Biomedical subjects

Wojciech Silny

Publications and source records attributed to Wojciech Silny.

At least 19 recordsLinked to original sources

PubMed2006

Contact allergy in patients with chronic venous leg ulcers-- possible role of chronic venous insufficiency.

The purpose of this study was to evaluate frequency of contact allergy in patients with chronic venous leg ulcers (CVLU) and to estimate possible relationships between allergic contact reactions and characteristics of both chronic venous insufficiency (CVI) and CVLU. We performed patch tests with the European standard series, antibiotics, glucocorticosteroids and ointment vehicles in 50 patients with CVLU. Patients underwent detailed CVI diagnostics using colour flow duplex ultrasound examination, ankle brachial pressure index determination and leg ulcers area measurement. Positive patch tests results were found in 80% and polyvalent allergy in 56% of patients. Statistically significant correlations were recorded between CVI and CVLU duration, CVLU duration and CVLU area and between CVI duration and polyvalent allergy frequency. Statistically significant differences were observed between coexistence of superficial and deep system insufficiency and CVLU duration, characteristics of contact allergic reactions and CVI duration, frequency of allergic contact reaction and presence or absence of long saphenous vein insufficiency, incidences of vein thrombosis and characteristics of contact allergic reactions as well as between characteristics of contact allergic reactions and both CVLU duration and area. Complex pathophysiological processes, including inflammatory reactions, in course of CVI may influence development of allergic contact reaction in CVLU patients.

Aged↗

PubMed2006

Immunological parameters in the sera of patients with atopic dermatitis and airborne allergy treated with allergy vaccines.

Patients with atopic disorders present an increased production of IgE, which is usually limited to specific antibodies against various environmental allergens. It has also been suggested that the production of these antibodies may be influenced by effective specific immunotherapy (SIT). Of course, a decline of serum antigen specific IgE in the course of such a treatment cannot explain the clinical efficacy of SIT and is probably not a key mechanism. However, SIT may at least participate in the final clinical result. In this study, 37 patients with atopic dermatitis were treated with allergy vaccines (Novo-Helisen Depot) for a time period of 48 months. The control group consisted of 29 patients with atopic dermatitis who were treated with classical methods. The clinical score (W-AZS), total IgE and antigen specific IgE (asIgE) in the sera of patients were assessed before treatment and after 24 and 48 months of therapy (FEIA CAP System, Pharmacia). There was a significant difference between the two investigated groups from both the clinical and immunological standpoints after 2 and 4 years of observation. There was a significant decrease of serum total IgE and asIgE (directed against airborne allergens) in the course of specific immunotherapy. In the control group, the total IgE level tended to increase, and this tendency was also recorded in case of asIgE measurements. We also evaluated the influence of specific immunotherapy on the serum level of IFN-G, sIL-2R, IL-4, IL-5 and IL-10 before treatment and after 4 years of therapy with the quantitative 2-step colorimetric sandwich ELISA method (R and D Systems). In the group of patients treated with allergy vaccines, a significant decrease of the serum sIL-2R level was observed after 48 months of therapy (p<0.01). In the control group, a significant increase of serum IL-4 (p<0.01) as well as IL-5 (p<0.05) was registered at the end of the observation period. There was no significant correlation between the clinical score and serum level of any of the investigated cytokines in either group of patients before the treatment or after 48 months of therapy.

Adolescent↗

PubMed2006

Specific immunotherapy in atopic dermatitis.

Despite the existence of various scientific research on the beneficial effect of specific immunotherapy with specific airborne allergens in the treatment of atopic dermatitis, this method has not been easily accepted, as the methodology and the valuation of the studies were heterogeneous. Over the last few years, meta-analysis technology has been developed as a useful tool to globally value the results of different research trials related to one specific scientific problem. When meta-analyses are carried out correctly, they are accepted as the most appropriate way to express the results obtained from different studies. Not many studies have been published in the case of atopic dermatitis and specific immunotherapy. In this paper, we attempt to present and discuss results obtained by various authors on this topic, beginning with the publication of Strauss and Kligman in 1957. It should be noted that for patients with IgE-mediated airborne allergy, especially children, specific immunotherapy as an early treatment in cases of atopic dermatitis could have an additionally preventive nature in terms of protection against the development of a respiratory atopic problem. Specific immunotherapy should therefore be at least considered in the treatment of selected cases of atopic dermatitis patients presenting airborne IgE-mediated allergy.

