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J Liebhart

Publications and source records attributed to J Liebhart.

At least 19 recordsLinked to original sources
PubMed2003

Prevalence of asthma with aspirin hypersensitivity in the adult population of Poland.

BACKGROUND: Acetylsalicylic acid (ASA) and other nonsteroid anti-inflammatory drugs (NSAIDs) are reported to account for 21-25% of all adverse drug reactions. Some asthmatics may react to ASA and other NSAIDs with acute bronchoconstriction, profuse rhinorrhea and skin flushing. This is a distinct clinical syndrome called aspirin-induced asthma (AIA). The prevalence of AIA among asthmatic patients in Poland has not been previously assessed. METHODS: A questionnaire survey of 12,970 adults of both sexes, randomly selected from the population of Poland. RESULTS: The prevalence of AIA in the general population of Poland was estimated as 0.6%. Thirty patients (4.3%; 95% CI: 2.8-5.8) of 703 asthmatics (5.4% of general population) reported symptoms attesting to hypersensitivity to aspirin. In 27% of them the reactions were precipitated by aspirin, whereas in the remaining subjects by other NSAIDs. CONCLUSIONS: The prevalence of AIA in Poland is 4.3%, being somewhat lower than in Finland and Australia, where it was recently reported to account for 8.8 and 10.9% of the adult asthmatics, respectively. These figures indicate that aspirin hypersensitivity might be a significant community problem.

Adolescent↗
PubMed2002

Relevance of the selected cytokine release (TNF-alpha, IL-6, IFN-gamma, and IFN-alpha) to the exacerbation of bronchial asthma from airway mycotic infections. Predominant role of TFN-alpha?

Airway fungal infections are often associated in asthmatics with the exacerbation of asthma symptoms. However, the pathomechanism of this phenomenon has not been fully understood. The aim of our study was to assess whether antimycotic treatment can influence the capacity of bronchoalveolar (BAL) leukocytes to release proinflammatory cytokines, which could contribute to increase in asthma severity. Ten patients with bronchial asthma complicated by airway fungal infections (Candida albicans and/or Aspergillus fumigatus) were included in the study. Seven asthmatics were treated with systemic and inhaled corticosteroids, whereas the remaining three with inhaled ones only. All subjects underwent several courses of therapy with antibiotics due to respiratory infections. BAL leukocytes obtained from the patients were cultured in the absence or presence of lipopolysaccharide E.coli (LPS) or Newcastle disease virus (NDV). The BAL procedure and measurement of the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (II-6), interferon-gamma (IFN-gamma), and interferon-alpha (IFN-alpha) by specific bioassays were performed twice: before antimycotic treatment and after 3 weeks of therapy with 8 mg of nebulized fluoconazole and 400 mg of oral ketoconazole per day. The elimination of fungi from respiratory tract resulted in an apparent clinical improvement. This coincided with diminished production of TNF-alpha in response to LPS and the production of IFN-alpha in response to NDV, which were initially high and subsided significantly after antimycotic therapy (p = 0.035, and 0.011, respectively). Such changes were not observed in the case of IFN-gamma and IL-6. This may suggest that TNF-alpha as well as IFN-alpha are secreted by fungi-prestimulated leukocytes from the lower respiratory tract and may be involved in the processes of exacerbation of asthma complicated by fungal infections. Further analyses of relationships between changes in cytokine levels and clinical parameters indicated that IFN-alpha seems to be of particular interest in fungal stimulation of asthma.

Adult↗
PubMed2000

[Allergy to nickel, chromium and cobalt after osteosynthesis].

Metals are known as a common cause of contact allergies. The prevalence of sensitisation to the composite metals makes for a potential risk of osteosynthesis complications in patients suffering from long bones fractures. In the study the prevalence of delayed allergy to nickel sulphate, potassium dichromate and cobalt was estimated as well as the relation to the osteosynthesis complications. The atopy prevalence was estimated too. Persons under examination were divided into 3 groups. I--treated with osteosynthesis without complications (n = 20), II--treated with osteosynthesis with synostosis complications (n = 16) and III--negative controls (n = 34). We estimated 5% prevalence of delayed allergy to nickel in group I, 6.25% in group II and 5.8% in group III. In patients exposed to chromium we observed delayed allergy prevalence of 5.8% in group I and 3% in group III. No allergy to chromium in group II was revealed. No allergy to cobalt in all groups was revealed. The prevalence of atopy in group II was rare (6.35%) when in group I it was 45% and in controls 32%. The more frequent occurrence of type IV allergy to metals in atopic patients was not confirmed. There was no difference between the prevalence of delayed allergy to metals in groups I and II. Only one case of secondary allergy to chromium was observed.

