Paweł Sowa

Allergic diseases: the price of civilisational progress

Atopic disorders are a major global health problem. The prevalence of asthma, allergic rhinitis and atopic dermatitis has been increasing over the last four decades, both in the industrialized and developing countries. It seems to be related to changes in the social structure, increasing industrialization, pollution and dietary changes. Many hypotheses link the allergy epidemic to stringent hygiene, dominance of a westernized lifestyle and an accelerated pace of life. Dietary antioxidants, lipids, sodium, vitamin D seem also to be implicated. We endeavour to review the most relevant theories with a special emphasis on the hygiene, antioxidative, lipid and air pollution hypotheses. It is however important to note that none of them explains all the aspects of unprecedented rise in the prevalence of allergic disorders. A complex interplay between hosts immune response, invading pathogens, diversity of environmental factors and genetic background seems to be of a particular importance. Current allergy epidemic is multifactorial and basic and epidemiologic studies are warranted to further our understanding of this phenomenon.

Role of melatonin receptor MT2 and quinone reductase II in the regulation of the redox status of 3T3-L1 preadipocytes in vitro

We have examined the role of melatonin receptor MT2 and quinone reductase II in the regulation of the redox status of preadipocytes (3T3‐L1) in vitro. 3T3‐L1 cells were treated with melatonin at a physiological concentration (10−9 mol/L) and a supraphysiological (pharmacological) concentration (10−3 mol/L) for 24 h. Luzindole (10−4 mol/L), an antagonist of MT2 receptor, and prazosin (10−5 mol/L), an inhibitor of quinone reductase II, were added 30 min before subsequent exposure of the cells to melatonin. The level of oxidative stress was determined by the analysis of activities of enzymes neutralising reactive oxygen species, and determination of the malondialdehyde (MDA) content. Melatonin increased activities of manganese and copper‐zinc superoxide dismutase (MnSOD, Cu/ZnSOD) and catalase (CAT) at both a physiological concentration (10−9 mol/L) and a pharmacological concentration (10−3 mol/L). MDA content was unchanged, whereas activities of glutathione peroxidase (GSH‐Px) and glutathione reductase (GSSG‐Rd) were increased only by the physiological concentration. Both effects were partially inhibited by luzindole, but not prazosin. These observations suggest that melatonin, acting at least partially via MT2 receptors, can increase antioxidant enzymes activities in 3T3‐L1 preadipocytes.

Current view on nasal polyps management in Samter's triad patients

UNLABELLED The nasal polyps associated with Samters triad are often very extensive, difficult to treat, with great tendency to recurrence. In this paper the current opinion on nasal polyps management in aspirin triad patients was presented. PATHOGENESIS Opinions on pathogenesis of these disease was remembered as well as its epidemiology. DIAGNOSTIC METHODS The available diagnostic methods were presented. Treatment options: The available preservative treatment options was analyzed including aspirin desensitization. The role of surgical treatment, functional endoscopic sinus surgery was analyzed.

Kikuchi-Fujimoto disease as a rare cause of lymphadenopathy--two cases report and review of current literature.

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a benign and self-limited disease, characterized typically by enlargement of regional lymph nodes accompanied by fever. KFD affects predominantly young adult females of Asian origin and is rarely seen in European countries, where it may cause diagnostic difficulties. Two cases of KFD in a 33 and 27-year-old woman with mild fever, malaise, lymphadenopathy initially misdiagnosed for indolent non-Hodgkins lymphoma was presented. The definitive diagnosis was established on the basis of histopathological examination of totally excised cervical lymph nodes. The propriety diagnosis allowed us to avoid inappropriate chemotherapy. The disease course in our patient was uneventful during the 1.5 and 12-year follow-up period. The clinical presentations, complications as well as current concepts on pathogenesis, diagnosis and treatment of the Kikuchi-Fujimoto disease was briefly reviewed in this paper. The need of a long-term follow-up of patients with Kikuchi-Fujimoto disease was emphasized.

Frequency of IgE-dependent hypersensitivity to moulds in patients with chronic rhinosinusitis with polyps.

Introduction The complicated etiology of chronic sinusitis with polyps and frequent allergy to mould is established. Aim We aimed to investigate the frequency of the IgE-dependent hypersensitivity in this group of patients and prove the need of surgery in allergic chronic rhinosinusitis patients. Material and methods Forty-two patients (19 females, 23 males) aged 34–73 years (55 ±12.6 years), with chronic sinusitis with polyps were included into the study. Functional endoscopic sinus surgery, laryngological examination, sinus computed tomography scans, and smear from maxillary sinus for microbiological examination were done in all patients. Skin prick tests with common perennial and seasonal inhalant allergens, tIgE and sIgE against moulds were required. Results Thirty-two of 42 patients (71.4%) were allergic to at least one inhalant allergen. A mean concentration of total IgE was 241.2 ±186.3 kU/l (35.0–708.0 kU/l) and was lower in patients with fungal culture found in sinus mucin than in patients without fungal presence 75.1 ±54.6 kU/l vs. 284.3 ±204.1 kU/l. We found no difference in the number of positive skin prick tests in a group with and without fungal culture. None of patients with fungal culture found in sinuses presented a detectable level of mold sIgE. All patients with fungal vegetation in sinuses required at least two polypectomy procedures. Conclusions The total IgE concentration was significantly lower in patients with fungal presence in sinuses. Nasal polyps occurred more frequently in patients with fungal presence in sinuses.

