Biomedical subjects

Anna Breborowicz

Publications and source records attributed to Anna Breborowicz.

7 recordsLinked to original sources

PubMed2004

[Effectiveness and safety of fluticasone propionate in therapy of children suffering from asthma. Part I. Mechanisms of actions and clinical effectiveness of treatment in children with asthma].

The introduction of inhaled corticosteroids (ICS) has been a milestone in asthma therapy. According to current guidelines ICS are the first line drug in chronic anti-inflammatory therapy. The purpose of first part of this publication is to present updated knowledge on mechanisms of anti-inflammatory action as well as some pharmacokinetics and pharmacodynamics data about commonly used ICS, especially fluticasone propionate (FP) and two others: budesonide (BUD), beclomethasone dipropionate (BDP). Some differences between mentioned drugs have been found concerning systemic activity and safety of therapy. Fluticasone propionate is twice as active as the BUD and BDP. First results of therapy are seen 1-2 week after administration. Fluticasone propionate, more lipophilic than other steroids, has also high glucocorticoid receptor affinity and specificity, high topical anti-inflammatory activity and low systemic bioavailability. Systemic availability of FP depends on absorption from respiratory system. Oral bioavailability can be neglected because of almost total inactivation in liver during first pass. Fluticasone propionate has some features of dissociated steroids which means predominance of transrepression over transactivation--beneficial from safety point of view. Clinical efficacy of FP in chronic asthma therapy in children was confirmed in many studies. It significantly reduces the symptoms and exacerbations of asthma. There is a close correlation between FP use and lung function tests. The therapy with FP decreases bronchial hyperreactivity and the use of systemic steroids and rescue medication. The beneficial action of fluticasone propionate in asthma is due its anti-inflammatory properties within the airways (decreasing levels of direct and indirect markers of airways inflammations are observed).

Administration, Inhalation↗

PubMed2004

[Effectiveness and safety of fluticasone propionate in therapy of children suffering from asthma. Part II. Safety aspects of therapy with fluticasone propionate in asthmatic children].

Inhaled administration of glucocorticoid doesn't mean lack of systemic effects of drug. Bioavailability of steroid depends on oral absorption and absorption from respiratory system. In case of fluticasone propionate (FP) swallowed dose can be neglected because almost total (>99%) inactivation in liver during first pass. In second part of paper the most important safety parameters of therapy with FP are discussed, it means; influence on hypothalamic-pituitary-adrenal axis, growth and bone metabolism. Interpretation of potential side effects should differentiate between abnormal value of laboratory test and clinically important symptoms. Adrenal suppression depends on dose of FP and was found even after low dose (about 200 microg per day), but clinical value of this findings is unknown. Prolonged administration of high doses can suppress hypothalamic-pituitary-adrenal axis; exceptionally, it can induce adrenal insufficiency. Recommended doses of FP given 1 to 2 years doesn't cause growth retardation. Long term studies on influence of drug on final height are needed. FP as other inhaled corticosteroids, may transiently alter bone metabolism. Till now there are no evidences that this drug, when prescribed appropriately in standard doses for asthma control, may decrease the bone mineral density or induce osteoporosis and may increase the risk of bone fractures in asthmatic children. Effective asthma control achieved with FP therapy permits normal activity and development of asthmatic children which prevails over exceptionally noticed side effects.

Administration, Inhalation↗

PubMed2004

[The prevalence of allergic rhinitis and conjunctivitis in school children from Kraków and Poznań--ISAAC study (International Study of Asthma and Allergies in Childhood)].

BACKGROUND: The aim of study was to assess the prevalence of symptoms and diagnosis of allergic rhinitis (AR) and allergic rhinitis and conjunctivitis (ARC) in school children in 1994/95 and 2001/02. METHODOLOGY: Standardized ISAAC questionnaire was used for assessment population of school children 6-7 yrs of age and 13-14 yrs of age in Kraków and Poznań. RESULTS: The prevalence of AR ever symptoms increased significantly in group 6-7 yrs of age from 28.5% to 33.6% in Kraków and from 13.0% to 31.3% in Poznań. The similar rise was found in group 13-14 yrs of age in Kraków from 26.1% to 41.1%, in Poznań from 19.0% to 39.6%. In both age groups and both centers the number of children with established AR diagnosis increased: in group 6-7 yrs of age in Kraków from 15.3% to 21.1%, in Poznań from 5.0% to 19.5%; in group 13-14 yrs of age in Kraków from 19.7% to 29.9%, in Poznań from 12.0% to 32.6%. Analysis of AR and ARC current symptoms (in the last year) confirmed significant increasing prevalence in both age groups, too. CONCLUSION: The prevalence of AR and ARC diagnosis and symptoms increased significantly during last 7 years.