Dermatitis, Atopic↗

PubMed2006

Selected eosinophil proteins as markers of inflammation in atopic dermatitis patients.

Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic and recurrent course, beginning primarily in early childhood. The etiopathogenesis of AD has not yet been fully understood, although various types of inflammatory cells including eosinophils may be involved in its pathomechanism. The basic aim of the study was to evaluate the usefulness of selected eosinophil proteins in serum and urine of AD patients, as markers of disease severity. The study also aimed to analyze correlations between the level of examined proteins and parameters such as skin prick test (SPT) results, serum concentration of total IgE, and coexistence of symptoms of other atopic diseases. The study included 30 AD patients and two control groups: 30 patients suffering from chronic urticaria and 30 healthy individuals. The mean level of eosinophil proteins measured in serum and urine of AD patients was higher than that in controls, although a significant difference was only recorded for serum and urine level of eosinophil protein X (EPX). Patients with very severe/severe AD presented higher levels of eosinophil proteins than patients presenting with mild/moderate AD, although no significant difference was found between these two groups. AD patients with positive SPT results and detectable specific IgE in serum, and with coexisting symptoms of other atopic diseases presented with higher mean levels of serum and urine eosinophil proteins than AD cases with negative SPT results and without any symptoms of other atopic diseases. In children suffering from AD, serum eosinophil cationic protein level, EPX level and urine EPX level were higher than those in healthy children, however, without statistical significance. Study results suggested a significant role of eosinophils in the etiopathogenesis of AD. Serum and urine levels of selected eosinophil proteins may serve as an important part of diagnostic approach to AD patients, especially in differentiation of allergic and non-allergic forms of AD. The results are also promising for the usefulness of selected eosinophil proteins in the diagnosis of AD in children, however, thorough analysis on a larger group of patients is needed.

Adolescent↗

PubMed2005

Atopy patch test reaction to airborne allergens in the diagnosis of atopic dermatitis.

The aim of the study was to evaluate the possible use of atopy patch test in the diagnosis of atopic dermatitis and to characterize an optimal standardized system for atopy patch test in terms of allergen concentrations and time of allergen exposure. The study included 36 patients with atopic dermatitis and IgE-mediated airborne allergy. Patients presented positive results of skin prick tests and serum antigen specific IgE against house dust mite allergens and/or selected grass pollen allergens. Control groups consisted either of patients with allergic rhinitis (control group 1) or healthy volunteers with no signs or symptoms of atopy (control group 2). Allergologic diagnostic workup consisted of skin prick test, serum antigen specific IgE and total IgE evaluation, atopy patch test with selected airborne allergens of different concentrations (0.1xSPT, 1xSPT and 10xSPT), time of allergen exposure (8, 24 and 48 h), and readings of the results (8, 24, 48 and 72 h). Positive results of atopy patch test with airborne allergens were obtained in 47.2% of atopic dermatitis patients and none of control subjects. Contact reaction itself and the intensity of reaction were demonstrated to correlate with allergen concentration and time of allergen exposure on atopy patch test. The dose and time response analysis showed the optimal concentration of allergens for atopy patch test to be 10xSPT, 500000 SBE/ml, and optimal evaluation time 24 and 48 h of allergen application. There was no correlation between atopy patch test results and mean serum concentrations of total or antigen specific IgE. Atopy patch test results did not correlate with localization of skin lesions, severity and extensiveness of skin inflammation. A significantly higher contact reactivity to airborne allergens was recorded in the group of atopic dermatitis patients with polyvalent allergy in comparison with atopic dermatitis patients allergic to only one aeroallergen. It is concluded that atopy patch test is the only provocation test currently available with clinical relevance for contact IgE-mediated sensitization in atopic dermatitis patients. Using petrolatum as a vehicle, allergen concentration of 500000 SBE/ml and evaluation time of 24 and 48 h of allergen application may lead to improved atopy patch test results.

