Exacerbations of chronic rhinosinusitis : microbiology and perspectives of phage therapy

The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis (ABRS), as our understanding of its microbiology is insufficient to establish specific treatment recommendations. Unfortunately, antibiotics frequently fail to control the symptoms of AECRS due to biofilm formation, disruption of the natural microbiota, and arising antibiotic resistance. These issues can potentially be addressed by phage therapy. In this study, the endoscopically-guided cultures were postoperatively obtained from 50 patients in order to explore the microbiology of AECRS, evaluate options for antibiotic treatment, and, most importantly, assess a possibility of efficient phage therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Haemophilus influenzae, Pseudomonas aeruginosa, and Enterobacteriaceae. Alarmingly, mechanisms of antibiotic resistance were detected in the isolates from 46% of the patients. Bacteria not sensitive to amoxicillin were carried by 28% of the patients. The lowest rates of resistance were noted for fluoroquinolones and aminoglycosides. Fortunately, 60% of the patients carried bacterial strains that were sensitive to bacteriophages from the Biophage Pharma collection and 81% of the antibiotic-resistant strains turned out to be sensitive to bacteriophages. The results showed that microbiology of AECRS is distinct from ABRS and amoxicillin should not be the antibiotic of first choice. Currently available bacteriophages could be used instead of antibiotics or as an adjunct to antibiotics in the majority of patients with AECRS

Ścieżki rozwoju egzaminu gimnazjalnego

Artykuł z numeru 2/2012 internetowego czasopisma edukacyjnego ORE "Trendy

Objawy otolaryngologiczne u chorych leczonych z powodu chorób przenoszonych przez kleszcze

Wstęp: Choroby przenoszone przez kleszcze stały się w ciągu kilkunastu ostatnich lat bardzo poważnym problemem. Najbardziej rozpowszechnionymi są borelioza oraz kleszczowe zapalenie mózgu (KZM). W ostatnim czasie znacząco rośnie również liczba zakażeń patogenami z rodzaju Bartonella, Babesia, Anaplasma, Brucella i in. Podobieństwo objawów chorób odkleszczowych do objawów innych chorób jest poważnym wyzwaniem diagnostycznym. Materiały i metody: Badaniem objęto grupę 216 chorych w wieku 18–55 lat, zgłaszających się na wizytę w poradni otolaryngologicznej z powodu chorób odkleszczowych w latach 2014–2016. Chorzy mieli zdiagnozowaną boreliozę i koinfekcje, a głównymi testami potwierdzającymi obecność tych chorób były testy: ELISA, Western-Blot oraz badanie KKI (krążące kompleksy immunologiczne). Wyniki: Spośród 216 chorych wyodrębniono grupę 162 pacjentów manifestujących objawy otolaryngologiczne. Głównym objawem zgłaszanym przez pacjentów były uciążliwe szumy uszne (76,5%) – w przeważającej mierze wysokoczęstotliwościowe, zawroty głowy i zaburzenia równowagi (53,7%), bóle głowy (39%), niedosłuch odbiorczy jednostronny (16,7%). Wśród badanych oprócz boreliozy zaobserwowano również obecność innych chorób odkleszczowych. Najliczniejszą grupę stanowili pacjenci zakażeni bakteriami z rodzaju Bartonella henselae (33,4%) oraz Bartonella quintana (13%). Dyskusja: Objawy otolaryngologiczne są częstą manifestacją chorób przenoszonych przez kleszcze. Najczęściej występują w przebiegu boreliozy oraz zakażeń bakteriami z rodzaju Bartonella spp. Objawy ze strony narządów głowy i szyi najczęściej występują w przebiegu przewlekłego procesu chorobowego. Świadczy o tym zdecydowana przewaga przeciwciał IgG i antygenu VlsE w grupie badanych chorych

Analysis of voice modifications for persons after tonsillectomy

The goal of the research described in the present paper was the determination of modification range for voice acoustic parameters resulting from tonsillectomy. Within the scope of the described research program, an attempt has been made to determine the changes of selected voice parameters for persons after such a treatment and also to elaborate work out some premises for prediction of potential voice modifications for persons who have not yet decided to undergo such a treatment. In order to achieve the goal, analyses have been carried out for voice utterances of persons before the tonsillectomy surgery and after the treatment. The first voice recordings took place between one and three days before the surgery. The post-treatment recordings have been carried out about 6 weeks after the surgery, as a procedure accompanying the follow-up examinations. In the present paper, an analysis has been carried out concerning phonemes /a/, /e/, /i/, and /u/ with prolonged phonation. The completed research shows that for evaluation of voice modification in the aspect of changes resulting from tonsillectomy, the most useful parameters are some of the mel-cepstral coefficients, the formant frequencies, and also the relative power coefficients

Cat scratch disease : an underestimated diagnosis

Introduction: Cat scratch disease is a rare and frequently underestimated cause of lymphadenopathy, which may occur also in the head and neck. The infection is most commonly caused by intracellular bacilli Bartonella, transmitted by domestic animals. Aim: We present a case report of a patient treated in the Department of Otolaryngology UJ CM in Krakow. The patient presented with a neck tumor. Due to unclear clinical manifestation he underwent surgical treatment. The postoperative histopathological examination suggested cat scratch disease. In detailed anamnesis the patient admitted contact with cats and dogs in his household. No posoperative complications were observed. Conclusions: In every case of neck tumor it is advisable to consider cat scratch disease, remembering that exclusion of a neoplastic process remains a priority

Endoscopic treatment of giant skull base osteomas

Introduction: Osteomas are relatively common, benign, slow-growing neoplasms. Mainly occurring in frontal and ethmoid sinuses. Endoscopic surgery plays an important role in management of ethmoid, sphenoid and frontal osteomas. Aim: We discuss our experiences in endoscopic treatment of giant osteomas. Results: In giant osteomas Draf III or Lothrop approaches are prefered. Periostium of the orbit was intact in all cases. Discharge of cerebrospinal liquid was not observed. Conclusions: Size of tumor determines type of surgical aprroach. Endoscopic surgery is more and more popular way in surgical treatment of giant osteomas