Allergic Rhinitis and Adenoidal Hypertrophy

Background: Allergic rhinits is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air. The underlying mechanism involves IgE antibodies that attach to an allergen, and subsequently result in the release of inflammatory chemicals such as histamine from mast cells. It is triggered by environmental allergens such as pollen, pet, hair, dust or mold. Inherited genetics and environmental exposures contribute to the development of allergies. Signs and symptoms of allergic rhinitis are runny or stuffy nose and it can affect sleep and normal daily functions. Adenoidal hypertrphy is the unusual growth of the adenoid (pharyngeal tonsil) that causes an obstruction of the nasal airways. Adenoids start to get sizable during the first year of life and reach maximal volume in the age group of 5-6 years. Just how big the adenoids become is quite variable among individual children. Objective: To determine the relationship between adenoid hypertrophy and allergic rhinits in children. Methods: Retrospective study of clinical studies for adenoid hypertrophy in children with allergic rhinitis. Results: Some authors found that patients with allergic rhinitis have larger adenoidal tissue, but most of them found a reverse clinical picture with possible interpretation that severe anterior nasal obstruction, mainly caused by allergy, affects the passage of allergens able to stimulate adenoid tissue to enlarge. Infections may also play a more important role in the absence of allergy. Conclusion: In children with allergic rhinitis, we should not only look for adenoidal hypertrophi. ENT doctor must pay attention to the anterior nasal obstruction by inferior turbinate hypertrophy

Prisutnost bakterije helicobacter pylori u želucu i sluznici grkljana kod bolesnika s karcinomom grkljana

Helicobacter (H.) pylori is the cause of one of the most common chronic bacterial infections in humans. Risk factors for the development of laryngeal cancer are cigarette smoke, alcohol, and human papillomavirus. Several papers report on H. pylori isolated in tooth plaque, saliva, middle ear and sinuses. Many articles describe the presence of H. pylori in laryngeal cancer cases, however, without noting the possible source of infection, i.e. stomach or oral cavity. The aim of this study was to determine which patients and to what extent simultaneously developed H. pylori colonization in the stomach and the larynx. Prospective examinations were performed in 51 patients with laryngeal squamous cell carcinoma. The study group included patients with laryngeal squamous cell carcinoma histopathologically confirmed by two independent pathologists. The patients underwent fiber esophagogastroduodenoscopy with tumor tissue biopsy. Laryngeal and gastric biopsies were examined by histologic staining technique for histopathologic detection of H. pylori and with DNA analyses using the standardized fluorescent ABI Helicobacter plus-minus PCR assay. Laryngeal carcinoma patients showed positive H. pylori test results simultaneously in the laryngeal and stomach areas, implying H. pylori transmission from the stomach to the laryngeal area. In addition, H. pylori positive test results along with negative H. pylori results in the stomach region were also recorded, suggesting a possible bacteria migration from the oral cavity. In conclusion, H. pylori was found in the area of laryngeal carcinoma, and its migration appeared likely to occur both upwards (from the stomach to the mouth) and downwards (from the oral cavity to the stomach).Helicobacter (H.) pylori uzročnik je jedne od najčešćih kroničnih bakterijskih infekcija u ljudskoj populaciji, prisutne u svim zemljama u svijetu. Incidencija infekcije bakterijom H. pylori teško se može izravno utvrditi, jer akutna infekcija ima vrlo malo karakterističnih simptoma ili ih uopće nema. Planocelularni karcinom je najčešći karcinom grkljana koji čini 95% svih karcinoma grkljana. U čimbenike rizika za razvoj karcinoma grkljana ubrajaju se cigaretni dim i alkohol te infekcija humanim papilomavirusima. H. pylori je dokazan kao jedan od uzročnika karcinoma grkljana, ali nigdje nije jasno opisan rezervoar te bakterije s obzirom na to da je u nekoliko članaka dokazano nepostojanje bakterije H. pylori u zdravoj sluznici grkljana. Svrha našega rada bila je ispitati istodobnu prisutnost bakterije H. pylori u karcinomu grkljana i želucu. Kod 51 bolesnika s karcinomom grkljana učinjena je ezofagogastroskopija s uzimanjem uzoraka sluznice iz antruma i korpusa želuca te iz područja karcinoma grkljana za analizu na H. pylori pomoću lančane reakcije polimeraze i patohistološkom metodom. U tkivu karcinoma grkljana dobiveni su pozitivni rezultati testova na H. pylori istodobno s pozitivnim testom na H. pylori u području želuca, što upućuje na migraciju bakterije iz želuca u područje grkljana. U određenom broju ispitanika dobiveni su pozitivni rezultati testova na H. pylori u području karcinoma grkljana s negativnim testom na H. pylori u sluznici želuca, što upućuje na moguću migraciju bakterije iz usne šupljine. Iz nalaza se može zaključiti da je H. pylori prisutan u području karcinoma grkljana te da je njegov prijenos moguć i uzlaznim i silaznim putem iz usne šupljine i želuca

