcal virulence factors was determined in 30 Enterococcus urinary isolates (12 E. faecalis, 12 E. faecium, 3 E. casseliflavus, 3 E. gallinarum). Silicone, siliconized latex and polyvinyl chloride (PVC) were examined by sonication quantitative culture technique and scanning electron microscope. As compared to E. faecalis and E. faecium, E. casseliflavus and E. gallinarum displayed lower adhesion to all synthetic materials. All the tests performed showed higher adherence of all tested strains to siliconized latex and silicone than to PVC. Biofilmforming ability was observed in 5 E. faecalis but in none of the remaining strains. The gene coding enterococcal surface protein (Esp) was detected in 7 E. faecalis and 6 E. faecium strains. Gelatinase was found in 1 E. faecalis, 2 E. faecium and hemolysins were found in 6 E. faecalis and 1 E. faecium strains. All E. casseliflavus and E. gallinarum strainswere negative for these traits. Hydrophobic type of cell surface (measured by its affinity for n-hexadecane) was shown in a few isolates. Bacterial adherence was not significantly associated with the above pathogenic factors.

Cohort study on low physical activity level and recurrent acute respiratory infections in schoolchildren.

The purpose of the study was to explain childhood respiratory infections in terms of life-style factors like being overweight or physically inactive. In the course of the cohort study we gathered data on respiratory health of 1028 preadolescent children in Krakow. Recurrent acute respiratory infections (RARI) in children have been defined as frequent spells (10 or more infections) over the two-year follow-up. In scoring the physical activity level, the data on regularly exercising sport and the number of hours spent daily TV watching or doing homework have been used. Excessive weight was based on the BMI index. In the total sample, the RR estimates of RARI adjusted to BMI and other potential confounders were consistently higher in children with low physical exercise (RR = 2.96; 95% CI: 1.78-4.93) or with moderate exercise (RR = 1.87; 95% CI: 1.33-2.65). Than among the highly active group. In the subgroups of allergic and non-allergic or overweight and not-overweight children the adjusted RR estimates were consistent with those found in the total sample. We concluded that physical exercise in preadolescent children may lessen the risk of acute respiratory infections and that the low physical activity is an independent predictor of increased risk of RARI besides excessive weight and other potential risk factors.

[Validity study on the certification and coding of underlying causes of death for the mortality statistic]. / Trafnosc wyboru przez lekarza wyjsciowej przyczyny zgonu i kodowania danych z kart zgonów.

The study was designed to assess the differences in the quality of certification and coding practices of underlying causes of death, which the mortality statistics is based upon. The mains focus of the study was the problem of proper selection of the underlying cause of death in various diseases. In the analysis the potential impact of medical experience of the physicians and the hospitalization of patients before the death have been taken in consideration. There were 479 death certificates chosen randomly out of all certificates filled in by 240 medical doctors in 1999 in Krakow. For each death certificate the available clinical case histories for deceased persons have been collected in order that a team of medical experts could formulate their independent opinion about the underlying cause of death. From comparisons of the underlying causes of death from the death certificates with those of experts, the indices of agreement have been calculated. The best overall agreement has been found for the neoplasmatic diseases (83.1%) and the lowest for the chest diseases (30.7%). For cardiovascular diseases the overall agreement was 65.5%, however in coronary heart disease it reached 74.0% and in cerebrovascular diseases 78.7%. Generally, the better agreement has been demonstrated if the additional information about the coexistent diseases or direct causes of the death has been mentioned in the death certificates as well. The longer period of hospitalization of subjects before death was related significantly with the higher agreement indices.

[Population based studies on the incidence of chronic respiratory symptoms and lung function in children from Krakow]. / Badania populacyjne nad wystepowaniem przewleklych objawów ze strony ukladu oddechowego i czynnoscia pluc u dzieci w Krakowie.

