E. Dzięciołowska-Baran

Rhinitis as a cause of respiratory disorders during pregnancy.

Rhinitis is a common disease of women during pregnancy. It can start in almost any gestational week and disappears after delivery. The main symptoms are sneezing, nasal congestion or running nose. The diagnosis is usually based on history, physical examination, blood tests, and exclusion of the other more common types of rhinitis. The etiology remains to be clarified. The rhinitis may be caused by numerous substances and hormones secreted during pregnancy (PGH, VIP, estrogen, progesterone). They lead to changes in the nasal mucosa in the form of increased activity of serous-mucous glands and increase of their vasculature. The best treatment is using saline irrigations, exercise, and mechanical alar dilators. The nasal decongestants provide only temporary relief. The aim of this study was to evaluate the prevalence of pregnancy rhinitis. The study was conducted on 117 pregnant women in the province of the West Pomerania in 2009-2010. The information was obtained from interviews, questionnaires, and data contained in pregnancy records. About 39% of pregnant women suffered from pregnancy rhinitis. Most such ailments were found during 13th and 21st week of gestation. Doctors should pay more attention to symptoms which result from pregnancy rhinitis, which are reported by their patients. The quality of prenatal care understood as an education of pregnant women as far as pregnancy rhinitis is concerned, is much insufficient. Pregnancy rhinitis significantly affects quality of life of pregnant women and, as a result, it may affect fetal development.

Influence of body mass index on treatment of breathing-related sleep disorders.

BackgroundBreathing-related sleep disorders cover several conditions (isolated snoring, UARS - upper airway resistance syndrome, obstructive sleep apnea, hypopnea, obesity hypoventilation syndrome) characterized by a variety of symptoms and complex etiology. The conditions can be successfully treated in most cases. Excessive body mass is a factor increasing the probability of the disorders. In most patients it is the only reason for breathing-related sleep disorders. However, it often coexists with various anatomical abnormalities in the upper airway, endocrinological diseases or genetic defects of the facial skeleton, and occurs more frequently in older people, especially men. Excessive body mass significantly affects the range and success of the treatment.ObjectiveTo analyze treatment outcome in patients treated at the otolaryngology unit for snoring and related diseases with submucosal tissue reduction within the nasal cavity, pharynx, and soft palate.Materials and methodsPatients were stratified into three study groups depending on the body mass index (BMI): normal, overweight, and obese. The BMI value was compared to the severity of breathing disorders during sleep, with the incidence of other systemic diseases (e.g., hypertension, diabetes), and with treatment outcome.Results and conclusionsThe analysis demonstrated a significant influence of body mass on snoring, particularly in complicated and severe types of breathing disorders, such obstructive sleep apnea or hypopnea, and the obesity hypoventilation syndrome. Corrective interventions carried out to eliminate anatomical abnormalities causing obstruction of upper airways provided the best therapeutic effects in patients with normal body mass.

Respiratory diseases in the late middle ages

Respiratory diseases have beset humanity from the earliest times. The aim of this study was to evaluate the prevalence of respiratory diseases in the inhabitants of a large medieval city. We analyzed 110 skeletons, coming from 12 to 17th century of individuals of either gender. In order to assess pneumatisation of paranasal sinuses and nasal septum curvature, radiographs were performed in the PA projection. Nasal septum deviation was found in 50% of individuals, asymmetry of the frontal sinuses and their aplasia in 11% of individuals. There was no significant relationship between the curvature of the nasal septum and frontal sinus aplasia. One case of tuberculosis and one case of periradicular abscess causing perforation of the maxillary sinus were noted. Developmental variation of the sternum was present in two individuals. In another two individuals, rib fractures with bone union were observed. Analysis of the presence of respiratory disease in bone material is particularly difficult, but the use of modern methods: X-rays, CT scans and endoscopy significantly extends the capability to unravel the underlying causes of bygone diseases.

Snoring and sleep disorders in children with hypertrophy of lymphoid tissue in the throat.

