Zaburzenia funkcji narządu słuchu w cukrzycy typu 1

Wstęp: Celem badania była ocena funkcji narządu słuchu u relatywnie młodych osób z cukrzycą typu 1, o krótkim czasie trwania choroby i bez jawnych klinicznie ubytków słuchu. Analizie poddano także wpływ wieku, czasu trwania cukrzycy i jej kontroli metabolicznej na funkcję słuchu. Materiał i metody: Trzydzieści jeden osób z cukrzycą typu 1, w wieku poniżej 45 lat (średnio 29,1 &#177; 7,1 lat), z czasem trwania cukrzycy poniżej 120 miesięcy (średnio 54,7 &#177; 32,5 miesięcy), i bez jawnego ubytku słuchu, porównano z dwudziestoma sześcioma zdrowymi ochotnikami dopasowanymi pod względem wieku (30,3 &#177; 7,8 lat, p = 0,567). U wszystkich osób, po przeprowadzeniu badania laryngologicznego, wykonano badanie audiometrii tonalnej progowej, emisji otoakustycznej wywołanej trzaskiem oraz słuchowych potencjałów wywołanych pnia mózgu. Wyniki: U osób z cukrzycą średni próg słuchu w audiometrii tonalnej progowej był znamiennie wyższy w wysokich częstotliwościach, średnia amplituda emisji otoakustycznej była niższa (7,75 &#177; 4,43 dB v. 10,00 &#177; 4,01 dB, p < 0,001), także czasy latencji fali V i interwału I&#8211;V w badaniu słuchowych potencjałów wywołanych były dłuższe (odpowiednio 5,78 &#177; 0,25 ms v. 5,69 &#177; 0,18 ms, p = 0,025 i 4,03 &#177; 0,20 ms v. 3,95 &#177; 0,17 ms, p = 0,017) w porównaniu z osobami zdrowymi. U osób z cukrzycą próg słuchu wykazywał dodatnią, zaś amplituda emisji otoakustycznej ujemną korelację liniową z wiekiem. W badaniu słuchowych potencjałów wywołanych czasy latencji fali V i interwału I&#8211;V ujemnie korelowały z czasem trwania cukrzycy. Wnioski: Praca ta potwierdza wpływ cukrzycy typu 1 na funkcję narządu słuchu. Dla oceny wartości prognostycznej uzyskanych wyników, jak też potencjalnych sposobów zapobiegania uszkodzeniu słuchu w cukrzycy konieczne są dalsze prospektywne badania tego zjawiska. (Endokrynol Pol 2011; 62 (2): 138&#8211;144)Introduction: The aim of this study was to evaluate auditory organ function in relatively young type 1 diabetic patients, with short duration of the disease and without overt hearing loss. The impact of age, diabetes duration and metabolic control on hearing function was also analysed. Material and methods: Thirty-one patients with type 1 diabetes, aged below 45 years (mean 29.1 &#177; 7.1 years), with diabetes duration of less than 120 months (mean 54.7 &#177; 32.5 months), and no evident hearing impairment, were compared to 26 age-matched (30.3 &#177; 7.8 years, p = 0.567) healthy volunteers. In all subjects, pure-tone audiometry, transient evoked otoacoustic emissions (TEOAE), and auditory brainstem responses (ABR) were performed, after an ENT examination. Results: In diabetic patients, compared to healthy subjects, the mean hearing threshold in the pure-tone audiometry was significantly higher at high frequencies, the mean amplitude of TEOAE was lower (7.75 &#177; 4.43 dB v. 10.00 &#177; 4.01 dB, p < 0.001), and latency times of wave V and interval I&#8211;V in ABR were longer (5.78 &#177; 0.25 ms v. 5.69 &#177; 0.18 ms, p = 0.025 and 4.03 &#177; 0.20 ms v. 3.95 &#177; 0.17 ms, p = 0.017 respectively). In the diabetic group, the hearing threshold showed positive linear correlation with age, whereas TEOAE was inversely correlated with this parameter. In ABR latency, times of wave V and interval I&#8211;V were negatively correlated with diabetes duration. Conclusions: This study confirms the involvement of the auditory organ in type 1 diabetes mellitus. To determine the prognostic and predictive values of this finding, and methods of possible prevention of hearing loss, further prospective observations are required. (Pol J Endocrinol 2011; 62 (2): 138&#8211;144

