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The dynamics of pollen seasons of the most allergenic plants - 15-year observations in Warsaw

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Lipiec A., Rapiejko P., Furmańczyk K., Jurkiewicz D.
Polish Journal of Otolaryngology
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2018
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vol. 72
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issue 6
44-53
EN
Introduction: Allergic rhinitis concerns nearly 25% of the Polish population. Among pollen allergens, the most common reasons for allergic rhinitis are: grass, birch and mugwort. Knowledge of the characteristics of pollen seasons is necessary in diagnostics, monitoring of therapy and prevention of allergic rhinitis. Purpose: This work aims to analyze pollen seasons of the most allergenic plants in the Polish population; grass, birch and mugwort in the years 2003–2017 in Warsaw. Material and methods: Measurements of pollen concentration were carried out using Burkard volumetric spore trap operating in continuous mode. Analysis of pollen seasons was conducted based on the following characteristics: beginning, end, and length of season, the seasonal pollen index (SPI), defined as the sum of average daily pollen concentrations over the year, maximum daily concentration, number of days with maximum and threshold concentration. Linear regression together with the Pearson correlation coefficient were used in statistical analysis to study the relationship between variables; furthermore, descriptive characteristics of distributions studied were determined. Results: The average beginning of the birch pollen season in the analyzed period is April 10th, and it belongs to seasons of medium length (47 days on average). Birch pollen count above 75 grains/m3, when most allergic people develop symptoms, was recorded for an average of 18 days. The highest daily birch pollen count reaching 6321 grains/m3 (2012) exceeded the lowest value of the maximum concentration by almost 20 times (2015). Among the taxa analyzed, the highest values of daily counts and annual sums were recorded for birch pollen. The average date for the beginning of grass pollination season is on May 13th. It is the longest pollen season (on average 134 days), and the period when concentration exceeded 50 grains/m3 covered an average of 26 days. The highest daily grass pollen counts reaching
496 grains/m3 (2007) exceeded the lowest value of maximum concentration by 3.5 times (2016). The average date of the beginning of mugwort pollen season is July 16th. The season lasts 65 days on average, when concentration exceeding 30 grains /m3 was registered for an average of 12 days. The highest daily mugwort pollen count reaching 154 grains/m3 (2007) exceeded the lowest value of maximum concentration by 4 times (2013). For all analyzed taxa, the strongest correlated variables are the sum of average daily pollen concentrations over the year (SPI ) and daily maximum concentration (correlation for birch pollen = 0.92, for grass pollen = 0.88, and for mugwort pollen = 0.91). Conclusions: Periods of pollen in the air show certain variation in the analyzed 15-year period. The maximum concentration in the pollen season for the analyzed taxa and the the sum of average daily pollen concentrations over the year show the highest variability, particularly strongly expressed in the case of birch pollen. There is a linear relationship between the sum of average daily pollen concentrations over the year and the maximum concentration value as well as the number of days with the threshold concentration for all analyzed taxa. Variability of parameters describing the dynamics of pollen seasons indicates the need to monitor, both by patients with hay fever and physicians, the current information on the concentration of pollen in the air during the pollen season.
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Sterydoterapia donosowa – EPOS 2020

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Rot P., Rapiejko P., Jurkiewicz D.
Polish Journal of Otolaryngology
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2020
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vol. 74
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issue 3
41-49
PL
Wprowadzenie: Donosowe glikokortykosteroidy (dnGKS), z uwagi na swoje silne, wielokierunkowe działanie przeciwzapalne, są podstawą leczenia zapaleń błony śluzowej nosa i zatok przynosowych – zarówno ostrego zapalenia zatok przynosowych, przewlekłego zapalenia zatok przynosowych, przewlekłego zapalenia zatok przynosowych z polipami nosa, jak i alergicznego nieżytu błony śluzowej nosa. Nowoczesny dnGKS – furoinian mometazonu, ze względu na wysokie bezpieczeństwo ogólnoustrojowe i miejscowe oraz wysoką skuteczność przeciwzapalną, w 2019 r. został dopuszczony w Polsce do sprzedaży bez przepisu lekarza dla chorych z rozpoznanym alergicznym nieżytem nosa. Rekomendacje towarzystw naukowych oraz grup ekspertów zalecają stosowanie dnGKS w znacznie szerszym zakresie wskazań. W lutym 2020 r. w czasopiśmie „Rhinology” ukazała się nowelizacja konsensusu EPOS 2020 (European Position Paper on Rhinosinusitis and Nasal Polyps 2020). Cel: Autorzy przedstawiają miejsce dnGKS w schematach leczenia zapaleń zatok przynosowych, opublikowanych w dokumencie EPOS 2020, z uwzględnieniem realiów specyficznych dla Polski.
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Intranasal steroid therapy – EPOS 2020

