Itch and Cough - Similar Role of Sensory Nerves in Their Pathogenesis.

Itch is the most common chief complaint in patients visiting dermatology clinics and is analogous to cough and also sneeze of the lower and upper respiratory tract, all three of which are host actions trying to clear noxious stimuli. The pathomechanisms of these symptoms are not completely determined. The itch can originate from a variety of etiologies. Itch originates following the activation of peripheral sensory nerve endings following damage or exposure to inflammatory mediators. More than one sensory nerve subtype is thought to subservepruriceptive itch which includes both unmyelinated C-fibers and thinly myelinated Adelta nerve fibers. There are a lot of mediators capable of stimulating these afferent nerves leading to itch. Cough and itch pathways are mediated by small-diameter sensory fibers. These cough and itch sensory fibers release neuropeptides upon activation, which leads to inflammation of the nerves. The inflammation is involved in the development of chronic conditions of itch and cough. The aim of this review is to point out the role of sensory nerves in the pathogenesis of cough and itching. The common aspects of itch and cough could lead to new thoughts and perspectives in both fields.

[Pharmacotherapy of chronic obstructive pulmonary disease in patients with indications for long-term home oxygen therapy]. / Farmakoterapia chronickej obstrukcnej choroby plúc u pacientov indikovaných na dlhodobú domácu liecbu kyslíkom.

The authors submit a cross-sectional analysis of out-patient pharmacotherapy of chronic obstructive lung disease in 138 patients where long-term home oxygen therapy was indicated. To this group of patients no inhalatory bronchodilatating drugs were administered in 19.6% of the patients! The authors provide evidence of a non-significant better survival of patients who used inhalatory bronchodilatating drugs. From the mentioned group during the follow up period 41 (29.7%) died with a mean survival of 16.5 +/- 11.9 (0-39) months. Based on the mentioned results the authors draw attention to the relatively late indication of long-term home oxygen therapy and also to the fact that pharmacotherapy of patients with chronic obstructive lung disease indicated for long-term home oxygen therapy is not fully exploited and its optimalization could lead to better patient survival.

[Potential predictors of therapeutic response in patients with cryptogenic fibrosing alveolitis]. / Potenciálne prediktory liecebnej odpovede u pacientov s kryptogénnou fibrotizujúcou alveolitídou.

The authors present a clinical observation with the objective to test which objective indicators make it possible to predict the effect of treatment in patients with cryptogenic fibrotizing alveolitis. Retrospective analysis of the documentation of a longitudinal follow up of 34 patients with this diagnosis revealed that the presence of fibroproliferative changes on the high resolution CT image predicts significantly the absence of a therapeutic effect and conversely the absence of such changes predisposes for significant improvement of pulmonary functions during treatment. They found also a significant correlation between he ratio of lymphocytes in the bronchoalveolar lavage fluid and the dynamics of the development of pulmonary functions. The age of establishment of the diagnosis correlates also significantly with indicators of the therapeutic response. Based on these results the authors conclude that a favourable therapeutic effect can be expected in patients without fibroproliferative changes, with a significant lymphopcytosis in the bronchoalveolar lavage fluid and a younger age at the time of manifestation. On the other hand, in patients with a marked fibroproliferation and absence of alveolitis there is no point in attempting to influence the disease by pharmacological gents.

[The sleep apnea syndrome in the Slovak Republic]. / Syndróm spánkového apnoe v Slovenskej republike.

Sleep related breathing disorders represent life threatening disorders for cardiovascular and neuropsychiatric complications. Sleep apnea syndrome is evaluated in Slovak Republic since 1990. Four sleep laboratories are established with polysomnography ALICE 3. 628 investigations together were realized till March 31, 2000. Except diagnostic and therapeutic area our interest is focused on cardiovascular complications. Ventilatory treatment of patients with sleep apnea syndrome is insufficiently provided by health insurance companies.