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Underdiagnosis of childhood asthma: A comparison of survey estimates to clinical evaluation

100%

Brożek G. M., Farnik M., Lawson J., Zejda J. E.

International Journal of Occupational Medicine and Environmental Health

2013

vol. 26

issue 6

900-909

Objectives: Diagnostic patterns play a role in asthma prevalence estimates and could have implications for disease management. We sought to determine the extent to which questionnaire-derived estimates of childhood asthma reflect the disease's true occurrence. Materials and Methods: Children aged 6-12 years from Katowice, Poland, were recruited from a crosssectional survey (N = 1822) via primary schools. Students were categorized into three mutually exclusive groups based on survey responses: "Asthma" (previously diagnosed asthma); "Respiratory symptoms" (no previous diagnosis of asthma and one or more respiratory symptoms during last year), "No respiratory symptoms" (no previous diagnosis of asthma or respiratory symptoms). A sample of children from each group (total N = 456) completed clinical testing to determine asthma presence according to GINA recommendations. Results: Based on the survey, 5.4% of children were classified with asthma, 27.9% with respiratory symptoms, and 66.7% with no respiratory symptoms or asthma. All previously known 41 cases of asthma were confirmed. New diagnoses of asthma were made in 21 (10.9%) and 8 (3.6%) of subjects from the "Respiratory symptoms" (N = 192) and "No respiratory symptoms" (N = 223) groups, respectively. The overall prevalence of childhood asthma, incorporating the results of clinical examination, was 10.8% (95% CI: 9.4-12.2), compared to the questionnaire-derived figure of 5.4% (95% CI: 4.4-6.5%) and affected females more than males. Conclusions: Asthma prevalence was underestimated in this population possibly resulting from under-presentation or under-diagnosis. This could have potential implications for proper management and well-being of children. Questionnaire estimates of prevalence should be considered carefully in the context of regional diagnostic patterns.

Wskaźnik śmiertelności infekcji (IFR) w przebiegu pandemii COVID-19 w Aglomeracji Górnośląskiej w 2020 r.

88%

Zejda J. E., Kowalska M., Brożek G. M., Barański K., Kaleta-Pilarska A.

Medycyna Pracy

2021

vol. 72

issue 6

671-676

BackgroundDuring the course of COVID-19 pandemic, a wide range of scientific projects was implemented worldwide, including studies focusing on infection fatality rate (IFR). The value of IFR depends on the number of COVID-19 deaths in a population in a given period and the number of infected people in this population, usually provided by seropepidemiological studies (anti-SARS-CoV-2 IgG in the case of COVID-19). The objective of our study was to estimate IFR in the course of COVID-19 pandemic in 2020, in the general population of Upper Silesia Metropolitan Area (USMA).Material and MethodsThe seroepidemiological study was conducted in October–November 2020. Among randomly selected inhabitants of Katowice, Gliwice, and Sosnowiec (N = 1167), the presence of SARS-CoV-2 virus infection was assessed based on a positive IgG test result performed with the ELISA method. Data on deaths due to COVID-19 were obtained from the Registry Offices of each city. The infection fatality rate was calculated using the formula IFR (%) = [number of deaths/number of infected] × 100.ResultsResults of our study showed the prevalence of infection at 11.4% (95% CI: 9.5–13.2). In three examined towns, in the period January–November 2020, there was a total of 516 COVID-19 deaths. The resulting crude IFR was 0.65% (95% CI: 0.56–0.78). The IgG test had 88% sensitivity and 99% specificity and these figures were used to adjust IFR. The adjusted IFR value was similar to the crude value: IFR = 0.62% (95% CI: 0.53–0.74).ConclusionsThe value of IFR estimated for the USMA population was similar to average values obtained in other countries and can be used as the background for monitoring the course and impact of COVID-19 pandemic in the Upper Silesian Industrial Area. Med Pr. 2021;72(6):671–6