Adolescent↗

PubMed2003

[The influence of inhaled glucocorticoids on the growth of asthmatic children].

In this paper general characteristic of the growing process of children is described. Various factors may modify this process including genetic predisposition, environmental factors, diseases, diet, and drugs. Asthmatic children present growth retardation, however without significant influence on final height. Low and moderate doses of inhaled glycocorticosteroids have no significant effects on growth. The results of short, medium and long term studies are discussed.

Anti-Inflammatory Agents↗

PubMed2003

[Practical aspects of specific immunotherapy].

Specific immunotherapy is the only method of causal therapy of allergic diseases. The general principles of this type of intervention are described, including indications, contraindications, efficacy and safety. Attention is paid to the recommended age range of patients, type of hypersensitivity and clinical manifestations that justify undertaking of such intervention. Specific immunotherapy should be supervised by a specialist.

Anti-Inflammatory Agents↗

PubMed2003

Changes in the bronchial epithelia in patients with immotile cilia syndromes.

Immotile cilia syndromes is a cause of recurrent infection of the airways and recurrent bronchopneumonias. Among the ciliary abnormalities are found changes in the structure of the microtubules, unco-ordinated ciliary movements caused by the absence of inner or outer or both dynein arms, and abnormalities of the kinetosomes and/or rete ridges. In patients with ciliary dyskinaesia bronchitis occurs early in life (during infancy) and usually has a recurrent tendency, so that bronchial biopsy is frequently undergone for diagnostic purposes. In this study we include 127 bronchial biopsies from patients (from 2 months to 49 years) unsuccessfully treated for recurrent respiratory tract infections. When performing regular diagnostic procedures on the light and electron microscopic level, we have looked for cilia abnormalities and also focused on changes within the mucosa and submucosa. The most common abnormality recorded was absence of the inner dynein arms, but in 40 cases neither of the dynein arms were present. Only a few patients had classical Kartagener's syndrome. Special attention is drawn to biopsies from elderly patients, in whom long-standing infections were followed by extensive damage to the bronchial epithelium, including even a total absence of ciliated cells. In some cases enhanced regenerative processes and some foci of squamous metaplasia were found. In two cases even foci of low-grade dysplasia were diagnosed.

Adolescent↗

PubMed2003

[Increasing prevalence of asthma in school children--ISAAC study (International Study of Asthma and Allergies in Children)].

UNLABELLED: The aim of the study was to assess changes in asthma prevalence between 1994/1995 (study I) and 2001/2002 (study II). Standardized ISAAC questionnaire was used. Randomly assigned population of school children 6-7 and 13-14 yrs of age was surveyed in Kraków and Poznań. RESULTS: The prevalence of wheezing ever increased significantly in group 6-7 yrs of age from 25.5% to 28.6% in Krakow and from 17.3% to 27.6% in Poznań, respectively in study I and study II. The similar rise was found in group 13-14 yrs of age in Krakow from 14.6% to 21.6%, in Poznań from 17.1% to 22.2%. In both age groups and in both centers the number of children with established asthma diagnosis increased: in group 6-7 yrs of age in Krakow from 4.0% to 5.8%, in Poznań from 1.3% to 5.9%; in group 13-14 yrs of age in Krakow from 2.3% to 6.8%, in Poznań from 2.0% to 5.2%. Analysis of current symptoms (in the last year) confirmed increasing prevalence of wheezing, wheezing after exercise and night cough in Poznań in both age group, in Krakow only in older children. In younger children in Kraków significant difference concerned only wheezing after exercise. The most frequent symptom reported by children was nocturnal cough in the last year. CONCLUSIONS: The prevalence of the asthma symptoms and established asthma diagnosis increased during last 7 years. However significant number of children presenting asthma symptoms remains still underdiagnosed.

Adolescent↗