Allergic and nonallergic rhinitis in schoolchildren: part II : relationship to spirometric parameters, bronchial hyperresponsiveness and biomarkers of allergic inflammation

In recent years, with the increasing prevalence of allergic rhinitis (AR), a higher incidence of nonallergic rhinitis (NAR) has been observed. Aim: The aim of the study was the comparison of pulmonary function tests and the degree of bronchial hyperresponsiveness (BHR) in children with AR and NAR, evaluation of the biomarker for clinical AR or BHR diagnosis. Material and methods: Pulmonary function tests and BHR in the exercise tests were done in 139 schoolchildren (8-14 years of age) with symptoms of non-infectious rhinitis. The analyzed biomarkers included exhaled nitric oxide (FeNO), total IgE (tIgE), serum IL-4, serum tumour necrosis factor α (TNF-α), absolute eosinophils count in blood (Eos). Positive prick tests with 10 aeroallergens identified children with AR. Results: Spirometric parameters and values of BHR were not different in AR (n = 73) and NAR (n = 66) groups. The risk of BHR was higher in children with AR than those with NAR (OR = 2.768; p = 0.051). In the logistic regression analysis, none of the analyzed biomarkers was related to BHR. Differences in the area under the ROC curve (AUC) for: tIgE and FeNO (AUC tIgE-AUC FeNO = 0.102; p = 0.042), FeNO and Eos (AUC FeNO-AUDEos = 0.07; p = 0.219), tIgE and Eos (AUC tIgE-AUC Eos = 0.172; p = 0.002) showed that measurements of tIgE level were the best diagnostic tool for AR (sensitivity = 78.9%, specificity = 79.4% for tIgE = 68 kU/l). Conclusions: There were no differences in pulmonary function test parameters between groups of children with AR and NAR. Bronchial hyperresponsiveness was more often observed in AR than in NAR. Any biomarker of allergic inflammation predicts BHR in children with rhinitis. The accuracy of diagnostic AR testing with tIgE measurement (cut-off level = 68 kU/l) was moderately good in schoolchildren

Di-μ-oxido-bis­{[(R,R)-(+)-1-amino-2-(3-methoxy-2-oxidobenzyl­ideneamino-κ2 O 2,N)-1,2-diphenyl­ethane-κN]oxidovanadium(V)} dihydrate

In the crystal structure of the title compound, [V2(C22H21N2O2)2O4]·2H2O, oxide-bridged dimers of the complex are linked to water mol­ecules by hydrogen-bonding inter­actions. The two five-membered chelate rings in the dimeric mol­ecule both adopt twist conformations. Each VV atom is six-coordinated by one oxide group and by two N and one O atom of the tridentate Schiff base ligand, and is bridged by two additional oxide atoms. The metal centre has a distorted octa­hedral coordination. The monoanionic ligands occupy one equatorial and two axial positions

Difficult asthma in children

The assessment of patients with difficult asthma comprises three major issues: 1) does the patient really have asthma, 2) is the patient compliant with prescribed therapy, and 3) are there any environmental or co-morbid factors worsening asthma

The use of computer-assisted image analysis in measuring the histological structure of the human median nerve

Background and aim: The aim of this study was to assess the histological structure of the median nerve and its motor branch (number and arrangement of nerve bundles) and the cross-sectional area (CSA) of the median nerve (on the level of the carpal tunnel). Material and methods: This study has been conducted using median nerves dissected from cadavers stored in a 10% solution of formaldehyde at the Department of Anatomy of the Jagiellonian University Medical College and cadavers from the Department of Forensic Medicine of the Jagiellonian University Medical College. After dissection the median nerves were stained with haematoxylin and eosin and histological slides were prepared. These were later photographed (16 x magnification) and analysed using ImageJ software. The research protocol was approved by the Jagiellonian University Ethics Committee (registry KBET/209/B/2002). Results: The studied group comprised 8 women and 22 men (age between 23–92 years), yielding a total of 60 median nerves (30 right vs. 30 left). In 4 (6.67%) cases an accessory motor branch was found. The mean CSA of the median nerve was 0.19 cm2. The median nerves from the right hand had a statistically larger CSA (p = 0.017). The number of nerve bundles in the median nerve varied between 13 to 38 and in the motor branch of the median nerve between 4 to 14. Conclusions: The nerve bundles of the median nerve, at the level of the carpal tunnel, display no particular type of arrangement. ImageJ software proved useful in the assessment of the histological structure of the human median nerve and its motor branc