Adolescent↗

PubMed2005

[Efficacy of specific immunotherapy in the treatment of children and youngsters suffering from atopic dermatitis. Part I. Evaluation of clinical score].

Despite undoubted progress in the field of allergology and clinical immunology we still lack an effective and secure therapeutic methods in many cases of atopic dermatitis. The aim of the study was to evaluate efficacy of specific immunotherapy performed for the time period of 3 years with Novo-Helisen Depot allergy vaccines in the group of 36 children and youngsters with atopic dermatitis, allergic to house dust mites (24 patients) and grass pollen allergens (12 patients). The control group consisted of 20 patients with atopic dermatitis and analogous IgE-mediated airborne allergy treated with conventional methods. Clinical evaluation of patients was performed before treatment and after 36 months of therapy and was based on severity and extensiveness of skin inflammation in atopic dermatitis index: W-AZS. Clinical efficacy of specific immunotherapy was significantly higher than efficacy of conventional methods (p < 0.001). It was concluded that in selected patients with atopic dermatitis with IgE-mediated airborne allergy this method of treatment could be a promising alternative.

Adolescent↗

PubMed2005

[Efficacy of specific immunotherapy in the treatment of children and youngsters suffering from atopic dermatitis Part II. Evaluation of skin reactivity and concentration of serum antigen specific immunoglobulin E directed against selected airborne allergens].

Atopic dermatitis (AD) still remains a difficult clinical problem in terms of effective therapy. The aim of our study was to evaluate efficacy of specific immunotherapy performed with Novo-Helisen Depot allergy vaccines in the group of 36 children and youngsters with atopic dermatitis allergic to house dust mites (24 persons) and grass pollen allergens (12 patients), for the time period of 3 years. Skin reactivity (skin prick tests) and serum concentrations of antigen specific IgE were monitored in the course of treatment. The control group consisted of 20 patients with atopic dermatitis and IgE-mediated airborne allergy who were treated with conventional methods. Specific immunotherapy resulted in negativization of skin prick tests results and decrease of serum antigen specific IgE concentrations. On the contrary in the control group there was no tendency for negativization of skin prick tests and we observed an increase of serum concentration of antigen specific IgE directed against grass pollen allergens. Specific immunotherapy seems to be an effective therapeutic approach in selected cases of atopic dermatitis.

Adolescent↗

PubMed2005

Bacterial flora of leg ulcers in patients admitted to Department of Dermatology, Poznań University of Medical Sciences, during the 1998-2002 period.

Venous leg ulcers are an important cause of morbidity in a significant percentage of the world population. The percentage of leg ulceration, either active or healed, in the European population is about 1%-2%. The aim of this study was to analyze the rate of colonization and qualitative composition of the bacterial flora isolated from leg ulcers in patients admitted to Dermatology Department, Poznań University of Medical Sciences, during the 1998-2002 period, with special reference to the infection risk factors. Bacteriological diagnosis of 175 wound swabs was performed in compliance with compulsory laboratory methods. In 173 positive results, the predominant culture composition included Staphylococcus aureus (56.57%), Pseudomonas aeruginosa (37.14%), Enterococcus faecalis (22.29%), Proteus mirabilis (13.71%) and Escherichia coli (12.57%). There was a significant increase in the incidence of Pseudomonas aeruginosa, Enterococcus faecalis and Escherichia coli, along with a decrease in the incidence of Staphylococcus aureus isolation during the study period. The rate of yeast-like fungi strains, mainly Candida albicans, recorded in culture composition showed a systematic increase. Changes in the qualitative and quantitative composition of bacterial flora, presence of multiple isolates, and concomitant diseases that may influence the characteristics of leg ulcer disease were closely monitored.

