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D Plavec

Publications and source records attributed to D Plavec.

At least 19 recordsLinked to original sources
PubMed2003

Differences in mite fauna between the continental and Mediterranean climates of Croatia: microscopy and Dustscreen test findings.

BACKGROUND: The aim of this study was to evaluate the difference between the mite fauna in the inland and coastal Croatia. METHODS: Ninety-nine floor house dust samples were collected: 28 from the coastal area, 31 from the inland rural and 40 from the inland urban area. Data on basic household characteristics were collected for 81 of 99 households. The mites were separated from the dust using the floatation method and then microscopically identified. The levels of Dermatophagoides pteronyssinus (Der p) 1, Dermatophagoides farinae (Der f) 1 and Der 2 were measured using the Dustscreen test. Ordinal descriptive statistics and nonparametric tests were used for data analysis, assuming statistical significance at P < 0.05. RESULTS: More than 70% of mites identified in all areas were pyroglyphids. Nonpyroglyphid mites accounted for 20-25% of all identified mites in the coastal areas (Blomia, Lepidoglyphus and Glycyphagus) and with 15% in the inland areas (Lepidoglyphus and Acarus). The highest Der p 1 median levels were found in the coastal area, with significantly lower levels in the inland rural and inland urban areas (4.5; 2; 0.85 microg/g of dust; P = 0.0001). The highest Der f 1 median levels were found in the inland urban area, with significantly lower levels in the inland rural and coastal areas (0.88; 0.75; 0 microg/g of dust; P = 0.0013). The levels of Der f 1 were significantly higher in samples taken from households with central heating than from those with traditional heating (1; 0.25 microg/g of dust; P < 0.01). CONCLUSIONS: Separate diagnostic dust mite lists for the coastal and inland areas because of climatic and dwelling differences required to be implemented. Compared with traditional heating, central heating significantly increases the risk of exposure to Der f 1 levels >2 microg/g of dust (odds ratio, 7.35; 95% confidence interval, 1.43-37.87; P = 0.01).

Animals↗
PubMed2002

The 3 mm skin prick test (SPT) threshold criterion is not reliable for Tyrophagus putrescentiae: the re-evaluation of SPT criterion to dust mites.

BACKGROUND: The mean wheal diameter >/= 3 mm is the usual criterion for positive skin prick test (SPT) reaction to dust mites. The study assessed the accuracy of this SPT criterion with respect to specific IgE values of above 0.35 kUA/l (+ sIgE). METHODS: Specific IgE (ImmunoCAP, Pharmacia AB Diagnostics, Uppsala, Sweden) and standard SPT to Dermatophagoides pteronyssinus (DP) and farinae (DF), Lepidoglyphus destructor (LD) and Tyrophagus putrescentiae (TP) (ALK, Hørsholm, Denmark) were performed in a random sample of 457 subjects, of whom 273 men (mean age 35.3 +/- 11.0 years) and 184 women (mean age 37.9 +/- 9.5 years). Statistical analysis was performed using the chi-square test, regression analysis and discriminant analysis. RESULTS: When the mean wheal diameter of >/= 3 mm was considered positive (+ SPT), the correlation between + SPT and + sIgE was 0.47 for DP (P < 0.001), 0.43 for DF (P = 0.004), 0.35 for LD (P = 0.03) and 0.37 for TP (P = 0.014). Regarding + sIgE, this SPT criterion has a specificity of 92.2% for DP, 82.3% for DF, 80.8% for LD and 70.1% for TP. When the value 4.5 mm was taken as the threshold for the positive SPT reaction to TP, specificity increased significantly from 70.1% to 86.4% (chi2 = 32.04, P < 0.001). CONCLUSIONS: The 3 mm SPT threshold criterion is not reliable in evaluating sensitization to TP due to an insufficient specificity of the allergen extract to this mite. It is advisable either to re-evaluate the TP allergen extract or change the threshold criterion for positive SPT reaction to TP.

Adult↗
PubMed2000

[Outdoor and indoor allergens and the respiratory tract].

