Expression of contact allergy in undergoing prosthodontic therapy patients with oral diseases.

AIM: Contact allergy is a postponed reaction of hypersensitivity where a localised cutaneous or mucosal lesion occurs due to a recurrent contact with an allergen. Placement of a fixed or removable prosthetic replacement into the oral cavity causes corrosive processes on the surface of the restoration and discharge of ions, which as haptens can induce allergic reactions. The purpose of this study was to examine occurrence of allergies to basic and auxiliary restorative dental materials in patients with lichen, stomatitis and stomatopyrosis by means of an epicutaneous allergy test. METHODS: The study included 32 patients with a fixed and/or removable replacement and 7 patients with one of the mentioned diagnoses, but without any replacement. Testing was conducted using a standard method (patch test), and hypersensitivity to 13 most common allergens in prosthodontics was examined. RESULTS: The research results revealed higher frequency of positive allergic reactions in persons with the mentioned diseases and with a restoration. Patients with lichen indicated positive patch test in the majority of cases. The allergens of nickel, cobalt and chromium demonstrated the highest score of positive results, and negative score was found for dibutylphthalate and HH mix. Stomatopyrosis was more common in persons with hypersensitivity to chromium. A lower incidence of positive allergic reactions to epoxide resins was found in female than in male subjects. CONCLUSIONS: The epicutaneous (patch) test performed in the subjects examined in this study, showed that the majority of positive reactions was caused by mixes of nickel, cobalt and chromium; however, unwanted reactions also to other auxiliary materials used in dental practice should also be considered.

Perception of ecological factors in asthmatic and coronary patients.

The aim of the study was to determine whether an examined group of asthmatic patients differ significantly from a control group of coronary patients with regard to perception of two groups of etiological factors and their interaction: a) ecological factors, and b) habits and behavior of the patients. The study included 100 patients with bronchial asthma and 102 with coronary disease. A questionnaire was used to obtain data on ecological factors in the living environment of the patients and information on habits and behavior. The questionnaire was structured according to the specific needs of the study, and as a starting point known, calibrated, psychometric scales were used. Asthmatic and coronary patients did not differ with regard to their place of residence, i.e. the same number lived in the town and village, in similar ecological environments, and they also did not differ with regard to life style and habits. The study indicated statistically significant differences between asthmatic and coronary patients in their perception of several ecological and other risk factors. The asthmatic patients significantly more frequently perceived harmful ecological factors in their environment and regarded them significant for the occurrence of their disease. The coronary patients perceived their unhealthy habits and behavior as the causal factors of their disease.

Clinical validation of bronchial hyperresponsiveness, allergy tests and lung function in the diagnosis of asthma in persons with dyspnea.

The aim of the study was to determine the most useful tests for decision making in the diagnosis of asthma in patients with dyspnea assessed by commonly used terms: sensitivity, specificity, positive and negative predictive values and diagnostic accuracy. In a group of 195 patients with dyspnea data were analyzed with respect to case histories and different diagnostic procedures: bronchial hyperresponsiveness (BHR), skin prick tests (SPT), total IgE, spirometry (FEV1), sputum eosinophils (SE) and blood eosinophilia (BE). Asthma was diagnosed in 141 subjects. The control group comprised 18 subjects. Sensitivity for BHR in asthma in subjects with dyspnea amounted to 97%, for SPT to 62%, while all other diagnostics were lower than 50%. Specificity was highest for SE (94%), and BHR (85%). Positive predictive value (PPV) in asthma was for BHR 94%, for SE 86%, for SPT 81%, for decreased FEV1 79%, total IgE 72% and BE 64%. The highest negative predictive value (NPV) was found for BHR (92%). Diagnostic accuracy was highest for BHR 93% and for SPT 62%, while all other tests were comparable or lower than 50%. It is not possible to conclude whether or not a person has asthma merely on the basis of data on skin sensitization to aeroallergens, total IgE, eosinophils or lung function tests. Bronchial hyperresponsiveness showed the highest values for sensitivity (97%), PPV (94%), NPV (92%) and accuracy (93%). The second most efficient test is the skin prick test, with PPV 81% and diagnostic accuracy 62%.

[Hodgkin's lymphoma of the lungs]. / Hodgkinov limfom pluca.

A case of the patient with Hodgkin's lung lymphoma, who ten years ago was treated because of having Hodgkin's lymphoma of the mediastinum and neck, is reported in this paper. This time, the patient has been admitted to the hospital due to the pulmonary infiltration in the left upper lobe. As the etiology of the pulmonary infiltration could not be established by a routine diagnostic procedure (sputum cytology, catheter bronchial aspirate smears, bronchial brushing, excision of the bronchial mucosa, transtracheal and transbronchial aspiration), the transthoracic fine needle aspiration was performed to confirm the diagnosis. Cytologically, beside erythrocytes, the cells of the bronchial epithelium, eosinophilic granulocytes and lymphocytes, the cells of the Reed-Sternberg cell type were found in the transthoracic aspirate smears too.