The clinical differences of asthma in patients with molds allergy

INTRODUCTION: Bronchial asthma is an increasing problem worldwide. The course of bronchial asthma is dependent on the type of inducing allergens. The differences between the clinical features of asthma in patients with monovalent allergies to molds and with other allergies were explored. MATERIAL AND METHODS: Randomly selected 1910 patients (924 women and 986 men) between 18−86 years in age were analyzed according to type of allergy and asthma. The diagnosis of asthma was confirmed on the basis of GINA criteria, physical examination and spirometry. Allergy diagnosis was confirmed on the basis of medical history, a positive skin prick test and the measurement of serum-specific IgE to inhalant allergens, using an extended profile of mold allergens. RESULTS: Patients with monovalent allergies to molds (4% of analyzed group) had significantly more frequent diagnoses of asthma than patients in the other group (53% vs. 27.1−32.4%, p < 0.05). Patients with allergies to Alternaria alternata had an odds ratio of 2.11 (95%CI: 1.86−2.32) for receiving a diagnosis of bronchial asthma. They had less control over their asthma, which was more severe compared to patients with other allergies. Patients with asthma and allergies to mold had significantly more frequent exacerbation of asthma requiring systemic corticosteroids and/or hospitalization. They used a significantly greater mean daily dose of inhaled steroids compared to other patients. CONCLUSION: Patients with monovalent IgE allergies to molds are at a higher risk for asthma than patients with other allergies. Their asthma is often more intense and less controlled compared to that of patients with other types of allergies.INTRODUCTION: Bronchial asthma is an increasing problem worldwide. The course of bronchial asthma is dependent on the type of inducing allergens. The differences between the clinical features of asthma in patients with monovalent allergies to molds and with other allergies were explored. MATERIAL AND METHODS: Randomly selected 1910 patients (924 women and 986 men) between 18−86 years in age were analyzed according to type of allergy and asthma. The diagnosis of asthma was confirmed on the basis of GINA criteria, physical examination and spirometry. Allergy diagnosis was confirmed on the basis of medical history, a positive skin prick test and the measurement of serum-specific IgE to inhalant allergens, using an extended profile of mold allergens. RESULTS: Patients with monovalent allergies to molds (4% of analyzed group) had significantly more frequent diagnoses of asthma than patients in the other group (53% vs. 27.1−32.4%, p < 0.05). Patients with allergies to Alternaria alternata had an odds ratio of 2.11 (95%CI: 1.86−2.32) for receiving a diagnosis of bronchial asthma. They had less control over their asthma, which was more severe compared to patients with other allergies. Patients with asthma and allergies to mold had significantly more frequent exacerbation of asthma requiring systemic corticosteroids and/or hospitalization. They used a significantly greater mean daily dose of inhaled steroids compared to other patients. CONCLUSION: Patients with monovalent IgE allergies to molds are at a higher risk for asthma than patients with other allergies. Their asthma is often more intense and less controlled compared to that of patients with other types of allergies

Corylus pollen season in southern Poland in 2016

The aim of the study was to compare the hazel pollen season in 2016 in Zielona Gora, Opole, Wroclaw, Sosnowiec, Cracow, Lublin, and Guciow (Roztocze National Park). Due to the mild winter, the hazel pollen season in Zielona Gora and Opole began very early, i.e. in the third decade of December 2015. In the other cities, the onset of the pollen season was noted between 30th January and 7th February. In a majority of the cities, the maximum daily pollen concentrations were recorded in the period between 7th and 10th February. The highest seasonal peak was reported from Lublin and the lowest – in Guciow and Wroclaw. The highest risk of allergy related to the persistence of high concentrations of airborne hazel pollen was noted for Zielona Gora, Lublin, and Cracow

Betula pollen season in southern Poland in 2016

The paper presents a comparison of birch pollen seasons in 2016 in study sites located in the southern part of Poland: Zielona Gora, Opole, Wroclaw, Sosnowiec, Cracow, Lublin, and Guciow in the Roztocze National Park. The pollen concentrations were measured with the volumetric method using Burkard or Lanzoni pollen samplers. The annual pollen sum was calculated for each measurement site. In 2016, the birch pollen season started at a similar time, i.e. between 4th and 6th April in all the localities. The highest annual sums and maximum pollen concentrations were recorded in Lublin and Guciow. The maximum concentrations of birch pollen were noted from 5th and 15th April, with the highest value in Lublin, i.e. 8573 P/m3 (14.04)

Grass pollen season in Cracow, Lublin, Opole, Piotrkow Trybunalski, Sosnowiec, Wroclaw and Zielona Gora in 2015

