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Seasonal allergic rhinitis: diagnosis and treatment

Spring is a wonderful time. But not for everyone, the awakening of nature after winter promises joy. For some, spring romance may turn into a completely non-romantic state. A stuffy, swollen nose, swollen and watery eyes are the typical appearance of a person with seasonal allergic rhinitis and conjunctivitis. Sneezing and runny nose make it difficult not only to breathe, but also to communicate, and tears and itchy eyes prevent you from admiring the sun and flowering.

In the spring, it is the flowering of trees that causes allergic rhinoconjunctivitis. People suffering from this disease are not at all happy about the appearance of bright greenery on birch and alder trees. For them, this is a signal to start taking anti-allergic drugs.

Pollinosis (from English Pollen - pollen) was first called hay fever.

In 1819, the English physician John Bostock made the first official report about this disease. At that time, it was believed that the appearance of symptoms in May and June was associated with mown grass, which later becomes hay. It wasn't until 1873 that Charles Blackley proved that plant pollen was the cause of malaise. In Russia, the first official report on pollinosis belongs to Dr. L. Silich, who made it in 1889 at a meeting of the Society of Russian Physicians in St. Petersburg.

There are several periods of flowering plants. In late April and early May, pollen from birch, alder, hazel, oak, and linden trees becomes the cause of the malaise.

It is popularly believed that poplar fluff causes the development of symptoms in June. But due to its size, it cannot penetrate the respiratory tract, and besides, it is not pollen, but only a filler for poplar fruits, which carries small pollen particles and therefore poses a significant allergenic danger.

In late June and early July, cereal plants begin to bloom (rye, wheat, oats, barley, timothy, hedgehog, ryegrass, wheatgrass). The flowering period of weeds (wormwood, ragweed, quinoa) falls at the end of July - beginning of September. Therefore, it is not surprising that seasonal rhinoconjunctivitis can last until autumn or begin at the very end of summer, when, it would seem, nature is preparing to wither.

Not everyone knows the fact that during the flowering period of allergen-significant plants, a pathological reaction to certain products, the so-called cross allergy, may appear. For example, rhinoconjunctivitis in birch blossoms may be accompanied by similar symptoms when eating carrots, hazelnuts, apples, peaches. If the patient reacts to the flowering of cereals, then it is not advisable for him to eat sorrel. And those who are "not friends" with wormwood, citrus fruits, honey, and sunflower seeds will make them itch and cry.

The most characteristic symptoms of pollinosis are nasal congestion, the appearance of clear mucus, itchy nose and sneezing. My eyes also start to itch, turn red, and watery eyes get worse. With a severe allergic reaction, general malaise, a feeling of heat, and irritability may appear. Sometimes the disease does not manifest itself with all the symptoms, and the general condition does not change at all. Then the diagnosis is not entirely obvious. But if a child has a stuffy nose in the morning or acute respiratory infections become more frequent during the flowering period, parents may suspect a pathological reaction of the mucous membranes to plant pollen.

Different methods are used to diagnose pollinosis. To distinguish acute respiratory viral infections from manifestations of allergic rhinitis, nasal mucus is microscopically examined. According to the ratio of cells in the smear, it is concluded that an inflammatory or allergic process prevails.

Allergy testing is more thorough. It is possible either in the form of skin tests, when a solution containing allergens is applied to the skin after a light injection, or by assessing the presence of specific antibodies in the blood to proteins contained in pollen. These methods allow us to answer the question of which plants the patient should avoid. Those who have experienced the symptoms of hay fever for the first time will certainly need the help of a doctor. The doctor will help make the correct diagnosis and prescribe treatment, as well as recommend further medical care tactics, since it is important not only to relieve symptoms during an exacerbation, but also to prevent the occurrence of pathological reactions in the future. Fortunately, this is currently possible.

Those who have had reactions for several seasons should monitor pollen monitoring, which predicts the onset and intensity of flowering of certain plants, and also remember that some time before the start of plant pollination, medications should be taken that allow the body to withstand the onslaught of pollen storms more stoutly.

