Molecular mechanisms of glucocorticoids action: implications for treatment of rhinosinusitis and nasal polyposis

Intra-nasal glucocorticoids are the most effective drugs available for rhinosinusitis and nasal polyposis treatment. Their effectiveness depends on many factors and not all of them have been well recognized so far. The authors present the basic information on molecular mechanisms of glucocorticoid action, direct and indirect effects of glucocorticoids on transcription of genes encoding inflammatory mediators. They focus on recently proved nongenomic mechanisms which appear quickly, from several seconds to minutes after glucocorticoid administration and discuss clinical implications resulting from this knowledge. Discovery of nongenomic glucocorticoid actions allows for better use of these drugs in clinical practice

Computerized rhinomanometry: a study of total nasal resistance normal values

Computerized rhinomanomatry with the practical software programmes is used widely as a research tool to evaluate objectively nasal air flow and resistance parametres, while the increase of its clinical application may be facilitated by further standardization of the method. The aim of the study was to determine the total nasal resistance normal values in healthy adult population using a method of computerized rhinomanometry. A randomized sample of 108 white healthy adults (216 nasal cavities), both sexs with a mean age of 32 (20- 45) years comprised the test group. Nasal patency was measured by active anterior rhinomanometry in non-decongested mucosa ("at rest") during 10 repetitive measurements at inspiratory and expiratory reference pressure of 150 Pa. Nasal resistance was measured and calculated accoding to the recommendations of the Committee on objective assessment of the nasal airway, International Rhinologic Society. 1,2 The mean total nasal resistance in the sample was found to be 0.179 Pa/cm 3 /s with the confidant interval from 0,167 to 0,191 Pa/cm 3 /s at the probability level of 95%. Total nasal resistance was very significantly influenced by sex (t =- 4.614), height (F=11.625) and weight (F=11.529) of the examinees. This paper provides additional information on total nasal resistance normal values in healthy adult population important for computirezed rhinomanometry normative parameters standardization

/PRIKAZ SLU^AJA UDK 616.211-003.6-089 DOI:10.2298/ACI0804113D

Overlooked nasal foreign body with a 48-year laten

Characteristics of chronic obstructive pulmonary disease patients with depressive disorder

© 2017, Serbia Medical Society. All rights reserved. Introduction/Objective The origin of depressive disorder in chronic obstructive pulmonary disease (COPD) patients is still not completely known and probably is caused by various factors. The aim of this study is to establish the most important characteristics of COPD patients who have depressive disorder. Methods Eighty-nine COPD patients and 65 demographically-matched referents without COPD were included. All the patients underwent lung function examination, and gas exchange, nutritional status, dyspnoea level by the modified Medical Research Council (mMRC) scale and exercise tolerance were also assessed, as well as depressive disorder by Hospital Anxiety and Depression Scale (HADS) and Geriatrics Depression Scale (GDS) and quality of life by St. George’s Respiratory Questionnaire (SGRQ). Results Depressive disorder has been found in 30.3% of COPD patients evaluated by HADS and 25.3% of COPD patients evaluated by GDS. When COPD subjects were stratified by forced expiratory volume in 1 second (FEV1) categorization, all subgroups were more likely to have depressive disorder, according to HADS and GDS, relative to referents with the odds ratio highest (3: 95% confidence interval 1.6–4.9) among those with the FEV1 < 30%. COPD patients with depressive disorder (HADS) compared to non-depressed patients had (differences in mean values) higher intensity of smoking [6.9 (0.5–10.1)], lower body mass index [-4.9 (-7.2–5.4)], lower value of FEV1% [-8.3 (-16.3–1.2)], higher value of total lung capacity (%) [17.8 (2.3–28.4)], higher mMRC score (1.07 (-1–3.0), and higher SGRQ – giving a total score of 32.9 (24.1–40.3). Conclusion Evaluation of depressive disorder should be considered in every patient with COPD, especially in patients with greater degree of airflow limitation and lung hyperinflation, dyspnoea level and malnourished