Histamine intolerance is defined as a disequilibrium of accumulated histamine and the capacity for histamine degradation. This clinical term addresses a non-immunologically mediated pathology when ...histamine ingested with food is not particularly high, however its degradation is decreased. This paper aims to provide a narrative review on etiopathology, epidemiology, possible diagnostic algorithms and diagnostic challenges of histamine intolerance in children. The clinical picture of histamine intolerance in children is similar to that observed in adults apart from male predominance found in paediatric patients. Both in children and adults, a histamine-reduced diet is typically the treatment of choice. Diamine oxidase supplementation offers another treatment option. There is no symptom or test pathognomonic for histamine intolerance. Nevertheless, manifestations of chronic gastrointestinal symptoms, measurements of diamine oxidase deficits, positive results of histamine provocation tests and improvement in symptoms with histamine-reduced diet considerably increase the probability of histamine intolerance diagnosis. These factors have been included in the proposed diagnostic algorithm for histamine intolerance. In children histamine intolerance most likely co-occurs with allergies and bowel diseases, which creates an additional diagnostic challenge. As the evidence for children is poor further research is needed the determine epidemiology, validate diagnostic algorithms and establish possible treatment options regarding histamine intolerance.
High-quality echocardiogram images are the cornerstone of accurate and reliable measurements of the heart. Therefore, this study aimed to develop, validate and compare machine learning and deep ...learning algorithms for accurate and automated assessment of transthoracic echocardiogram image quality. In total, 4090 single-frame two-dimensional transthoracic echocardiogram images were used from apical 4-chamber, apical 2-chamber and parasternal long-axis views sampled from 3530 adult patients. The data were extracted from CAMUS and Unity Imaging open-source datasets. For every raw image, additional grayscale block histograms were developed. For block histogram datasets, six classic machine learning algorithms were tested. Moreover, convolutional neural networks based on the pre-trained EfficientNetB4 architecture were developed for raw image datasets. Classic machine learning algorithms predicted image quality with 0.74 to 0.92 accuracy (AUC 0.81 to 0.96), whereas convolutional neural networks achieved between 0.74 and 0.89 prediction accuracy (AUC 0.79 to 0.95). Both approaches are accurate methods of echocardiogram image quality assessment. Moreover, this study is a proof of concept of a novel method of training classic machine learning algorithms on block histograms calculated from raw images. Automated echocardiogram image quality assessment methods may provide additional relevant information to the echocardiographer in daily clinical practice and improve reliability in clinical decision making.
Guanosine (Guo) is a nucleotide metabolite that acts as a potent neuromodulator with neurotrophic and regenerative properties in neurological disorders. Under brain ischemia or trauma, Guo is ...released to the extracellular milieu and its concentration substantially raises. In vitro studies on brain tissue slices or cell lines subjected to ischemic conditions demonstrated that Guo counteracts destructive events that occur during ischemic conditions, e.g., glutaminergic excitotoxicity, reactive oxygen and nitrogen species production. Moreover, Guo mitigates neuroinflammation and regulates post-translational processing. Guo asserts its neuroprotective effects via interplay with adenosine receptors, potassium channels, and excitatory amino acid transporters. Subsequently, guanosine activates several prosurvival molecular pathways including PI3K/Akt (PI3K) and MEK/ERK. Due to systemic degradation, the half-life of exogenous Guo is relatively low, thus creating difficulty regarding adequate exogenous Guo distribution. Nevertheless, in vivo studies performed on ischemic stroke rodent models provide promising results presenting a sustained decrease in infarct volume, improved neurological outcome, decrease in proinflammatory events, and stimulation of neuroregeneration through the release of neurotrophic factors. In this comprehensive review, we discuss molecular signaling related to Guo protection against brain ischemia. We present recent advances, limitations, and prospects in exogenous guanosine therapy in the context of ischemic stroke.
COVID-19 pandemic impacts many communities worldwide. In this study the Poles' knowledge about COVID-19 as well as people's behaviours, attitudes and fears during the pandemic were assessed. Changes ...in these between the outset of the pandemic and the imposition of the strictest lockdown measures in Poland were investigated.
Physicians, nurses, students of medicine-oriented faculties, non-medical professionals, students of non-medicine-oriented faculties and secondary school students were surveyed by an anonymous online questionnaire two times: at the onset of the pandemic and in the second week of the strictest lockdown. Statistical analyses were performed using non-parametric tests - Pearson Chi Square, Kruskal-Wallis tests.