Adolescent↗
PubMed1999

[Comparison of exercise and histamine provocation tests in patients with bronchial asthma].

Fifty-eight asthmatic patients (22 men and 36 women), aged 17 to 61 years, participated in this study. Thirty-two of them had atopic asthma. Exercise test and histamine inhalation challenge test were performed in all subjects. Patients exercised on a bicycle ergometer for 6-8 min. to increase the heart rate to 80% of predicted maximal heart rate. Twenty-three patients had a bronchospasm following exercise. The PC20 values in patients with exercise induced asthma (Me = 0.35 mg/ml) were significantly lower (p = 0.006) than in subjects without exercise induced asthma (Me = 1.89 mg/ml). There was low but statistically significant correlation between PC20 and delta FEV1 after exercise (R(s) = 0.32; p = 0.01). These results suggest that there are not only similarities but also differences in pathomechanisms of bronchial hyperreactivity to histamine and exercise-induced bronchoconstriction. The lack of statistically significant correlation between diurnal PEF variation and PC20 values suggest that the former parameter cannot be considered as an useful marker of nonspecific bronchial hyperreactivity.

Adolescent↗
PubMed1999

[Validation of the Polish version of St. George's respiratory questionnaire in patients with bronchial asthma].

St George's Respiratory Questionnaire (SGRQ) has been widely used in the assessment of health related quality of life (HRQOL) in patients with asthma and chronic obstructive pulmonary disease. Introduction of the new language version of the HRQOL questionnaire needs to be preceded by a highly structured process of validation. We aimed to validate the Polish version of SGRQ in the group of 83 patients with asthma. Following the comprehension study, we thus evaluated reliability, validity, reproducibility, responsiveness, and measurement equivalence of the Polish version of SGRQ. Disease severity and health status were also concurrently assessed. The reliability was good, with Cronbach's alpha coefficient exceeding 0.75 for global and all subscale scores. There have been highly significant correlations between spirometric parameters, intensity of symptoms, health status self-assessment, and the degree of depression, and quality of life scores. Reproducibility, stability and responsiveness were confirmed in the follow-up study. Minimal clinically important difference was found to be 5.3 points. Polish version of SGRQ was found to be psychometrically equivalent to four other versions of SGRQ, which underscores its validity in the population of Polish asthmatics.

Adult↗
PubMed1998

[The results of research on the prevalence of allergy to Hymenoptera venom in Southwestern Poland].

A questionnaire designed to estimate the prevalence of allergic reactions to Hymenoptera venom was posted to 1000 inhabitants of south west Poland. 881 persons responded to the questionnaire. 255 (28.9%) reported allergic reactions to stinging insects venom 141 persons (16%) report large local reactions (LL) and 114 (12.9%) systemic reactions (SYS) after stinging. At the second stage of the study 95 persons, out of the 255, were examined by a physician and tested with the intracutaneous skin test. Anamnesis carried out by the physician initially confirmed venom allergy in 87% of the LL group and 77.5% of the SYS group. Skin test results verified the above assessments confirming venom allergy in 38% persons initially reporting LL reactions and in 55% of those initially reporting SYS reaction.

Adolescent↗
PubMed1998

[Diagnostic standard for differentiation between bronchial asthma and chronic obstructive pulmonary disease].