And the best part is that pollinosis can be cured! The use of microdoses of an allergen to "habituate" the body to it has become an achievement of medical science. This method is called allergen-specific immunotherapy (ASIT).

Doctors of various specialties: pediatricians, ophthalmologists, otolaryngologists, allergists - are ready to help their patients with allergic rhinoconjunctivitis make life more comfortable in the conditions of flowering. After all, nature gives us beautiful colors and smells of flowering so that we can enjoy them!

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Questions and answers

Dermoid cyst and pregnancy
An ultrasound revealed a mass in my left ovary during the first pregnancy. I was told that it is a dermoid cyst. Five years have passed since then. I gave birth to a second child. An ultrasound was performed annually. There were differences in size, but not significant. Since I’m going to have the 3rd child, another
ultrasound was done today. The doctor said that the cyst had increased. I am concerned about it. Don't know where to start. What tests are needed? Thank you.
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Surgical treatment is strictly indicated in your case given the long history of the mass in the ovary and its rapid growth in recent times. In our clinic, we perform such an intervention laparoscopically through 3 small punctures. Patients go home next morning after the surgery and may return to work after 3 days.
This surgery must be as delicate to preserve healthy ovarian tissue (considering your reproductive plans) as radical at the same time to remove the mass together with the capsule. At the preoperative stage an expert level ultrasound with Doppler is required, as well as blood tests for Ca-125 and НЕ-4 tumor markers. The decision concerning the necessity of FEGDS and colonoscopy is taken based on the results of these tests.
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Total knee replacement
My mom suffers from gonarthrosis for the past three years. Despite treatment by injections the pain is still present. MRI revealed a meniscal tear in the posterior horn, the presence of small bony osteophytes on the patella, a small amount of fluid in the joint cavity (signs of exudative synovitis were detected)
joint space is asymmetrically narrowed in the medial segment. The pain is ongoing but the knee remains flexible. Tell me, please, whether the surgery is contraindicated for meniscal tear in case of arthrosis? Is it possible to do an arthroscopic surgery on the meniscus in our case or it should be «major» surgery? And what would you advice concerning knee replacement for the patient in the age of 57? What is the life time of the artificial joint?
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It is necessary to make an X-ray of the knee in direct projection in standing position. If it turns out that there is no medial cartilage in the medial area, then the knee replacement is the only solution. The age of 57 is normal for the prosthetics. Modern artificial knee joint (when properly placed of course) will
serve for a lifetime. You can make an appointment via phone +7 (495) 933-66-44.
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Kardanov Andrey
07 September 2016
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I am 19 years old, professionally engaged in weightlifting. I did an arthroscopy of both knee joint a year ago, now feel pain in them and it prevents me from training at full capacity. I visited a traumatologist, and «osteoarthritis of 1 degree» was diagnosed. Could you advise me some medicines or anything else to
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First of all you should undergo an MRI and find out what was done at arthroscopy; if it’s really an arthrosis of 1 degree, hyaluronic acid injections are possible and physiotherapy is not required. Anyway, you are always welcome to consultation for thorough examination.
Question to Dr. Yakobashvili
Tell me, please, at which age child's hearing should be checked-up if we were informed at the hospital before discharge that one ear does not hear. At the moment the child’s age is 1.5 months. Thank you.
These tests done in the hospital are often false negative. Hearing can be tested now, it is necessary to make an appointment to the audiologist.
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A child of 11 years old, suffers from cough for more than six months. The cough is dry, sometimes attack-like, mainly begins during the day, and often occurs before sleep. There is no cough at night. CBC is normal, glucose is 4.16, total IgE 111.80, Toxocara, Ascaride are negative, Cytomegalovirus, Mycoplasma are
negative, PPD test is negative as well. A chest x-ray is normal. We have already consulted with a therapist, otolaryngologist, pulmonologist, neurologist, gastroenterologist... the cough is still present. What should we do?
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First of all, there are no results of whooping cough testing among the results provided above. The disease cannot be ruled out, even if your child was vaccinated. The blood test for antibodies against the whooping cough germ is required (blood test for class M and G antibodies against Bordetella pertussis). Second,
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