Mariusz Duplaga

Prevalence of asthma with aspirin hypersensitivity in the adult population of Poland

Background: Acetylsalicylic acid (ASA) and other nonsteroid anti‐inflammatory drugs (NSAIDs) are reported to account for 21–25% of all adverse drug reactions. Some asthmatics may react to ASA and other NSAIDs with acute bronchoconstriction, profuse rhinorrhea and skin flushing. This is a distinct clinical syndrome called aspirin‐induced asthma (AIA). The prevalence of AIA among asthmatic patients in Poland has not been previously assessed.

Inhibition of Thrombin Generation by Aspirin Is Blunted in Hypercholesterolemia

Recent evidence indicates that aspirin inhibits thrombin generation in clotting blood. We noticed that this effect was less pronounced in patients with hypercholesterolemia. The aim of the study was to prove this observation. The effects of aspirin on thrombin generation were evaluated in (1) 46 healthy volunteers, 2 hours after ingestion of a single, 500-mg dose and (2) 28 survivors of myocardial infarction who took 300 mg aspirin/d for 2 weeks. In both populations, two well-matched subgroups were distinguished, using a serum cholesterol level of 6.2 mmol/L (240 mg/dL) and an LDL cholesterol level of 4.0 mmol/L (155 mg/dL) as borderline. Thrombin generation was monitored ex vivo in blood emerging from a skin microvasculature injury and additionally, in a single-dose study in vitro in recalcified plasma. Aspirin depressed thrombin generation in the group of subjects with serum cholesterol < 6.2 mmol/L and LDL cholesterol < 4.0 mmol/L but not in the group with high blood cholesterol levels. Inhibitory effects of aspirin were more pronounced after the 2-week treatment than after a single dose. There was a significant correlation between total serum cholesterol or LDL cholesterol and total amount of thrombin generated after aspirin treatment. In subjects with high blood cholesterol levels, thrombin generation was not affected by aspirin. Blunting of aspirin action in hypercholesterolemia might be explained by (1) alterations in platelet lipid-protein matrix that render their membrane proteins less accessible for acetylation by aspirin and (2) changes in composition and structure of plasma lipoproteins that diminish the chance of aspirin to interact with prothrombin.

Intranasal fluticasone propionate for chronic eosinophilic rhinitis in patients with aspirin‐induced asthma

We performed a double‐blind, crossover, placebo‐controlled study on the effect of fluticasone propionate (FP) treatment on chronic eosinophilic rhinosinusitis in 15 patients with aspirin‐induced asthma (AIA). There were 10 women and five men aged 32–60 years; average: 45 years. After a 10‐day run‐in period, patients underwent two 4‐week treatment courses (FP vs placebo), separated by a 2‐week washout interval. Clinical activity of FP was evaluated by daily measurement of peak nasal inspiratory flow (PNIF) and a scoring system of subjective symptoms. Nasal challenges with L‐lysine aspirin, using active anterior rhinomanometry, were performed at the entry and on the last day of each treatment period. Weekly mean values of symptom scores were generally lower and PNIF measurements higher during treatment with FP than with placebo. This difference was statistically significant for most recorded parameters for the whole 4‐week FP treatment. On average, the reactions evoked by aspirin nasal challenge were significantly shorter and milder after treatment with FP than with placebo. In 8/13 patients, FP completely prevented aspirin‐precipitated nasal reaction, whereas protection after placebo was observed in only 2/12 subjects (P=0.004). We conclude that intranasal FP is an effective therapy for chronic eosinophilic rhinitis in patients with AIA.

Epidemiology and impact of rotavirus diarrhoea in Poland.

Hospital and laboratory data were analysed in three hospitals to estimate rotavirus disease burden in 1994‐96. Community acquired gastroenteritis was diagnosed in 757 children of whom 41% tested positive for rotavirus. A total of 196 children had rotavirus nosocomial infections (39% of all rotavirus community‐acquired and nosocomial cases) Infants less than 24 months old and children less than 3 months old comprised 74% and 11.9% of admissions for rotavirus, respectively. Almost 94% of children with rotavirus infection had severe gastroenteritis (score 11). The annual rate of rotavirus associated hospitalization in Poland in 1996 was 3.1/1000 children under the age of 60 months and 5.2/1000 infants under 24 months of age. The mean hospital stay was 9.5 d (±9.8 d). We estimated that 8918 children under 60 months of age were hospitalized for rotavirus gastroenteritis in 1996; they accounted for 84899 inpatient days. We conclude that rotavirus is a leading aetiological agent of severe gastroenteritis in young children in Poland and that the Burden of this infection is significant. Rotavirus vaccine could significantly decrease the hospitalization rate and the financial impact of rotavirus Gastroenteritis in Poland. □Acute diarrhoea, disease burden, epidemiology, gastroenteritis, rotavirus

Low-Power Image Compression for Wireless Capsule Endoscopy

In the paper image compression algorithm suitable for wireless capsule endoscopy is proposed. In general, image compression is the best way to decrease the communication bandwidth and save the transmitting power. However due to power limitation and small size conditions traditional image compression techniques are not appropriate and dedicated ones are necessary. The proposed algorithm is based on integer version of discrete cosine transform (DCT) and entropy Huffman coder. Thanks to integer DCT application it has low complexity and power consumption. Additionally, the algorithm can provide lossless compression as well as high-quality lossy compression.

