The impact of specialized physiotherapy methods on BODE index in COPD patients during hospitalization.

OBJECTIVES: To evaluate the effectiveness of specialized physiotherapy methods measured by the BODE index in patients with COPD during hospitalization. MATERIAL AND METHODS: The study was conducted on a group of 30 patients diagnosed with COPD, all under treatment at the clinical hospital in Wroclaw due to the exacerbation of their symptoms. All patients were undergoing standard pharmacological treatment along with basic physiotherapy. The subjects of the study were randomly divided between an experimental group of 20 persons and a control group of 10 persons. Patients in the experimental group underwent a series of 6 additional massage treatments performed over a period of a few days, aimed at reshaping the following muscles: the sterno-cleidomastoid, pectoralis major, pectoralis minor, trapezius, levator scapulae, rhomboids and serratus anterior. Each massage lasted for 30 minutes and consisted of stroking, grinding, vibration and kneading techniques. Before and after therapy the patients were assessed based on the BODE index. First, the patient's BMI was calculated (B). Airflow obstruction (O) was determined by the percentage value of FEV1 while the MRC scale was used to evaluate a patient's dyspnea (D). Exercise capacity (E) was measured by the distance a patient could cover in a 6-minute walk test. Each variable of the BODE index was ranked on a scale from 0 to 3 points except the BMI, for which was given either 0 or 1 point. RESULTS: Analysis of the results showed a significant improvement of the BODE index in the experimental group while in the control group this ratio changed slightly. The FEV1 and MRC parameters changed significantly only in the experimental group. CONCLUSIONS: After a week of therapy the BODE index improved in both groups, but in the experimental group there was a significantly higher difference. In the experimental group all BODE components except BMI improved highly significantly, whereas in the control group only exercise capacity was significantly improved.

Exercise-induced bronchospasm among athletes in Lower Silesia Province.

A few studies have reported data on the prevalence of exercise-induced bronchospasm in high school and university athletes. Recently published data suggest that exercise-induced bronchospasm may affect up to 39% of American university athletes. To date, no data describing this pathology in athletes from Central Europe have been published. The aim of the present study was to establish the prevalence of exercise-induced bronchospasm in pupils attending sports mastership classes in secondary school as well as students of the University of Physical Education in Wroclaw. The participants were 77 athletes (30 women and 47 men) aged 16-27 years (mean 17.3 years). Only one athlete (1.29%) diagnosed with atopic asthma before testing experienced a fall in forced expiratory volume in one second (12.9% FEV(1)) compared with baseline, which showed that the exercise test result was positive. From a clinical point of view, the ventilation disturbance was asymptomatic. In the other participants, there were slight but statistically significant rises in FEV(1) (P < 0.02). The results of our study indicate a very low prevalence of exercise-induced bronchospasm in the population of athletes examined.

The overproduction of nitric oxide associated with neutrophilic predominance is relevant to airway mycotic infections in asthmatics undergoing prolonged glucocorticoid treatment.

The complex relationship between the local inflammatory response and the spread of airway mycosis during prolonged glucocorticoid therapy in bronchial asthma patients remains unclear. We assessed the ability of airway leukocytes to produce nitric oxide (NO) in relation to differential inflammatory cell counts, levels of asthma severity, and coexisting airway mycotic infections. The study was carried out on leukocytes from the induced sputa (IS) of 14 patients with asthma complicated by mycotic airway infections undergoing prolonged glucocorticoid therapy (group FcA). Three groups of subjects without airway fungal infections were also studied: 18 glucocorticoid-treated asthmatics (group cA), 11 steroid-free asthmatics (group A), and 13 healthy control subjects (group H). In group FcA, both the level of spontaneous production of NO and the percentages of neutrophils in the IS were significantly higher than in all the remaining groups. Additionally, a significant positive correlation was noticed between the NO levels and both the percentages of neutrophils in the IS and the symptom intensity scores. The results suggest a possible predominant role of neutrophils in the overproduction of NO related to asthma severity and coexisting fungal infections in glucocorticoid-treated patients.

[TGF-beta1 gene polymorphism in chronic obstructive pulmonary disease]. / Polimorfizm genu TGF-beta1 w przewleklej obturacyjnej chorobie pluc.