The epidemiologic study has been carried out in the sample of 1048 schoolchildren at the age of 11 years in order to assess the impact of various chronic respiratory symptoms on lung function. The symptoms included chronic dry cough, chronic phlegm, attacks of cough at nights, breathlessness, wheezing independent from respiratory infections or colds, attacks of wheezing at nights, and attacks of dyspnea with wheezing. Lung function was measured by the following spirometric indices: FEV1/FVC%, FEV1, FEF25-75% and PEFR. Multiple regression analysis showed strong statistical inverse relationship between FEV1/FVC% and FEF25-75% and attacks of wheezing at night and attacks of dyspnea with wheezing or asthma diagnosed by physician. The separate analysis performed in the subsample of children without asthma and asthmatic symptoms (attacks of wheezing at night and attacks of dyspnea with wheezing) found out that only chronic dry cough was related significantly to the lower values of FEV1 and PEFR in the children.

[Sensitization to common airborne allergens in school children with bronchial asthma]. / Uczulenie na alergeny wziewne u dzieci szkolnych z astma oskrzelowa.

The main purpose of the paper was to assess the prevalence of atopy in the population of preadolescent children in Krakow on the basis of allergic skin testing to airborne allergens and to look into the relationship between atopy and chronic asthma-like respiratory symptoms. The field study was carried out in 1998 among 311 children being the subgroup of the cohort of 1044 children included in the 3-year follow-up in Krakow. The health assessment accounted for the standardised interviews and skin prick testing to 11 common airborne allergens. In the total, the positive allergic reaction at least to only one allergen was found in 32.5% children, and it was more prevalent in boys than in girls (40.4% vs 28.1%). Allergy only to indoor allergens was present in 9.7% children, allergy only to outdoor allergens in 9.7%, and allergy both to outdoor and indoor allergens was confirmed in 13% persons. Most frequently, allergy was established to house mites: Dermatophagoides pter. (16.2%), Dermatophagoides farinae (12.0%) and to cat dander (11.4%). Asthma-like symptoms occurred in 11.0% of children and asthma diagnosed by physician in 7.8% of the sample under the study. The results of this study proved that the prevalence of asthma was about twice so high in boys than in girls. The risk of asthma-like symptoms and/or asthma diagnosed by physician increased significantly with the number of positive allergic tests to airborne allergens (OR = 1.30; 95% CI: 1.11-1.52) and atopy in mother (OR = 1.84; 95% CI: 1.03-3.37).

The adverse effect of low levels of ambient air pollutants on lung function growth in preadolescent children.

The main purpose of our study was to assess the effect of low concentrations of ambient air pollution on lung function growth in preadolescent children. We accounted for height velocity over the follow-up period and also for other possible confounders such as baseline anthropometric and physiologic characteristics of children. In addition to outdoor air pollution, we considered the possible effects of social class and exposure to indoor pollutants such as gas stove fumes or environmental tobacco smoke. The cohort prospective study was carried out in 1,001 preadolescent children from two areas of Krakow, Poland, that differed in ambient air pollutants. In the city center (higher pollution area), the mean annual level [+/- standard deviation (SD)] of suspended particulate matter was 52.6 +/- 53.98 microg/m(3) and that of SO(2) was 43.87 +/- 32.69 microg/m(3); the corresponding values in the control area were 33.23 +/- 35.99 microg/m(3) and 31.77 +/- 21.93 microg/m(3). Mean lung function growth rate adjusted to height velocity and lung function level at the study entry was significantly lower in boys and girls living in the more polluted areas. Also, the proportion of children with the slower lung function growth (SLFG) was higher in the children from the more polluted area of the city. The analysis completed in the group of children after the exclusion of asthmatic subjects and those with asthmalike symptoms confirmed that, in boys, odds ratios (ORs) for SLFG [forced vital capacity (FVC)] and air pollution after adjustment to baseline FVC, height, and growth rate was significant [OR = 2.15; 95% confidence interval (CI), 1.25-3. 69)]. The analysis also confirmed that for SLFG(FEV(1)) the OR was 1. 90 (CI, 1.12-3.25). The corresponding OR values in girls were insignificant (OR = 1.50; CI, 0.84-2.68 and OR = 1.39; CI, 0.78-2. 44). The association between ambient pollutants and poorer gain of pulmonary volumes in children living in more polluted areas suggests that air pollution in the residence area may be a part of the causal chain of reactions leading to retardation in pulmonary function growth during the preadolescent years.

Predisposition to acute respiratory infections among overweight preadolescent children: an epidemiologic study in Poland.