Hitna traheotomija kod trahealne stenoze - prikaz slučaja

Airway management in an emergency department is the first step in critical care of an urgent patient. When orotracheal intubation is not possible due to upper airway obstruction, such an emergency is known as a ‘cannot intubate – cannot ventilate’ situation. Then, emergency tracheotomy is indicated. We present a case of a 70-year-old patient complaining of progressive dyspnea. The patient was conscious, highly tachydyspneic, and tachycardic. Loud stridor and a scar from previous tracheostomy suggested upper airway obstruction. Patient history confirmed previous partial laryngectomy and temporary tracheostomy due to laryngeal cancer 10 months before. Differential diagnosis of tracheal stenosis was set, and an ENT specialist was requested. Flexible fiberoptic laryngoscopy demonstrated a 1-mm subglottic tracheal stenosis. Emergency surgical tracheotomy below the obstruction in awake state using local anesthesia was performed to secure the airway. Early postoperative care was complicated by incipient right-sided pneumonia, which may have provoked narrowing of the existing subglottic stenosis in the first place. Tracheal stenosis is an important differential diagnosis of airway obstruction in patients with previous malignant diseases of the upper respiratory system. Emergency physicians should promptly recognize these situations based on clinical examination to secure appropriate airway management.Zbrinjavanje dišnoga puta u hitnoj službi prvi je korak u procjeni i liječenju hitnog bolesnika. Situacije u kojima orotrahealna intubacija nije moguća zbog opstrukcije gornjih dišnih putova poznate su pod nazivom ‘nemoguće intubirati – nemoguće ventilirati’ (cannot intubate – cannote ventilate). U takvim situacijama indicirana je hitna kirurška traheotomija. Autori prikazuju slučaj 70-godišnjeg bolesnika koji se žalio na progresivni osjećaj nedostatka zraka. Bolesnik je bio pri svijesti, izrazito tahidispnoičan i tahikardan. Glasan stridor i ožiljak od prethodne treaheotomije ukazali su na opstrukciju gornjih dišnih putova. Anamnestički se doznaje da je kod bolesnika prije 10 mjeseci učinjena parcijalna laringektomija i privremena traheotomija zbog karcinoma grkljana. Postavljena je dijagnoza trahealne stenoze i pozvan je specijalist otorinolaringologije. Fleksibilna fiberoptička laringoskopija pokazala je subglotičnu trahealnu stenozu promjera 1 mm. Zbog osiguranja dišnog puta učinjena je hitna kirurška traheotomija ispod mjesta opstrukcije u budnom stanju u lokalnoj anesteziji. Rani poslijeoperacijski oporavak kompliciran je početnom desnostranom upalom pluća koja je možda i izazvala suženje postojeće subglotičke stenoze. Trahealna stenoza važna je diferencijalna dijagnoza opstrukcije dišnih putova u bolesnika s prethodnim malignim bolestima gornjega dišnog sustava. Na temelju kliničkog pregleda nužno je odmah prepoznati ovakve situacije kako bi se primjereno zbrinuo dišni put

Connection between knowledge of oral hygiene and dental status of the elderly in Požeško-slavonska County