This paper gives an overview of common outdoor and indoor allergens which cause sensitisation of the respiratory tract and considers relevant biological and ecological hallmarks and symptoms of allergies. Grass, tree, and weed pollens as well as moulds (Cladosporium and Alternaria species) are a major source of allergens in the outdoor environment whereas mites (Pyroglyphidae, Acaridae, and Glycyphagidae), animals (pets, rodents, and insects), and moulds (Aspergillus, Penicillium, and Mucor species) are a major source in the indoor environment. The paper pays attention to the seasonal, geographical, and climatic influence on the concentration of allergen in the environment. The authors discuss differences between exposure to outdoor and indoor allergens, as well as the impact of pollutants on sensitisation of the respiratory tract. The paper proceeds with a short description of the primary prevention measures such as avoidance of the allergens and the secondary measures which are intended to prevent the occurrence or deterioration of respiratory symptoms in sensitised persons.

Allergens↗
PubMed2000

The changing pattern of poisoning with psychoactive drugs in Croatia.

The aim of this study was to analyse the frequency of poisoning with psychoactive drugs (benzodiazepines, antidepressants and neuroleptics) over the last 15 years in Croatia. The analysis was based on poisoning incidents reported over the phone (hot line) to the Zagreb Poison Control Center and included two periods: 1985-1991 (period I) and 1992-1999 (period II). The data were analysed separately for children and adults. Each phone call was counted as one poisoning incident. Child poisoning with neuroleptics was significantly higher in period II than in period I and so was the adult poisoning with antidepressants, amytriptyline, and combined psychoactive drugs. The frequency of total psychoactive drug poisoning was significantly higher in adults than in children in both periods. From 1992, the frequency of adult poisoning with antidepressants considerably increased as one of the many consequences of war-related stress. The results indicate a need for careful psychiatric evaluation and more critical use of antidepressants in affected individuals.

Adult↗
PubMed2000

Household chemicals--common cause of unintentional poisoning.

Of 4736 poisoning incidents registered in the Poison Control Centre in Zagreb from 1985 to 1999, household chemicals caused 23%. In the group of cleaning products, 11% of poisoning incidents were caused by corrosives, 9% by liquid detergents and 4% by hypochlorite. Organic solvents caused 18% of household chemical poisonings; among them gasoline and thinners were the most frequent. Cosmetics were responsible for 7% of poisoning incidents; the most frequent were hair shampoo, hydrogen peroxide, and acetone. In the group of other chemicals, the most common were ingestion of thermometer mercury and of silica gel, while poisonings with highly toxic antifreeze, mothballs, or liquid fertilisers were rare. Ingestion or other exposure to household chemicals often caused excessive concern and therapeutic measures. It is therefore advisable to consult a Poison Control Centre in order to get proper information about the composition of a chemical and toxicity of a product.

Child↗
PubMed1999

Nasal challenge with histamine decreases nonspecific bronchial reactivity in workers exposed to respiratory irritants.

BACKGROUND: A link ("naso-bronchial reflex") between nasal and bronchial reactivity seems to exist. The effect of nonspecific nasal challenge (standing for the exposure to irritative stimuli at the workplace) on lung function indices and nonspecific bronchial reactivity is not known. METHODS: In 80 healthy workers (age: 36.0 +/- 8.6 years) continuously exposed to acceptable levels of different respiratory irritants (for more than 2 years) nasal challenge was performed by spraying doubling concentrations of histamine (0.0625-16.0 mg/mL, doses of histamine: 7.8 micrograms-2.08 mg) into each nostril. Before and immediately after nasal challenge spirometry and the bronchoprovocation test with histamine (0.5-128 mg/mL) was performed. RESULTS: Although nasal challenge with histamine had not reduced airway caliber (before nasal challenge vs. following nasal challenge: FEV1 3.8 +/- 0.8 vs. 3.7 +/- 0.8 L, and MEF50 4.3 +/- 1.4 vs. 4.3 +/- 1.4 L/s, mean +/- SD, respectively), it had significantly reduced nonspecific bronchial reactivity in 30.2% of the irritant-exposed subjects. CONCLUSIONS: Nasal challenge with histamine decreases nonspecific bronchial reactivity in workers occupationally exposed to respiratory irritants. Thus, a methodological implication would be that these two tests should not be performed consecutively in less than 2 hr in the same subjects.

Bronchial Provocation Tests↗
PubMed1999

Non-specific nasal and bronchial reactivity are not correlated in non-asthmatic subjects occupationally exposed to irritants and in healthy subjects.