The aim of this study was to work out the simplified standard for distinguishing COPD from bronchial asthma. An overall sample of 150 individuals was used for statistical analysis. Sixty one were diagnosed as having COPD and 89 as suffering from asthma. For each patient the modified ATS-DLD-75-C questionnaire was filled out, and laboratory tests results were collected. Laboratory findings included: basic spirometry and flow-volume curve parameters, diurnal PEF variation, tests with bronchodilators (salbutamol, ipratropium bromide and corticosteroids), challenges with histamine and exercise, blood gas analysis, skin tests, chest X-ray, ECG, blood cell count, blood and sputum eosinophilia. Continuous variables were transformed into discrete (dichotomous) ones using commonly accepted threshold values. Then, sensitivity, specificity and accuracy indexes were calculated for each variable and for all possible sets of 2, 3 and 4 variables. Finally, 2 sets of 4 signs and symptoms were selected as the most characteristic of the diseases of interest. Asthma was diagnosed if 3 out of 4 following conditions were present: 1) episodes of shortness of breath and wheezing, 2) smoking index (cigarettes number per day x years of smoking) < or = 200, 3) PC20 < or = 8 mg/ml or delta FEV1 after bronchodilator > or = 15% predicted, 4) diurnal PEF variation > or = 20% predicted. COPD was recognised in the same way on the basis of: 1) productive cough, 2) smoking index > 200, 3) signs of emphysema on the chest X-ray, 4) maximal FEV1 < 80% predicted (after treatment). Diagnosis established using this model was correct in 76% and false (what was very important) in only 2.6% of cases. In the remaining 21% of patients it was uncertain (e.g. both of the diseases confirmed).

Adult↗
PubMed1998

[Specificity and sensitivity of some signs, symptoms and basic laboratory findings for differentiation between bronchial asthma and chronic obstructive pulmonary disease].

The aim of this study was to asses the importance of the most frequently observed signs and symptoms, as well as commonly used laboratory tests for differentiation between bronchial asthma and chronic obturative pulmonary disease (COPD). Sensitivity(Se) and specificity (Sp) indices were calculated for 140 analysed variables. Sixty one patients diagnosed as having COPD and 89 as suffering from asthma were analysed. For each patient the modified ATS-DLD-75-C questionnaire was filled out, and laboratory tests results were collected. Laboratory findings included: basic spirometry, diurnal PEF variation, bronchodilator tests with salbutamol, ipratropium bromide and corticosteroids, challenges with histamine and exercise, blood gas analysis, skin tests, chest X ray, ECG, blood cell count, blood and sputum eosinophilia. The results obtained have shown that there is no single parameter characterised by specificity and sensitivity that enable to differentiate between the diseases of interest with sufficient accuracy. Sputum expectoration for et least 3 months of the year (Se = 84%, Sp = 69%), smoking index (cigarettes number per day x years of smoking) > or = 200 (Se = 89%, Sp = 74%), have appeared to have the highest sensitivity and specificity for COPD. Most typical of asthma are: intermittent episodes of wheezing (Se = 89%, Sp = 69%), positive bronchodilator tests: with salbutamol (Se--73%, Sp--93%), with ipratropium bromide and with corticosteroids (Se--66%, Sp--94%) and diurnal variation of PEF > or = 20% predicted (Se--64%, Sp--92%). Challenge test with histamine is of limited value for differentiation bronchial asthma from COPD (Se--96%, Sp--40%), while blood eosinophilia, resting spirometry or blood gases are useless for this purpose.

Adult↗
PubMed1998

TNF-alpha, IL-6 and IFN-gamma secreted by bronchoalveolar leukocytes isolated from patients with bronchial asthma, complicated by fungal airways infections.

It is widely known that fungal airways infections may deteriorate the course of bronchial asthma. The mechanism of the phenomenon is still unclear. The aim of our study was to assess the effect of fungal infections on the secretion of selected cytokines by bronchoalveolar leukocytes. Five patients (group FA) with bronchial asthma and Candida albicans or Aspergillus fumigatus airways infections (confirmed by bronchoscopy and culture) were included in the study. All of them were on the chronic treatment with corticosteroids (10-20 mg of prednisone per day) and underwent several courses of therapy with antibiotics. The control groups comprised 5 previously untreated asthmatics without bronchial colonization with fungi (group A) as well as 5 healthy volunteers (group H). Leukocytes were isolated from bronchoalveolar lavage fluid (BALF) and cultured in the presence or absence of cytokine inducers such as phytohemagglutin L (PHA), lipo-polysaccharide (LPS) from E. coli. The activity of TNF-alpha, IL-6 and IFN-gamma were measured in the BAL cell culture supernatants by using specific bioassays. In comparison with healthy controls the spontaneous or induced secretion of cytokines were significantly augmented in patients from group A. In contrast the asthmatics who represented group FA demonstrated normal levels of spontaneous cytokine secretion. However, the tendency to increase LPS and PHA-induced production was observed in BAL leukocytes from the patients. The above results support the view that beneficial effect of corticosteroid treatment in bronchial asthma may act, at least in part, by inhibition of the high spontaneous secretion of proinflammatory cytokines. Nevertheless, fungal airways infections may lead to increase of LPS- or PHA-induced production of TNF-alpha, IL-6 or IFN-gamma (despite prednisone therapy) by prestimulation of the BAL cells with fungi.

