Influence of Allergy and Bacterial Colonization on the Quality of Life in Nasal Polyposis Patients

Allergies and bacterial colonization are frequently found in patients with chronic rhinosinuitis with nasal polyposis (CRSwNP). The aim of this study was to identify patients with allergy and present microorganisms in ethmoid sinus among the patients with refractory CRSwNP undergoing surgical treatment at the University Hospital Centre Osijek, and to compare their life quality, defined by SNOT-20 analysis (sinonasal outcome test) to the rest of patients, and a con- trol group consisting of patients undergoing septoplasty but free of allergy and/or CRS. An additional aim was to iden- tify specific types and strains of microorganisms (bacteria and fungi) found in these patients, in order to compare them to other reports, and to revise the empirical antimicrobial therapy. In this paper we demonstrate a high incidence of bacte- rial colonization (83.3%) among CRSwNP patients. As in previous studies, gram positive aerobes were the most fre- quently isolated bacteria and all of them were covered by specific antibiotics given before the specimen collection. Allergy was found in only 20% of these patients, who presented with a reduced quality of life when compared to the control group and CRSwNP without allergy. Significantly more frequent dominant symptoms in these patients were cough, frustration and irritation. In the line with this finding is the objective assessment by endoscopy (Malm score) that showed more prominent nasal polyposis in allergy patients

Open Approach Rhinoplasty

The aim of this study was to present the advantages and disadvantages of open approach in rhinoplasty. In it, we also present the development of this technique in Croatia and examine its application in the last five years at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Hospital Centre Osijek. Retrospectively, from January 2008 to August 2012, 400 patients with septal deviation and/or deformities of the nasal pyramid who underwent open rhinoplasty at the Department of Otorhinolaryngology, Head and Neck Surgery of the Clinical Hospital Centre of Osijek, Croatia were identified. The clinical diagnosis was based on a detailed medical history of the patient and nasal endoscopy. The patients were photographed in six projections before and after the surgery, and followed up on two occasions. (Bogović V, Milanković SG, Zubčić Ž, Včeva A, Mihalj M, Maleš J, Kotromanović Ž, Grebenar M, Mendeš T, Mihalj H. Open Approach in Rhinoplasty. SEEMEDJ 2019; 3(2); 56-62

The Effect of Dietary Intake of Omega-3 Polyunsaturated Fatty Acids on Cardiovascular Health: Revealing Potentials of Functional Food

Functional food is a food containing components that show beneficial effects on one or more body functions and improve general condition and health or significantly affect lowering of disease risks. This chapter is aimed to examine the effect of dietary intake of omega‐3 polyunsaturated fatty acids (n3‐PUFA) on cardiovascular health. This chapter presents current knowledge on functional poultry products and the reasons to consume them, omega‐3 enrichment of eggs and poultry meat, and the differences in profile of fatty acids in conventional and omega‐3–enriched eggs. The second part of the chapter focuses on the metabolism of fatty acids and effectiveness of n‐3 PUFA in the improvement of endothelial function, improvement of elasticity of the vascular wall and the anti‐inflammatory effects in patients with chronic diseases, such as metabolic syndrome, diabetes mellitus and hypercholesterolemia, and overall effect on cardiovascular health and protection. To achieve long‐term protective effects, the functional food should be consumed on daily basis. There are no specific constrains in taking functional food; even more, it can be recommended to athletes and cardiovascular patients. General population can also benefit from eating functional food enriched with n‐3 PUFA due to their anti‐inflammatory and vascular‐protective effects

Laryngopharyngeal reflux is not gastroesophageal reflux

Laringofarinksni refluks (LPR) i gastroezofagusni refluks (GER) dva su različita klinička entiteta, dvije različite bolesti koje se razlikuju po simptomima, kliničkim manifestacijama, mehanizmu nastanka refluksa, različitim dijagnostičkim kriterijima i terapijskom pristupu. Osnovni simptomi LPR-a su ovi: promuklost, kronično čišćenje grla, postnazalni drip, teškoće gutanja, suhi kašalj, teškoće s disanjem, a samo 6 do 11% bolesnika ima žgaravicu, podrigivanje, pečenje iza prsne kosti i osjećaj vraćanja želučanoga sadržaja u grlo. Osnovni su klinički znakovi LPR-a: pseudosulkus vokalis, ventrikularna obliteracija, eritem u grkljanu, edem glasnica, difuzni laringalni edem, hipertrofija stražnje komisure, granulomi/granulacije, gusti endolaringalni mukus. Dijagnoza se temelji na kombinaciji kliničkih simptoma i znakova bolesti, 24-satnoj pH-metriji, višekanalnoj intraluminalnoj impedanciji i detekciji pepsina u slini. U terapiji se primjenjuju inhibitori protonske pumpe u dvokratnoj dozi.Laryngopharyngeal refux and gastroesophageal reflux are two different clinical entities, two different diseases which differ in symptoms, clinical manifestations, mechanism of reflux, diagnostic criteria and therapeutic schedules. Main symptoms of LPR are hoarseness, clearing of throat, postnasal drip, swallowing difficulties, coughing, breathing difficulties and in only 6 to 11 % of patients heartburn, chest pain, indigestion or stomach acid coming up. Main clinical signs of LPR are: pseudosulcus vocalis, ventricular obliteration, erythema/hyperemia, vocal fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulations and thin endolaryngeal mucus. The diagnosis is usually based on a combination of diagnostic signs and symptoms, 24-hour pH-metry, multichannel intraluminal impedance and pepsin in saliva. In therapy proton pump inhibitors are being applied twice a day

