Objective: Numerous studies of the population prevalence of asthma, allergic rhinitis, and atopic... more Objective: Numerous studies of the population prevalence of asthma, allergic rhinitis, and atopic eczema revealed some international differences. However, the International Study of Asthma and Allergies in Childhood (ISAAC) was the first one using a standardized methodology to evaluate the prevalence of these diseases, and to make comparisons within and between countries. The results showed marked variations in 12-month prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms with 20-fold (range 1.6-36.8%), 30-fold (range 1.4-39.7%), and 60-fold (range 0.3-20.5%) differences between the centres with the highest and the lowest prevalence, respectively. Aim: Our aim was to gain the insight into the prevalence of allergic diseases in Zagreb, Croatia by the methods of internationally standardized protocol, proposed by the ISAAC Steering Committee. Methods: Original questionnaires, translated from English into Croatian, consisting of questions about the child's demographic characteristics, core modules on wheezing, rhinitis and eczema, and supplementary modules, were completed by parents of 10-year-old children (4th grade) attending 18 elementary schools in a city of Zagreb. Total of 1047 questionnaires were returned and analysed after the inconsistent responses were eliminated by phone calling. Discussion: Phase one of the ISAAC study has shown a wide variation in the prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms throughout the world, with differing international patterns for the different disorders. Four prevalence ranges have been established for better illustration of the geographic distribution of asthma prevalence: (I) < 5%; (II) 5 to < 10%; (III) 10 to < 20%; (IV) > or = 20%. The highest 12-month prevalences of asthma symptoms were found in developed countries (UK, Australia, New Zealand, Republic of Ireland, and most centres in North, Central, and South America), being in prevalence range IV. The lowest prevalences (range I) were found in several Eastern European countries, Indonesia, Greece, China, Taiwan, Uzbekistan, India, and Ethiopia. According to the results of our study, a continental part of Croatia with a 12-month prevalence of wheezing of 6.02% corresponds to range II. Prevalence of asthma symptoms was greater in males, which is consistent with the results of the younger age group previously analysed. For allergic rhinoconjunctivitis and atopic eczema symptoms grouping of centres with a high prevalences into specific regions was less well defined than for asthma. Centres with the highest prevalences were scattered across the world. In contrast, centres with the lowest prevalences were similar to those for asthma symptoms. Our results of the 12-month prevalence of allergic rhinoconjunctivitis (12.13%), and atopic eczema (7.83%) symptoms were somewhere between the two extremes. As with asthma symptoms, the prevalence of rhinoconjunctivitis symptoms was greater in males. Contrary, the difference in prevalence of atopic eczema symptoms between the sex groups has not been found. The worldwide variations in prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms suggest that environmental factors may be critical to the development of these disorders in childhood. Furthermore, different patterns of geographical distribution of particular disorders suggest that major risk factors for them may be different or may involve different latency periods and time trends. Therefore, studies that include objective clinical assessment are required. Conclusion: According to our results, Zagreb is a city with relatively low prevalence of allergic diseases symptoms. Larger sample size of at least 3000 subjects is required to provide sufficient precision for estimates of symptom severity, and to generate adequate number of subjects with particular disorders for further analyses. Therefore, we recently increased our sample size to more than 3000 subjects, and started ISAAC Phase two (clinical examination, measures of bronchial hyperresponsiveness, measures of atopy, measures of environmental exposure to aeroallergens, and genetic analyses) in Zagreb, Croatia.
... Source: Journal of the World Allergy Organization, Abstracts / Baena-Cagnani CE, Wahn U. (ed)... more ... Source: Journal of the World Allergy Organization, Abstracts / Baena-Cagnani CE, Wahn U. (ed). - Göttingen : Hogrefe &amp; Huber publishers ... Abstract: BACKGROUND Oral allergy syndrome (OAS) to fruits and vegetables often coexists with pollen allergy, and draws attention to ...
