Biomedical subjects

Henryk Mazurek

Publications and source records attributed to Henryk Mazurek.

6 recordsLinked to original sources

PubMed2006

[Nasal provocation test with lysine-aspirin in diagnosis of nonallergic rhinitis with eosinophilia].

Nonallergic rhinitis with eosinophilia is characterized by persistent nasal symptoms without allergy and by a marked eosinophil recruitment in the nasal cavities. The incidence of it is more than 15% among all types of rhinitis. A part of them is caused by nonsteroidal anti-inflammatory drugs hypersensivity. For this study 114 patients were selected on the basis of perennial rhinitis, the absence of allergy and with an eosinophil count higher than 10% of total leukocytes in nasal cytology. In all of them the nasal provocation test with lysine-aspirin was made. The clinical response was evaluated based on nasal symptoms (sneezes, itching, secretion and blockage). The nasal response was measured by acoustic rhinometry. The results of the test was positive in 19 cases, mostly in patients with nasal polyps, bronchial asthma and higher level of nasal eosinophilia (differences statistically significant). The count of nasal eosinophilia corresponded better with the decrease of nasal volume in acoustic rhinometry (r = 0,84) then with the clinical score (r = 0,52). The nasal challenge was well tolerated by almost all subjects. We conclude that the nasal challenge with lysine-aspirin is safe and can be helpful as a diagnostic test in patients with nonallergic rhinitis with eosinophilia.

Administration, Intranasal↗

PubMed2006

[The influence of medical treatment of the perennial allergic rhinitis on the adenoid size in children].

BACKGROUND: Allergic sensitization of the airways occurs not only in the mucosa of the shock organ, but also in the lymphatic stations draining these structures. The lymphatic structure closest to the nasal mucosa in humans is the adenoid. Many researches show that in part of children allergic rhinitis can be a risk factor for adenoid hypertrophy. MATERIAL AND METHODS: We examined changes in clinical symptoms score, and used acoustic rhinometry and endoscopy to evaluate the influence of three months anti-allergic treatment (topical nasal steroid and antihistaminic) on the adenoid size in children with adenoid hypertrophy. Three separate groups of children were examined. The study group consisted of 31 children with adenoid hypertrophy and perennial allergic rhinitis (interview, positive skin-prick test results, presence of sIgE in the serum and positive nasal provocation test with dust allergens). The first control group consisted of 23 atopic children hypersensitive to dust allergens (positive skin-prick test results, presence of sIgE in the serum) with adenoid hypertrophy but without signs of perennial allergic rhinitis and with negative nasal provocation test. This group was not treated. The second control group consisted of 20 non-allergic children with adenoid hypertrophy. The children were treated similar to the children from the study group. RESULTS: In children from the study group we observed the most significant decrease of clinical symptoms and endoscopic adenoid size and increase of nasopharyngeal cavity in acoustics rhinometry after the treatment. In the first control group there were almost no changes and in the second control group, the improvement concern only 25% of children. The medical treatment had however no statistical important influence on the tympanometry results in all the examined groups. CONCLUSION: Properly administered nasal glucocorticoid spray together with antihistaminic in standard doses can significantly reduce adenoidal hypertrophy and considerably eliminate airway obstructive symptoms in children with allergic rhinitis. Likely only in this children the antiallergic treatment can be a useful alternative to surgery.

Adenoids↗

PubMed2005

[Allergic tonsillitis: myth or reality].

The tonsils are part of Waldeyer's ring, the basic function of which is antibody formation; they react later against a wide variety of antigens. Allergic sensitization of the airways occurs not only in the mucosa of the afflicted organ, but also in the lymphatic stations draining these structures. The lymphatic structures closest to the nasal mucosa in humans are the adenoids and tonsils. Adenoidal, nasal, and middle ear diseases are frequent health problems in young children. Pediatric adenoidal obstruction of the nasal airway is associated with significant morbidity and is also a frequent indication for surgery. Research done with respect to Waldeyer's ring in people dealing concurrently with allergy is a seldom subject in medical literature, both Polish and world wide. The study shows that allergy and sensitivity to different kinds of allergens are risk factors for adenoid hypertrophy (AH) in children. Histopathological and immunohistochemical studies confirms that tonsil dendritic cells, macrophages, eosinophils, and mast cells are involved in and are important in allergic tonsillitis. Ig synthesis and switching also occur in the adenoid and tonsils. Early treatment of allergic diseases may help reduce the occurrence of AH. Properly administered nasal steroids and antihistamines can reduce adenoidal hypertrophy and nasal airway obstructive symptoms in atopic children.