In total 2618 responses were collected. At the beginning people knew that the respiratory system was attacked (97.9%); correctly identified the major symptoms of COVID-19 (95.0%) and ways to prevent infection: hand washing (99.8%), covering mouth (85.9%) and the need to call sanitary-epidemiological services if one experienced COVID-19-like symptoms (92.1%). The biggest changes between the first and second phase of the study concerned behaviours: more people wearing facial masks (+ 37.5%) and staying at home (+ 66.1%). Respondents in the second wave of the survey were also more scared of the pandemic (+ 19.6%), economic crisis (+ 64.1%), and worried about their families (+ 26.5%). However, they were less afraid of the quarantine (lockdown) (- 18.2%). Nurses and physicians were the most worried groups.
The study showed that even at the outset of the pandemic Polish population had a good initial knowledge about symptoms, transmission, and preventive behaviours regarding COVID-19. People revealed more short-term concerns, such as the worries about coping with quarantine and isolation. After a month, the knowledge and the concerns among the respondents changed. A shift towards long-term pandemic management issues was observed. Respondents reported to experience more fears concerning the pandemic in general, as well as economic and healthcare crises. Medical professionals reported higher level of fear of the pandemic than other groups included in this study. This study uses before-and-after approach which highlights the changes in people's knowledge and perception of the COVID-19 pandemic during the pandemic's progression.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
According to the World Bank Group, 36 of the 50 most polluted cities in the European Union are in Poland. Thus, ambient air pollution and its detrimental health effects are a matter of immense ...importance in Poland. This narrative review aims to analyse current findings on air pollution and health in Poland, with a focus on respiratory diseases, including COVID-19, as well as the Poles' awareness of air pollution. PubMed, Scopus and Google Scholar databases were searched. In total, results from 71 research papers were summarized qualitatively. In Poland, increased air pollution levels are linked to increased general and respiratory disease mortality rates, higher prevalence of respiratory diseases, including asthma, lung cancer and COVID-19 infections, reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The proximity of high traffic areas exacerbates respiratory health problems. People living in more polluted regions (south of Poland) and in the winter season have a higher level of air pollution awareness. There is an urgent need to reduce air pollution levels and increase public awareness of this threat. A larger number of multi-city studies are needed in Poland to consistently track the burden of diseases attributable to air pollution.
Background: The coronavirus disease 2019 (COVID-19) pandemic presented a new challenge in modern medicine: the development of vaccines was followed by massive population vaccinations. A few reports ...on post-vaccination allergic reactions have made patients and medical personnel uneasy as to COVID-19 vaccines’ allergic potential. Most of the studies in this area to date have been small, and some that were based on global databases skipped most of the allergic diseases and concentrated only on anaphylaxis. We aimed to analyze the incidence of serious allergic reactions based on the EudraVigilance (EV) database, regardless of the reported symptoms and allergy mechanism. Methods: The total number of administrated vaccine doses was extracted on 5 October 2023 from Vaccine Tracker and included all administrations since vaccinations began in the European Economic Area (EEA). Data on serious allergic reactions to COVID-19 vaccines were extracted from the EudraVigilance database with the same time point. The code names of 147 allergic symptoms or diseases were used. Results: The frequency of serious allergic reactions per 100,000 administered vaccine doses was 1.53 for Comirnaty, 2.16 for Spikevax, 88.6 for Vaxzevria, 2.11 for Janssen, 7.9 for Novavax, 13.3 for VidPrevtyn Beta, and 3.1 for Valneva. The most prevalent reported reactions were edema (0.46) and anaphylaxis (0.40). Only 6% of these reactions were delayed hypersensitivity-oriented. Conclusions: The overall frequency of potential serious allergic reactions to COVID-19 is very rare. Therefore, COVID-19 vaccines seem to be safe for human use. The lowest frequency of allergic reaction was observed for Comirnaty and the highest for Vaxzevria.
. Coeliac disease (CD) often co-occurs with autoimmune conditions or genetic syndromes, but there are few studies on the co-existence of CD and immunoglobulin E (IgE)-mediated allergies. The purpose ...of this study was to assess sensitization to food and aero-allergens in pediatric patients with CD.
. A multiplex ALEX
2 test was used to determine specific IgEs (sIgEs).