Limfangiolejomiomatoza je progresivna i fatalna bolest plucnog intersticija nepoznate etiologije ... more Limfangiolejomiomatoza je progresivna i fatalna bolest plucnog intersticija nepoznate etiologije koju obilježava abnormalna proliferacija glatkog misicnog tkiva u plucima i limfnim žilama. Zahvaca gotovo iskljucivo žene generativne dobi. Prevalencija ove bolesti u Hrvatskoj nije poznata. Prikazujemo slucaj 41 godisnje pacijentice s anamnezom umora 2 mjeseca prije hospitalizacije te pojavom febriliteta i dispneje nekoliko dana prije. Klinicki je težeg opceg stanja, dispnoicna, ortopnoicna, adipozna, tahikardna sa diskretnim pretibijalnim edemima. Nad plucima obostrano difuzno oslabljenog disanja uz sitne isprekidane sumove i po koji kontinuirani bronhiticni sum nad bazama. Na rendgenskoj snimci pluca vidljiv je pneumonicki infiltrat supradijafragmalno desno uz pleuralni izljev s iste strane. Izražen je retikularni intersticijski uzorak plucnog parenhima, posebice u donjim plucnim poljima, te pojacan peribronhalni crtež. Laboratorijska obrada pokazala je CRP 9, SE 3, Sat.O2 87%, pO2 7...
Lymphangioleiomyomatosis (LAM) is a rare disease of the lungs and lymphatics, which can occur spo... more Lymphangioleiomyomatosis (LAM) is a rare disease of the lungs and lymphatics, which can occur sporadically or in association with tuberous sclerosis. LAM almost exclusively affects females, generally developing before the menopause. The disease is characterised by progressive pulmonary cystic change, recurrent pneumothorax, chylous pleural collections and, in most cases, progressive respiratory failure. Abdominal manifestations include lymphadenopathy, cystic lymphatic masses (lymphangioleiomyomas), chylous ascites and angiomyolipoma (a benign tumour). Survival in LAM is approximately 70% at 10 yrs, although this is highly variable since long-term survivors have been described. Diagnosis is made by a combination of clinical features and computed tomography scanning or, in cases of doubt, lung biopsy. In patients with rapidly progressive disease, hormone treatment (predominantly progesterone) has been used, although no firm evidence supports its use. Otherwise, treatment is aimed at ...
31 years after malignant thymoma surgery and performed oncological therapy, 76.- annual patient r... more 31 years after malignant thymoma surgery and performed oncological therapy, 76.- annual patient received metastasis to the liver and lungs, with peripheral T-cell proliferation.
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2012
House dust mites are the most common sources of allergic sensitization, primarily responsible for... more House dust mites are the most common sources of allergic sensitization, primarily responsible for the occurrence of various clinical forms of respiratory and skin allergies, but also of certain forms of food allergy. There are many various mite species, of which only a small number are constantly or occasionally found in house dust samples. Mites from Pyroglyphidae family, Dermatophagoides pteronyssinus and Dermatophagoides farinae are most frequently responsible for sensitization of susceptible persons. Other less commonly found species may represent individual primary sources of sensitization, or may cause disease symptoms due to cross-reactivity. The exposure to various mite species within different geographical regions accounts for the generation of various sensitization profiles. Knowing these profiles is important for planning rational specific immunotherapy, which greatly determines its efficacy. The aims of this paper are to review the environment conditions that influence m...
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2012
Manifestations of house dust mite allergy include perennial allergic rhinitis often accompanied b... more Manifestations of house dust mite allergy include perennial allergic rhinitis often accompanied by ocular symptoms, allergic asthma, and somewhat rarer atopic dermatitis. Sensitization to mite tropomyosin may lead to hypersensitivity to certain foodstuffs. Allergic sensitization and development of the disease are connected to the level of allergen exposure, indicating that the patients' home exposure to mite allergens is a useful indicator of their risk. Since the possibility of allergen avoidance is limited, and available pharmacological treatments have just symptomatic effects, the only causative treatment for mite allergy is specific immunotherapy. Its well-documented clinical effects include reduction of symptoms, prevention of the disease severity progression, and prevention of sensitization to new allergens. Immunological parameters show characteristic dynamics during treatment, which is also reflected in gradual reduction of the skin reactivity towards the allergen. Despi...