Timely visits to the dentist are extremely important for the preservation of dental health. Given the biological predisposition of teeth decay with age, it is important to act preventively in order to minimize the adverse effects of age on dental health. Aim: The aim of this study is to establish the correlation between the various factors related to oral health and dental status in older age and to examine the differences in dental status between retirement home residents and those living at home. Materials and methods: The data were collected through a survey consisting of 39 questions. The sample consisted of 110 participants located in the Požega HPP and the Home for the Elderly and Infirm in Požega, 42.7% of which were men and 57.3% women. The study used the selection criterion of persons over the age of 65. The average age in the sample was 77.35 years (SD = 7.18) ranging from 65 to 97 years of age. The data were collected in the period from January 2018 to July 2018. The participants were divided into two groups, those living in the Požega Nursing Home and those living in their own household but were hospitalized once in the Požega County Hospital. Results: The obtained results showed that participants have different dental problems that were partially related to their knowledge of oral hygiene. This paper emphasizes the importance of additional training and education for the elderly population in order to preserve and improve the quality of their dental health. Conclusion: The results of this study suggest that participants, in average, were less concerned about their dental health, which was confirmed by the small number of healthy teeth. There was a partial correlation between the knowledge about oral hygiene and the dental status of elderly people in Požega-Slavonia County, i.e. their knowledge was related only to some aspects of their dental status. According to the results obtained, it is important to organize training for the elderly about the importance of timely interventions when dental health is in question, as well as to further educate them about the harmful factors when it comes to the preservation of their dental health

Primarni limfom kože centra folikula u području lica - prikaz slučaja

Primarni limfom kože centra folikula – Primary Cutaneous Follicle Center Lymphoma (PCFCL) je kožni limfom B stanica koji primarno zahvaća kožu, bez znakova sustavne proširenosti bolesti. Godišnja incidencija je 0,3 slučaja na 100.000 ljudi i čini otprilike 10-20% svih kožnih limfoma, te je uglavnom indolentnog tipa. Najčešće je lokaliziran na glavi i u vlasištu, a klinički se očituje pojavom eritematoznih nodula ili plakova. Dijagnoza PCFCL potvrđuje se patohistološki i imunohistokemijski, te ih je ključno razlikovati od histološki sličnih sistemskih limfoma, a po postavljanju dijagnoze izrazito je bitno isključiti sistemsko širenje bolesti. Postoji više modaliteta liječenja koji uključuju lokalnu radioterapiju, kiruršku eksciziju i kemoterapiju. Najčešće ima odličnu prognozu s 5-godišnjim preživljenjem od 95%. Autori predstavljaju slučaj 74-godišnje bolesnice koja se u ORL ambulantu javila zbog eritema na koži obraza. Biopsijom je potvrđena dijagnoza primanog limfoma kože centra folikula, te smo za metodu izbora liječenja izabrali kiruršku eksciziju

LINKAGE OF KNOWLEDGE OF ORAL HYGIENE TO THE DENTAL STATUS OF THE ELDERLY IN POŽEGA-SLAVONIA COUNTY

Uvod: Pravovremeni posjeti stomatologu iznimno su važni za očuvanje dentalnog zdravlja. S obzirom na biološku predodređenost propadanja zubi s dobi, važno je djelovati preventivno kako bi se što više smanjile negativne posljedice na dentalno zdravlje. Cilj: Cilj je ovog istraživanja utvrditi povezanost različitih čimbenika vezanih uz oralno zdravlje i ponašanje s dentalnim statusom u starijoj životnoj dobi. Metode: Podatci su prikupljani putem ankete koja se sastojala od 39 pitanja. Uzorak se sastojao od 110 ispitanika od čega je 42,7 % muškaraca, a 57,3 % žena. U studiji je korišten kriterij odabira osoba starijih od 65 godina. Prosječna je dob u uzorku 77,35 godina (SD=7,18) raspona od 65 do 97 godina. Rezultati: Prosječna je dob ispitanika vezana za gubljenja zubi je 30,54 godine, a ispitanici u prosjeku imaju šest zdravih zubi. Kada je u pitanju broj zubnih mostova, više od 70 % ispitanika nema ni jedan most. 12,7 % ispitanika ima jedan most, 13,6 % ih ima dva mosta, a 0,9 % ispitanika ima pet mostova. Ni jedan ispitanik nema zubni implantat, a prosječan je broj ispuna 0,57. Prosječna je dob pri dobivanju zubne proteze 54,08 godina. Ispitanici koji češće posjećuju stomatologa te oni koji čiste zube poslije svakog obroka imaju bolji dentalni status. Zaključak: Rezultati ovog istraživanja upućuju na to da se ispitanici u prosjeku slabije brinu o svojem dentalnom zdravlju što potvrđuje mali broj zdravih zubi koje imaju. Znanje o oralnoj higijeni utječe na dentalni status starijih osoba. Potrebno je je organizirati edukacije o važnosti pravovremenih intervencija u području dentalnog zdravlja u ranijoj životnoj dobi kako bi dentalni status osoba starije životne dobi bio bolji.Introduction: Timely visits to the dentist are extremely important for the preservation of dental health. Given the biological predisposition of teeth decay with age, it is important to act preventively in order to minimize the adverse effects of age on dental health. Aim: The aim of this study is to establish the correlation between the various factors related to oral health and dental status in older age. Methods: The data were collected through a survey consisting of 39 questions. The sample consisted of 110 respondents 42.7% of which were men and 57.3% women. The study used the selection criterion of persons over the age of 65. The average age in the sample was 77.35 years (SD = 7.18) ranging from 65 to 97 years of age. Results: Average age of examinees related to teeth loss is 30,54 years old while examinees are having six healthy teeth in the average. Regarding teeth bridges, more than 70% of examinees are having none of bridge. 12,7% examinees are having one bridge, 13,6% of examinees are having two bridges and 0,9% five bridges. None of examinees have tooth implant, with average number of dental fillings: 0,57. Average age at which examinees are getting dentures is 54,08 years. Examinees who are visiting dentist more often just as those who are cleaning their teeth after each and every meal are showing better dental case. Conclusion: results of this exploration are insinuating low dental care at the examinees; confirmed by low number of healthy teeth. Knowledge of oral hygiene influences dental case of older persons. It is necessary to organize educations concerned about importance of prompt interventions on level of dental health in earlier life stages with purpose of improving dental case in later life ages