This cross-sectional field health survey has as its subjects 1129 preadolescent children resident in Krakow. Trained health visitors interviewed the mothers at the children's schools or at the parents' homes in order to gather standardized information regarding the families' social background and the families' and children's respiratory health and episodes of respiratory infections. Predisposition to respiratory infections in children has been defined as frequent spells (3 or more) of acute respiratory infections experienced by a given child over the 12 months preceding the interview. Clinical examination of children consisted of anthropometric measurements and spirometric testing. Anthropometric measurements (weight and height) were used for calculation of the body mass index (kg/m2). A child whose BMI was 20 or higher was defined as overweight (90th percentile). Susceptibility to acute respiratory infections was related significantly to body mass index. The children with BMI > or = 20 experienced twice as high a risk for acute respiratory infections than children with low BMI (OR = 2.02, 95% CI: 1.13-3.59). Out of other potential factors possibly involved in the occurrence of respiratory infections only the presence of chronic respiratory symptoms (OR = 2.43, 95% CI: 1.64-3.59), allergy (OR = 1.89, 95% CI: 1.34-2.66), and Environmental Tobacco Smoke (OR = 1.54; 95% CI: 1.05-2.25) increased the susceptibility of children to acute respiratory infections. Central heating in the household was shown to have a protective effect (OR = 0.65, 95% CI: 0.43-1.00) when compared with children from households where coal or gas was used for home heating.

PIP: Factors predisposing to recurrent acute respiratory infection were investigated in a cross-sectional field study of 1129 schoolchildren 9 years of age from Krakow, Poland. Predisposition to respiratory infections was defined as 3 or more spells in the 12 months preceding the 1995 study. Susceptibility to acute respiratory infections was significantly associated with body mass index. Overweight children (body mass index of 20 or higher) had twice the risk of infection than children with a lower body mass index (odds ratio (OR), 2.02; 95% confidence interval (CI), 1.13-3.59). Other significant risk factors were the presence of chronic respiratory symptoms (OR, 2.43; 95% CI, 1.64-3.59), allergy (OR, 1.89; 95% CI, 1.34-2.66), and environmental tobacco smoke (OR, 1.54; 95% CI, 1.05-2.25). Central heating in the household exerted a protective effect compared to households where coal or gas was used (OR, 0.65; 95% CI, 0.43-1.00). The strong effect of obesity on acute respiratory infection risk was independent from other host and environmental factors. Findings of a strong correlation in these children of body weight with the lung function tests FVC and FEV further support the view that the predictive spirometric formulas for preadolescents should consider weight as an important independent predictor of lung function.

[Allergy and lung function in school children]. / Wystepowanie alergii i sprawnosc wentylacyjna pluc w populacji dzieci szkolnych.

In order to measure the effect of allergy on the lung function among schoolchildren a cross-sectional study has been performed in 1048 children of 10-11 year age who attended the grammar schools in Krakow. The lung function was assessed by the following spirometric indices: VC, FVC, FEV0.5, FEV0.75, FEV1, FEF25-75%, FEF0.2-1.2, PEFR while the data on allergy diagnosed clinically by physician was obtained by self-administered questionnaires from the parents of children. For those of the children who had the allergic skin test performed a search in medical records has been carried out. The frequency of allergy diagnosed clinically (without skin tests) was higher in boys (22.3%) than in girls (18.4%) and the same differences have been found for allergy confirmed by skin testing (15.7% vs. 9.3%). Except for VC and FVC, all adjusted mean values of spirometric indices were significantly lower in allergic than in non-allergic group of children. Regression coefficient of spirometric indices were related inversely with the presence of allergy. The greatest effects of allergy (without skin tests) have been observed on PEFR (-180 ml), FEF0.2-1.2 (-171 ml), FEF25-75% (-121 ml) and for FEV0.75 (-69 ml) and FEV1 (-68 ml). The smallest differences were found for VC and FVC. The additional series of analysis done in the subgroup of children without attacks of dyspnea with wheezing or wheezing independent from colds or respiratory infections confirmed the results obtained in the total study sample. The prevalence of obstructive syndrome, defined as FEV1/FVC < 80%, was 4.5% in the total sample, however, only 2.9% in non-allergic children, 7.2% in children in whom allergy was diagnosed by physicians and 8.5% among those children among whom allergy was diagnosed by allergic skin tests.