BACKGROUND: Non-specific nasal and bronchial reactivity are frequently correlated in disease (rhinitis and asthma). It is not known whether such a correlation exists in subjects exposed to irritants and in healthy subjects. In order to test the hypothesis that a correlation between non-specific nasal and bronchial reactivity exists in non-asthmatic subjects, two groups of subjects were studied: 110 workers occupationally exposed to respiratory irritants, and 86 non-exposed healthy controls. METHODS: Allergy, non-specific nasal, and non-specific bronchial reactivity were tested, and smoking habits were categorized in each subject. RESULTS: Respiratory irritants cause a substantial increase in nasal and bronchial reactivity when compared with the group of healthy, non-exposed subjects (33.6% nasal hyperreactors and 20.0% bronchial hyperreactors vs. 4.7% nasal hyperreactors and 2.3% bronchial hyperreactors, respectively). But, occupational exposure to respiratory irritants does not induce a correlation between non-specific nasal and bronchial reactivity frequently found in asthmatic and rhinitic subjects. CONCLUSIONS: We found no correlation between non-specific nasal and bronchial reactivity either in subjects occupationally exposed to respiratory irritants or in the group of healthy subjects. This lack of correlation in both studied groups seems to be a feature of non-diseased airways. Smoking as an additional factor does not increase nasal and bronchial reactivity either in workers exposed to irritants or in healthy subjects. Smoking also does not strengthen the correlation between upper and lower airways' reactivity in both groups.

Adult↗
PubMed1999

Lack of correlation between nonspecific nasal and bronchial reactivity in allergic rhinitis subjects.

A link between allergic rhinitis and asthma has long been suspected, allergic rhinitis being considered a precursor of asthma. The hypothesis is that if such a link exists, then nonspecific nasal and bronchial reactivity are already correlated in acute rhinitis patients. To test for this correlation, we compared nonspecific nasal and bronchial reactivity in two groups of rhinitis subjects: 37 rhinitis pollinosis patients tested during the pollen season and 35 rhinitis pollinosis patients tested outside the pollen season. We also assessed how smoking affects this link. In each subject, allergy, nonspecific nasal, and nonspecific bronchial reactivity were tested, and smoking was categorized. We found no correlation between nonspecific nasal and bronchial reactivity in the two nonasthmatic rhinitis groups. During active allergic inflammation (pollinosis season) no shift toward a stronger link between upper and lower airways can be found compared with the latent period (out of pollinosis season). Unexpectedly, among smokers we found a significant relationship between nonspecific nasal and bronchial reactivity. Thus, there is not yet sufficient evidence for a straightforward link between nasal and bronchial hyperreactivity in nonasthmatic pollinosis rhinitis subjects. The development of asthma seems to be crucial for this link.

Adult↗
PubMed1998

Quantitative assessment of color vision impairment in workers exposed to toluene.

Color vision was examined by the Lanthony-D-15 desaturated test in two groups of workers occupationally exposed to toluene and in a control group. Biological parameters of toluene exposure were analyzed: toluene in air and in venous blood, orthocresol, and hippuric acid in urine after workshift. The first exposed group, Group E1, comprised 41 workers (toluene exposure ranged from 11.30 to 49.30 ppm), and the second exposed group, Group E2, comprised 32 workers (toluene exposure ranged from 66.00 to 250.00 ppm). The nonexposed group, Group NE, comprised 83 subjects. Each group was divided into two subgroups; alcohol consumers and nonconsumers. Color vision loss was expressed as a color confusion index (CCI) and as age and alcohol intake-adjusted color confusion index (AACCI). Significantly higher values of CCI and AACCI (both P < 0.0001) in Group E2 in comparison to Group NE, and significantly higher CCI (P < 0.0001) and AACCI (P < 0.05) values in Group E2 in comparison to Group E1 were established. The significant difference in CCI value between alcohol consumers and nonconsumers was established only in Group NE (P < 0.05). In Group NE significant correlation was found between CCI value as a dependent and age and alcohol intake as independent cofactors (R2 = 0.45; P = 0.0000). In Group E2 significant correlation was established between CCI as a dependent factor and age, toluene in air, and alcohol intake (R2 = 0.72; P = 0.0001), or between CCI as dependent and age, toluene in blood and alcohol intake as independent cofactors (R2 = 0.68; P = 0.0002). In Group E1 significant correlation was established only between CCI and age (P <0.005). In Group E2, AACCI value significantly correlated with toluene in air (P < 0.0001), toluene in blood (r < 0.0005), orthocresol (P < 0.005) and hippuric acid (P < 0.005) in urine after workshift. There were no differences between smokers and nonsmokers in CCI values in the examined groups. Results of this study indicate that toluene in exposed workers can impair color vision. The role of alcohol intake and age influence on color vision loss cannot be ignored in such workers.

