Intranasal combo: fixed-dose combination of mometasone furoate and olopatadine hydrochloride in therapeutic strategies for rhinosinusitis

A novel strategy for the treatment of allergic rhinitis results from the innovative combination of antihistamine and intranasal corticosteroid drugs. By combining two preparations with different mechanism of action, this novel approach facilitates quick and effective controls of all upper respiratory tract allergy symptoms. The article presents the results of a study of olopatadine hydrochloride and mometasone furoate fixed-dose combination (GSP301) administered intranasally from a spray formulation, with an attempt at positioning the treatment within the ARIA and EPOS guidelines.

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

Background

Links between multimorbidity of allergic diseases and allergen sensitization are still under debate, especially in adults. This study aimed to establish a relationship between polysensitization and allergic multimorbidity in children and adults and the allergens involved in multimorbidity.

Material and method

A cross-sectional multicentre study enrolled children aged 6-7 and 13-14 years and adults aged 20-44 years from a Polish national cohort. The diagnosis of allergic diseases was made by a physician. Skin prick tests to 13 allergens and serum IgE levels to 4 allergens were tested.

Results

Among the 3856 participants, single disease (asthma, allergic rhinitis or atopic dermatitis) was diagnosed in 27.7% subjects and allergic multimorbidity in 9.3%. Allergic multimorbidity occurred more commonly in children than in adults (p < 0.01). Asthma or atopic dermatitis alone were not associated with polysensitization. Rhinitis and multimorbidity were associated with polysensitization. Allergic multimorbidity occurred in 2.2% of participants with negative skin prick tests, 9.8% of those with one positive prick test (SPT ≥ 3 mm) and 20.6% of polysensitized ones (p < 0.001). There was an increasing risk of multimorbidity depending on the number of positive prick tests for both SPT ≥ 3 mm (OR 9.6-16.5) and SPT ≥ 6 mm (OR 5.9-13.7). A statistically significant relationship was found between allergic multimorbidity and sensitization to cat and mite allergens.

Conclusions

Multimorbidity is associated with polysensitization especially in children compared with adults in Polish population cohort. New insights into single disease patterns were found: bronchial asthma is the strongest risk factor for the development of multimorbidity in comparison with allergic rhinitis and atopic dermatitis.

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

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

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

OBJECTIVE

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

MATERIAL AND METHODS

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

RESULTS

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

CONCLUSIONS

Fur-bearing animals kept in rural settings exhibit preventive effects on the development of allergies; whereas in urban areas they exacerbate allergic symptoms, especially the symptoms of bronchial asthma.

Methane oxidation in heavy metal contaminated Mollic Gleysol under oxic and hypoxic conditions

Soils are the largest terrestrial sink for methane (CH4). However, heavy metals may exert toxicity to soil microorganisms, including methanotrophic bacteria. We tested the effect of lead (Pb), zinc (Zn) and nickel (Ni) on CH4 oxidation (1% v/v) and dehydrogenase activity, an index of the activity of the total soil microbial community in Mollic Gleysol soil in oxic and hypoxic conditions (oxia and hypoxia, 20% and 10% v/v O2, respectively). Metals were added in doses corresponding to the amounts permitted of Pb, Zn, Ni in agricultural soils (60, 120, 35 mg kg(-1), respectively), and half and double of these doses. Relatively low metal contents and O2 status reflect the conditions of most agricultural soils of temperate regions. Methane consumption showed high tolerance to heavy metals. The effect of O2 status was stronger than that of metals. CH4 consumption was enhanced under hypoxia, where both the start and the completion of the control and contaminated treatment were faster than under oxic conditions. Dehydrogenase activity, showed higher sensitivity to the contamination (except for low Ni dose), with a stronger effect of heavy metals, than that of the O2 status.

Epidemiology of atopic dermatitis in Poland according to the Epidemiology of Allergic Disorders in Poland (ECAP) study

Epidemiological studies (International Study of Asthma and Allergies in Childhood [ISAAC], The European Community Respiratory Health Survey [ECRHS]) revealed considerable geographical differences in prevalence of atopic dermatitis (AD). The aim of our study is to present the epidemiology and the risk factors of AD in a Polish population. A total of 18,617 subjects were selected. The sample included respondents in eight cities and one rural area each over 150,000 citizens. The study had two parts: (i) questionnaire survey conducted among all respondents (response rate, 64.4%); and (ii) allergological examination performed among 25.7% with skin prick test (SPT) with 15 aeroallergens. AD was identified in 3.91% of subjects, more often in females, living in the cities, with a mother and/or father with atopy and with a higher education and higher economic status. Comorbidities of AD were atopic rhinitis (AR) in 26.17% and AR and asthma in 14.6%. AD was diagnosed by allergologists in 311 subjects (6.5%). Positive SPT occurred in 66.9% persons with AD (house dust mite, 33.1%; grasses/crop plants, 30.6%). Of the patients, 9.5% with perennial versus 9.3% seasonal and 9.6% with polyvalent versus 9.0% monovalent sensitization had AD. AD prevalence in Poland is below the mean rate for Europe, but risk factor profile is similar to other countries. AD is more frequent in female, well-educated individuals, of high socioeconomic status, with atopic parents and who live in a city. Seasonal and monovalent atopy play a more essential role in subjects with AD compared with AR and asthma.