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Rot P., Rapiejko P., Jurkiewicz D.
Polish Journal of Otolaryngology
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2020
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vol. 74
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issue 3
41-49
EN
Introduction: Due to their strong, multidirectional anti-inflammatory activity, intranasal glucocorticoids are the mainstay of treatment in rhinosinusitis, including acute rhinosinusitis, chronic rhinosinusitis, and chronic rhinosinusitis with nasal polyps, as well as allergic rhinitis. Owing to its high systemic safety and high anti-inflammatory efficacy, mometasone furoate – a new-generation intranasal glucocorticoid – was approved in 2019 as an over-the-counter (OTC) medication for Polish patients diagnosed with allergic rhinitis. Scientific societies and expert groups recommend the use of intranasal glucocorticoids in a much broader range of indications. In February 2020, an updated version of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020) was published. Aim: This article discusses the role of nasal glucocorticoids in regimens used in the treatment of nasal sinusitis as published in EPOS 2020 with Polish country-specific realities being taken into account.
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Biologicals in the treatment of chronic rhinosinusitis with nasal polyps – position of the Polish Society of Otorhinolaryngologists – Head and Neck Surgeons and the Polish Society of Allergology experts

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Jurkiewicz D., Kupczyk M., Brożek-Mądry E., Rapiejko P.
Polish Journal of Otolaryngology
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2023
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vol. 77
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issue 2
1-11
PL
Przewlekłe zapalenie błony śluzowej nosa i zatok przynosowych z polipami nosa (PZZPzPN) wywiera duży wpływ na samopoczucie i funkcje społeczne chorego. Uogólniony proces zapalny przebiegający z powstawaniem polipów nosa i nadmiarem eozynofilów w obrębie błony śluzowej zatok przynosowych to zapalenie typu 2., w którym pośredniczą limfocyty Th2 – komórki układu immunologicznego, odpowiadające za przewlekłe procesy zapalne. Dziś znamy też kluczowe mediatory prozapalne, przeciwko którym powstały nowe leki, tzw. leki biologiczne, wytwarzane w liniach komórkowych. W dokumencie przedstawiamy dostępne, w obecnej chwili, leczenie biologiczne zatwierdzone do leczenia pacjentów z T2 – zależnym przewlekłym zapaleniem zatok przynosowych.
EN
Chronic rhinosinusitis with nasal polyps (CRSwNP) has a significant impact on the well-being and social functions of the patient. The generalized inflammatory process with the formation of nasal polyps and excess eosinophils in the mucosa of the paranasal sinuses is called type 2 inflammation, which is mediated by Th2 lymphocytes – cells of the immune system responsible for chronic inflammatory processes. Today, we also know the key pro-inflammatory mediators against which new drugs have been developed, the so-called biological drugs, are produced in cell lines. In this document, we present currently available biologicals approved for the treatment of patients with T2-related chronic rhinosinusitis.
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Rola czynników psychologicznych w patogenezie zaburzeń głosu spowodowanych guzkami głosowymi

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Ratajczak J., Grzywacz K., Wojdas A., Rapiejko P., Jurkiewicz D.
Polish Journal of Otolaryngology
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2008
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vol. 62
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issue 6
758-763
EN
Introduction. Hoarseness is most frequent complaint notified by ill in phoniatric outpatient clinics. Looking of causes notified of disturbances of voice often we ascertain in larynx existence of vocal nodules. Changes these come into being in consequence of excessive or irregular phonations. Single incident of disturbances of voice caused with oedema changes nascent of in consequence of inappropriate work with voice does not wake of our trouble, instead returns this of type of complaint provoke to other researches coexisting of etiological factors this diseases. Aim. Estimation of influence of individual personality trait of ill on formation of vocal nodules. Material and methods. One examined 20 patients with vocal nodules classified to treatments operating and 20 without disturbances of voice. All patients were subjected to otolaryngological and stroboscopic examinations. Character created of voice one examined at help of scale GRBAS, instead influence of disturbances of voice on quality of life ill at help of test VHI. Psychological examinations one executed using questionnaire State-Trait-Anxiety-Inventory( STAI), questionnaire NEO-FFI and questionnaire of aggression Buss-Perry. Results. Obtained results showed, that persons with returning vocal nodules, both during of research as in different situations everyday lives characterizes with higher level of fear and have greater inclination to worry oneself. Ill from groups examined in greater degree are extroverts, show greater activity and more are contagious socially in comparison to persons of comparative group. Attitude this in situations extorting rivalry will be able to be ruthless, are well organized guided, scrupulous and consistently endeavour to aim. Conclusions. Wanting efficiently to treat persons with returning vocal nodules we should subject to ill psychological examination and in once of ascertainment of irregularity to correct it, what at simultaneous correct treatment of organic changes should diminish frequency or to eliminate returns of disease. Skill psychological looks on patient by therapists treating disturbances of voice and speeches in case not large emotional instabilities probably would be able to improve results of treatment ill not only with functional disturbances of voice but also with disturbances of voice caused with organic changes in larynx.
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Strategia leczenia ANN w obliczu zagrożeń współczesnego świata