. The study included 108 children newly diagnosed with CD. Allergen extract- and/or allergen molecule-sIgEs were detected in 49.1% of children. Most children (41.5%) were sensitized to both inhalant and food allergens. The three most common aero-allergens (timothy pollen, ryegrass, silver birch) were molecules Phl p 1, Lol p 1, and Bet v 1. The most common food allergens (hazelnut, apple, and peanut) were Cor a 1, Mal d 1, and Ara h 8 molecules of the PR-10 subfamily. Patients were not sensitized to cereal allergens containing gluten. Spearman's rank correlation analysis of sensitized patients showed a significant positive relationship (
= 0.31) between the patients' age and the occurrence of positive sIgEs (≥0.3 kU
/L) for inhalant allergen molecules (
= 0.045). In sensitized patients, mainly symptoms of inhalant allergy were observed, such as hay fever, conjunctivitis, and bronchial asthma.
. The current study indicates the co-occurrence of IgE sensitization to food and inhalant allergens in children with CD. The study highlights the need to take a closer look at the diagnosis of IgE-mediated allergy in patients with CD, which may help in their care and lead to a better understanding of the relationship between CD and IgE-mediated allergy.
Decreased air quality is connected to an increase in daily mortality rates. Thus, people’s behavioural response to sometimes elevated air pollution levels is vital. We aimed to analyse spatial and ...seasonal changes in air pollution-related information-seeking behaviour in response to nationwide reported air quality in Poland. Google Trends Search Volume Index data was used to investigate Poles’ interest in air pollution-related keywords. PM10 and PM2.5 concentrations measured across Poland between 2016 and 2019 as well as locations of monitoring stations were collected from the Chief Inspectorate of Environmental Protection databases. Pearson Product-Moment Correlation Coefficients were used to measure the strength of spatial and seasonal relationships between reported air pollution levels and the popularity of search queries. The highest PM10 and PM2.5 concentrations were observed in southern voivodeships and during the winter season. Similar trends were observed for Poles’ interest in air pollution-related keywords. Greater interest in air quality data in Poland strongly correlates with both higher regional and higher seasonal air pollution levels. It appears that Poles are socially aware of this issue and that their intensification of the information-seeking behaviour seems to indicate a relevant ad hoc response to variable threat severity levels.
Low air quality in Poland is a problem of particularly high urgency. Therefore, Poles must be aware of air quality levels, also during the COVID-19 pandemic. The study aimed to compare ...air-pollution-related information-seeking behaviour between the pre- and intra-pandemic periods as well as between the actual and theoretical machine-learning-forecasted intra-pandemic models. Google Trends search volumes (GTSVs) in Poland for air-pollution-related keywords were collected between January 2016 and January 2022. To investigate the changes that would have occurred without the outbreak of the pandemic, Seasonal Autoregressive Integrated Moving Average (SARIMA) machine-learning models were trained. Approximately 4,500,000 search queries were analysed. Between pre- and intra-pandemic periods, weighted mean GTSVs changed by -39.0%. When the actual intra-pandemic weighted mean GTSVs were compared to the intra-pandemic forecasts, the actual values were lower by -16.5% (SARIMA's error = 6.2%). Compared to the pre-pandemic period, in the intra-pandemic period, the number of search queries containing keywords connected with air pollution decreased. Moreover, the COVID-19 pandemic might have facilitated the decrease. Possible causes include an attention shift towards everyday problems connected to the pandemic, worse mental health status and lower outdoor exposure that might have resulted in a lower intensity of non-pandemic-related active information-seeking behaviour.
The aim of the presented review is to summarize the literature data on the accuracy and clinical applicability of artificial intelligence (AI) models as a valuable alternative to the current ...guidelines in predicting cardiac resynchronization therapy (CRT) response and phenotyping of patients eligible for CRT implantation. This systematic review was performed according to the PRISMA guidelines. After a search of Scopus, PubMed, Cochrane Library, and Embase databases, 675 records were identified. Twenty supervised (prediction of CRT response) and 9 unsupervised (clustering and phenotyping) AI models were analyzed qualitatively (22 studies, 14,258 patients). Fifty-five percent of AI models were based on retrospective studies. Unsupervised AI models were able to identify clusters of patients with significantly different rates of primary outcome events (death, heart failure event). In comparison to the guideline-based CRT response prediction accuracy of 70%, supervised AI models trained on cohorts with > 100 patients achieved up to 85% accuracy and an AUC of 0.86 in their prediction of response to CRT for echocardiographic and clinical outcomes, respectively. AI models seem to be an accurate and clinically applicable tool in phenotyping of patients eligible for CRT implantation and predicting potential responders. In the future, AI may help to increase CRT response rates to over 80% and improve clinical decision-making and prognosis of the patients, including reduction of mortality rates. However, these findings must be validated in randomized controlled trials.
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