W pracy przedstawiono najważniejsze cechy sezonu pyłkowego traw w Krakowie, Lublinie, Opolu, Piotrkowie Trybunalskim, Sosnowcu, we Wrocławiu i w Zielonej Górze w 2015 r. Badania wykonano metodą objętościową przy użyciu aparatów firmy Burkard i Lanzoni. Najwyższe dobowe stężenia pyłku traw odnotowano w Lublinie i Krakowie; wynosiły one odpowiednio 349 z/m3 i 294 z/m3. Najwyższą sumę roczną ziaren pyłku traw zarejestrowano w Lublinie (5149) i Sosnowcu (4492).The paper presents the most important features of grass pollen season in Krakow, Lublin, Opole, Piotrkow Trybunalski, Sosnowiec, Wroclaw and Zielona Gora in 2015. Volumetric method with the use of Burkard and Lanzoni spore trap was implemented. The highest concentration values of pollen grains were recorded in Lublin and Cracow (349 grains/m3 and 294 grains/m3) respectively. The highest annual sum of pollen concentrations were stated in Lublin (5149) and Sosnowiec (4492)

Analiza stężenia pyłku dębu w wybranych miastach Polski w 2015 r.

W pracy przedstawiono przebieg sezonu pylenia dębu w wybranych miastach Polski w 2015 r. Zanalizowano dane z pomiarów przeprowadzonych w Białymstoku, Bydgoszczy, Drawsku Pomorskim, Krakowie, Olsztynie, Opolu, Piotrkowie Trybunalskim, Sosnowcu, Szczecinie, Warszawie i we Wrocławiu. Badania prowadzono metodą objętościową przy wykorzystaniu aparatów Burkard i Lanzoni. Czas trwania sezonu pyłkowego wyznaczono jako okres, w którym w powietrzu występuje 95% rocznej sumy ziaren pyłku. Najwcześniej sezon pylenia dębu zaczął się w Sosnowcu (16 kwietnia). Najwyższe wartości średniodobowych stężeń pyłku dębu odnotowano we Wrocławiu, gdzie 25 kwietnia zanotowano stężenie 368 z/m3 powietrza.This paper presents the course of oak pollination season in selected cities of Poland in 2015. The measurements were performed in Bialystok, Bydgoszcz, Drawsko Pomorskie, Cracow, Olsztyn, Opole, Piotrkow Trybunalski, Sosnowiec, Szczecin, Warsaw and Wroclaw. Volumetric method with the use of Volumetric Spore Trap (Burkard and Lanzoni) was implemented. Pollen season was defined as the period in which 95% of the annual total catch occurred. The season started first in Sosnowiec (16 April). The highest 24-hour average pollen count was recorded in Wroclaw on 25 April (368 oak pollen grains/1 m3)

Clinical recommendations for dry powder inhaler use in the management of COPD in primary care

Acknowledgements The study sponsor was the General Practitioners Research Institute; data collection and analysis were performed by General Practitioners Research Institute. Boehringer Ingelheim was the funding and scientific partner. The members of the PIFotal study group would like to acknowledge Dr. Jaco Voorham from Data to Insights Research Solutions for his assistance with the statistical analyses, Dr Wilma Zijlema for her assistance with the review, drafting and editing of the paper, and Dr. Hans Wouters for his contribution to the project administration in the initial phase of the project. They would also like to thank all contributing researchers: Maria João Barbosa, Ana Margarida Cruz, Liliana Silva, Duarte Araújo, Eurico Silva, Daniel Castro, João Ramires, Ana Fernandes, Catarina Carvalho, Raquel Castro, Jerzy Zientek, Ewa Pasko, Witold Drzastwa, Tomasz Kachel, Kornelia Ciekalska, Krzysztof Wytrychowski, Bernard Panaszek, Krzysztof Kowal, Ebian Brill, Willemien Feenstra, Geert Struik, Hans Schuurman, Mariette van Oostrum, Hennie Holwerda Meekma, Boudewijn Dierick, George Amofa, Esther Kuipers, Lennard Ringnalda, Boris Tyndall, Mark Drenth, Peter Mast, Hilbert Talsma, Raoul Wolfs, Cobie Hoogeboom, Hanneke van Andel, Paul Stoutenberg, Nancy van de Laak, Tessa Hillaert, Laura Holtzer, Natascha Fehrmann, Anniek Makkinga – Maassen van den Brink, Annemarie Hilbink, Erik Feenstra, Murat Tek, Sabrina Burer, Jan van Ginkel, Rinze Boersma, Alyssa Bonger, Miguel Roman Rodriguez, Marina García Pardo, Alejandra Valero Suau, Laura López Velasco, Cecilia Amato, Francisco Palmer Simó, Alberto Abenza, Rosa Llull Vila, Bartolomé Llompart Van Belzen, Silvia Jimeno Martínez, Francesc Moranta Ribas, Margarita Perelló Oliver, Yolanda Gómez López, Patricia Ibañez Gómez, María Nieves Mendieta Lagos, Laura Bueno López, Virginia María Mirabal Sánchez, Ana Delia Rodríguez Delgado, Nils Fischer, Alicia González Sansó, Nayra Ramírez Mendoza, Valeria Gazzaneo, Paula Merced Guillama Rodríguez, Virginia Naranjo Guerrero, Jose Angel Suarez Caballero, Isidoro Souto Bethencourt, Juan R. Dominguez Beatell, Elena Vanesa Rojas Manrique, Maria Jose Sanz Orejas, Cary Perez Lorenzo, Jesús Antonio Pérez Jiménez, Silvia 480 Lara Afonso Trujillo, Bartolomé Dominguez Del Río Boada, Stavroula Papageorgakopoulou, Eleytheria Vakouti, Claire Gkatzoudi, Thodoris Krasanakis, Dimitris Kounalakis , Izoldi Bouloukaki , Nikolaos Tsakountakis, Emmanouela Chronaki, Katherine Mary Borg and Kamila Abutalieva for their time and efforts to perform the study measurements and complete patient inclusion, even in the challenging times of the pandemic. Finally, they would like to thank the participants who generously gave their time to participate in the study.Peer reviewedPublisher PD

