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EN
The nasal allergen challenge (NAC) is used in the diagnosis of rhinitis. The primary use of NAC is to confirm allergy to a specific inhaled allergen. NAC reproduces the allergic reaction of the nasal mucosa under standardized and controlled conditions that occurs after direct intranasal administration of allergens. As the only used method for assessing the degree of allergy, it mimics the body’s natural response to the sensitizing factor in the early and late stages of an allergic reaction. NAC is used in the diagnosis of chronic, occupational and local rhinitis, as well as in the differential diagnosis of rhinitis and ophthalmic symptoms. Under conditions similar to natural exposure, it determines the relationship between the allergen and symptoms of allergic rhinitis, especially in the case of difficulties in interpreting the results of skin tests and the serum concentration of specific IgE. It is a truly valuable tool in determining the indications for immunotherapy and the selection of allergens for desensitization therapy. It also serves as a method of monitoring the effectiveness of immunotherapy and pharmacotherapy. For scientific purposes, NAC is used to study the mechanisms of an allergic reaction and the influence of various factors on its course. It is considered safe, but requires appropriate instruments and qualified personnel.
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Rhinitis in children

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EN
Rhinitis (RN) is inflammation of the nasal mucous membrane, manifested by impaired patency, pruritus, sneezing and the presence of secretions. Depending on the mechanism of creation of an inflammatory reaction, RN is divided into: (1) allergic rhinitis (AR) and (2) nonallergic rhinitis (NAR), and in case of their overlap, it is said to be (3) mixed (MR). The basis for the diagnosis of NN are: physical examination and interview (including ENT) and properly selected auxiliary research. The fundamental approach in RN in children is: education of patients and their parents, avoiding exposure to irritants (including allergens), nasal irrigation, air humidification and proper hydration of the child, and pharmacotherapy, and in selected cases of ARN, also allergen specific immunotherapy. The basis of pharmacotherapy in RN are intranasal glucocorticoids (dnGKS) and second-generation antihistamines, although their efficacy in NAR is lower than in AR. Due to the high incidence and adverse consequences, such as: decreased quality of life, sleep and mood disorders, deterioration in school education and relationship with other diseases, including: asthma, adenoid hypertrophy, conjunctivitis, chronic inflammation of paranasal sinuses and otitis media, RN is an important clinical problem. It is necessary to further investigate the issue to better understand this problem and to avoid its negative consequences, especially in the paediatric population.
EN
Inflammation of the paranasal sinuses is a common condition that affects the upper respiratory tract. The pathomechanism and course of sinusitis are multifaceted, depending on the etiological factors, duration of the disease, anatomical abnormalities, and additional conditions exacerbating the inflammation of the nasal mucosa and paranasal sinuses. The gold standard of diagnostic imaging is computed tomography (CT), performed in particular cases. An auxiliary examination is a magnetic resonance imaging (MRI) for soft tissue imaging when there is a suspicion of a neoplastic process. The treatment of patients with rhinosinusitis is very complex and long-lasting, associated with the use of nasal or systemic corticosteroids, irrigation with physiological saline, as well as antibiotic therapy, antihistamines or herbal supplements. The treatment is selected individually for the patient's condition or the sinus phenotype, and in exceptional cases, surgical intervention is undertaken. Work is continuing on genetic, molecular and immunological research to search for new and effective methods of treatment of rhinosinusitis.
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