Gene polymorphism is often responsible for occurrence of some chronic diseases. It has not been clarified, why only 15-20% of smokers suffer from chronic obstructive pulmonary disease (COPD). TGF-beta1 gene polymorphism has been postulated as one of possible genetic risk factors. The aim of our study was to evaluate TGF-beta1 gene polymorphism in codons 10 and 25 in COPD patients in comparison to healthy controls. Thirty six COPD patients and 60 healthy persons entered the study. The distribution of TGF-beta1 genotypes in codon 10 was as follows in COPD group: T/C--50%, T/T--25% and C/C--25% in control group: 45%, 42% and 13% respectively. The distribution of genotypes in codon 25 in COPD patients was: G/G 86% and G/C 14%, in control group 83% and 17% respectively. There were not statistically significant differences between evaluated groups with regard to both polymorphisms. Moreover, in group of 27 smokers without COPD the distribution of the analysed TGF-beta1 gene polymorphism was similar to that in COPD group. After adjustment to sex, age and smoking index, in the logistic regression model, we can not confirm the hypothesis that TGF-beta1 gene polymorphisms in codons 10 and 25 might be significant risk factors of COPD.

[Markers of oxidative balance and concentration of selected metals in pollinotics]. / Markery równowagi oksydacyjnej i stezenia wybranych metali u osób chorych na pylkowice.

It was reported that catalytically active metals are presented in both the soluble and insoluble fractions of ambient air pollution particles. Both catalyses generate and stimulate oxidative stress. There are very few reports on the role of oxidative stress in pollen allergy Theoretical presumptions may suggest that oxidative metabolism can be influenced by the activity of some metals and, on the other hand, pollens could be a carrier of at least catalytic amount of metals. The aim of our study was to evaluate concentrations of some metals (Cd, Cr, Pb, Ni, Mg, Zn) and compare the markers of oxidative balance expressed as malondialde-hyde (MDA) concentration, superoxide dismutase (SOD) and glutathion peroxidase (GPx) activities in the blood of patients with pollinosis. The investigation was performed on the group of 50 individuals, 34 diagnosed as pollen allergic and 16 healthy volunteers. We have found Pb blood concentration higher in pollen allergics group, but only on the verge of statistical significance (p = 0.058). No statistically significant differences in the concentrations of other examined metals between pollen allergics and controls were observed; whereas SOD activity was higher in allergics (p = 0.015), GPx activity lower in allergics (p = 0.045) and MDA concentration higher in allergics (p = 0.044). The positive linear correlations between SOD and Pb (r = 0.492; p < 0.001) as well as between Mg and MDA (r = 0.329; p = 0.02) were observed. On the basis of these results we formulated the following hypotheses, in our opinion worth further investigations: The statistically significant increase in SOD activity in the group of pollen allergics when compared to the group of controls points out the role of oxidative stress in pollen allergic persons. The statistically significant decrease in GPx activity suggests the long-lasting duration of oxidative stress in pollen allergic. The positive correlation between SOD activity and Pb level may suggest the putative role of Pb in oxidative stress. The positive correlation between Mg and MDA may suggest the presence of an additional mechanism in pollen allergy probably connected with the activation of phagocytosis by magnesium.

Prevalence of Hymenoptera venom allergy and its immunological markers current in adults in Poland.

BACKGROUND: The prevalence of insect venom allergy is still being assessed. The aim of our study was to estimate, on the basis of an interviewer-administered questionnaire survey, the frequency of post-sting allergic reactions and venom sensitization. MATERIAL/METHODS: The study was performed within the framework of the ECRHS. A random sampling of 3000 persons was selected from among 68,000 persons living in the area of Wroclaw, Poland. Of the 2050 persons responding to a mailed screening questionnaire, 169 were randomly selected to complete a questionnaire designed only for insect allergy detection. Venom skin test and sIgE assessment were performed on 146 and 132 patients, respectively. RESULTS: Allergic post-sting symptoms were found in 20.7% of surveyed patients. Large local reactions (LLs) occurred in 11.8% and systemic reactions (SYSs) in 8.9% of the study population. SYS was most often manifested by urticaria (4.7%). The frequencies of SYS II, III and IV were 1.8%, 1.8%, and 0.6%, respectively. Only LLs were more frequent in subjects with other allergic diseases (p=0.03). The presence of positive skin tests and/or sIgE in serum were 42.8% of subjects with LL, 53.3% with SYS, and 17.1% of "asymptomatic" patients. No significant differences were found between these groups regarding venom skin test results and sIgE serum concentrations. Occurrence of sIgE to bee venom was frequently associated with the presence of sIgE to timothy grass. CONCLUSIONS: Insect venom allergy and asymptomatic venom sensitization in adults are common in Poland. Only some venom allergy cases are IgE dependent.