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2011
The rise in a prevalence of allergic diseases observed in industrialized countries over many year... more The rise in a prevalence of allergic diseases observed in industrialized countries over many years, and generally a rising number of the patients, require constant searching for newer and better ways of treatment. The central event in the formation of the allergic inflammation, the activation of mast cells and basophils, is mediated by signaling through the high-affinity IgE receptor, FcepsilonRI. The signaling starts by cross-linking of receptor-bound IgE with an allergen. This initiates a cascade of signaling events that activates the cell and ultimately causes the release of mediators responsible for allergic responses. The major flaw of medications traditionally used for the treatment of allergies is their orientation to single mediators, and not to the whole sequence of complex events leading to the onset of early and late symptoms. The aim of this paper was to review a complex sequence of events from the allergen binding to the onset of symptoms, highlighting the importance of...
95 Brojnim istraživanjima dokumentiran je visegodisnji trend porasta prevalencije alergijskih bol... more 95 Brojnim istraživanjima dokumentiran je visegodisnji trend porasta prevalencije alergijskih bolesti u industrijaliziranim zemljama, pri cemu su alergeni unutarnjeg okolisa, a posebno grinje kucne prasine, vodeci rizicni cimbenik (1). Novijim epidemioloskim istraživanjima potvrđena je i u nasem podrucju visoka prevalencija simptoma alergijskih bolesti (2), a među alergenima odgovornima za senzibilizaciju, grinje su pokazivale najvecu ucestalost (3).
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2011
Why the exposure to the harmless and ubiquitous environmental substances causes inappropriately s... more Why the exposure to the harmless and ubiquitous environmental substances causes inappropriately strong reactions of the immune system clinically manifested as allergies in some people, and how repeated exposures to the same substances during the specific immunotherapy divert immunologic reactivity, are so far only partially answered questions. The events that occur during the allergic inflammatory response are relatively well-known, as are the major operative mechanisms through which the specific immunotherapy, the only causative treatment method, changes that response. Nevertheless, everyday new findings are completing the puzzle and our understanding of these complex processes. The aim of this paper was to review the up-to-date known mechanisms of allergic disease occurrence and treatment, with regard to the key role of T cells in these processes.
Objective: Numerous studies of the population prevalence of asthma, allergic rhinitis, and atopic... more Objective: Numerous studies of the population prevalence of asthma, allergic rhinitis, and atopic eczema revealed some international differences. However, the International Study of Asthma and Allergies in Childhood (ISAAC) was the first one using a standardized methodology to evaluate the prevalence of these diseases, and to make comparisons within and between countries. The results showed marked variations in 12-month prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms with 20-fold (range 1.6-36.8%), 30-fold (range 1.4-39.7%), and 60-fold (range 0.3-20.5%) differences between the centres with the highest and the lowest prevalence, respectively. Aim: Our aim was to gain the insight into the prevalence of allergic diseases in Zagreb, Croatia by the methods of internationally standardized protocol, proposed by the ISAAC Steering Committee. Methods: Original questionnaires, translated from English into Croatian, consisting of questions about the child's demographic characteristics, core modules on wheezing, rhinitis and eczema, and supplementary modules, were completed by parents of 10-year-old children (4th grade) attending 18 elementary schools in a city of Zagreb. Total of 1047 questionnaires were returned and analysed after the inconsistent responses were eliminated by phone calling. Discussion: Phase one of the ISAAC study has shown a wide variation in the prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms throughout the world, with differing international patterns for the different disorders. Four prevalence ranges have been established for better illustration of the geographic distribution of asthma prevalence: (I) < 5%; (II) 5 to < 10%; (III) 10 to < 20%; (IV) > or = 20%. The highest 12-month prevalences of asthma symptoms were found in developed countries (UK, Australia, New Zealand, Republic of Ireland, and most centres in North, Central, and South America), being in prevalence range IV. The