Smell dysfunction from symptoms to diagnosis – recent methods of olfactory function assessment

Sense of smell poses an incredibly significant aspect of our life, it has been present from the beginning of our existence and its role in maintaining the well-being of our organism is non-sustainable. Olfactory system dysfunctions have a negative influence on general health status, psychological condition and quality of life. Smell detection disturbances can not only lead to loss of pleasant feelings or basic defence mechanism deficiency, but also may be symptoms of serious ongoing or commencing diseases. The authors aimed to present in this article the most important information on physiology of olfaction system, most recent methods of examination and possible causes of smell dysfunction. A systematic review of the literature concerning smell examination was conducted including both previous review articles and original papers. Smell assessment remains an enigmatic branch of medicine, qualified personnel and special equipment which would enable to fully and reliably evaluate the condition of olfactory function is still not widely available. It seems that serious consideration of patients' complaints on odour perception, directed and complete investigation of reported dysfunctions, and adequately adjusted multidisciplinar treatment would be effective according to both, quality and length of patients' life

The correlation between second-hand tobacco smoke exposure and biofilm formation in chronic rhinosinusitis

Introduction and purpose Tobacco smoke is a major health concern globally. Due to tobacco epidemic, approximately 8 million people died as a result of cigarette smoking in 2020 alone, where 1.2 million were caused by non-smokers inhaling second-hand smoke. Chronic rhinosinusitis (CRS) is an inflammatory condition that has a significant health and&nbsp; economic impact worldwide. Despite its great burden on the health-care system and patients' quality of life, the variety of therapy options for CRS is currently limited. Tobacco-induced biofilm formation may contribute to the refractory nature of many respiratory diseases reported in smokers and second-hand smokers, due to increased resistance to antibiotics. The aim of this study is to present that exposure to household passive smoking may induce the formation of nasal biofilms. Brief description of the state of knowledge &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Chronic bacterial infections involving biofilms have recently been recognised as a factor in CRS pathogenesis. The presence of biofilms on the mucosa of CRS patients is associated with more severe pre-operative disease, persistent postoperative symptoms, ongoing mucosal inflammation, and infections following endoscopic sinus surgery. Tobacco smoke and CRS have been associated because of the immunosuppressive and irritating effects of tobacco smoke on sinonasal epithelial cells. Smoking uptake and cessation have been shown to affect microbial communities, with smokers having not just distinct microbial communities, but also a higher frequency of possible pathogens in those communities. Summary &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Biofilms may play a significant role in the development of chronic rhinosinusitis. The impact of tobacco smoke on biofilm development could have major implications not only for CRS but also for other respiratory infections. &nbsp

Programowanie płodowe

Programowanie wewnątrzmaciczne zachodzi podczas rozwoju zarodkowego i płodowego, które są uznawane zakrytyczny okres zarówno w procesie tworzenia tkanek i narządów, jak i w etiologii chorób cywilizacyjnych. Dziejesię tak zwłaszcza wtedy, gdy wpływ niekorzystnego środowiska nakłada się na genetyczną predyspozycję. Koncepcjaprogramowania płodowego zakłada, że zaburzenia metaboliczne i nieprawidłowe odżywianie ciężarnej mogąmieć trwały i międzypokoleniowy wpływ na zdrowie potomstwa i rozwój chorób cywilizacyjnych, takich jak otyłość,cukrzyca, czy choroby układu sercowo-naczyniowego

Acute Rhinosinusitis in Children with Inhalant Allergies

Rhinosinusitis is an essential medical problem in pediatric populations. Due to a lack of studies considering allergy impact on pediatric rhinosinusitis, it seems legitimate to investigate this subject. The aim of this paper was to assess the influence of inhalant allergy on acute rhinosinusitis in children. The study involved 100 pediatric patients aged between 3 and 17 years who were admitted to the Chair and Department of Pediatric Otolaryngology, Phoniatrics and Audiology of the Medical University of Lublin due to acute rhinosinusitis. The control group consisted of 50 children without allergy, and the study group consisted of 50 children suffering from inhalant allergy. The methodology employed in this study involved medical history and laryngological examination, as well as laboratory and radiological testing. Dust mite allergy was the most common allergy among patients in the study group. Patients with allergies presented at the hospital later than patients without allergy, and their hospitalization lasted longer due to more severe sinus disease, higher inflammatory parameters, multiple sinus involvement, more frequent fever or rhinosinusitis complications, especially orbital occurrence. Most children in the control group required only pharmacological treatment. Inhalant allergy, especially dust mite allergy, contributes to more severe acute rhinosinusitis in children