Academic Medical Centers↗

PubMed2005

Analysis of antibiotic susceptibility and resistance of leg ulcer bacterial flora in patients hospitalized at Dermatology Department, Poznań University Hospital.

Effective treatment of frequently infected, poorly healing wounds such as leg ulcers due to chronic venous insufficiency poses a major clinical problem. Antibiotic resistance in dermatology patients, especially those with non-healing leg ulcers, is a widespread phenomenon. Various antibiotics, mainly broad-spectrum agents, are frequently and sometimes inappropriately prescribed, which often leads to the selection of antibiotic-resistant bacteria strains. The aim of this study was to analyze antibiotic susceptibility and resistance of bacterial isolates cultured from leg ulcers. Wound swabs were obtained from patients admitted to Dermatology Department, Poznań University of Medical Sciences, during the 1998-2002 period. Bacteriologic diagnosis of 175 wound swabs was performed in compliance with compulsory laboratory methods. The analysis yielded 173 positive results, predominated by Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis, Proteus mirabilis and Escherichia coli. Bacterial isolates were evaluated for resistance to commonly used antibiotics, taking into consideration the presence of methicillin resistant Staphylococcus aureus strains. Antibiotic resistance profiles were compared between the years 1998 and 2002, with detailed account of clinical characteristics and history of leg ulcers disease. The study pointed to an increasing tendency of antibiotic resistance in the study group of patients.

Adult↗

PubMed2005

[Results of skin prick tests and evaluation of serum antigen specific immunoglobulin E in patients with atopic dermatitis and airborne allergy with regards to the type of sensitising allergens and seasonal course of the disease].

UNLABELLED: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with sensitivity to common airborne allergens. The aim of the study was to evaluate immediate type of immunological reaction initiated by main types of airborne allergens in the pathomechanism of atopic dermatitis. The exacerbation of skin inflammation of patients with AD in relation to the seasons was also evaluated. MATERIAL AND METHODS: 529 patients with AD aged (0.5-60 years) who fulfilled basic Hanifin and Rajka criteria and 60 healthy volunteers in the control group were investigated. In order to evaluate IgE-mediated allergy to common airborne allergens skin prick tests (SPT) were performed (26 airborne allergens) and concentration of serum antigen specific IgE (asIgE) was measured. Evaluation of exacerbation of skin inflammation of patient with AD in for patient with monovalent allergy of airborne allergens. RESULTS: Our results indicated predominance of grass pollen (63.2%) and house dust mite (57.0%) allergens of all patients sensitive to airborne allergens (n-405). In the group of patients sensitive to pollen allergens seasonal exacerbation of skin inflammation was predominant (over 90% of patients) and in the groups of patients sensitive to house dust mite and animal allergens the clinical manifestation of allergy for the whole year was observed in the most patients (77.1% and 57.1%). CONCLUSIONS: We conclude, that house dust mite and plant pollen allergens play an important role in the pathomechanism of atopic dermatitis.

Adolescent↗

PubMed2005

[Evaluation of skin prick tests and serum concentration of antigen-specific immunoglobulin E in patients with atopic dermatitis sensitive to airborne allergens in relation to the type of allergens and age of patients].

UNLABELLED: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with sensitivity to common airborne allergens. The aim of the study was to evaluate the immediate type of immunological reaction initiated by main types of airborne allergens in the pathomechanism of atopic dermatitis in relation to the age of patients. MATERIAL AND METHODS: 529 patients with AD aged (0.5-60 years) who fulfilled basic Hanifin and Rajka criteria and 60 healthy volunteers in the control group were investigated. In order to IgE-mediated allergy to common airborne allergens skin prick tests (SPT) were performed (26 airborne allergens) and concentration of serum antigen specific IgE (asIgE) was measured. RESULTS: Our results indicated increasing prevalence to sensitisation to airborne allergens in patients with AD in relation to the age of these patients (age 0.5-4--17 cases; 5-12 years--127 cases; 13-18 years--88 cases; above 18 of age--173 cases). The sensitisation to grass pollen and house dust mite allergens was predominant. CONCLUSIONS: We conclude, that predominance to sensitization to airborne allergens tends to increase with the age of patients.