Sufficient inspiratory effort for a dry powder inhaler - do we have to measure it, or can we observe it? : Post hoc analysis of the PIFotal study.

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Pyłek leszczyny w powietrzu wybranych miast Polski w 2015 r.

Celem pracy było porównanie sezonu pyłkowego leszczyny w 2015 r. w Białymstoku, Bydgoszczy, Drawsku Pomorskim, Krakowie, Lublinie, Olsztynie, Opolu, Piotrkowie Trybunalskim, Sosnowcu, Szczecinie, Warszawie, we Wrocławiu i w Zielonej Górze. Pomiary stężenia pyłku prowadzono metodą objętościową z zastosowaniem aparatów Burkard oraz Lanzoni. Sezonowy indeks pylenia (SPI) obliczono jako sumę średnich dobowych stężeń pyłku w danym sezonie. Sezon pylenia leszczyny w 2015 r. najwcześniej rozpoczął się w Zielonej Górze, Drawsku Pomorskim (13 stycznia), we Wrocławiu (14 stycznia) i w Opolu (15 stycznia). Najwyższe wartości stężeń pyłku leszczyny zaobserwowano w Lublinie, maksymalne stężenie, wynoszące 215 ziaren/m3, zarejestrowano 1 marca. Maksymalne wartości stężenia pyłku leszczyny we wszystkich miastach wystąpiły 1 marca lub 8–12 marca.The aim of the study was to compare the pollen season of hazel in the cities of Bialystok, Bydgoszcz, Drawsko Pomorskie, Cracow, Lublin, Olsztyn, Opole, Piotrkow Trybunalski, Sosnowiec, Szczecin, Warsaw, Wroclaw and Zielona Gora in 2015. Measurements were performed by the volumetric method (Burkard and Lanzoni pollen sampler). Seasonal Pollen Index (SPI) was estimated as the sum of daily average pollen concentrations in the given season. The pollen season of hazel started first in Zielona Gora and Drawsko Pomorskie (January 13) and in Wroclaw (January 14) and in Opole (January 15). The highest airborne concentration (215 pollen grains/m3) was noted in Lublin on the 1st of March. The maximumvalues of seasonal pollen count occurred on the 1st of March or 8–12 of March in all cities

Suboptimal Peak Inspiratory Flow and Critical Inhalation Errors are Associated with Higher COPD-Related Healthcare Costs

Purpose: To assess the relationship between suboptimal Peak Inspiratory Flow (sPIF), inhalation technique errors, and non-adherence, with Healthcare Resource Utilisation (HCRU) in Chronic Obstructive Pulmonary Disease (COPD) patients receiving maintenance therapy via a Dry Powder Inhaler (DPI). Patients and methods: The cross-sectional, multi-country PIFotal study included 1434 COPD patients (≥40 years) using a DPI for maintenance therapy. PIF was measured with the In-Check DIAL G16, and sPIF was defined as a typical PIF lower than required for the device. Inhalation technique was assessed by standardised evaluation of video recordings and grouped into 10 steps. Patients completed the "Test of Adherence to Inhalers" questionnaire. HCRU was operationalised as COPD-related costs for primary healthcare, secondary healthcare, medication, and total COPD-related costs in a 1-year period. Results: Participants with sPIF had higher medication costs compared with those with optimal PIF (cost ratio [CR]: 1.07, 95% CI [1.01, 1.14]). Multiple inhalation technique errors were associated with increased HCRU. Specifically, "insufficient inspiratory effort" with higher secondary healthcare costs (CR: 2.20, 95% CI [1.37, 3.54]) and higher total COPD-related costs (CR: 1.16, 95% CI 1.03-1.31). "no breath-hold following the inhalation manoeuvre (<6 s)" with higher medication costs (CR: 1.08, 95% CI [1.02, 1.15]) and total COPD-related costs (CR 1.17, 95% CI [1.07, 1.28]), and "not breathing out calmly after inhalation" with higher medication costs (CR: 1.19, 95% CI [1.04, 1.37]). Non-adherence was not significantly associated with HCRU. Conclusion: sPIF and inhalation technique errors were associated with higher COPD-related healthcare utilisation and costs in COPD patients on DPI maintenance therapy