Asymptomatic radiological changes in computer tomography in children with head trauma

Introduction: Computed tomography is an important imaging technique in Emergency Units. Thanks to its popularity, radiological changes are found in healthy children more commonly. The aim of this paper is to evaluate the incidence of maxillary sinus radiological changes in children with head trauma who admitted to the Emergency Unit of the University Children Hospital in Lublin. Material and Methods: A retrospective analysis of computed tomography scans of children suffering from head trauma admitted to the Emergency Unit of the University Children Hospital in Lublin was carried out. A group of 425 patients was analyzed. Results: Maxillary findings were present in 81 cases (19.06%); in 38 patients (8.94%) the changes were unilateral, while in 43 (10.12%) they were bilateral. Maxillary mucosal thickening was the most common radiological abnormality, present in almost 12% of the investigated cases (approximately 62% of all revealed changes). Maxillary total opacification as an isolated finding was found in younger children only. Retention cysts and maxillary polyps were found with a similar low frequency as maxillary opacification but in elder children only. Discussion: Asymptomatic radiological changes in computed tomography scans are common. Maxillary mucosal thickening is the most frequent asymptomatic abnormality. Maxillary polyps and pseudocysts are rare in the paediatric population. Maxillary opacification suggests other more significant pathologies and requires further diagnostics. Physicians should avoid diagnosing patients with sinusitis without proper examination and based on radiological abnormalities only. Paediatric patients with revealed maxillary changes should remain under regular laryngological control

COMPENSATION CAPACITIES OF THE BRAIN IN UNILATERAL AND BILATERAL AUDITORY SYSTEM DAMAGE IN CHILDREN

Neuroplasticity is a basic feature of neuronal system which provides function rebuilt or developmental dysfunction repair. Hearing impairment can have an impact on intelligence levels, organization and structure of cognitive processes. Cognitive capacities profiles of deaf people present neuropsychological results of functional reorganization of brain. 208 children were accepted for this study. Experimental group con- sisted of 126 children suffering from sensorineural hearing insufficiency. 26 children were diagnosed with right-sided hearing loss, 34 children were diagnosed with left-sided hearing loss and 66 children were diagnosed with bilateral hearing loss. Control group consisted of 82 normally hearing children, confirmed in audiometric assessment. In order to establish levels of cognitive abilities and intelligence in patients enrolled for the study polish adaptation of Wechsler Intelligence Scale for Children (WISC-R) was administered. Children with bilateral hearing loss obtained worse results in verbal scale compared to well hearing controls. Verbal intelligence in control group was statistically higher than in right-sided auditory dysfunction group. Control group average result in nonverbal scale was statistically significantly higher compared to left-sided hearing loss patients. Children with right-sided auditory dysfunction obtained higher results in nonverbal scale compared to children with left-sided auditory dysfunc- tion. Left-sided hearing impairment group had higher scores in almost all subtests of verbal scale than right-sided hearing impairment group. Left-sided auditory disability enhances linguistic capacity, which indicates compensation abilities of left hemisphere responsible for verbal processes. Right-sided auditory disability enhances analytic processes, visual synthesis and image reasoning, which indicates compensation abilities of right hemisphere responsible for nonverbal processes. -----------------------------------------------------------------------------------------------------------------------------------

Infuence of HbA1c, serum lipids, blood pressure and BMI on Auditory Brainstem Response in diabetic patients