Mechanisms of HBO-Induced Vascular Functional Changes in Diabetic Animal Models

The mechanisms by which HBO exerts its potentially beneficial effects are not completely clear. Interactions of mechanisms affecting endothelial dysfunction, NO synthesis, EETs and HETE formation, CYP expression changes, oxidative stress and antioxidant defense system changes, and multiple effects on inflammation take place that might be considered as mediating factors for the observed positive (or negative) clinical effects in diabetes mellitus (for instance in chronic diabetic wounds). Studies on vasculature in diabetic animal models can provide us with more information that can help us understand its effects on blood vessel function. This chapter discusses the most relevant studies that have assessed the potential mechanisms of HBO-induced vascular functional changes in diabetic animal models

Kikuchi-Fujimoto Disease: the First Reported Case in Croatia

Kikuchi-Fujimoto disease (KFD) is an extremely rare disease known to have a worldwide distribution with higher prevalence among Japanese and other Asiatic individuals. KFD presents as benign and self-limited disorder, characterized by regional cervical lymphadenopathy with tenderness, usually accompanied with mild to high fever and night sweats. Less frequent symptoms include weight loss, nausea, vomiting and sore throat. Final diagnosis can only be determined on the basis of typical morphological changes in the lymph node, therefore lymph node biopsy is crucial for proving the diagnosis. Here we present a 16-year-old, native Croatian, aucasian girl with KFD, as a first case of KFD reported in Croatia. We suggest that this disease should be considered as a possible cause of fever of the unknown origin followed by lymphadenopathy

Leukocyte Activation and Antioxidative Defense Are Interrelated and Moderately Modified by n-3 Polyunsaturated Fatty Acid-Enriched Eggs Consumption—Double-Blind Controlled Randomized Clinical Study

This placebo-controlled, double-blind, randomized, interventional study investigated the effects of low/intermediate doses of n-3 polyunsaturated fatty acids (PUFAs) on the endothelial function, markers of leukocyte activation, and oxidative status following dietary intake of n-3 PUFA-enriched hen eggs in young healthy individuals. Twenty young healthy adults of both sexes who consumed n-3 PUFA- enriched hen eggs (two eggs per day, for three weeks, total of approximately 407 mg/day n-3 PUFAs) or regular eggs (two eggs per day for three weeks, total of approximately 75 mg/day n-3 PUFAs) participated in this study. Skin microvascular endothelium-independent and endothelium-dependent vasodilation were assessed by laser Doppler flowmetry. Serum lipid profile and content of free fatty acids, markers of leukocyte activation, biochemical parameters of oxidative stress, as well as antioxidative enzymes serum activity were measured before and after respective dietary protocol. The results of this study revealed significant differences in the markers of leukocyte activation (such as CD11a/LFA-1) and antioxidative defense, which are related to increased intake of n-3 PUFAs, providing the evidence that consumption of nutritionally enriched hen eggs may affect physiological processes related to oxidative balance. The absence of significant changes in microvascular reactivity following supplementation with a low-intermediate dose of n-3 PUFAs, unlike in our previous studies where functional eggs contained ~1 g of n-3 PUFA, suggests the existence of a dose-dependent effect

