Elaboration of selected respiratory system diseases in children in the pediatric hospital Bielsko-Biala In years 2015-2022. / Omówienie wybranych chorób ukladu oddechowego u dzieci na terenie szpitala pediatrycznego w Bielska-Bialej w latach 2015-2022.

INTRODUCTION: Respiratory tract infections in children are an interdisciplinary problem that pediatricians, allergists, laryngologists and immunologists encounter on a daily basis. In the youngest children, these diseases are caused by the structure of the respiratory tract, which is shorter and narrower than in an adult, as well as the immaturity of the immune system. Among all children under 5 years of age hospitalized due to respiratory diseases, 20% of cases are acute respiratory infections. OBJECTIVE: The aim of the study is to discuss selected respiratory diseases in children aged 0-18 years hospitalized at the Pediatric Hospital in Bielsko-Biala. MATERIAL AND METHODS: In June 2023, statistical data from the Pediatric Hospital was received regarding the number of hospitalized children aged 0-18 in 2015-2022. This article covers the following respiratory diseases: acute laryngitis, acute pharyngitis, pneumonia, bronchitis and bronchiolitis, bronchial asthma, adenoid hypertrophy and palatine tonsil hypertrophy coexisting with adenoid hypertrophy. Then, a table was prepared illustrating the trends of individual disease entities in the discussed time period. RESULTS: A total of 5,573 hospitalizations were analyzed for the period from 2015-2022. The largest group of children (1,583) were hospitalized due to acute bronchitis and bronchiolitis (28.41%), due to hypertrophy of the adenoid (1,093) and palatine tonsils (1,039), which is 19.6% and 18.64% respectively. The smallest number of children and adolescents were hospitalized due to acute laryngotracheitis (474) and pharyngitis (361), which is 8.51% and 6.47%, respectively, and due to asthma (54), which is 0.97%. It has been observed that from 2017 to 2022 the number of hospitalized patients is constantly increasing due to acute pharyngitis and pneumonia, and from 2018 to 2022 due to acute laryngotracheitis. CONCLUSIONS: In the analyzed Pediatric Hospital in Bielsko-Biala, the number of hospitalized children (from 0 to 18 years of age) due to pharyngitis, laryngotracheitis and pneumonia increased during the COVID-19 pandemic (2020-2022). The number of hospitalized patients due to pneumonia increased by as many as 70 from 2021 (197) to 2022 (267). In the case of hospitalizations for pharyngitis during the COVID-19 period, the number ranged from 46 in 2019 to 69 in 2022. Also in the case of acute laryngotracheitis in the period 2019-2022, the number of hospitalized young patients increases and ranges from 61 to 76. Respiratory tract infections are an important and common health problem for children. The vast majority of respiratory infections are caused by viruses.

Pulmonary outcomes in adults with a history of Bronchopulmonary Dysplasia differ from patients with asthma.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is a risk factor for respiratory disease in adulthood. Despite the differences in underlying pathology, patients with a history of BPD are often treated as asthmatics. We hypothesized that pulmonary outcomes and health-related quality of life (HRQoL) were different in adults born preterm with and without a history of BPD compared to asthmatics and healthy individuals. METHODS: We evaluated 96 young adults from the LUNAPRE cohort ( clinicaltrials.gov/ct2/show/NCT02923648 ), including 26 individuals born preterm with a history of BPD (BPD), 23 born preterm without BPD (preterm), 23 asthmatics and 24 healthy controls. Extensive lung function testing and HRQoL were assessed. RESULTS: The BPD group had more severe airway obstruction compared to the preterm-, (FEV1- 0.94 vs. 0.28 z-scores; p ≤ 0.001); asthmatic- (0.14 z-scores, p ≤ 0.01) and healthy groups (0.78 z-scores, p ≤ 0.001). Further, they had increased ventilation inhomogeneity compared to the preterm- (LCI 6.97 vs. 6.73, p ≤ 0.05), asthmatic- (6.75, p = 0.05) and healthy groups (6.50 p ≤ 0.001). Both preterm groups had lower DLCO compared to healthy controls (p ≤ 0.001 for both). HRQoL showed less physical but more psychological symptoms in the BPD group compared to asthmatics. CONCLUSIONS: Lung function impairment and HRQoL in adults with a history of BPD differed from that in asthmatics highlighting the need for objective assessment of lung health.

Pracenje vrsnog ekspiratornog protoka u dijagnozi profesionalne astme.