Introduction. Impaired hearing organ function including abnormalities in auditory brainstem response (ABR) are more frequent in diabetic subjects compared to the general population. The aim of our study was to assess the impact of selected modifiable factors on ABR latencies in diabetic subjects. Material and Methods. 58 patients with type 1 and type 2 diabetes, aged <45 years, with diabetes duration <10 years, and without clinically overt hearing impairment or diabetic neuropathy, were included. In all subjects vital signs and blood samples were obtained, and ABR audiometry was performed. Results. Significantly delayed latencies in ABR were found in patients with total cholesterol <192 mg/dL, with HDL-cholesterol <49.5 mg/dL, with triglycerides >89 mg/dL, with presence of hypertension, and with systolic and diastolic blood pressure >135 and >78 mm Hg respectively. A linear correlation between triglycerides and wave I and III latencies, and between systolic blood pressure and wave III latency were revealed. A relationship between ABR latencies and HbA1c, LDL-cholesterol or BMI was not found. Conclusions. Several modifiable factors affect functioning of the retrocochlear part of the auditory pathway. If these results were confirmed in further studies, a vast area of possible therapeutic interventions to preserve hearing function in diabetic patients would become available

The Molecular Epidemiology of Pneumococcal Strains Isolated from the Nasopharynx of Preschool Children 3 Years after the Introduction of the PCV Vaccination Program in Poland

The genetic mechanisms of resistance, clonal composition, and the occurrence of pili were analyzed in 39 pneumococcal strains isolated from healthy children in the southeastern region of Poland. Strains with resistance to combinations of erythromycin, clindamycin, and tetracycline were found in clonal groups (CGs) related to Tennessee 23F-4 and Taiwan 19F-14 clones. Capsular switching possibly occurred in the Spain 9V-3 clone and its variants to serotypes 35B and 6A, as well as DLVs of Tennessee 23F-4 to serotype 23A. The double-locus variants of Colombia 23F-26 presented serotype 23B. The major transposons carrying the erythromycin and tetracycline resistance genes were Tn6002 (66.6%), followed by Tn916 (22.2%) and Tn2009 (11.1%). The macrolide efflux genetic assembly (MEGA) element was found in 41.7% of all erythromycin-resistant isolates. The majority of the isolates carrying the PI-1 gene belonged to the CGs related to the Spain 9V-3 clone expressing serotypes 35B and 6A, and the presence of both PI-1 and PI-2 was identified in CG4 consisting of the isolates related to the Taiwan 19F-14 clone expressing serotypes 19F and 19A. Importantly, in the nearest future, the piliated strains of serogroups 23B, 23A, and 35B may be of concern, being a possible origin of the emerging clones of piliated non-vaccine pneumococcal serotypes in Poland. This study reveals that nasopharyngeal carriage in children is an important reservoir for the selection and spreading of new drug-resistant pneumococcal clones in the community after the elimination of vaccine serotypes

Health-Related Quality of Life Assessed in Children with Adenoid Hypertrophy

Introduction: The quality of life issue began to be earnestly studied in the second half of the 20th century. It had originally been used as a criterion for measuring levels of human development in the USA and Western Europe. At first, only objective parameters were assessed, such as material goods; however, later, subjective and non-material parameters were added, such as health, freedom, and happiness. Over time, more and more attention has been paid to the subjective parameters regarding any quality of life assessment. Adenoids are physiological clusters of lymphoid tissue included in Waldeyer’s ring, which play an important role in shaping and directing the child’s local and systemic lines of defence. Adenoid hypertrophy occurs due to a variety of factors, such as recurring or chronic infections of the upper respiratory tract. Study aim: To assess health status in children with adenoid system hypertrophy compared with a group of healthy children. Materials and methods: The study group consisted of children suffering from adenoid hypertrophy, this being the most common chronic disease of the upper respiratory tract. The control group was composed of children attending nursery school (kindergarten), primary school, middle school, and high school. The study was performed by using the Child Health Questionnaire—Parent Form 50 CHQ-PF-50 (CHQ-PF50), which is a general purpose research tool based on psychometric testing when assessing physical and mental well-being in children aged 5 to 18 years. Results: There were 101 filled out questionnaires for the test group (54 girls and 47 boys), mean age 8.62 years (ranging 5–17), whilst 102 questionnaires for the controls (50 girls and 52 boys), mean age 10.58 years (ranging 5–18). Insignificant differences were found between social functioning resulting from behaviour or emotional state (REB), pain and discomfort (BP), and family cohesion (FC). Conclusions: Children suffering from adenoid hypertrophy demonstrate the largest decreases in wellbeing in the following areas: behaviour, general perception of health, and mental health