lowest prevalences (range I) were found in several Eastern European countries, Indonesia, Greece, China, Taiwan, Uzbekistan, India, and Ethiopia. According to the results of our study, a continental part of Croatia with a 12-month prevalence of wheezing of 6.02% corresponds to range II. Prevalence of asthma symptoms was greater in males, which is consistent with the results of the younger age group previously analysed. For allergic rhinoconjunctivitis and atopic eczema symptoms grouping of centres with a high prevalences into specific regions was less well defined than for asthma. Centres with the highest prevalences were scattered across the world. In contrast, centres with the lowest prevalences were similar to those for asthma symptoms. Our results of the 12-month prevalence of allergic rhinoconjunctivitis (12.13%), and atopic eczema (7.83%) symptoms were somewhere between the two extremes. As with asthma symptoms, the prevalence of rhinoconjunctivitis symptoms was greater in males. Contrary, the difference in prevalence of atopic eczema symptoms between the sex groups has not been found. The worldwide variations in prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms suggest that environmental factors may be critical to the development of these disorders in childhood. Furthermore, different patterns of geographical distribution of particular disorders suggest that major risk factors for them may be different or may involve different latency periods and time trends. Therefore, studies that include objective clinical assessment are required. Conclusion: According to our results, Zagreb is a city with relatively low prevalence of allergic diseases symptoms. Larger sample size of at least 3000 subjects is required to provide sufficient precision for estimates of symptom severity, and to generate adequate number of subjects with particular disorders for further analyses. Therefore, we recently increased our sample size to more than 3000 subjects, and started ISAAC Phase two (clinical examination, measures of bronchial hyperresponsiveness, measures of atopy, measures of environmental exposure to aeroallergens, and genetic analyses) in Zagreb, Croatia.
... Source: Journal of the World Allergy Organization, Abstracts / Baena-Cagnani CE, Wahn U. (ed)... more ... Source: Journal of the World Allergy Organization, Abstracts / Baena-Cagnani CE, Wahn U. (ed). - Göttingen : Hogrefe &amp; Huber publishers ... Abstract: BACKGROUND Oral allergy syndrome (OAS) to fruits and vegetables often coexists with pollen allergy, and draws attention to ...
Limfangiolejomiomatoza je progresivna i fatalna bolest plucnog intersticija nepoznate etiologije ... more Limfangiolejomiomatoza je progresivna i fatalna bolest plucnog intersticija nepoznate etiologije koju obilježava abnormalna proliferacija glatkog misicnog tkiva u plucima i limfnim žilama. Zahvaca gotovo iskljucivo žene generativne dobi. Prevalencija ove bolesti u Hrvatskoj nije poznata. Prikazujemo slucaj 41 godisnje pacijentice s anamnezom umora 2 mjeseca prije hospitalizacije te pojavom febriliteta i dispneje nekoliko dana prije. Klinicki je težeg opceg stanja, dispnoicna, ortopnoicna, adipozna, tahikardna sa diskretnim pretibijalnim edemima. Nad plucima obostrano difuzno oslabljenog disanja uz sitne isprekidane sumove i po koji kontinuirani bronhiticni sum nad bazama. Na rendgenskoj snimci pluca vidljiv je pneumonicki infiltrat supradijafragmalno desno uz pleuralni izljev s iste strane. Izražen je retikularni intersticijski uzorak plucnog parenhima, posebice u donjim plucnim poljima, te pojacan peribronhalni crtež. Laboratorijska obrada pokazala je CRP 9, SE 3, Sat.O2 87%, pO2 7...
Lymphangioleiomyomatosis (LAM) is a rare disease of the lungs and lymphatics, which can occur spo... more Lymphangioleiomyomatosis (LAM) is a rare disease of the lungs and lymphatics, which can occur sporadically or in association with tuberous sclerosis. LAM almost exclusively affects females, generally developing before the menopause. The disease is characterised by progressive pulmonary cystic change, recurrent pneumothorax, chylous pleural collections and, in most cases, progressive respiratory failure. Abdominal manifestations include lymphadenopathy, cystic lymphatic masses (lymphangioleiomyomas), chylous ascites and angiomyolipoma (a benign tumour). Survival in LAM is approximately 70% at 10 yrs, although this is highly variable since long-term survivors have been described. Diagnosis is made by a combination of clinical features and computed tomography scanning or, in cases of doubt, lung biopsy. In patients with rapidly progressive disease, hormone treatment (predominantly progesterone) has been used, although no firm evidence supports its use. Otherwise, treatment is aimed at ...