WstępW trakcie pandemii COVID-19 wszczęto w skali globalnej szerokie spektrum badań, w tym także ukierunkowanych na oszacowanie wskaźnika śmiertelności infekcji (infection fatality rate – IFR). Wyznaczenie IFR wymaga znajomości liczby zgonów w danej populacji i danym czasie oraz liczby osób zakażonych, zwykle określanej na podstawie wyników badania serologicznego (anty-SARS-CoV-2 IgG w przypadku COVID-19). Celem badania było oszacowanie IFR w przebiegu pandemii COVID-19 w 2020 r. w Aglomeracji Górnośląskiej (AG).Materiał i metodyBadanie seroepidemiologiczne przeprowadzono w październiku i listopadzie 2020 r. Wśród losowo wybranych mieszkańców Katowic, Gliwic i Sosnowca (N = 1167) oceniano obecność zakażenia wirusem SARS-CoV-2 na podstawie dodatniego wyniku testu IgG wykonanego metodą ELISA. Dane o zgonach z powodu COVID-19 uzyskano z Urzędów Stanu Cywilnego każdego z miast. Wskaźnik śmiertelności infekcji obliczono, stosując formułę: IFR (%) = (liczba zgonów / liczba zakażonych) × 100.WynikiWyniki badania potwierdziły obecność przeciwciał anty-SARS-CoV-2 (klasa IgG) na poziomie 11,4% (95% CI: 9,5–13,2). Do listopada 2020 r. w populacji ww. miast zarejestrowano 516 zgonów, a tym samym surowy współczynnik IFR wyniósł 0,65% (95% CI: 0,56–0,78). Test diagnostyczny (IgG) odznaczał się czułością na poziomie 88% i swoistością wynoszącą 99%. Parametry te pozwoliły na oszacowanie skorygowanej pod względem trafności diagnostycznej testu wartości IFR. Skorygowany IFR miał podobną wartość: 0,62% (95% CI: 0,53–0,74).WnioskiOszacowana dla populacji AG wartość IFR jest zbliżona do przeciętnych poziomów obserwowanych w innych państwach i stanowi podstawę monitorowania przebiegu i skutków pandemii COVID-19 w tym regionie. Med. Pr. 2021;72(6):671–676

New ideas, old problems? Heated tobacco products – a systematic review

76%

Jankowski M., Brożek G. M., Lawson J., Skoczyński S., Majek P., Zejda J. E.

International Journal of Occupational Medicine and Environmental Health

2019

vol. 32

issue 5

595-634

Heated tobacco products (HTPs) are a form of nicotine delivery intended to provide an alternative to traditional cigarettes. The aim of this systematic review was to present the current state of knowledge on HTPs with an emphasis on the potential impact of HTP use on human health. During the preparation of this systematic review, the literature on HTPs available within Medline/PubMed, EMBASE, CINAHL, ScienceDirect, and Google Scholar was retrieved and examined. In the final review, 97 research papers were included. The authors specifically assessed the construction and operation of HTPs, as well as the chemical composition of HTP tobacco sticks and the generated aerosol, based on evidence from experimental animal and cellular studies, and human-based studies.Heated tobacco products were found to generate lower concentrations of chemical compounds compared to traditional cigarettes, except for water, propylene glycol, glycerol, and acetol. The nicotine levels delivered to the aerosol by HTPs were 70–80% as those of conventional combustion. The results of in vitro and in vivo assessments of HTP aerosols revealed reduced toxicity, but these were mainly based on studies sponsored by the tobacco industry. Independent human-based studies indicated that there was a potentially harmful impact of the active and passive HTP smoking on human health. Currently, a large body of knowledge on HTP exposures and health effects is provided by the tobacco industry (52% of identified studies). Based on the available evidence, HTPs produce lower levels of toxic chemicals, compared to conventional cigarettes, but they are still not risk-free. Int J Occup Med Environ Health. 2019;32(5):595–634

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2 International Journal of Occupational Medicine and Environmental Health

1 Medycyna Pracy

3 Brożek G. M.

3 Zejda J. E.

2 Lawson J.

1 Barański K.

1 Farnik M.

1 Jankowski M.

1 Kaleta-Pilarska A.

1 Kowalska M.

1 Majek P.

1 Skoczyński S.

1 2021

1 2019

1 2013

Search results

Underdiagnosis of childhood asthma: A comparison of survey estimates to clinical evaluation

Wskaźnik śmiertelności infekcji (IFR) w przebiegu pandemii COVID-19 w Aglomeracji Górnośląskiej w 2020 r.

New ideas, old problems? Heated tobacco products – a systematic review