Adult↗
PubMed1997

[Secondary hypertension during a course of phaeochromocytoma in a 71-year old woman].

The case of secondary hypertension to pheochromocytoma in 71 year old woman is described. This woman has been made a false diagnosis of primary hypertension 10 years earlier. The primary objective of this paper was to call practitioners' attention to the necessity of penetrating diagnosis of arterial hypertension, also in elderly patients. Over-hasty diagnosis of primary arterial hypertension hampers the possibility of proper and causal treatment. Labile and paroxysmal hypertension with headache, tachycardia and sweating should alert the clinician to tumor of the adrenal medulla as well as the extra-adrenal paraganglion system (pheochromocytoma is the cause of arterial hypertension in 0.1-1.0% of all cases). Twenty four hours excretion level of vanillylmandelic acid in urine is of diagnostic relevance for patients with pheochromocytoma. The measurement which is done after elevation of blood pressure is more sensitive.

Adrenal Gland Neoplasms↗
PubMed1995

[Role of the autonomic nervous system (adrenergic, cholinergic and nonadrenergic, noncholinergic) in regulation of respiratory system function].

There is now recognized that the autonomic innervation of airways consists of classic adrenergic and cholinergic nerves as well as of a "third" - nonadrenergic noncholinergic (NANC) - nervous system. Taking into account its complex regulatory role can be crucial for better understanding of various phenomena attributable to bronchial asthma.

Adrenergic Fibers↗
PubMed1993

[A comparative study on skin tests and allergen-specific IgE levels determined by enzyme allergo-sorbent testing (EAST)].

Ninety seven randomly selected subjects with bronchial asthma and allergic rhinitis were classified for the comparative studies. The level of allergen specific IgE determined by Enzyme Allergo-Sorbent Testing (EAST) was compared with skin tests. The statistically significant correlation was found for 9 selected allergens. However, the Spearman's rank correlation coefficient values varied largely, depending on a given allergen. They ranged from 0.74 (Dermatophagoides pteronyssinus) to 0.33 (Birch pollen) what might be, in the authors' opinion, a result of Bencard allergens use for skin tests and Kallestad allergens for EAST.

Adolescent↗
PubMed1991

Robust trend analysis in predicting histamine provocation concentration.

Trend analysis is used to predict the histamine provocation concentration PC20 during the so-called challenge test, where increasing doses of the bronchoconstricting agent are given to a patient and the spirometric examination is subsequently performed. Classical least-squares analysis of trends as well as least absolute deviations analysis are compared. The results are interesting and promising from a statistical as well as medical point of view. The methods presented can be applied to many practical problems in medicine.

Algorithms↗
PubMed1990

Robust logistic discriminant functions in diagnosing chronic obstructive airways disease.

The paper gives a comparison of the classical logistic discriminant function, the alpha-trimmed logistic discriminant function and the L1-logistic discriminant function as used for assistance of medical diagnosis in chronic obstructive airways disease. The robustified logistic discriminant functions enable one to obtain higher rates of correctly classified individuals, especially the L1-logistic discriminant function should be recommended.

Discriminant Analysis↗
PubMed1989

Binding of histamine by gastric juice.

Ability of in vitro histamine binding by gastric juice was tested in aspirates from 10 normal subjects, collected during basal acid output (BAO) as well as after pentagastrin stimulation (maximal acid output - MAO). Histamine binding by 1 ml of gastric juice averaged 218.7 micrograms and after stimulation with pentagastrin was about 31% higher.

Adult↗