Elderly asthmatic patients presented a high rate of falls, which is comparable to that of patients with COPD.

The forced oscillation technique (FOT) requires minimal patient cooperation and is useful for children. However, comprehensive values of respiratory impedance at baseline and after the reversibility test have not been definitively confirmed. The aim of this study was to evaluate the basic parameters of FOT reactance (Xrs) and resistance (Rrs) in groups of healthy children and children with controlled and uncontrolled asthma. The second aim was the assessment of the reversibility bronchial test using the forced oscillation method in children with bronchial asthma. Materials and Methods. One hundred and six children aged from 2 to 6 years diagnosed with early-onset controlled or uncontrolled asthma and healthy controls were included in this single-center, prospective, randomized study. All asthmatic patients and healthy controls underwent basic FOT as one measurement according to the recommendation of Resmon Pro FOT. The reversibility test was then performed 15 min after the administration of 200 mcg salbutamol by MDI in all patients. Results. Basic Rrs showed significantly higher mean values in patients with uncontrolled asthma compared to patients with controlled asthma, which were in turn higher than the values for patients in the control group (11.14 ± 1.29 versus 15.71 ± 2.6 versus 9.21 ± 0.98, resp.; p < 0.05). The data analysis showed similar relationships in terms of the Xrs between the studied groups (−4.76 ± 1.19 versus −7.31 ± 2.33 versus −2.11 ± 0.48, resp.; p < 0.05). According to the changes in the Rrs values, 35 (66%) positive bronchial reversibility tests were obtained in 53 subjects with controlled asthma and in 39 (74%) subjects with uncontrolled asthma. Conclusions. Rrs and Xrs obtained by FOT well-discriminate patients with asthma from healthy children. A bronchial reversibility test involving the use of FOT is valuable for the diagnosis of bronchial asthma.

Allergen immunotherapy (AIT) is a very useful therapy for allergic rhinitis. However, some patients do not achieve the expected results. The aim of the study was to investigate the potential factors that could affect the result, either good or poor, from AIT. Methods: A retrospective analysis of 1624 patients with allergic rhinitis who underwent AIT and 1519 matched patients who underwent only symptomatic therapy (without AIT) was performed. Symptoms, medications scores and quality of life related to allergic diseases before and after therapy were recorded. Cluster analysis on all of the patients was performed to find any associations between responsiveness to therapy and the analyzed parameters. Responsiveness to therapy was assessed by the Mailing criteria. Results: A total of 1266 (77.8%) patients from the AIT group met the criterion of 30% or greater improvement, and 1061 (65.2%) of these patients met the threshold of 60% or greater improvement according to the Mailing criteria. Patients who had a frequently better response to AIT were highly represented in the two clusters. There were subjects with a short history of allergic rhinitis and concomitant allergy to grass pollen or house dust mites. Patients with a prolonged duration of allergic rhinitis before therapy and with polysensitization were more frequently worse responders to AIT. Conclusion: Responsiveness to therapy, including that to AIT, is difficult to assess. However, there were associations suggesting that short-term allergic rhinitis and monovalent allergies to grass pollen or mites could correspond to a better response to AIT.

A prolonged positive effect after AIT to grass pollen was observed in elderly patients with allergic rhinitis. Further trials are needed to confirm this effect.

Introduction: Allergen immunotherapy (AIT) is very important and effective and reduces medication use in patients with allergic rhinitis. However, some patients have no response to AIT. Aim: To explore the problem of nonresponding patients after AIT. Material and methods: This retrospective randomized observational study included 1056 patients with allergic rhinitis who underwent subcutaneous injection allergen immunotherapy (SCIT). Patients who received SCIT to one of the following allergens: grass pollen, birch, trees, mugwort, house dust mites, Alternaria or cat were analyzed according to the inclusion criterion of ≥ 20% improvement in all monitored parameters. There were symptoms and medication score, rhinitis symptom score and serum allergen-specific IgE and IgG4. Results: A total of 806 (76.3%) patients met the criterion of 20% or greater improvement after SCIT. The greatest effectiveness was obtained in patients receiving SCIT to grass pollen (293 participants; 83.2%), birch (82; 81.2%) and house dust mites (255; 76.4%). Statistically significant predictors of an improved AIT outcome in the multivariate analysis were SCIT to grass pollen (OR = 2.34, p = 0.035), SCIT to birch (OR = 2.25, p = 0.021) and the presence of only intermittent allergic rhinitis before SCIT (OR = 2.05, p = 0.039). Patients who received SCIT to mugwort, Alternaria or cat had weak response results especially in long-term observations. Conclusions: The best predictors to obtain good responsiveness to SCIT are the presence of intermittent allergic rhinitis to grass or birch pollen. Patients with allergies to mugwort, Alternaria and cat with a prolonged duration of persistent allergic rhinitis dominated in the group of nonresponders to SCIT.