[Occurrence of allergy in school-age children and their parents in relation to atmospheric air pollution. Prospective study in Cracow]. / Wystepowanie alergii u dzieci w wieku szkolnym oraz wsród ich rodziców w powiazaniu z zanieczyszczeniami powietrza atmosferycznego. Badanie prospektywne w Krakowie.

The main purpose of the study was to estimate unknown frequency of allergy in children and in their parents in Krakow and to check the hypothesis that allergy may be related to environmental urban factors. The three-year prospective study was carried out in two areas of the city with contrast air pollution levels and covered 1129 children. The occurrence of allergy in children was based on information from the parents that the disease had been diagnosed by a physician. Data on atopy in parents were supported by the information from parents that atopy-related diseases had been diagnosed by a physician. The prevalence of allergy in boys was much higher than in girls (28.1% vs 17.6%) but the inverse was observed in parents--more frequently it occurred in mothers (17.8%) than in fathers (12.9%). Among parents the prevalence and incidence of atopy was not related to air pollution levels in the place of residence. However, the prevalence odds ratio for allergy in children after accounting for potential confounders (parental atopy, environmental tobacco smoke, social class and household characteristics), was significantly higher among those who lived in streets with higher traffic (OR = 1.37, 95% CI: 1.0-1.9) or in vicinity of local industrial emission sources (OR = 1.70, 95% CI: 1.2-2.4) but it was not related to communal air pollutants (SO2/particulate matter). The similar analysis performed for new cases of allergy in children diagnosed over the three year period confirmed the conclusions gained from the prevalence data.

[Chronic respiratory symptoms and lung function in children related to air pollution in the residential areas]. / Przewlekle objawy ze strony ukladu oddechowego u dzieci oraz ich sprawnosc wentylacyjna pluc a zanieczyszczenia powietrza atmosferycznego w miejscu zamieszkania.

The main purpose of the paper was to answer the question whether the various respiratory symptoms are related to type of air pollution in the residential areas and to which extent the worse lung function in children could have been explained by the air pollutants. Cross-sectional field study has been carried out in 1048 children aged 11 years attending grammar schools in Krakow. The results of the study provided the evidence that the current level of communal air pollutants (SPM and SO2) is not related to an excessive risk of respiratory symptoms in children, provided it is not combined with other sources of air pollution such as heavy traffic or local low point industrial emission. The risk of obstructive ventilation disorders (FEV1/FVC% 85) was significantly higher in children from the residential areas with higher air pollution (RR = 1.71; 95% CI: 1.19-2.47).

[Atmospheric air pollution as a factor potentiating the risk of asthma in school children. Epidemiologic studies in Krakow]. / Zanieczyszczenia powietrza atmosferycznego jako czynnik potegujacy ryzyko zachorowania na astme u dzieci szkolnych. Badania epidemiologiczne w krakowie.

The purpose of this study was to assess the prevalence of asthma in schoolchildren in relation to residency in areas with higher urban air pollution in Krakow. The material consisted of 1129 children aged 9 years among whom health survey based on standardized interviews with parents, together with anthropometry and spirometry has been carried out in 1995. In the asthmatic children allergy diagnosed by doctor was 4 times more prevalent (83.3% vs 20.2%) and asthma or allergy was twofold more prevalent in their biologic parents (42.6% vs 29.3%). The children with asthma resided more frequently in the city areas with the higher air pollution level (62.5% vs 46.2%). Mean spirometric values of FVC, FEV1, FEF25-75% I PEFR did not differ across the groups, however, FEV1/FVC% was significantly higher in nonasthmatic than in asthmatic groups (corresponding values in boys 90.9% vs 88.7%, in girls 92.7% vs 89.8%). After accounting for potential confounders (child's gender, education level of parents, environmental tobacco smoke, cigarette smoking of mothers in pregnancy and household standard) it was estimated from the multiple logistic regression that the separate effect of air pollution category was relatively small (OR = 2.27; 95%, CI = 1.11-3.93) in comparison with that of allergy (20.5; 95% CI = 9.40-44.7), however, combined effect of both risk factors on the occurrence of asthma in children was multiplicative.