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Rapiejko P., Jurkiewicz D., Pietruszewska W., Zielnik-Jurkiewicz B., Woroń J., Lipiec A.
Polish Journal of Otolaryngology
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2018
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vol. 72
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issue 2
1-12
PL
Alergiczny nieżyt nosa (ANN) jest najczęstszą postacią alergii, która dotyczy – jak wykazały badania epidemiologiczne – prawie 25% populacji. ANN wpływa znacząco na jakość życia chorego, a im cięższa postać choroby, tym większe ryzyko rozwoju astmy oskrzelowej. Jednym z czynników wpływających na nasilenie objawów i stopień ich kontroli jest zanieczyszczenie powietrza. U niektórych chorych, mimo właściwego leczenia, obserwuje się utrzymywanie lub tylko częściowe ustąpienie dolegliwości (niekontrolowany alergiczny nieżyt nosa). Może prowadzić to do nasilenia chorób towarzyszących – zapalenia zatok przynosowych, zapalenia ucha środkowego i astmy – zarówno u dzieci, jak i u dorosłych. Postępowanie w alergicznym nieżycie nosa, zgodnie ze standardami, polega na: edukacji chorego, eliminacji z otoczenia alergenu i czynników nasilających przebieg choroby, dobraniu właściwej farmakoterapii oraz swoistej immunoterapii alergenowej. Na wybór stosowanego leku przeciwhistaminowego wpływa wiele czynników, m.in. możliwość bezpiecznego zwiększenia jego dawki.
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Drug-induced diseases in otolaryngology – causes, clinical signs, treatment

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Woroń J., Jurkiewicz D., Rapiejko P., Lorkowska- Zawicka B., Tymiński R., Wordliczek J.
Polish Journal of Otolaryngology
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2021
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vol. 75
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issue 5
9-15
EN
Introduction: In the daily practice of an otolaryngologist, we encounter cases where the symptoms are not the result of disease but result from pharmacotherapy. In the case of symptoms such as hearing loss, tinnitus, or dizziness, polytherapy may be used as the basis for their occurrence, which, due to the lack of rationality in combining drugs, leads to symptoms that the patient and the doctor very often interpret as a new disease syndrome. Aim: The aim of the study is to show and to raise awareness of the fact that the symptoms of hearing organ impairment are frequently drug-related and only a modification of the currently used pharmacotherapy is a rational procedure in such cases. Material: This paper describes 30 cases who developed side effects of polypharmacy in the form of hearing disorders, dizziness, and tinnitus. The causes of drug-related complications were discussed, as well as effective methods of their prevention.
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Treatment strategy of allergic rhinitis in the face of modern world threats

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Rapiejko P., Jurkiewicz D., Pietruszewska W., Zielnik-Jurkiewicz B., Woroń J., Lipiec A.
Polish Journal of Otolaryngology
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2018
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vol. 72
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issue 2
1-12
EN
Allergic rhinitis (AR) is the most common form of allergy, which - as epidemiological research has shown - applies to nearly 25% of the population. AR significantly affects the quality of life of the patient, and the more severe the disease, the greater the risk of developing bronchial asthma. One of the factors affecting the severity of symptoms and the degree of their control is air pollution. In some patients, despite proper treatment, persistence or only partial remission of symptoms (uncontrolled allergic rhinitis) is observed. This can lead to an increase in comorbidities - inflammation of the paranasal sinuses, otitis media and asthma - both in children and in adults. The treatment of allergic rhinitis, in accordance with the standards, consists in: education of the patient, elimination of the allergen from the environment and factors intensifying the course of the disease, selection of proper pharmacotherapy and specific allergen immunotherapy. Many factors influence the selection of the antihistamine used, e.g., the opportunity of safe increase of the dosage.
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