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.

The impact of hypertonic saline inhalation on mucociliary clearance and nasal nitric oxide.

Nitric oxide (NO) has an influence on airway physiology by mediation in ciliary activity, inflammation, host defence, bronchial tone, and pulmonary vascular resistance. However, the clinical relevance of the measurement of nasal NO (nNO) in different physiological and pathological conditions has yet to be established before it can be used as a diagnostic tool. The aim of our study was to establish the relation between nNO and mucociliary clearance (MCC) and the impact of hypertonic saline inhalation on these markers. We examined 43 subjects. nNO was measured in the right (RnNO) and left (LnNO) nostrils before and after inhalation of hypertonic saline (HS) using a NIOX® analyser. MCC was measured before and after inhalation of HS by saccharin test. The levels of nNO before inhalation of HS (RnNO 806 ppb, IQR-337.6; LnNO 854 ppb, IQR 295.8) were significantly lower than levels after inhalation (RnNO 841.8 ppb, IQR 342.3; LnNO 897.4 ppb, IQR 304.1) (p<0.05, Wilcoxon T-test). The difference between RnNO and LnNO before and after inhalation of HS was not statistically significant. However, the difference in MCC before inhalation (507 s, IQR 233) and after inhalation of aerosol (360 s, IQR 238) was statistically significant (p<0.0001, Wilcoxon T-test). We did not confirm a correlation between nNO and MCC. An increase in osmolarity of the airway surface increases MCC and nNO, which could help to clear accumulated secretions in the airways and prevent respiratory tract infections.

Tobacco control and the role of the medical community in the Slovak Republic.

The Slovak Republic (SR) is located in central Europe and has a population of about 5.4 million. Epidemiological data indicate that trends in smoking prevalence and incidence of lung cancer have not shown any tendency to decrease in the SR. Surveys of Martin residents and of medical students at Comenius University provided important data on many aspects of cigarette smoking and tobacco dependence and served as a basis for planning and implementing focused tobacco control activities at the regional and national levels. The activities were focused not only on the Slovak public but also the medical community. With assistance from international organizations, Slovak doctors are learning to take direct responsibility for treatment and prevention and also a public responsibility to influence governmental policies. As a result, tobacco control activities in the SR enjoy collaboration between different agencies, community participation and personal involvement of health professionals.

[Immunologic indicators in ascites]. / Imunologické ukazovatele v ascitoch.

The authors investigated specific and non-specific immunological parameters in malignant, cirrhotic, cardial and nephrogenic ascites. At the same time bacteriological and cytological examinations of ascites were made. In the submitted paper the authors compare, using statistical methods, immunological parameters of ascites in different patient groups and pay attention to their relationship with positive bacteriological and cytological findings in ascites. The authors recorded the largest number of positive bacteriological cultivation in cirrhotic and malignant ascites which correlates with lower values of some non-specific immunological parameters in ascites.