Antibody Formation↗

PubMed2005

[The results of extra diagnostic methods in patients allergic to dust mites treated by specific immunotherapy].

BACKGROUND: In addition to allergen elimination, specific immunotherapy remains the only recognized causal treatment of allergic diseases. Nevertheless, there are no commonly accepted parameters and tests allowing for the evaluation and prediction of its efficacy. The aim of this study was to evaluate the results of readily available supplemental allergy tests and to attempt to associate those findings with the outcome of therapy for desensitized patients. METHODS: This study was conducted in a group of 22 patients receiving specific immunotherapy for perennial allergic rhinitis to dust mites. The results of skin prick tests, sIgE levels, nasal eosinophilia levels as well as specific nasal provocation tests measured by acoustic rhinometry were compared prior to desensitization and two years following the therapy. The control group comprised 17 allergic patients treated without immunotherapy. RESULTS: Apart from the confirmation of immunotherapy efficacy, a positive correlation between its results and the results of the nasal provocation test (correlation coefficient r = 0.85) were demonstrated in this study. No relationship was however found between the obtained result and the results of skin prick tests (r = 0.57) and serum sIgE levels (r = 0.59) or nasal eosinophilia (r = 0.57). The result of acoustic rhinometry corresponded well with clinical manifestations observed in nasal provocation tests. CONCLUSIONS: The specific nasal provocation test is an easy method that may be used for monitoring the efficacy of immunotherapy, and acoustic rhinometry is a good method for measuring its results.

Adult↗

PubMed2004

[Effectiveness and safety of fluticasone propionate in therapy of children suffering from asthma. Part I. Mechanisms of actions and clinical effectiveness of treatment in children with asthma].

The introduction of inhaled corticosteroids (ICS) has been a milestone in asthma therapy. According to current guidelines ICS are the first line drug in chronic anti-inflammatory therapy. The purpose of first part of this publication is to present updated knowledge on mechanisms of anti-inflammatory action as well as some pharmacokinetics and pharmacodynamics data about commonly used ICS, especially fluticasone propionate (FP) and two others: budesonide (BUD), beclomethasone dipropionate (BDP). Some differences between mentioned drugs have been found concerning systemic activity and safety of therapy. Fluticasone propionate is twice as active as the BUD and BDP. First results of therapy are seen 1-2 week after administration. Fluticasone propionate, more lipophilic than other steroids, has also high glucocorticoid receptor affinity and specificity, high topical anti-inflammatory activity and low systemic bioavailability. Systemic availability of FP depends on absorption from respiratory system. Oral bioavailability can be neglected because of almost total inactivation in liver during first pass. Fluticasone propionate has some features of dissociated steroids which means predominance of transrepression over transactivation--beneficial from safety point of view. Clinical efficacy of FP in chronic asthma therapy in children was confirmed in many studies. It significantly reduces the symptoms and exacerbations of asthma. There is a close correlation between FP use and lung function tests. The therapy with FP decreases bronchial hyperreactivity and the use of systemic steroids and rescue medication. The beneficial action of fluticasone propionate in asthma is due its anti-inflammatory properties within the airways (decreasing levels of direct and indirect markers of airways inflammations are observed).

Administration, Inhalation↗

PubMed2004

[Effectiveness and safety of fluticasone propionate in therapy of children suffering from asthma. Part II. Safety aspects of therapy with fluticasone propionate in asthmatic children].

Inhaled administration of glucocorticoid doesn't mean lack of systemic effects of drug. Bioavailability of steroid depends on oral absorption and absorption from respiratory system. In case of fluticasone propionate (FP) swallowed dose can be neglected because almost total (>99%) inactivation in liver during first pass. In second part of paper the most important safety parameters of therapy with FP are discussed, it means; influence on hypothalamic-pituitary-adrenal axis, growth and bone metabolism. Interpretation of potential side effects should differentiate between abnormal value of laboratory test and clinically important symptoms. Adrenal suppression depends on dose of FP and was found even after low dose (about 200 microg per day), but clinical value of this findings is unknown. Prolonged administration of high doses can suppress hypothalamic-pituitary-adrenal axis; exceptionally, it can induce adrenal insufficiency. Recommended doses of FP given 1 to 2 years doesn't cause growth retardation. Long term studies on influence of drug on final height are needed. FP as other inhaled corticosteroids, may transiently alter bone metabolism. Till now there are no evidences that this drug, when prescribed appropriately in standard doses for asthma control, may decrease the bone mineral density or induce osteoporosis and may increase the risk of bone fractures in asthmatic children. Effective asthma control achieved with FP therapy permits normal activity and development of asthmatic children which prevails over exceptionally noticed side effects.

Administration, Inhalation↗