Demographic characteristics of MS patients in Poland's upper Silesia region

Objectives: In Poland, no national registry of MS patients has yet been introduced. So far, no demographic studies have been conducted in patients with MS in Upper Silesia. The aim of the present study was to evaluate, for the first time, a selected demographic and clinical parameters in MS patients from the Upper Silesia region and compare these characteristics with previously published data from other regions of Poland. Materials & Methods: 640 patients with clinically defined MS, were prospectively and randomly selected for the study. Social, socio-economic, and demographic data were obtained through a questionnaire study. All subjects performed a self-assessment of their health condition using EQ-5D and EQ-VAS version questionnaires. Results: The ratio of women to men was 2.18. The average age of onset was 29.6 ± 11.1 years; the disease duration was 7.9 ± 4.5 years. The relapsing-remitting form of MS was diagnosed in 73.12%. In 71.25% the onset was monofocal and in 28.75% multifocal disease onset was observed. Among the studied population 339 (52.97%) patients were still employed. A mean EQ-VAS score of 66.11 ± 20.12 was calculated. Conclusions: Results from our study identify for the first time the demographic and clinical characteristics of the Upper Silesia MS population.

Reconstruction of the larynx after a resection of a huge chondrosarcoma

Chondrosarcoma of the larynx is a rare condition of still unknown pathogenesis. This tumor occurs usually between the sixth and seventh decade of life. Forty five years old patient was admitted to the ENT Department in Zabrze for a diagnosis of a slow growing tumor from about 3 years. The great unmovable tumor 2.5 cm/3 cm/3 cm was arising from the cricoid cartilage. The hist-pat result of the biopsy was cartilage. The patient did not agree on the proposed surgical treatment. After one year, in the MRI examination, the tumor sized 46 mm/37 mm/39 mm was found. The patient was again qualified for the operation and agreed for the proposed treatment. In general anesthesia, the tumor together with the part of trachea, cricoids and thyroid cartilages was resected. After excision the reconstruction was performed. During 10 months of the follow-up the patient remains free of the disease.

Oxidative Stress Markers Patients with Parotid Gland Tumors: A Pilot Study

Salivary gland tumors account for 3–6% of tumors of the head and neck. About 80% of salivary gland tumors occur in parotid glands. Oxidative stress (OS) is implicated in the origin, development, and whole-body effects of various tumors. There are no data on the occurrence of OS in the parotid gland tumors. The aim of this study was to ascertain if whole-body OS accompanies parotid gland tumors, based first of all on oxidative modifications of blood serum proteins and other markers of OS in the serum of the patients. The group studied included 17 patients with pleomorphic adenoma, 9 patients with Warthins tumor, 8 patients with acinic cell carcinoma, and 24 age-matched controls. We found increased concentration of interleukin 4 in patients with acinic cell carcinoma, decreased plasma thiols, increased AOPP concentration, and decreased FRAP of blood serum in all groups of the patients while protein oxidative modifications assessed fluorimetrically, protein carbonyls, protein nitration, malondialdehyde concentration, and serum ABTS⁎-scavenging capacity were unchanged. These data indicate the occurrence of OS in patients with parotid gland tumors and point to various sensitivities of OS markers.

An updated view on tuberculous lymphadenitis in the context of HIV epidemic as well as multidrug and extensively drug-resistant tuberculosis.

BACKGROUND An updated view on tuberculous lymphadenitis was presented in this paper. OBJECTIVES This article describes tuberculous lymphadenitis as the most common presentation of extrapulmonary tuberculosis and reviews its epidemiology, clinical aspects, diagnosis and treatment methods. The role of surgical procedures was also underlined. MATERIAL AND METHODS Since the 1990s, the incidence and severity of tuberculosis - particularly the prevalence of extrapulmonary tuberculosis - are increasing internationally, mainly due to the HIV epidemic and the emergence of multidrug-resistant and extensively drug-resistant strains. Hence, tuberculosis is once again a serious global problem not only in the developing countries of Africa or South East Asia, but also in highly-developed communities. CONCLUSIONS The latest data suggest that tuberculosis should be included in the list of differential diagnoses for all neck lymph node involvements, even in the absence of pulmonary involvement, in HIV-positive patients. If the otolaryngologist maintains a high index of suspicion, an early diagnosis can be made to contribute to more successful outcome of the disease.

Ropowica przestrzeni przygardłowej

The abscess of parapharyngeal space is very dangerous health condition graving numerous complications such as: jugular vein thrombosis, mediastinitis, arterial bleeding. This state originates most frequent during the acute pharyngitis, and especially acute tonsillitis. The aim of our study was to review the clinical sings, computed tomography scans and outcome of parapharyngeal space infection. 3 patients treatment in our Department were underwent surgical drainage and aggressive antibiotic therapy. One patient was treated solely with intravenous antibiotic therapy. The average time of hospitalization was 16 days. No one complication was observed.The abscess of parapharyngeal space is very dangerous health condition graving numerous complications such as: jugular vein thrombosis, mediastinitis, arterial bleeding. This state originates most frequent during the acute pharyngitis, and especially acute tonsillitis. The aim of our study was to review the clinical sings, computed tomography scans and outcome of parapharyngeal space infection. 3 patients treatment in our Department were underwent surgical drainage and aggressive antibiotic therapy. One patient was treated solely with intravenous antibiotic therapy. The average time of hospitalization was 16 days. No one complication was observed.