Filaggrin gene defects are independent risk factors for atopic asthma in a Polish population: a study in ECAP cohort

Background

FLG null variants of which 2282del4 and R501X are the most frequent in Caucasians are established risk factors for atopic dermatitis (AD) with an effect probably mediated through impairment of epidermal barrier. Among subjects with AD FLG defects are also consistently associated with asthma and allergic rhinitis (AR) but it is less clear to what extent these associations are also present independently from skin disease. The aim of the present study was to evaluate the role of 2282del4 and R501X in predisposing to these allergic phenotypes in a Polish population.

Methodology

2282del4 and R501X were typed among 3,802 participants of the Epidemiology of Allergic Diseases in Poland (ECAP) survey, a cross-sectional population-based study using ECRHS II and ISAAC questionnaires, and ambulatory examination.

Principal Findings

The FLG null variants were associated with AD (OR = 2.01, CI: 1.20–3.36, P = 0.007), allergic rhinitis (in particular persistent form, OR = 1.69, CI:1.12–2.54, P = 0.011), and asthma (in particular atopic asthma, OR = 2.22, CI:1.24–3.96, P = 0.006). Association with atopic asthma (but not persistent allergic rhinitis) was also present in the absence of AD, (OR = 2.02, CI: 1.07–3.81, P = 0.027) as well as in the absence of AD and history of broadly defined inflammatory skin disease (OR = 2.30, CI: 1.07–4.93, P = 0.03). Association to atopic asthma would have not been found if diagnosis was made by questionnaire only (OR = 1.15, CI: 0.58–2.32, P = 0.8). We did not observe an association between FLG variants and allergic sensitizations (P = 0.8) or total IgE. (P = 0.6).

Conclusions/Significance

In a Polish population FLG 2282del4 and R501X carriage increases risk for development of AD and atopic asthma (also in the absence of AD or history thereof). This suggests that interventions aimed at restoring epidermal barrier may have a general role in asthma prophylaxis/treatment.

Prevalence of rhinitis in Polish population according to the ECAP (Epidemiology of Allergic Disorders in Poland) study

The prevalence of allergic disorders, especially allergic rhinitis (AR), has dramatically increased in the past few decades and multicentre, standardized, randomized epidemiological studies are required to quantify this phenomenon in Poland.

AIM

The aim of the study was to estimate the prevalence of rhinitis and allergic rhinitis in Poland.

MATERIAL AND METHOD

The ECAP study was conducted using the ECRHS II and ISAAC questionnaires translated into the Polish language and validated, in selected nine regions of Poland, including eight cities and one rural area. The respondents within the regions were selected by means of multistage proportional stratified random sampling based on the identity number (PESEL) as the operat. The survey was conducted in 20,454 subjects (response rate of 41.9%) and 18,617 questionnaires were valid. Approximately 25% of the subjects (n=4783) were subsequently evaluated by clinicians (response rate of 43.4%).

RESULTS

Rhinitis was self-reported by 36.08% of the respondents (37.8% of 6- 7-year-olds, 34.5% of 13- 14-year-olds, and 36.0% of adults). The lowest prevalence rate was in the rural region (22.9%). Allergic rhinitis (AR) was self-reported by 22.54% of the respondents (23.6% of 6- 7-year-olds, 24.6% of 13- 14-year-olds, and 21.0% of adults). Again, the lowest prevalence rate was in the rural region (16.0%). AR was more frequent in males (24.0%) than in females (21.2%) (OR = 1.079; 95% CI: 1.044-1.116). AR was actually diagnosed by a clinician in 28.9%, including intermittent AR in 47.7% and persistent AR in 52.3%. Seasonal AR was diagnosed in 15.55%, and perennial rhinitis in 15.2%.

CONCLUSION

Allergic rhinitis is common in Poland as it affects nearly 25% of the population and it is a major social problem. Standards of early detection and prevention of allergic rhinitis should be introduced.

[Treatment of trochanteric fractures of the femur in elderly patients using Ender rods]

The paper presents the outcome of treatment of patients older than years who sustained trochanteric fractures. Thirty-four females and ten males underwent surgical procedure according to Ender's method. Average age among females was 81 years and among male 72 years. In 63% of the cases a good or excellent functional result was noted. No deaths were noted, neither during hospitalization nor during follow-up. Poor fracture healing nor malunions were noted. Only few local and general complications were observed. The cost of Ender rods is much lower in comparison with DHS, Spiral-Blade or intramedullary implants.

[Evaluation of remote results in 80 intra-articular calcaneal fractures treated by various methods]

The studies were done in 69 patients in whom 80 intra-articular calcaneus fractures were diagnosed of tongue or crush type. In the analysis of the remote results a subjective three-grade evaluation of the results was used as reported by the patients. The good results in 60% were closely related to the reconstruction of the shape of the calcaneus and its articular surface with simultaneous restoration of functional fitness of the foot. It was found that the fractures of tongue type were to be reduced by the Westhues method, while the crush fractures were to be treated surgically or functionally. Poor results were observed in all fractures not reduced and not immobilised additionally in plaster casts.