Adolescent↗

PubMed2005

[A case of sporadic pemphigus foliaceus in teenage girl with psoriasis vulgaris].

A 15-year-old girl with generalized erythematous, scaling plaques, bullous and erosive lesions on the skin was diagnosed as having pemphigus foliaceus. These symptoms occurred during the topical treatment for psoriasis vulgaris. Confirmation of diagnosis was made by routine histopathology and both direct and indirect immunofluorescence microscopy. The patient's serum gave positive reaction against desmoglein 1 in ELISA technique. The patient was successfully treated with systemic corticosteroids (at the beginning intravenous methylprednisolone) and immunosuppressants (cyclophosphamide p.o.).

Adolescent↗

PubMed2005

[Effectiveness of specific immunotherapy in the treatment of children and youngsters suffering from atopic dermatitis. Part III. Serum concentrations of selected immunologic parameters].

Etiology and pathomechanism of atopic dermatitis still remains partially unclear and therefore contemporary methods of treatment are not always satisfactory from the clinical standpoint. The aim of this study was to evaluate selected immunological parameters (tIgE, ECP, sIL-2R, IFN-gamma, IL-4,IL-5) in sera of atopic dermatitis patients in the course of specific immunotherapy performed for the time period of 3 years. Novo-Helisen Depot allergy vaccines of appropriate composition were used for the treatment of 36 children and youngsters with atopic dermatitis, allergic to house dust mites (24 patients) and grass pollen allergens (12 patients). The control group consisted of 20 patients with atopic dermatitis and analogous IgE-mediated airborne allergy who were treated with conventional methods. There was a clear difference between two investigated groups of patients in terms of immunological parameters. In the group treated with allergy vaccines serum concentrations of total IgE and ECP tended to decrease (p < 0.001) as well as sIL-2R (p < 0.01). On the contrary in the control group serum tIgE increased and IL-4 as well as IL-5 concentrations tended to increase significantly (p < 0.01; p < 0.05 respectively).

Adolescent↗

PubMed2005

Genetic aspects of atopy and atopic dermatitis.

This review presents updated evidence on the genetic basis of atopy and atopic dermatitis. The etiology of atopic processes remains partially unknown but is likely to result from multifactorial inheritance, with an interaction between genetic and environmental factors. It seems that at least two major mechanisms, non-antigen specific and antigen specific, regulate the immune response to environmental allergens in humans. While many of environmental components have been studied for years, only recently significant progress has been made in identifying the genes responsible for susceptibility or expression of atopic diseases. Genome-wide screens in various populations have identified the locations of susceptibility genes for asthma and atopy as well as associated phenotypes such as bronchial hyperresponsiveness and increased total IgE concentrations typical for patients suffering from atopic dermatitis. Further research on genetic and environmental relationships is necessary for better understanding of atopic processes and development of new therapeutic approaches.

Dermatitis, Atopic↗

PubMed2005

The new scoring system for evaluation of skin inflammation extent and severity in patients with atopic dermatitis.

The new scoring system for assessment of the extent and severity of skin inflammation index in atopic dermatitis patients, W-AZS, is presented. The system provides detailed assessment of both subjective and objective signs and symptoms of atopic dermatitis. With the use of W-AZS, acute and chronic skin manifestations of inflammatory process are appropriately evaluated and scored. It also enables the practitioner to assess various localizations of skin lesions at different time points. W-AZS is a relatively easy and rapid index to perform, and it seems very beneficial for clinicians. Other scoring systems used in atopic dermatitis are also presented, analyzed and compared, e.g., Atopic Dermatitis Area and Severity Index (ADASI), SCORing Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), and Three-Item Severity score (TIS). There is a strong necessity to standardize clinical evaluation of the extent and severity of skin diseases such as atopic dermatitis, as laboratory techniques and parameters are not really of great use for practitioners.