Prema podacima iz Registra profesionalnih bolesti Hrvatskoga zavoda za zastitu zdravlja i sigurnost na radu, u posljednjih deset godina (2008. ‒ 2017.) prijavljeno je samo 20 slucajeva profesionalne astme od ukupno 2234 prijavljene profesionalne bolesti. To upucuje na znacajne nedostatke u prepoznavanju toga poremecaja u nasoj radnoj populaciji. Cilj ovoga rada bio je opisati standardnu metodu pracenja vrsnog ekspiratornog protoka zraka (eng. peak expiratory flow, PEF) i predloziti prakticnu smjernicu za koristenje te dijagnosticke metode u ambulantama medicine rada i sporta. Pracenje vrsnog ekspiratornog protoka zraka (PEF-monitoring) jednostavna je, jeftina, neinvazivna i pouzdana metoda za utvrdivanje funkcije disnog sustava u stvarnim uvjetima rada i radnog okolisa. Sadasnje smjernice preporucuju PEF-monitoring kao inicijalnu dijagnosticku metodu prilikom sumnje na profesionalnu astmu. Pozitivan test upozorava na povezanost promjene plucne funkcije s radnom izlozenoscu i vazan je dio dijagnostickoga procesa utvrdivanja profesionalne astme. Najveci je nedostatak te metode da se tim testom ne moze utvrditi uzrok astme, tj. on ne razlikuje profesionalnu astmu od astme pogorsane na radu, nema standardizirane metode za interpretaciju rezultata, a mjerenja provode sami radnici pa su moguce namjerne i nenamjerne manipulacije rezultatima mjerenja. U radu je predlozena prakticna smjernica za primjenu te metode u ambulantama medicine rada i sporta, s preporukama protokola mjerenja PEF-a, prikaza rezultata mjerenja i njihove interpretacije u sklopu dijagnosticiranja profesionalne astme.

Deficiency of vitamin D and vitamin C in the pathogenesis of bronchial asthma.

Epidemiology of bronchial asthma (BA) indicates a marked paradox: rapid rise in the prevalence.Simultaneous decline in mortality is mostly related to improvement in the diagnosis and therapy. In many economically developed countries the BA affects more than 10 per cent of the population, while mortality related to this respiratory disorder is below 1/100,000. Factors favorably influencing mortality of BA include new more effective medications, decline in smoking and also improved nutrition, based on awareness of protective role of vitamins. Vitamin D deficiency has a number of biological effects that are potentially instrumental in the pathogenesis and severity of BA. Increased number of randomized, controlled, interventional studies is showing positive effects of vitamin D supplementation in pediatric and in adult BA. Oxidative stress is potentially an important pathogenic factor in the progression of BA. Vitamin C (ascorbic acid) belongs to the most effective nutritional antioxidants. By counteracting oxidants, reducing generation of reactive oxygen species, vitamin C may inhibit external attacks in the respiratory tract, thus modulating the development of BA (Fig. 2, Ref. 15).

Review of family relational stress and pediatric asthma: the value of biopsychosocial systemic models.

Asthma is the most common chronic disease in children. Despite dramatic advances in pharmacological treatments, asthma remains a leading public health problem, especially in socially disadvantaged minority populations. Some experts believe that this health gap is due to the failure to address the impact of stress on the disease. Asthma is a complex disease that is influenced by multilevel factors, but the nature of these factors and their interrelations are not well understood. This paper aims to integrate social, psychological, and biological literatures on relations between family/parental stress and pediatric asthma, and to illustrate the utility of multilevel systemic models for guiding treatment and stimulating future research. We used electronic database searches and conducted an integrated analysis of selected epidemiological, longitudinal, and empirical studies. Evidence is substantial for the effects of family/parental stress on asthma mediated by both disease management and psychobiological stress pathways. However, integrative models containing specific pathways are scarce. We present two multilevel models, with supporting data, as potential prototypes for other such models. We conclude that these multilevel systems models may be of substantial heuristic value in organizing investigations of, and clinical approaches to, the complex social-biological aspects of family stress in pediatric asthma. However, additional systemic models are needed, and the models presented herein could serve as prototypes for model development.

Prevalência de sintomas de asma em adolescentes de São José - SC / Prevalence of asthma symptoms in adolescents of São Jose - SC

Objetivo: Determinar a prevalência e gravidade da asma em adolescentes escolares do município de São José - SC, através do questionário padronizado escrito módulo Asma do Estudo Internacional de Asma e Alergias na Infância "International Study of Asthma and Allergies in Childhood" (ISAAC). Métodos: O questionário ISAAC foi aplicado em 2.367 adolescentes de 12 a 15 anos matriculados nas escolas de São José-SC. As escolas foram selecionadas aleatoriamente. Os alunos que participaram do estudo preencheram o questionário estruturado, o qual inclui perguntas sobre a presença passada (alguma vez na vida) e passada recente (últimos 12 meses) de asma. Resultados: A prevalência de sintomas de asma alguma vez na vida foi de 53% e no último ano foi de 24,3%. Destes, 8,4% apresentaram quatro ou mais crises de sibilos nos últimos 12 meses e 10% tiveram seu sono prejudicado por chiado no peito. Além disso, 13,3% apresentam a doença de forma grave. Quanto à asma diagnosticada, 11,1% afirmam alguma vez ter asma. Conclusão: A prevalência de sintomas de asma em adolescentes do município de São José foi de 24,3%, resultado superior ao de outras cidades de Santa Catarina e do Sul do Brasil. A gravidade da asma foi considerada leve para os adolescentes com sintomas da respectiva doença, concordando com dados de consensos nacionais e internacionais...