Factors associated with health status and exacerbations in COPD maintenance therapy with dry powder inhalers

Funding Information: J.K. reports grants, personal fees and non-financial support from AstraZeneca, GSK and Boehringer Ingelheim; grants and personal fees from Chiesi Pharmaceuticals and TEVA; grants from Mundipharma; personal fees from MSD and COVIS Pharma; and also holds 72.5% of shares in the General Practitioners Research Institute. H.W. has received grants from Boehringer Ingelheim, which is the financial and scientific partner of GPRI for the submitted study, and from AstraZeneca, Novartis and Chiesi for scientific projects in the area of COPD/asthma. S.B.-A. has received grants from TEVA, and personal fees from TEVA, Boehringer Ingelheim, AstraZeneca, GSK, Sanofi and Mylan. J.C.d.S. reports or personal fees from AstraZeneca, Bial, Boehringer Ingelheim, GSK, Medinfar, Mundipharma and Sanofi. B.C. received honorarium from GSK and Sanofi. J.v.C., L.D., I.v.G.-P., I.v.d.H., Y.J., M.K., B.M., K.S., N.S., M.H., B.M. and M.T.L. were employed by General Practitioners Research Institute (GPRI) at the time of the study. In the past three years (2019–2021), GPRI conducted investigator- and sponsor-initiated research funded by non-commercial organizations, academic institutes, and pharmaceutical companies (including AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Mundipharma, Novartis, and Teva). R.D. has received grants and personal fees from TEVA, Boehringer Ingelheim, AstraZeneca, GSK, Chiesi, Focus Care, and Glenmark. R.G. has received personal fees from AstraZeneca, GSK and Chiesi. E.D. holds 27.5% of shares in the General Practitioners Research Institute. M.G.P. receives grants from AstraZeneca, GSK and Boehringer Ingelheim. A.G. and A.d.l.H. are employees of Boehringer Ingelheim. F.L. received grants and personal fees from GSK, personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Menarini International, Novartis, Orion, and Trudell International, outside the submitted work. T.M. is an Assoicate Editor at npj Primary Care Respiratory Medicine. J.M. received grants from Boehringer Ingelheim, during the conduct of the study; and grants from AstraZeneca, Chiesi, Novartis, and GSK, outside the submitted work. D.P. reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Mylan, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, Theravance and Zentiva (Sanofi Generics); grants from the British Lung Foundation, Respiratory Effectiveness Group, UK National Health Service, and AKL Research and Development Ltd; personal fees from Cipla, GlaxoSmithKline, Kyorin, Merck, Mundipharma, Airway Vista Secretariat, EPG Communication Holdings Ltd, FIECON Ltd, Fieldwork International, OM Pharma SA, PeerVoice, Phadia AB, Spirosure Inc, Strategic North Limited, Synapse Research Management Partners S.L., Talos Health Solutions, and WebMD Global LLC; non-financial support from Efficacy and Mechanism Evaluation programme and Health Technology Assessment; stock/stock options from AKL Research and Development Ltd, which produces phytopharmaceuticals; owns 74% of the social enterprise Optimum Patient Care Ltd (Australia and UK) and 92.61% of Observational and Pragmatic Research Institute Pte Ltd (Singapore); and 5% shareholding in Timestamp, which develops adherence monitoring technology. M.R.-R. receives grants and personal fees from AstraZeneca and GSK; and personal fees from Boehringer Ingelheim, Chiesi, Menarini, Mundipharma, Novartis, Pfizer, TEVA and BIAL. I.T. reports grants and personal fees from GSK, AstraZeneca, Boehringer Ingelheim, Menarini, Novartis, Chiesi and Elpen. O.U. reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Edmond Pharma, Chiesi and GSK; grants from Edmond Pharma; and personal fees from Napp, Mundipharma, Sandoz, Takeda, Cipla, COVIS, Novartis, Mereobiopharma, Orion, and Menarini. S.B.-A. and T.M. are Associate Editors at npj Primary Care Respiratory Medicine, and I.T. is Editor in Chief. These authors were not involved in the journal’s review of, or decisions related to, this manuscript.Peer reviewedPublisher PD