Ewa Szynkiewicz

Analysis of the impact of selected socio-demographic factors on quality of life of asthma patients

Aim To evaluate the influence of selected socio-demographic factors on quality of life of patients with different degrees of asthma severity. Material and methods The study was conducted in 2009–2010 in the Clinic of Allergology, Clinical Immunology and Internal Diseases in Dr J. Biziel University Hospital No. 2 in Bydgoszcz. Patients were divided into a tested group (126) and a control group (86). The criterion for the division was the degree of asthma control according to GINA 2006. The following tools were used: the authors questionnaire containing questions about socio-demographic and clinical data, and the WHOQOL-100. Results In the tested group, a statistically significant correlation was observed between quality of life and age (p < 0.002 for the entire population), education (p < 0.05 in the group with controlled asthma, p = 0.0005 for the entire population), professional activity (p < 0.003 in the group with partially controlled asthma, p < 0.05 with uncontrolled asthma and p < 0.0001 in the entire population), marital status (p = 0.025 for the entire population) and financial situation (p < 0.0001; p < 0.0002; p < 0.009 in all groups; p < 0.0001 in the entire population). There was no significant difference between quality of life, and sex and the place of residence of the respondents. Conclusions Age, education, professional activity, marital status and financial situation affect the assessment of quality of life in patients with asthma. Socio-demographic factors such as sex and the place of residence do not influence the assessment of quality of life in patients with asthma.

Analysis of the quality of life of patients with asthma and allergic rhinitis after immunotherapy

Aim To assess the quality of life of Polish patients with asthma and/or allergic rhinitis before the implementation and after 30–36 months of immunotherapy. Material and methods Two hundred patients have been involved in the study: 101 with allergic asthma and 99 with pollinosis. In order to collect research material, the Polish versions of AQLQ (Asthma Quality of Life) and RQLQ (Rhinoconjunctivitis Quality of Life) questionnaires have been used. The self-administered questionnaires concerned such data as age, sex and the patients’ subjective evaluation of their quality of life. Results The average increase in quality of life of patients with asthma was 0.84 and of patients with allergic rhinitis – 1.50. A hypothesis was made that changes of quality of life in each examined group differed significantly. A test for two fractions showed that for patients with asthma it was 7.74 and for patients with allergic rhinitis – 10.38. A statistical analysis showed no such relation in the group of patients with asthma (coefficient of correlation = 0.08) and a slight correlation in the group of patients with allergic rhinitis (coefficient of correlation = 0.20). Applied tests did not show any significant differences, which means that an average increase in quality of life does not depend on sex and age of both examined groups. Conclusions On the basis of the research conducted among patients before and after a 3-year period of immunotherapy, the following conclusions have been drawn: 1) immunotherapy significantly improves the objective quality of life in both groups; 2) a slight correlation has been identified between the objective and subjective dimension of quality of life amongst patients with asthma, what contributes to a better quality of life; 3) in both study groups, no significant relationship between gender or age and improvement in quality of life has been noted; 4) immunotherapy, from the point of view of the improvement of quality of life, is a valuable therapeutic tool in patients with atopic bronchial asthma and allergic rhinitis.

Role of E-selectin and platelet endothelial cell adhesion molecule 1 in gastritis in food allergy patients

Introduction The prevalence of food allergies and other allergic reactions is increasing worldwide, particularly in highly-urbanized populations. Cell adhesion molecules are expressed in response to various pro-inflammatory cytokines. The expression of intercellular adhesion molecule 1 – ICAM-1 (CD54), ICAM-1 (CD106), P-selectin (CD62P), and E-selectin (CD62E) on vascular endothelial cells is induced by such pro-inflammatory cytokines as tumor necrosis factor α (TNF-α) and interleukin-1 (IL-1). Aim To analyze concentrations of E-selectin and platelet endothelial cell adhesion molecule-1 (PECAM-1) in patients with an allergic type of food sensitivity co-existing with gastritis and to compare them to the values determined in individuals with dyspeptic symptoms not associated with allergic disorders. Material and methods The study included 80 patients, among them 50 individuals with food sensitivity confirmed based on compulsory standards, and 30 subjects with dyspeptic symptoms not accompanied by allergic conditions. Venous blood samples were taken from each patient and concentrations of E-selectin and PECAM-1 were determined by means of ELISA. Results Mean concentrations of sE-selectin and sPECAM-1 in patients with food allergy amounted to 54.0 ±21.6 ng/ml and 132.8 ±31.4 ng/ml, respectively. In individuals without food allergy, mean concentrations of sE-selectin and sPECAM-1 were 57.7 ±17.9 ng/ml and 139.6 ±31.1 ng/ml, respectively. Patients with food allergy and individuals with dyspeptic symptoms not associated with food allergy did not differ significantly in terms of sE-selectin concentrations (Mann-Whitney U-test, p = 0.453028). Similarly, no significant intergroup differences were observed with regard to sPECAM-1 concentrations (Mann-Whitney U-test, p = 0.231054). Conclusions Adhesion molecules play an important role in the development of inflammation. This study did not find significant differences in the concentrations of such molecules as sE-selectin and sPECAM-1 between patients with food allergy and gastritis, and subjects in whom gastritis was not accompanied by atopic disorders. A positive correlation between the concentrations of sPECAM-1 and E-selectin was observed in food allergy patients. Consequently, it can be concluded that these molecules participate in the pathogenesis of the inflammatory process independently of the etiopathogenesis of gastritis.

