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EN
Objective. A tropism to epithelial cells and lymphocytes, an inhibition of apoptosis in host cells, an ability to occurrence in persistent form resistant to antibiotic treatment are the features of Chlamydia pneumoniae, which can have connection with chronic inflammation of an adenoid tissue and adenoid hypertrophy. This study aimed to (1) detect the C. pneumoniae in an adenoid in children undergoing adenoidectomy, (2) estimate a connection between C. pneumoniae occurrence and the size of adenoid, (3) demonstration in which of adenoid cells C. pneumoniae occurs most often. Material and methods. The examined group consisted of 200 children aged from 2 to 16 years (mean age 6,4) undergoing adenoidectomy. In all children during qualification for adenoidectomy a fiberoscopic examination of the nasopharynx was performed. A part of removed adenoid tissue was analysed by real-time PCR for C. pneumoniae. Adenoids from children with positive PCR examination and from 10 children with negative PCR examination were examined using immunohistochemistry (IHC). Results. C. pneumoniae in the adenoid was present in 5,5% children. Positive results were obtained most frequently (24,14%, 7/29) in the eldest group (10-16 years). A statistical analysis demonstrated the correlation between C. pneumoniae occurrence in an adenoid tissue and the size of adenoid. In immunohistochemistry C. pneumoniae was found the most frequently in lymphocytes and in epithelial cells. Conclusions. A presence of C. pneumoniae in lymphocytes and epithelial cells of the adenoid first of all in older children with adenoid hypertrophy confirms the participation of this bacteria in adenoid pathology.
EN
Objective. A tropism to epithelial cells and lymphocytes, an inhibition of apoptosis in host cells, an ability to occurrence in persistent form resistant to antibiotic treatment are the features of Chlamydia pneumoniae, which can have connection with chronic inflammation of an adenoid tissue and adenoid hypertrophy. This study aimed to (1) detect the C. pneumoniae in an adenoid in children undergoing adenoidectomy, (2) estimate a connection between C. pneumoniae occurrence and the size of adenoid, (3) demonstration in which of adenoid cells C. pneumoniae occurs most often. Material and methods. The examined group consisted of 200 children aged from 2 to 16 years (mean age 6,4) undergoing adenoidectomy. In all children during qualification for adenoidectomy a fiberoscopic examination of the nasopharynx was performed. A part of removed adenoid tissue was analysed by real-time PCR for C. pneumoniae. Adenoids from children with positive PCR examination and from 10 children with negative PCR examination were examined using immunohistochemistry (IHC). Results. C. pneumoniae in the adenoid was present in 5,5% children. Positive results were obtained most frequently (24,14%, 7/29) in the eldest group (10-16 years). A statistical analysis demonstrated the correlation between C. pneumoniae occurrence in an adenoid tissue and the size of adenoid. In immunohistochemistry C. pneumoniae was found the most frequently in lymphocytes and in epithelial cells. Conclusions. A presence of C. pneumoniae in lymphocytes and epithelial cells of the adenoid first of all in older children with adenoid hypertrophy confirms the participation of this bacteria in adenoid pathology.
EN
Pediatric rhinosinusitis in children is defined as a presence of two or more symptoms with one of them either being nasal blockage or nasal discharge and headache/facial pain or cough. Chronic rhinosinusitis (CRS) is recognized when the four most common symptoms such as cough, rhinorrhea, nasal congestion and post-nasal drip with a slightly higher predominance of chronic cough are present for over 12 weeks and influence the quality of life. CRS should be considered in respect of unique conditions due to the differences in predisposing factors (immunological and others) as well as the anatomy of the sinuses between children and adults. Adenoids are a prominent contributor to CRS in young children, both from bacteriologic and immunologic status. Older children suffer from CRS in the same manner as adults. During evaluation of a child with CRS symptoms , one should always consider the possibility of an underlying disease as a contributing factor. Diseases impacting sinuses and nasal function include CF, primary ciliary dyskinesia (PCD) and a variety of normal immune deficiencies, including the still-developing immature immunity of healthy young children. Surgical intervention for rhinosinusitis is usually considered for patients with CRS who have failed maximal pharmacological treatment. There are two important consensus statements for pediatric chronic sinusitis (CRS): European Position papers on Rhinosinusitis and Nasal Polyps - EPOS 2012 and Clinical Consensus Statement: Pediatric Chronic Sinusitis American Academy Otolaryngology-Head Neck Surgery 2014. Both of them contain necessary information and recommendations for diagnosis and treatment of CRS in children.
EN
We investigated children aged 2-5, who had gone adenoidectomy for recurrent and/or persistent symptoms of upper respiratory tract infections for prevalence of pneumococci in adenoid tissue. Serotypes and antibiotic resistance patterns of the isolated pneumococci were determined and also risk factors of pneumococcal colonization were defined. S. pneumoniae colonization in adenoids was found in 62 (60.2%) children. Serotypes belonged to 10-valent and 13-valent pneumococcal conjugated vaccines (PCVs) constituted 56.1% and 68.2% of the isolates, respectively. Decreased susceptibility to penicillin was found in 45.5% of isolates; pneumococci were resistant to co-trimoxazole (62.1%), tetracycline (43.9%), erythromycin (54.5%), clindamycin (54.5%) and chloramphenicol (31.8%). Multidrug resistant S. pneumoniae comprised 57.6% of the isolates. Antibiotic resistant pneumococci were mostly distributed among serotypes belonged to 10-valent and 13-valent PCVs. Good vaccine coverage among the isolated pneumococci confirmed that the introduction of PCVs in the national immunization programme may reduce the pool of resistant and multidrug resistant pneumococci in a community.
PL
Migdałek gardłowy wchodząc w skład obwodowych narządów limfatycznych jest miejscem pierwszego kontaktu z antygenami, docierającymi drogą oddechową i pokarmową. Migdałek gardłowy zawiera komórki aktywne immunologiczne niezbędne do odpowiedzi immunologicznej komórkowej oraz humoralnej. Komórki te zajmują trzy główne przedziały limfoidalne: limfonabłonek, grudkowe ośrodki rozmnażania wraz ze strefą osłonową tych ośrodków oraz przestrzeń międzygrudkowa. Wysiękowe zapalenie ucha środkowego (OME) jest częstą chorobą ucha środkowego występującą u dzieci. Jednak etiologia tej choroby nie jest do końca poznana. Reakcje immunologiczna toczące się w obrębie migdałka gardłowego, udział cytokin prozapalnych typu Th1 i Th2, limfocytów T i B oraz metaloproteinaz może prowadzić do przewlekłego zakażenia w obrębie ucha środkowego u dzieci.
EN
Adenoid is lymphoid tissues in the pharynx that play an important role in host defense against invading antigens. The structures of adenoid consist of well-defined microcompartments which all participate in the immune response: the lymphoepithelium, the follicular germinal center, the mantle zone, the interfollicular area. Otitis media with effusion (OME) is a common middle ear disease in children, but etiology of this disease is not clearly understood. Immunologic reaction within adenoid, pro-inflammatory cytokines (Th1 and Th2), decrease of lymphocytes T and B, metaloproteinase may lead to chronic infection.
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