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Split, Croatia

Allergic rhinitis (AR) is the most common allergic disorder and its prevalence is still increasing. Before using the ARIA guidelines, about one third of patients with moderately severe / severe symptoms despite therapy had severe symptoms. The ARIA guidelines defi ne AR as an infl ammatory disease. Treatment of AR implies accurate assessment of disease severity, and any relationship of AR and asthma should be evaluated. Intranasal corticosteroids (ICS) are the most eff ective drugs in the treatment of AR with minimal risk of systemic side eff ects. ICS can be the fi rst treatment option in all forms of AR because they treat all the symptoms of AR.

Vrabec-Branica B.,Klinicki bolnicki centar Zagreb | Smojver-Jezek S.,Klinicki bolnicki centar Zagreb | Stancic-Rokotov D.,Klinika za torakalnu kirurgiju Jordanovac | Branica S.,Klinika za bolesti uha
Medica Jadertina | Year: 2011

The aim of this study was to investigate the role of imprint cytology as a diagnostic tool, either alone or combined with histopathology, of oesophageal biopsy specimens. A two - year study of endoscopic cytology and histopathology was carried out on 86 patients suspected of having a malignant oesophageal lesion. Patients were biopsied on one to three locations and imprint cytology preparation was made for each biopsy specimen and then sent to histopathology. In 76 of 86 patients (88.3%) cytology and histopathology diagnosis were the same: 31 (36.0%) were negative and 45 (57.0%) were positive. Of 45 positive patients, a false-negative histopathology diagnosis was given in only four patients. Repeated biopsy confirmed the first positive cytology diagnosis. In one cytology positive and histopathology negative patient, carcinoma was diagnosed on surgical pathology. Of 50 histopathology positive patients, 45 were cytology positive, 3 were cytology suspected and 2 had severe cytology atypia. In tumor types evaluation, cytology and histopathology diagnosis were the same in 39 of 45 positive patients (86.6%): 24 were squamous cell carcinomas, 11 were adenocarcinomas while 4 were only carcinomas. Imprint cytology demonstrated high diagnostic accuracy in the diagnosis of malignant oesophageal tumors. Cytology and histopathology showed high correlation (96%) in the diagnosis of histologic type of squamous cell carcinoma. The cytology and histopathology techniques remain complementary and both should be utilized for maximum diagnostic efficiency. Positive cytology and negative histopathology diagnosis require repeated biopsy.

Roje Z.,Klinika za bolesti uha | Racic G.,Klinika za bolesti uha
Medicus | Year: 2011

Oral allergy syndrome was recognized as a separate entity in 1987. It is a part of the pollen-food syndrome which develops in patients with seasonal allergic rhinitis as a result of cross reactivity between pollen antigens and food proteins from fruits, vegetables and spices. Antigens related to oral allergy syndrome are generally thermolabile and degradable by digestive enzymes. The following symptoms may occur in the upper digestive tract (mouth, oral cavity and oropharynx): tingling, itching or burning sensation of lips, mouth and throat, and edema of the lips, tongue, soft palate and oropharynx. Symptoms occur immediately after implicated food consumption. Systemic symptoms are very rare. A positive history of typical symptoms after eating typical plant food and concomitant history of seasonal allergic rhinitis are essential for the diagnosis of oral allergy syndrome. Management includes avoidance of certain fruits and vegetables. Cooking can be helpful as well. Antihistamines can alleviate symptoms. The role of specific immunotherapy with pollen antigens remains controversial.

Roje Z.,Klinika za bolesti uha | Selimovic M.,Ustanova za hitnu medicinsku pomoc | Omero L.,Klinika za bolesti uha
Medicus | Year: 2011

Allergic rhinitis (AR) is a global health problem and one of the main reasons for visiting a family medicine physician. The effects of rhinitis symptoms on the quality of life define this disease as a public-health problem. All AR aspects are defined in ARIA guidelines (Allergic Rhinitis and its Impact on Asthma-ARIA). AR is a symptomatic disorder of the nose induced by an immunoglobulin E (IgE)-mediated inflammation following allergen exposure. Symptoms include rhinorrhea, nasal itching and sneezing, and nasal obstruction. In 40-70% of patients ocular symptoms (eye redness and itching, increased lacrimation) can occur as well. Diagnosis is not hard to establish on the basis of a patient's medical history, especially if symptoms occur seasonally. It can be confirmed by skin-prick test. Other diagnostic procedures are suggested only in individual cases. In more than 90% of patients a good disease control can be achieved by an appropriate therapy choice. According to ARIA guidelines, treatment depends on the type and severity of AR, and it is conducted on four levels: patient education, allergen avoidance, pharmacotherapy and immunotherapy. The results of alternative therapies are still controversial.

Klancnik M.,Klinika za bolesti uha | Grgec M.,Klinika za bolesti uha | Lozic B.,Klinika Za Djecje Bolesti | Sunara D.,Klinika za bolesti uha
Paediatria Croatica | Year: 2016

Otitis media with effusion (OME) is a common disease in children with a prevalence of up to 20% and great impact on conductive hearing loss, delayed speech development and destruction of middle ear mucosa lining. The aim of the study was to evaluate the association of allergy and persistent OME in children. Seventy-six children aged 2 to 14 years diagnosed with OME were included in the study. Control group included 76 age-matched healthy children attending pediatric surgical unit for different pediatric surgical procedures other than ENT surgery. Fifty-eight (76.3%) OME children had positive history of allergic rhinitis and 45 (59.2%) had positive results of intradermal skin tests. Total IgE levels were elevated in 46 (60.5%) children and specific IgE levels were elevated in 39 (51.3%) children in OME group. In control group, 12 (15.8) children had positive history of allergic rhinitis and only 10 (13.2%) had positive results of intradermal skin tests. Total IgE levels were elevated in 17 (22.4%) children and specific IgE levels were elevated in 9 (11.8%) control group children. This study showed the prevalence of allergic history to be higher in children with OME as compared with control group. The prevalence of positive results of different allergy tests was also higher in the OME group as compared with control group.

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