Adult↗
PubMed1998

Qualitative color vision impairment in toluene-exposed workers.

OBJECTIVE: The aim of this study was to evaluate whether toluene, like many other organic solvents and solvent mixtures, could impair color vision. SUBJECTS AND METHODS: We investigated color vision impairment in three groups of workers, two groups occupationally exposed to toluene and a nonexposed group. The first exposed group, group E1, comprised 41 workers (median value of toluene in air 35.00 ppm, range 11.3-49.3 ppm) and the second exposed group, group E2, comprised 32 subjects (median value of toluene in air 156.00 ppm, range 66.0-250.0 ppm). The nonexposed group, group NE, comprised 83 subjects. Color vision was evaluated by the Lanthony D-15 desaturated test according to Verriest's classification: type I, loss in the red-green range; type II, loss in the blue-yellow and red-green ranges, and type III, loss in the blue-yellow range. Subjects were classified as dyschromates if specific acquired loss was determined in at least one eye. In both exposed groups, exposure was evaluated by measurement of the concentration of toluene in the ambient air and in the blood. In group E2, level of hippuric acid and orthocresol in urine after the work shift were also determined. The Mann-Whitney U-test, t-test, chi 2-test, and Spearman's rank correlation and multiple regression analysis were used for statistical analysis. RESULTS: Type III dyschromatopsia was detected in all groups examined: 26.6% of the workers in group NE, 31.7% of those in group E1, and 50% of those in group E2. As many as 15.6% of the workers in group E2, 4.8% of those in group E1, and only 1.2% of those in group NE had type II dyschromatopsia. A statistically significant difference in the prevalence of total dyschromatopsia (type III + type II) was established among the three examined groups together (chi 2 = 14.13; df = 2; P < 0.01), between group E2 and group E1 (chi 2 = 4.96; P < 0.05), and between group E2 and group NE (chi 2 = 12.50; P < 0.005), whereas no significant difference was found between groups E1 and NE. Type III dyschromatopsia was significantly correlated with age in group NE (P < 0.01) and in group E1 (P < 0.005). In group E2, both type II (P < 0.05) and type III dyschromatopsia correlated with toluene in ambient air and with the duration of exposure to toluene (both P < 0.005). In group E2, total dyschromatopsia correlated significantly with toluene in ambient air and in blood (both P < 0.05) as well as with hippuric acid in urine after the work shift (P < 0.001). CONCLUSION: This study suggests that toluene can impair color vision.

Adult↗
PubMed1998

Assessment of colour vision impairment in male workers exposed to toluene generally above occupational exposure limits.

We investigated colour vision impairment in 45 male workers occupationally exposed to toluene (mean value of toluene concentration in ambient air = 119.96 ppm) and in 53 controls. Colour vision was evaluated by Lanthony-D-15 desaturated test and expressed as Age and Alcohol Intake Adjusted Colour Confusion Score (AACDS) or types of dyschromatopsia. Exposure was evaluated by measurement of toluene concentration in ambient air and blood, and hippuric acid and orthocresol determined in urine after the workshift. A statistically significant higher AACDS value was established in the exposed subjects compared to the controls (p < 0.0001). There was no significant difference between AACDS values on Wednesday morning compared to Monday morning. In the exposed group AACDS significantly correlated with the concentration of toluene in ambient air, concentration of toluene in blood and the concentration of hippuric acid in urine after the workshift (all p < 0.0001). Dyschromatopsias were detected in both groups, although no significant difference between groups was established. In the exposed group concentration of toluene in ambient air, alcohol intake and age explained 35.1%, concentration of toluene in blood, age and alcohol intake explained 19.9%, and concentration of hippuric acid in urine and age explained 19.2% of the variation in type III dyschromatopsia. Concentration of toluene in ambient air and age explained 28.3% of the variation in total dyschromatopsia, and concentration of hippuric acid and age explained 13.8%. In the control group, age and alcohol intake explained 19.6% of the variation in type III dyschromatopsia. In exposed workers a significant difference was found in the AACDS value compared to controls. However, no significant difference was found in the prevalence of colour vision loss in the yellow-blue and/or red-green axis. Based on the results of this study the authors conclude that the effect of toluene on colour vision can be chronic and that the possible reparation period in colour vision impairment is longer than 64 hours.

