Background: Frequent episodes of nasal symptoms are the usual clinical manifestations (CM) of allergic rhinitis (AR) and have a significant negative impact on health-related quality of life (HRQoL) in adolescents. The purpose of this cross-sectional study was to test the hypothesis that cytokines in nasal mucus may be associated with HRQoL in adolescents with AR. Methods: European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L), “The Adolescent Rhinoconjunctivitis Quality of Life Questionnaire” (AdolRQLQ) and the Total 4 Symptom Score (T4SS) scoring system were administered to 113 adolescents with AR, nonallergic rhinitis (NAR) and to healthy control subjects. Nasal secretions were sampled and tested for 13 cytokines using a multiplex flow cytometric bead assay. Results: The AR group had significantly lower EQ-5D-3L (0.661 ± 0.267 vs. 0.943 ± 0.088; p < 0.001) and higher AdolRQLQ total scores (2.76 ± 1.01 vs. 1.02 ± 0.10; p < 0.001) compared to the control group. The AR group had higher concentrations of IL-1β (p = 0.002), IL-6 (p = 0.031), IL-8 (p < 0.001), IL17-A (p = 0.013) and IL-18 (p = 0.014) compared to the control group, and IL-1β, IL-6, IL17-A and IL-18 were significantly (p < 0.050) increased with disease progression. Cytokines IL-1β, IL-6, as well as severe CM, were identified as significant predictors of lower HRQoL in adolescents with AR. Conclusions: This study identified IL-1β, IL-6, as well as severe CM, as predictors of lower HRQoL in adolescents with AR. However, these results should only serve as a starting point for additional confirmation research.

Introduction. Tinnitus is a perception of a sound in the ears in the absence of acoustic stimulation whose pathophysiological mechanisms have not been evaluated yet. Approximately, 1-2% of people report distress which can negatively affect their daily performance. Our study aimed to assess the incidence of anxiety in patients with tinnitus. Methods. The study was designed as a cross-sectional study. The participants were divided into two groups: a group of 73 patients with tinnitus (with two subgroups in relation to the duration of tinnitus-less than one year and more than one year) and a control group of 43 patients without tinnitus. We examined the presence of anxiety in all patients using the Burns Anxiety Inventory (BAI). The quality of life of all patients was estimated by Tinnitus Handicap Inventory (THI). Results. In the group of patients with tinnitus, 56.2% of them had mild and 24.7% moderate hearing loss, while 27.7% of respondents from control group had mild and 8.5% moderate levels of hearing impairment. THI results showed that patients with tinnitus less than 1 year had a significantly (p= 0.002) higher level of disorders in daily life, compared with the group who had tinnitus for more than 1 year. The 30.8% of respondents had minimal anxiety, 26.7% borderline anxiety, 17.5% mild anxiety, the same percentage of respondents moderate, 5% severe, while 2.5% had extreme anxiety based on BAI. Conclusion. Anxiety can be considered as potentially significant modulators of changes in brain structures observed in people with tinnitus.

Uvod. Akutni rinosinuzitisi (ARS) predstavljaju hetoregenu grupu zapaljenskihoboljenja sluzokože nosa i pneumatskih supljina u kostima lica ilobanje. Rinosinuzitis je najcesca bolest u Sjedinjenim Americkim Državama.Procenjeno je da preko 30 miliona stanovnika godisnje ambulantnoposeti lekara zbog ovog stanja, kao i da prosecno svaka sesta odrasla osobaoboli od ARS. Među svim komplikacijama ARS, preko 91% su orbitalnekomplikacije (engl. orbital complications-OC) sa prosecnom prevalencom6% i vecom incidencom kod dece u odnosu na odrasle.Prikaz bolesnika. Dvanaestogodisnji decak, u pratnji majke, je zbog naglonastalog, crvenog i bolnog otoka oba ocna kapka levog oka, bola u levomoku i povisene temperature do 38,5oC hitno upucen u otorinolaringoloskoodeljenje Univerzitetske bolnice Foca. Nakon urađene laboratorijske iCT imidžing dijagnostike, pregleda oftlamologa i stacionarnog klinickognalaza nakon 36h od ordinirane parenteralne trojne antibiotske terapije,pacijent je upucen u ustanovu tercijarnog tipa radi daljeg lecenja. Isto jesprovedeno konzervativno, tokom sest dana hospitalizacije.Zakljucak. Inicijalno lecenje orbitalnih komplikacija u decijem uzrastu jekonzervativno. Lecenje treba zapoceti empirijski, trojnom antibiotskom terapijom.Izbor antibiotika i protokoli lecenja u pedijatrijskoj populaciji josuvek nisu usaglaseni. Ali, ako nakon 36-48h od zapocetog konzervativnoglecenja klinicki odgovor izostaje, bez obzira na stadijum orbitalne komplikacije,hirusko lecenje je apsolutno indikovano.

Introduction. Acute rhinosinusitis (ARS) encompasses a heterogeneous group of inflammatory disorders affecting nasal mucosa and paranasal sinuses. Rhinosinusitis is the most common condition in the United States. It is estimated that over 30 million people annually visit the doctor due to this condition, while every sixth adult suffers from ARS. Among all ARS complications, over 91% are orbital complications (OC) with an average prevalence of 6% and a higher incidence in children compared to adults. Case report. Twelve-year-old boy, accompanied by his mother, was urgently referred to the Department of Otorhinolaryngology at the University Hospital in Foca due to a sudden red and painful left periorbital edema, pain in the left eye and a fever reaching 38.5ºC. After laboratory and CT scan diagnostics, an ophthalmologic examination and inpatient clinical findings after 36 hours of parenteral triple antibiotic therapy, the patient was referred to a tertiary-type institution for further treatment. The same procedure was performed conservatively during the hospitalization within 6 days. Conclusion. The initial treatment of orbital complications in children is conservative. Treatment should be started empirically, using triple antibiotic therapy. The choice of antibiotics and treatment protocols among pediatric population have not been agreed yet. If 36-48 hours after the beginning of the conservative treatment, there is lack of the clinical response, surgical treatment is absolutely indicated, regardless of the stage of orbital complication.