31 years after malignant thymoma surgery and performed oncological therapy, 76.- annual patient r... more 31 years after malignant thymoma surgery and performed oncological therapy, 76.- annual patient received metastasis to the liver and lungs, with peripheral T-cell proliferation.
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2012
House dust mites are the most common sources of allergic sensitization, primarily responsible for... more House dust mites are the most common sources of allergic sensitization, primarily responsible for the occurrence of various clinical forms of respiratory and skin allergies, but also of certain forms of food allergy. There are many various mite species, of which only a small number are constantly or occasionally found in house dust samples. Mites from Pyroglyphidae family, Dermatophagoides pteronyssinus and Dermatophagoides farinae are most frequently responsible for sensitization of susceptible persons. Other less commonly found species may represent individual primary sources of sensitization, or may cause disease symptoms due to cross-reactivity. The exposure to various mite species within different geographical regions accounts for the generation of various sensitization profiles. Knowing these profiles is important for planning rational specific immunotherapy, which greatly determines its efficacy. The aims of this paper are to review the environment conditions that influence m...
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2012
Manifestations of house dust mite allergy include perennial allergic rhinitis often accompanied b... more Manifestations of house dust mite allergy include perennial allergic rhinitis often accompanied by ocular symptoms, allergic asthma, and somewhat rarer atopic dermatitis. Sensitization to mite tropomyosin may lead to hypersensitivity to certain foodstuffs. Allergic sensitization and development of the disease are connected to the level of allergen exposure, indicating that the patients' home exposure to mite allergens is a useful indicator of their risk. Since the possibility of allergen avoidance is limited, and available pharmacological treatments have just symptomatic effects, the only causative treatment for mite allergy is specific immunotherapy. Its well-documented clinical effects include reduction of symptoms, prevention of the disease severity progression, and prevention of sensitization to new allergens. Immunological parameters show characteristic dynamics during treatment, which is also reflected in gradual reduction of the skin reactivity towards the allergen. Despi...
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2011
The rise in a prevalence of allergic diseases observed in industrialized countries over many year... more The rise in a prevalence of allergic diseases observed in industrialized countries over many years, and generally a rising number of the patients, require constant searching for newer and better ways of treatment. The central event in the formation of the allergic inflammation, the activation of mast cells and basophils, is mediated by signaling through the high-affinity IgE receptor, FcepsilonRI. The signaling starts by cross-linking of receptor-bound IgE with an allergen. This initiates a cascade of signaling events that activates the cell and ultimately causes the release of mediators responsible for allergic responses. The major flaw of medications traditionally used for the treatment of allergies is their orientation to single mediators, and not to the whole sequence of complex events leading to the onset of early and late symptoms. The aim of this paper was to review a complex sequence of events from the allergen binding to the onset of symptoms, highlighting the importance of...
95 Brojnim istraživanjima dokumentiran je visegodisnji trend porasta prevalencije alergijskih bol... more 95 Brojnim istraživanjima dokumentiran je visegodisnji trend porasta prevalencije alergijskih bolesti u industrijaliziranim zemljama, pri cemu su alergeni unutarnjeg okolisa, a posebno grinje kucne prasine, vodeci rizicni cimbenik (1). Novijim epidemioloskim istraživanjima potvrđena je i u nasem podrucju visoka prevalencija simptoma alergijskih bolesti (2), a među alergenima odgovornima za senzibilizaciju, grinje su pokazivale najvecu ucestalost (3).
Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti, 2011
Why the exposure to the harmless and ubiquitous environmental substances causes inappropriately s... more Why the exposure to the harmless and ubiquitous environmental substances causes inappropriately strong reactions of the immune system clinically manifested as allergies in some people, and how repeated exposures to the same substances during the specific immunotherapy divert immunologic reactivity, are so far only partially answered questions. The events that occur during the allergic inflammatory response are relatively well-known, as are the major operative mechanisms through which the specific immunotherapy, the only causative treatment method, changes that response. Nevertheless, everyday new findings are completing the puzzle and our understanding of these complex processes. The aim of this paper was to review the up-to-date known mechanisms of allergic disease occurrence and treatment, with regard to the key role of T cells in these processes.
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