Petar Drviš

Bacterial colonization and granulocyte activation in chronic maxillary sinusitis in asthmatics and non-asthmatics

The impact of bacterial colonization on the severity and pattern of chronic inflammation in rhinosinusitis is not clear. In this study, it was hypothesized that bacterial colonization of the sinus mucosa would have a greater impact on inflammatory response modulation in asthmatic patients than in non-asthmatic patients with chronic rhinosinusitis. In order to test this hypothesis, granulocyte activation was measured and related to bacteria identified in the sinus lavage. Lavages from the maxillary sinuses of 21 asthmatic and 19 non-asthmatic patients with chronic rhinosinusitis (CRS) were microbiologically examined for aerobic and anaerobic growth. Eosinophil cationic protein (ECP), an eosinophil activation marker, and myeloperoxidase (MPO), a neutrophil activation marker, were measured in the sinus lavages. Bacteria were recovered in 20/32 samples from the asthmatics and in 21/33 samples from the non-asthmatics. Gram-positive aerobes and anaerobes were slightly more common than Gram-negative bacteria. A different bacterial profile was found when comparing Gram-negatives between the groups. Concentrations of MPO were significantly higher in samples with bacterial recovery from asthmatic patients, compared to sterile samples of both groups. Concentrations of ECP in the samples from asthmatic patients were significantly higher than in the controls, with no significant difference related to bacterial colonization. Bacterial colonization in chronically inflamed sinuses may have an impact on neutrophil granulocyte activation in patients with bronchial asthma, which was not confirmed for patients with CRS without asthma.

Local IgE and inflammation in chronic rhinosinusitis of asthmatics and non-asthmatics.

The aim of the study was to show the difference in the pattern of inflammation, and Th1/Th2 polarization between asthmatic and non-asthmatic patients with CRS, specifically eosinophil activation, local IgE levels in the sinus fluid and tissue, and the severity of inflammation were measured. The maxillary sinus lavages, mucosal biopsies and bacteriological swabs were taken in 17 asthmatic and 36 non-asthmatic adult patients with CRS. The concentrations of IgE, eosinophil cationic protein (ECP), myeloperoxidase (MPO), and tryptase were analyzed and IgE+ cells, eosinophils, lymphocytes and plasma cells were counted. The granulocyte activation markers and IgE in sinus lavages, and the inflammatory and IgE+ cells counts were significantly higher in the asthmatics with the greatest difference in ECP and IgE concentrations. The tryptase concentrations did not differ, but only in the asthmatics they correlated significantly with the IgE concentrations and IgE+ cells count. Asthmatic patients present a distinct subgroup among the patients with chronic rhinosinusitis (CRS). The levels of the cellular markers and IgE in the sinus fluid differ from those of non-asthmatic patients with CRS. The activation of granulocytes (especially eosinophils), local IgE concentrations and the inflammatory cells infiltration are significantly higher in the asthmatics.

Thermography-measured effect of capsaicin, methylprednisolone and mitomycin on the survival of random skin flaps in rats

Aims: This study was designed to determine if steroids, capsaicin and mytomicin improved skin flap survival in rats, and it has confirmed that thermography is an effective method to measured skin flap vitality.

Evaluation of cutaneous flap survival by IR thermography

There are plenty of recent studies showing the influence of different drugs on the survival of the cutaneous flap. The effects of a topically applied capsaicin, methylprednisolon, mitomycin and gastric pentadecapeptide BPC-157 in improving skin vitality and preventing distal flap necrosis were tested in a random-pattern dorsal skin flap model. Wistar rats were randomized into five groups, four experimental groups and a control group. A standardized full thickness dorsal random-pattern skin flap was raised on each rat and sutured back into place. A gelatin sponge was placed before suturing between the flap and its recipient bed, with 0.9% saline in the control group and with capsaicin, methylprednisolon, mitomycin and pentadecapeptide BPC157 in the experimental groups. The flap survival was judged one

Endosinusal treatment impact and prognostic value of IL-5 in chronic maxillary sinusitis

Abstract Objectives: The aim of the study was to evaluate subjective outcomes in patients with chronic maxillary sinusitis after steroid/antibiotic endosinusal treatment. Furthermore, the aim was to test the hypothesis that pretreatment levels of interleukin-5 (IL-5) in sinus fluid could predict response to endosinusal steroid/antibiotic treatment. Methods: Thirty patients with chronic maxillary sinusitis were recruited for the study. Patients were treated endosinusally with 2 mg dexamethasone and 40 mg gentamycine per maxillary sinus for 5 days. Patients rated nasal/CRS disease-specific symptoms and completed a self-administered questionnaire concerning sinusitis symptoms at inclusion and after 30 days. Sinus lavage, collected at inclusion, was analyzed for IL-5 concentration. Results: 56.6% of patients had improvement after endonasal treatment with decrease in symptoms (responders), and 43.4% were unchanged or worsened after treatment (nonresponders). Significant improvement was noted for overall sinusitis symptoms score (P = 0.02) and for obstruction, postnasal drip, headache, sneezing, and cough (P Conclusions: Steroid-antibiotic endosinusal treatment in patients with chronic maxillary sinusitis was proven effective in reducing subjective sinusitis symptoms. Improvement rate to endosinusal treatment is expected be higher in patients with increased level of IL-5 in maxillary sinus lavage. Increased concentrations of IL-5 in sinus fluid might be used as a predictor of a good response to endosinusal treatment of maxillary chronic sinusitis.