Adult↗
PubMed1995

[Secondary inactive pulmonary tuberculosis and non specific bronchial reactivity].

Bronchial reactivity to methacholine was examined in three groups of smokers (N = 93): subjects with secondary inactive pulmonary tuberculosis (TPI) 2 years after the beginning of treatment (N = 44); subjects with asymptomatic chronic bronchitis (N = 25) and healthy control (N = 24). Mean PC20FEV1 was 9.54 (SD 6.05), 11.12 (SD 5.42) and 13.74 (SD 4.7) respectively (tuberculosis vs control, p < 0.02). According to the arbitrary criteria for bronchial asthma, nonspecific hyperreactivity was present in 50% of subjects with TPI, in 37.5% of bronchitic patients and in 16% of control subjects. No difference was found with regard to PC20FEV1, the chemotherapeutic regimen (9 or 12 months of therapy), results of tuberculin test (normo and hyperreactive) and X-ray findings determined before the onset of treatment. Mahalanobis statistical analysis with respect to smoking index, basal ventilatory function tests and nonspecific bronchial reactivity grouped together healthy volunteers and subjects with a history of pulmonary tuberculosis apart from the group with asymptomatic chronic bronchitis.

Adult↗
PubMed1994

Modified method of nonspecific nasal provocation with histamine for routine use.

An improved method for assessment of nonspecific nasal reactivity (NNR) was evaluated to validate it, and determine a criterion for nasal hyperreactivity. The efficacies of four different parameters to indicate nasal patency in assessment of the level of NNR were compared in 60 healthy subjects and 65 patients with allergic rhinitis (37 in the period of pronounced symptoms and 28 in the symptom-free period). Histamine/diphosphate was sprayed into both nostrils every three minutes in doubling concentrations (0.03125 to 32 mg/mL); during 90 seconds, sneezes were counted and symptom score was assessed; thereafter nasal inspiratory peak flow (NIPF), total nasal airway resistance (NART), nasal forced expiratory volume in one second (N-FEV1) and nasal midexpiratory flow rate (N-MEF25/75) were measured. Nasal inspiratory peak flow meter (Youlten, "Airmed") was used to measure NIPF. A spirometer (Pneumoscreen II, "Jaeger") with a face mask attached was used to measure NART, N-FEV1, and N-MEF25/75. The test of NNR was terminated when a significant change of values (as determined by a pilot study) occurred: NIPF, -30%; NART, +75%; N-FEV1, -20%; and N-MEF25/75, -25%. Our results indicate a significantly higher NNR (PCNART of patients = 0.77 mg/mL versus PCNART of healthy subjects = 4.5 mg/mL; P < .00001) period of pronounced symptoms than in healthy subjects or in rhinitic patients when symptom free. A criterion, that takes age into account, is set for separation of normoreactivity from hyperreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Nonspecific nasal responsiveness in workers occupationally exposed to respiratory irritants.

The aim of the study was to establish the level of the nonspecific nasal responsiveness in a group of workers (N = 84) occupationally exposed to respiratory irritants, and to compare it with its level in healthy subjects (N = 60). Another goal was to study the effect of occupational exposure to irritants, smoking, and atopy on nonspecific nasal responsiveness. The modified method of nonspecific nasal provocation with histamine developed by van Wijk and Dieges (Clin Allerg 17:563-570, 1987) was used. The method was performed by spraying doubling concentrations of histamine (0.03-32 mg/mL), starting with saline, in a cumulative manner into each nostril. The reaction was measured by total nasal resistance ("opening" interruption technique). The result of the test was expressed as provocation concentration of histamine that caused > or = 75% rise of total nasal resistance compared to its value measured after saline. We found a significantly higher percentage of nasal hyperreactors and a significantly greater nonspecific nasal responsiveness among 65 exposed workers (chi 2 = 78.6; p < 0.001, t = -5.48; p < 0.001, respectively) than in the group of healthy subjects. A significantly (t = 4.25; p < 0.001) increased nonspecific nasal responsiveness was observed during exposure when compared to nonspecific nasal responsiveness assessed after 2 weeks out of exposure, when tested in 19 patients. Higher smoking rate as measured by smoking category (number of cigarettes multiplied with years of smoking) was associated with the lower levels of nonspecific nasal responsiveness. Also, we failed to confirm a relation between atopy and nonspecific nasal responsiveness in a group of workers exposed to irritants.