PROPHYLAXIS OF MIGRAINE – A REVIEW OF LITERATURE

Cilj ovog prikaza literature je procijeniti mogućnosti profi lakse migrene. Prema preporukama International Headache Society (IHS) profi laksa migrene provodi se u bolesnika koji imaju ≥4 dana migrensku glavobolju na mjesec bilo da se radi o epizodičnoj ili kroničnoj migreni. Učinkovitim liječenjem smatra se smanjenje učestalosti migrenskih ataka za ≥50 %. Učinkovitima su se pokazali β-blokatori, kalcijski antagonisti, antiepileptici kao što su topiramat i valproat kao i gabapentin i pregabalin, te fl unarizin i antidepresivi. Učinkovitost levatiracetama, cervikalne miofascijalne anestezije te kožne elektrostimulacije i muskularne stimulacije još je u ispitivanju. Dvojben je učinak botulinum toksina. Istražuje se moguća primjena histamina, zatvaranje foramena ovale te primjena akupunkture, supraorbitalne i vagalne nervne stimulacije te transkranijske magnetske stimulacije. Istražuje se utjecaj kateholamina i melatonina te kontraceptiva, ribofl avina, dekstrometorfi na u nastanku migrenskih glavobolja. Potrebna je adekvatna procjena mogućih učinaka u profi laksi primjenom probiotika, koenzima Q10 i magnezija. Klinička istraživanja su pokazala da primjena humanih monoklonskih protutijela erenumaba, fremanezumaba i galkanezumaba pokazuju statistički značajnu učinkovitost (≥50 % učinkovitosti) u profi laksi migrene što je potrebno potvrditi u kliničkoj praksi.This literature review is aimed at assessing the possibilities of migraine prophylaxis. The International Headache Society (IHS) recommends performing migraine prophylaxis in patients suffering ≥4 migraine headaches per month, either episodic or chronic. The treatment is deemed successful when the migraine attacks are decreased by ≥50%. Effi ciency has been demonstrated for β-blockers, calcium antagonists, antiepileptics such as topiramate and valproate, as well as gabapentin, pregabalin, fl unarizine and antidepressants. The effi ciency of levetiracetam, cervical myofascial anesthesia, skin electrostimulation and muscular stimulation is still being tested. The effects of botulinum toxin are dubious. There is ongoing research of the possibility of using histamines, closing foramen ovale, acupuncture, supraorbital and vagal nerve stimulation and transcranial magnetic stimulation. Effects of catecholamine, melatonin, contraceptives, ribofl avin, dextromethorphan and melatonin in persisting migraine headaches are being researched as well. Required is an appropriate assessment of the possible effects of probiotics, coenzyme q10 and magnesium in migraine prophylaxis. Clinical researches have shown the use of human monoclonal antibodies erenumab, fremanezumab and galcanezumab to demonstrate a statistically signifi cant effi ciency (≥50%) in migraine prophylaxis, yet requiring further confi rmation in clinical practice

PROPHYLAXIS OF MIGRAINE – A REVIEW OF LITERATURE

Cilj ovog prikaza literature je procijeniti mogućnosti profi lakse migrene. Prema preporukama International Headache Society (IHS) profi laksa migrene provodi se u bolesnika koji imaju ≥4 dana migrensku glavobolju na mjesec bilo da se radi o epizodičnoj ili kroničnoj migreni. Učinkovitim liječenjem smatra se smanjenje učestalosti migrenskih ataka za ≥50 %. Učinkovitima su se pokazali β-blokatori, kalcijski antagonisti, antiepileptici kao što su topiramat i valproat kao i gabapentin i pregabalin, te fl unarizin i antidepresivi. Učinkovitost levatiracetama, cervikalne miofascijalne anestezije te kožne elektrostimulacije i muskularne stimulacije još je u ispitivanju. Dvojben je učinak botulinum toksina. Istražuje se moguća primjena histamina, zatvaranje foramena ovale te primjena akupunkture, supraorbitalne i vagalne nervne stimulacije te transkranijske magnetske stimulacije. Istražuje se utjecaj kateholamina i melatonina te kontraceptiva, ribofl avina, dekstrometorfi na u nastanku migrenskih glavobolja. Potrebna je adekvatna procjena mogućih učinaka u profi laksi primjenom probiotika, koenzima Q10 i magnezija. Klinička istraživanja su pokazala da primjena humanih monoklonskih protutijela erenumaba, fremanezumaba i galkanezumaba pokazuju statistički značajnu učinkovitost (≥50 % učinkovitosti) u profi laksi migrene što je potrebno potvrditi u kliničkoj praksi.This literature review is aimed at assessing the possibilities of migraine prophylaxis. The International Headache Society (IHS) recommends performing migraine prophylaxis in patients suffering ≥4 migraine headaches per month, either episodic or chronic. The treatment is deemed successful when the migraine attacks are decreased by ≥50%. Effi ciency has been demonstrated for β-blockers, calcium antagonists, antiepileptics such as topiramate and valproate, as well as gabapentin, pregabalin, fl unarizine and antidepressants. The effi ciency of levetiracetam, cervical myofascial anesthesia, skin electrostimulation and muscular stimulation is still being tested. The effects of botulinum toxin are dubious. There is ongoing research of the possibility of using histamines, closing foramen ovale, acupuncture, supraorbital and vagal nerve stimulation and transcranial magnetic stimulation. Effects of catecholamine, melatonin, contraceptives, ribofl avin, dextromethorphan and melatonin in persisting migraine headaches are being researched as well. Required is an appropriate assessment of the possible effects of probiotics, coenzyme q10 and magnesium in migraine prophylaxis. Clinical researches have shown the use of human monoclonal antibodies erenumab, fremanezumab and galcanezumab to demonstrate a statistically signifi cant effi ciency (≥50%) in migraine prophylaxis, yet requiring further confi rmation in clinical practice