Determination of ECP Concentration in Patients with Allergic Type of Food Hypersensitivity and in Patients with Dyspeptic Symptoms not Associated with Food Allergy

Introduction. The results of many studies suggest that the tendency towards the prevalence of food allergies is increasing [1, 2, 3]. It is estimated that approximately 20% of population modifies their diet due to adverse reactions observed after ingestion of certain foods [2]. Still, the exact prevalence rate of food allergies in pediatric and adult populations cannot be satisfactorily estimated [4]. The aim of this study was to determine serum concentrations of eosinophil cationic protein (ECP) in patients with allergic type of food sensitivity and to compare them to data obtained from patients with dyspeptic disorders without a concomitant allergic condition. Material and methods. This study included a group of 80 patients; among them 50 individuals with diagnosed food sensitivity based on existing standards, and 30 subjects with dyspeptic symptoms without an associated allergic condition. Venous blood was collected from each participant and ECP concentration was determined by means of fluoro-immunoenzyme assay (FIA) with UniCAP ECP test (Pharmacia Diagnostics). Results. The arithmetic mean serum ECP concentration in patients with food allergy was found to be 24.604 ± 40.36 μg/l. In all individuals, serum ECP concentrations were within the detection limit of the applied method. The average concentration of ECP in a group of subjects without food allergy was determined to be 29.9±64.76 μg/l and did not exceed the lower or the upper detection limit of the applied method. Conclusions. Patients with food allergy did not differ significantly from those with dyspeptic symptoms without a concomitant allergy in terms of ECP concentration (Mann-Whitney U test, p=0.754218).

The Influence of Surgical Treatment on Reported Ailments and Neurological Status of Patients with Spine Discopathy

Introduction. Treatment of patients with spine discopathy is the subject of interest in numerous medical disciplines and includes non-invasive as well as invasive methods. Both therapeutic ways aim to resolve the disc-root conflict. The clinical picture and the incidence of neurological complications depend on the location of herniated nucleus pulposus. Aim. To determine the influence of surgical treatment on reported ailments and neurological status of patients with spine discopathy. Material and Methods. The study was conducted twice (before and after the surgery) among 188 patients treated surgically due to cervical or lumbosacral spine discopathy. The analysis included: clinical and intraoperative diagnosis, the level of operation, BMI, and neurological status: Laseque’s sign, muscle strength, pain, dysesthesia, sphincter disorders. The results were analyzed by means of Microsoft Excel spreadsheet and Statistica 6.0, assuming a significance level of p≤ 0.05. Results. While assessing pain, in the case of L-S discopathy, the majority of patients belonged to group III (34%) and group IV (33.5%). After the operation, 37.8% of patients were classified as group II; in cervical discopathy this percentage was 12.2%. The positive Laseque’s sign before the operation was observed in 68.1% of the subjects; after the surgery in 56%. Dysesthesia in the case of the upper discopathy occurred in 72.9% of the patients, after the surgery in 30.3% (p <0.05). Conclusions. Performed surgery significantly results in reducing pain in patients. The improvement was also noticed in neurological status. ( JNNN 2015;4(3):109–116)

Evaluation of sE-selectin and sPECAM-1 levels in patients diagnosed with food allergy

Results The average sE-selectin levels in the food allergy patient population were 54.0 +/- 21.6 ng/mL, while in the allergy-free population, the average sE-selectin levels were 57.7 +/-17.9 ng/mL. No statistically significant difference between sE-selectin levels was found between food allergy patients and patients with dyspeptic symptoms without concomitant food allergy (Mann-Whitney U-test, p =0.453028). In the food allergy patient population, average sPECAM-1 levels were 132.8 +/-31.4 ng/ ml, while in the allergy-free population average sPECAM-1 levels were 139.6 +/- 31.1 ng/ml. The analysis of the obtained results revealed no statistically significant difference between sPECAM-1 levels in food allergy patients and patients with dyspeptic symptoms without concomitant food allergy. Conclusions The results of examinations conducted in this study showed no statistically significant differences in serum PECAM-1 and E-selecine levels between the study groups.

Diagnosis of cross-reactivity in patients with birth pollinosis

Material and Methods The clinical history and the positive SPT with the birch extract were the condition for qualifications. 23 patients included in the first group were only birch allergic. 35 patients in the other group had birch pollen allergy and they reported symptoms after eating apple, celery, carrot, tomato, banana, peach, peanut and hazelnut. The skin tests were performed and serum IgE concentration (total and specific) were determined for all individuals. The immunoblotting was performed for the patients with the positive value of birch, apple, celery and/or carrot specific IgE.

Evaluation of peripheral blood eosinophilia, serum ECP levels of eosinophils in inflammatory infiltrates of gastric mucosa in food allergy patients

Eosinophilic infiltration may be found in all segments of the gastrointestinal tract. The goal of this study was to evaluate the peripheral blood eosinophilia, serum ECP levels and presence of eosinophils in inflammatory infiltrates of the gastric mucosa in food allergy patients.