Hypertrophy of lymphoid tissue within the throat in children leads to a number of respiratory problems and sleep disorders. The aim of this study was to evaluate the prevalence of the above-mentioned changes depending on the location of overgrown lymphoid tissue, BMI, and coexisting allergies. The study was based on a survey conducted in a group of 103 children aged 3-14 with a hypertrophy of lymphoid tissue requiring surgery. The questionnaire included questions about symptoms of sleep disordered breathing. In addition, BMI was calculated and the coexistence of other diseases in the group of examined children was taken into account. Pathological changes predominated in children aged 4-6. The incidence of snoring was the most common, observed in 87%, followed by apnea in 45% of the examined group. Co-occurrence of allergies was observed in 36% and excess of body weight in 21% of the children. Overweight was an essential factor that facilitated apneic sleep episodes accompanying lymphoid hyperplasia. Snoring and nasal obstruction were observed more often in allergic patients.

Cigarette Smoking Among Students and the Influence of Legal Regulations on Passive Smoking

Research suggests that reducing the degree of nicotine addiction in the population cannot be achieved only by prevention programs. Legislative measures are necessary to be taken by the state. The aim of this study was to assess the degree of tobacco abuse in three groups of students. It also assesses the influence of ban on smoking in public places on passive contact of students with tobacco. A customized survey made up of open and closed questions was conducted among 102 students of electrical faculty, 109 medical students, and 71 students of animal husbandry faculty. The results showed that significantly more women from the electrical faculty smoked. Among the students of animal husbandry, men smoke significantly more cigarettes than women. Women studying animal husbandry start smoking significantly earlier (by about 2 years) than women from other faculties. They are also significantly less likely to smoke cigarettes at school and at home. According to the study, the Polish law to ban smoking in public places, in force since the 15th of November 2010, did not make students quit smoking, although the rate of smoking students decreased. Students did not observe restrictions on smoking in their environment. The study indicates a positive influence of the anti-nicotine legislation on passive smoking, just after 3 months from its introduction.

Changes of laryngeal parameters during intrauterine life

ObjectiveIncreased care of fetal and neonatal airways has led to advances in neonatal medicine. The early diagnosis and treatment of respiratory diseases require a detailed knowledge of fetal airway anatomy and development. The aim of this study was to determine the anatomical development of the thyroid and cricoid cartilages and their structural variability during fetal life.Materials and methodsThe study was performed on the thyroid and cricoid cartilages of 55 human fetal larynges of both sexes, between the ages of 13 and 27 weeks of intrauterine life. Numerous measurements of the thyroid and cricoid cartilages were performed.ResultsCorrelations between the obtained results were calculated in relation to the crown-rump (C-R) length of human fetuses and to sex. The structural variability of the thyroid and cricoid cartilages of human male and female fetuses in subsequent weeks of intrauterine life was observed. In both genders a correlation between laryngeal size and fetal crown-rump length, regardless of sex, was found. The thyroid cartilage presents a sexual dimorphism.ConclusionsThe results of this study can be useful in the analysis of prenatal examinations, and in planning the treatment of airway emergencies.

Causes of respiratory ailments in pregnancy.

ObjectiveDuring pregnancy, especially during its third trimester, most pregnant women reported respiratory discomfort (dyspnea), despite the absence of previously coexisting respiratory illnesses. The aim of this study was to determine the reason for this discomfort.Materials and methodsThe study included 24 women examined before and after childbirth. Evaluation of respiratory complains was made on the basis of the respiratory questionnaire of St. Georges Hospital. The data were correlated with the results of static and dynamic spirometric tests performed before and after childbirth.ResultsPregnancy did not affect vital capacity (VC). Frequency of perceived symptoms correlated positively with IRV and the ratio IC/VC. A negative correlation was found between ERV and its derivative ERV/VC. There was no relationship between perceived discomfort and parameters of the flow-volume loop.ConclusionsThe extent of perceived respiratory discomfort (dyspnea) during pregnancy was primarily associated with a reduction in expiratory reserve (ERV).