Adult↗
PubMedDate not supplied

[Exercise-induced bronchospasm and its prevention].

Exercise-induced bronchospasm (EIB) is a type of nonspecific bronchial hyperreactivity. It affects mostly children and younger adults with asthma (75%-95%) and allergic rhinitis (40%), but it is also found in 3-11% of the nonasthmatic and nonatopic younger population. Pathophysiology of this phenomenon is not clear and there are some attempts to explain it with hyperosmolality of bronchial epithelia, exchange of heat and water (reactive hyperemia) in airways and reflex vagal bronchospasm. Unrecognized and uncontrolled symptoms of EIB can lead patients to avoid general and occupational physical activities and sports. Diagnosis of EIB is focused on medical history and on pulmonary function testing after standardized exercise testing protocols on treadmill, cycle ergometer or by free running. Non-pharmacological and pharmacological prophylactic measures are the most important approach in the therapy of EIB. Inhalation of beta 2-agonists or cromolyns is the first choice in pharmacological prevention of EIB. With adequate therapy, symptoms of EIB can be controlled enough to maintain everyday as well as sports activities.

Asthma, Exercise-Induced↗
PubMedDate not supplied

[The role of nonspecific nasal reactivity in the evaluation of induced bronchial hyperreactivity].

The excitation of the irritant receptors in the upper respiratory tract may result in reflex bronchoconstriction. Does the raised reactivity of the nasal mucus membrane--the place of the first contact with respiratory irritants--play an important role in the expression of IBH? The level of NNR and the existence of relation between NNR and IBH have been assessed in 32 healthy subjects and 28 workers exposed to irritants with respiratory disorders. Nonspecific nasal provocation was performed by spraying of doubled concentrations of histamine solution in saline (0.03-16 mg/mL) in both nostrils in three minute intervals. The reaction was monitored by measurement of nasal peak inspiratory flow, nasal resistance, nasal forced expiratory volume in first second and nasal forced expiratory mid-flow. The level of NNR was expressed as provocation concentrations of histamine solution that produced significant change of all four measured parameters. Nonspecific bronchial provocation with histamine was performed by the modified method of Chai H. et al. The criterion for hyperreactivity was PC20FEV1 less than or equal to 8 mg/mL of histamine. There was statistically no significant correlation between NNR and IBH.

Adolescent↗
PubMedDate not supplied

[Prevalence of atopy indicators in the adult population of the Zagreb region].

In a sample of 583 subjects (303 men and 280 women) intradermal test with 13 inhalatory allergens, total serum IgE (PRIST Phadezym) determination and nonspecific bronchial reactivity measurement by histamin test, were performed. History data on respiratory symptoms was also taken. The following were evaluated: mean urtica diameter D+d/2 > 8 mm (KT+), value of IgE > 125 IU/ml, and bronchial hyperreactivity (BH), separately in symptomatic and asymptomatic subjects. In symptomatic smokers total IgE (G.M. IU/ml) was higher in women than in men (177.70:68.20-p < 0.01), and in asymptomatic smokers it was higher in men than in women (50.71:33.79-p < 0.01). A larger number of allergens discriminated skin reactivity between the symptomatic and asymptomatic women (grass, tree and weed pollen-p < 0.001; house dust-p < 0.05), than between the symptomatic and asymptomatic men (grass pollen-p < 0.001). The level of IgE < 125 and > 125 IU/ml discriminated significantly the prevalence of persons with KT+ in the group of symptomatic men (80%:27%-p < 0.001) but not in the group of symptomatic women (77%:67% N.S.). BH only partially coincides with KT+ and raised IgE (> 125 IU/ml) in symptomatic subjects (men 20%, women 23%) and in asymptomatic subjects only in men (8%).

Adult↗