Dermatitis, Atopic↗

PubMed2005

[Corticosteroid phobia in patients with atopic dermatitis].

Topical corticosteroid phobia is an interesting phenomenon recently mentioned often in the literature. It is characterized by an irrational fear and anxiety of patients about using topical corticosteroid preparations and may be associated with confusion and lack of knowledge regarding potency and indications for use of various groups of these widely used in dermatological practice topical drugs. So called "steroid phobia" may be additionally augmented by media. The aim of this study was to investigate the problem of corticosteroid phobia in atopic dermatitis (AD) patients, attending Allergic Diseases Diagnostic Center of the Department of Dermatology, University of Medical Sciences in Poznań. The study revealed confusion and anxiety among the AD patients about topical corticosteroid therapy. More than half of AD patients felt uncertain about using topical steroid preparations and had little knowledge regarding their potency and side effects, especially in case of drugs used less frequently. One of the most important sources of information about corticosteroids was doctor's consultation. It seems that proper education of patients provided by health care staff might improve clinical efficacy of treatment and patients' compliance.

Adolescent↗

PubMed2005

[Non-allergic type of atopic dermatitis among patients of Allergic Diseases Diagnostic Center, University of Medical Sciences in Poznań].

Atopic dermatitis (AD) is a chronic inflammatory skin disease of unclear etiopathogenesis. It belongs to the group of atopic diseases and an IgE-mediated uptake and antigen focusing of environmental allergens by IgE-bearing dendritic cells is assumed to be a central immunopathogenetic event resulting in clinical appearance of AD. In case of non-allergic (intrinsic) type of AD, non IgE-related factors are involved in the process. Potential immunological and clinical differences between allergic and non-allergic type of the disease are still being investigated. The aim of our study was to evaluate prevalence of non-allergic and allergic type of AD among patients of Allergic Diseases Diagnostic Center, University of Medical Sciences in Poznań between 2001 and 2002. We investigated 161 patients with AD and selected factors influencing course of the disease such as age, gender, month of birth, population of the region and characteristics of sensitizing allergens were analyzed. Allergological diagnostics consisted of skin prick tests and measurements of total and antigen specific IgE concentrations in sera of investigated patients (FEIA CAP). Non-allergic type of AD was registered in 38.5% of the investigated population. There was no significant difference between allergic and non-allergic type of AD in terms of month of birth and living conditions (urban areas or countryside). Especially in the case of children evaluations of total and antigen specific IgE serum concentrations were helpful in verification of skin prick test results. In the group of patients with allergic type of AD grass pollen allergens were sensitizing most frequently and finally type of sensitizing airborne allergens may be at least partially related to the environmental characteristics of the region.

Adolescent↗

PubMed2004

[Role of immediate hypersensitivity to airborne allergens in the pathogenesis of atopic dermatitis].

UNLABELLED: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with hyperproduction of immunoglobulin E directed against common environmental allergens. OBJECTIVES: The aim of the study was to evaluate the immediate type of immunological reaction indicated by airborne allergens in the pathomechanism of atopic dermatitis. MATERIAL AND METHODS: 529 patients with AD aged (0.5-60 years) who fulfilled basic Hanifin and Rajka criterias and 60 healthy volunteers in the control group were investigated. In order to evaluate IgE-mediated allergy to common airborne and alimentary allergens skin prick tests (SPT) were performed (26 airborne and 7 basic alimentary allergens) and concentration of serum antigen specific IgE (asigE) was measured. RESULTS: Our results indicated airborne allergy in case of 405 patients (76.6%) and food allergy only in 67 cases (12.7%). In the group of children aged 0.5-4 years food allergy was predominant but later on the predominance of airborne allergy was observed. CONCLUSIONS: We conclude that airborne allergy plays an important and predominant role in the pathomechanism of atopic dermatitis.

Adolescent↗