Data Processing Tasks in Wireless GI Endoscopy: Image-Based Capsule Localization & Navigation and Video Compression

The paper addresses data processing support that is required in capsule gastrointestinal endoscopy. First, capsule position estimation method using standard MPEG-7 image features (descriptors) is discussed. The proposed approach makes use of vector quantization, principal component analysis and neural networks. Next, new algorithms dedicated for virtual colonoscopy (VC) human body inspection are described. The VC images can be registered with endoscopic ones and help in capsule localization and navigation. Finally, an original, low- complexity, efficient image compression method, based on integer-to-integer 4x4 DCT transform, is presented and experimentally verified.

Hardware-Efficient Low-Power Image Processing System for Wireless Capsule Endoscopy

This paper presents the design of a hardware-efficient, low-power image processing system for next-generation wireless endoscopy. The presented system is composed of a custom CMOS image sensor, a dedicated image compressor, a forward error correction (FEC) encoder protecting radio transmitted data against random and burst errors, a radio data transmitter, and a controller supervising all operations of the system. The most significant part of the system is the image compressor. It is based on an integer version of a discrete cosine transform and a novel, low complexity yet efficient, entropy encoder making use of an adaptive Golomb-Rice algorithm instead of Huffman tables. The novel hardware-efficient architecture designed for the presented system enables on-the-fly compression of the acquired image. Instant compression, together with elimination of the necessity of retransmitting erroneously received data by their prior FEC encoding, significantly reduces the size of the required memory in comparison to previous systems. The presented system was prototyped in a single, low-power, 65-nm field programmable gate arrays (FPGA) chip. Its power consumption is low and comparable to other application-specific-integrated-circuits-based systems, despite FPGA-based implementation.

The Acceptance of e-Health Solutions Among Patients with Chronic Respiratory Conditions

OBJECTIVE The main objective of this study was to assess the acceptance of the use of e-health applications by patients suffering from bronchial asthma and other chronic respiratory conditions. SUBJECTS AND METHODS The questionnaire, consisting of 73 items, was distributed among 200 patients remaining under the care of a tertiary-care pulmonology center in Krakow, Poland (return rate, 82.5%; n=165). RESULTS The mean age (standard deviation) of respondents was 50.8 (14.9) years. Of the respondents, 48.5% (n=80) suffered from bronchial asthma, 29.1% (n=48) from chronic obstructive pulmonary disease, and 32.1% (n=53) from other respiratory diseases. The Internet was used by 58.2% (n=96) of respondents. The most frequent types of health-related information searched for online included diseases (59.4%) and treatments (medication, 54.2%; treatment options, 58.3%), as well as information about physicians and healthcare institutions (32.3% and 31.3%, respectively). The differences between acceptance scores for specific e-health applications were significant (analysis of variance, Friedman chi-squared=166.315, p<0.001). The respondents revealed the highest acceptance of e-health solutions allowing them to book appointments with physicians, access laboratory test results, view educational resources, and renew prescriptions. The acceptance of the most popular e-health applications depended on the duration of disease, respondents age and education, and his or her use of computers and the Internet. CONCLUSIONS Patients suffering from chronic respiratory conditions demonstrate higher levels of acceptance of e-health applications such as appointment booking, prescription renewal, and access to information (laboratory test results, educational resources) than of solutions directly related to medical care (communication with healthcare providers, disease monitoring).

Interferon-gamma in the treatment of atopic dermatitis: influence on T-cell activation

Atopic dermatitis (AD) is a chronic relapsing skin disease characterized by various immunologic abnormalities. Its pathogenesis remains obscure and its treatment difficult. We have studied the efficacy of systemic recombinant human interferon‐gamma (rhIFN‐γ) treatment (0.05 mg/m2 sc on 3 consecutive days, during 4 weeks) in 10 patients with severe AD. Marked clinical improvement was observed starting from the third week of treatment. Erythema, dryness, and lichenification were the most responsive symptoms. Serum immunoglobulin E and IgG4 levels did not change during treatment. Blood eosinophil count decreased only transiently at the end of the first and second series of injections (days 4 and 11; P= 0.02). Patients with AD showed an increase in CD25‐positive cells (11.0% vs 4.88%; P= 0.0001) as compared to 10 age‐matched healthy controls. Moreover, in parallel with clinical improvement, a distinct decrease in CD25‐positive lymphocytes was observed on days 32 and 50 (P= 0.002 and P= 0.006, respectively). We suggest that in AD the beneficial effect of rhIFN‐γ might be related to the inhibition of excessive T‐cell activation, perhaps of the subpopulations, producing interleukin (IL)‐4 and IL‐5.

Hardware Implementation Aspects of New Low Complexity Image Coding Algorithm for Wireless Capsule Endoscopy

The paper presents hardware implementation aspects of new efficient image compression algorithm designed for wireless capsule endoscopy with Bayer color filter array (CFA). Since power limitation, small size conditions and specific image data format (CFA) exclude application of traditional image compression techniques dedicated ones are necessary. Discussed algorithm is based on integer version of discrete cosine transform (DCT). Therefore it has low complexity and power consumption. It is demonstrated that the perfor-mance of proposed algorithm is comparable to the performance of JPEG2000 --- very complex, sophisticated wavelet based coder. In the paper a VLSI coder architecture is proposed and power requirements are discussed.