Bronchopulmonary dysplasia - early and long-term pulmonary sequelae

Poprawa opieki perinatalnej w ostatnich latach spowodowała wzrost przeżywalności dzieci przedwcześnie urodzonych. Przerwanie prawidłowego, wewnątrzmacicznego rozwoju płuc wraz z następowym urazem, związanym z koniecznością stosowania wentylacji mechanicznej i tlenoterapii, powoduje rozwój zaburzeń określanych dysplazją oskrzelowo-płucną (BPD). W pierwszym okresie życia zasadniczym problemem tych chorych jest zależność od tlenu. Zwiększona zapadalność na infekcje o ciężkim przebiegu (zwłaszcza o etiologii RSV) jest przyczyną rehospitalizacji w ciągu 1. roku życia u około 50% wcześniaków z rozpoznaniem BPD. U takich dzieci dużym problemem staje się zwalczanie objawów obturacji dróg oddechowych, które w wielu wypadkach słabo ustępują po podaniu bronchodylatatorów. Prawdopodobnie u podłoża tego zjawiska leżą zaburzenia prawidłowego rozwoju układu oddechowego i następujący remodeling w obrębie dróg oddechowych. Nieprawidłowości w wynikach badań czynnościowych (obniżenie FEV1, PEF, FVC) utrzymują się do późnego okresu dojrzewania, a przyspieszenie tempa spadku wskaźnika FEV1/FVC z wiekiem może sugerować, że osoby te stanowią grupę ryzyka rozwoju "nowej POChP". Ocena radiogramów płuc w 11. roku życia w grupie byłych wcześniaków z rozpoznaną BPD wykazuje obecność przetrwałych zmian rozedmowych z obecnością jednego lub więcej pęcherzy u 86% dzieci. Nieprawidłowości w obrazie tomografii komputerowej wysokiej rozdzielczości stwierdza się u większości tych pacjentów (u 81,3% w grupie badanych w 10. roku życia i u 92,5% w wieku 18 lat). Dalsze prospektywne badania obejmujące wieloletnią obserwacją dzieci przedwcześnie urodzone są niezbędne dla określenia odległego rokowania i wyznaczenia standardów ich leczenia.Improvement in perinatal care have resulted in significantly increased survival of premature infants. Discontinuation of correct intrauterine lung development and a necessity of oxygen-therapy and/or mechanical ventilation become a reason of bronchopulmonary dysplasia (BPD). In the first period of life the main complaint of these patients is oxygen dependence. Moreover the risk of serious infections of lower respiratory tract (particularly RSV) increases. This becomes the reason of readmission of about 50% prematures with diagnosed BPD in the first year of life. The main problem of these patients is airway obstruction, which very often doesn’t respond to brochodilatators. The probable reason of these disturbances is imperfect development of respiratory system and remodelling of respiratory tract. Reduction in lung function (reduced FEV1, PEF, FVC) persists until adolescence. Acceleration of the decrease in FEV1/FVC ratio may suggest that these patients are a risk group of COPD development. The assessment of lung radiography at the age of 11 years of former prematures with diagnosed BPD reveals the presence of persistent emphysematic changes (86% of these children had one or more bubbles). Abnormalities in chest high resolution CT occur in the majority of these patients (in 81.3% of the 10-years-olds group and in 92.5% of 18-year-olds group). Further prospective long-term study of prematures is essential for the establishment of remote prognosis and treatment standards

Types of laryngomalacia in children : interrelationship between clinical course and comorbid conditions

The aim of this study was to: (1) find out whether laryngomalacia (LM) types are related to clinical course; (2) which patients with LM are at higher risk of other airway malacia [tracheomalacia (TM) and/or bronchomalacia (BM)]; and (3) evaluate the prevalence of LM in our region. Patients with established LM diagnosis and complete clinical and endoscopy records were enrolled. They were classified into different LM types according to classification based on the side of supraglottic obstruction. One hundred ten children were included. The most common LM appearance was type I—58 children, followed by combine types (I + II and I + III)—38. The other airway malacia were found in 47 patients: TM in 31, BM in 10, and TM with BM in 6. Other comorbidities (cardiac, neurological, and genetic disorders) were identified in 30 children. Patients with combine types of LM differ from those with single type of LM in terms of prematurity (13 vs 31 %, p = 0.04) and higher weight on the examination day (p = 0.006). Patients with other airway malacia differ from children with isolated LM in terms of prematurity (40 vs 13 %, p = 0.008), comorbidities (38 vs 19 %, p = 0.024), and lower weight on the examination day (p = 0.014). The prevalence of clinically relevant LM was one in 2600–3100 newborns. Clinical course of LM cannot be anticipated on the basis of solely endoscopic evaluation of the larynx. Comorbidities and prematurity increase the risk of other airway malacia. The prevalence of LM is relatively high in the middle-south part of Poland

Pulmonary function tests leading to the diagnosis of vascular malformations in school-aged children

Vascular rings are congenital defects of great vessels. They cause compression of the trachea or/and the esophagus and therefore result in symptoms like inspiratory stridor, cough, wheezing, recurrent respiratory tract infections or dysphagia. In some cases, the correct diagnosis can be delayed for many years, especially when vascular rings produce less severe symptoms or symptoms mimicking other diseases (most of all asthma). In this article, we would like to emphasis the usefulness of pulmonary function test (spirometry) in the initial diagnosis of vascular rings in school-aged children, as well as the importance of spirometry in evaluating patients with asthma presumption

Development of parents' of Children with Hymenoptera Venom Allergy Quality of Life Scale (PoCHVAQoLS)

Introduction: Venom allergy in children, as a potentially life-threatening disease, may have a considerable impact on the quality of life of the parents of the affected patients. Aim: To present development of the quality of life scale for such parents. Material and methods: The study sample included 70 parents of children with a history of insect sting reaction, referred for consultations to the allergy centre of the University Children's Hospital of Krakow, Krakow, Poland, in 2000-2010. An initial pool of 56 items divided into 6 domains was prepared. The items with intercorrelations higher than 0.7 were removed from each domain and principal component analysis was conducted for each domain separately to provide a one-dimensional subscale for each domain. Reliability of the subscales was assessed using the Cronbach a coefficient in terms of the Classical Test Theory and with the rho coefficient in terms of the Item Response Theory. The multidimensionality of the scale was tested using multitrait scaling. Results: Two to four items from each domain were selected to constitute five subscales. Both the rho and a coefficients for all the subscales were 0.75 or higher. The multitrait method showed that almost all the items indicated stronger correlations with their own subscale than with other subscales. Correlations between subscales were lower than 0.5. Conclusions: The presented scale consists of high validity and reliability subscales measuring the quality of life of parents of Hymenoptera venom allergic children. As their quality of life is strongly related to the health of their children, such information may be helpful in everyday clinical practice