Influence of physiological stress on the presence of hypoplasia and fluctuating asymmetry in a medieval population from the village of Sypniewo

This study aims to estimate the levels of physiological stress in the medieval rural population of Sypniewo by evaluating patterns of fluctuating asymmetry (FA) and enamel hypoplasia (EH), and provide information on the influence of physiological stress during the prenatal and perinatal period on early childhood development. Stress is defined as any external or internal condition that challenges homeostasis of an organism. FA is associated with physiological stress occurring mainly during prenatal development and early childhood. The level of FA is thought to reflect the intensity of the stressor(s). EH is caused by physiological stress such as nutritional instability during the first years of life. The studied material consisted of 126 skulls from the village of Sypniewo (Poland). Cranial radiographs were taken in postero-anterior (P-A) and basal views. The images were scanned and calibrated. Measurements of the cranium were used to estimate FA. The presence of EH was assessed using standard anthropological methods The highest levels of FA were observed in the region of the cranial base. EH was observed in 29% of individuals from the rural skeletal series. There was no statistically significant correlation between FA and EH occurrence or between sex and the studied stress indicators.

Diseases of the Upper Respiratory Tract in Preschool and School Age Children in Ambulatory Ear Nose Throat Practice

The most common diseases of the upper respiratory tract in children treated by ear-nose-throat (ENT) specialists in ambulatory practice are infections, such as colds, rhinitis, sinusitis and pharyngitis, very frequently accompanied and promoted by chronic nasal obstructions of various etiology. These diseases, when treated incorrectly or for too long, cause frequent school absenteeism and may also lead to hearing disorders linked with acute or suppurative otitis. They may also habitually perpetuate abnormal breathing and result in occlusal disorders. The aim of this study was to assess the incidence and type of upper respiratory tract diseases in children, depending on age and sex of patients and on the seasons. We also discussed the role of the ENT specialist in the diagnosis and treatment of certain diseases. In the study we analyzed the medical records of patients of preschool and school age treated in the ENT outpatient clinic over one calendar year. It was found that the largest group of patients comprised children of 3-7 years of age, and most children visited the outpatient clinic in the period March-May. The most common main disorder, according to ICD-10, was acute nasopharyngitis (J00) and vasomotor and allergic rhinitis (J30). Among the comorbid disorders H65 and H66 were the most frequent. No significant gender differences were noted in the frequency of particular types of disease.

Analysis of eating behaviors and eating habits, body mass index and waist-to-hip ratio in association with spirometry results of young adults

Abstract Behavior and eating habits stands as an important factor in terms of maintaining a good health condition in every age group. This involves optimal digestion, maintaining proper metabolism of the entire organism and thus maintaining proper body weight. It is especially important for students, as the increased mental activity results in increased energy expenditure. The state of body weight can affect the respiratory efficiency measured in spirometry. The aim of the study was to assessthe relation between behavior and eating habits, body mass index (BMI), waist-to-hip ratio (WHR) and results from spirometry tests among young adults. The study sample included 185 students from the University of Szczecin (mean age 21.2±1.3). Using a questionnaire prepared for the study, information on the eating plan of students for three consecutive days was collected. Dietary analysis was concerned with: eating in stressful situations, dieting, regularity of main meals, eating between main meals. Afterwards spirometry examination was performed along with a detailed measurement of body weight and height, waist and hip circumferences in order to calculate BMI and WHR index of each respondent. The data obtained was processed statistically. Significant correlations between FVC and “dieting” (Spearman’s rs=0.3) were recorded in the group of women. However, the association of other behavior and eating habits with spirometry parameters did reveal null results in both males and females. Correct behaviors and eating habits at a young age affect spirometry parameters to a negligible extent. The absence of direct health related effects of bad consumption habits at a young age makes it all the more important to raise the awareness of students, that their current decisions will have an apparent effect in the future, maybe only after a few years.