Prikaz rijetkog slučaja hamartoma larinksa

Hamartoma (from the Greek language, where hamartia means defect or an error and -oma denoting a tumor or neoplasm) is a benign tumor-like mass composed of mature tissue or cells that are present in abnormal proportions or show a disorganized arrangement. Hamartomas are rarely seen in the head and neck area and especially rare in the larynx. Only few cases of laryngeal hamartoma have been reported in the literature so far. They are usually manifested by stridor, dysphonia and symptoms associated with airway obstruction. The diagnosis must be confirmed histologically and the method of choice in treatment is complete excision of the lesion. The authors present a case of laryngeal hamartoma of a 43-year-old woman treated for hoarseness and paralysis of the left vocal cord.Hamartom (iz grčkog hamartia, što znači greška, defekt i -oma, označava tumor ili neoplazmu) je benigna masa izgledom slična tumoru, sastavljena od zrelih tkiva ili stanica koje pokazuju poremećaj proporcija ili se pojavljuju u neorganiziranom rasporedu. Hamartomi rijetko zahvaćaju područje glave i vrata, a još rjeđe ih pronalazimo u području larinksa. Dosad je u literaturi opisano samo nekoliko slučajeva laringealnih hamartoma. Najčešće se manifestiraju stridorom, disfonijom te simptomima vezanim uz opstrukciju dišnih putova. Dijagnoza se postavlja patohistološki, a metoda izbora u liječenju je potpuna ekscizija lezije. Autori prikazuju slučaj laringealnog hamartoma u 43-godišnje žene obrađivane zbog promuklosti i pareze lijeve glasnice

The Correlation between Iron Deficiency and Recurrent Aphthous Stomatitis: A Literature Review

Aphthous lesions of the oral mucosa are a very common symptom and can be seen in both family medicine practice, dental medicine practice, and dermatology or otorhinolaryngology clinics. Some patients develop a chronic recurrent condition, which is clinically known as recurrent aphthous stomatitis (RAS). These ulcers are round, clearly defined, and can be visible on the movable part of the oral mucosa, with variations in size. A prodromal symptom like the burning or stinging sensation can precede the appearance of lesions. The main reason why patients seek medical help is oropharyngeal pain with lack of appetite. The exact etiopathogenesis of RAS remains unknown. Immune disorders, nutritional deficiencies, allergies, mechanical injuries, and even psychological disorders are being studied as potential causes of this condition. Some authors claim that iron deficiency may be a possible causative factor of RAS due to its role in DNA synthesis, mitochondrial function, and enzymatic activity. In iron deficiency, epithelial cells turn over more rapidly and produce an immature or atrophic mucosa. Such mucosa is vulnerable and can be a fertile soil for chronic inflammation and development of aphthae. Finally, our goals were to describe the clinical aspects and etiology of RAS, as well as to determine whether RAS may be related to iron deficiency, in order to identify potential patients with iron deficiency in everyday work