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Background: Acute rhinosinusitis (ARS) is a common and well-defined disorder, primarily of viral aetiology, with rhinovirus and coronavirus accounting for more than 50% of viral ARS. The fight with COVID-19 pandemic resulted in an increased availability viral testing, which in turn allowed testing for presence of SARS-Cov-2 in all patients presenting common cold (or ARS) symptoms. The aim of this study was to assess the clinical characteristics of acute rhinosinusitis in patients diagnosed with COVID-19.Methodology/Principal: This study is a post-hoc analysis. Patients symptoms were evaluated using a structured questionnaire twice: directly after a positive SARS-Cov-2 result and 7-12 days following the first evaluation. Subjects were asked about presence of nasal and systemic symptoms as well as headache.Results: A total of 130 COVID-19 symptomatic patients were recruited into the study, 58 (45%) patients met EPOS2020 diagnostic criteria for ARS. Of all ARS patients, 72% presented with rhinorrhoea, 69% with pain perceived over paranasal sinuses, 62% with nasal congestion, 52% with cough, 45% with olfactory dysfunction, 38% with fever, 33% with facial pressure and in 22% pain was exacerbated by sinus palpation. Conclusions: Half of COVID-19 subjects has ARS. The course of SARS-Cov-2 ARS does not seem to differ significantly from ARS of other aetiologies. Since ARS in the course of COVID-19 seems to meet the definition of ARS proposed by EPOS 2020, we hypothesize that substances validated for ARS treatment, such as intranasal corticosteroids could be effective in SARS-Cov-2 ARS.

Tuberculous otitis media is not a common disease, especially in developed countries. Its low incidence and manifestation mimicking other diseases often results with delayed diagnosis and wrong treatment. A 29-year-old women presented to ENT department with history of bilateral acute otitis media not responding to regular treatment. Multiple tympanic membrane perforations noticed in the course of disease suggested tuberculosis. To confirm the diagnosis multiple examinations were performed: Quantiferon Test, traditional culture of Mycobacterium tuberculosis and genetic test. The patient responded well to anti-TBC treatment, however some of the damages done are irreversible and some requires adequate reconstructional treatment. This case emphasize that it is important to remain watchful, as tubercoulous otits media is often misdiagnosed. Proper early diagnosis may prevent further damage as chemotherapy is usually very effective and in most cases complete healing is achieved.

Aim: Development of an effective method of rinsing the nasal cavities and paranasal sinuses using the Zatoxin Rinse kit. Material and methods: In order to develop recommendations for rinsing the nasal cavities, a cadaver head specimen from Poznań Lab was used. The nasal cavities were rinsed with a methylene blue solution - 0.8 ml of 10% methylene blue in 240 ml of water. Rinsing was performed in the standard recommended position - the head tilted slightly forward (approx. 20–30 degrees) and to the side – approx. 45 degrees. After endoscopic examination, endoscopic surgery of the paranasal sinuses was performed and the staining of the mucosa of the paranasal sinuses was assessed. The nasal cavities were rinsed again with a solution of water and methylene blue in the head position as described above. Endoscopic examination was performed with the assessment of the staining of the nasal mucosa and paranasal sinuses, and the rinsing was repeated with the head tilted forward to 60 degrees and laterally to 45 degrees. The staining of the mucosa was recorded during the endoscopic examination. Results: The nasal rinsing performed allowed the fluid to flow along the turbinates into the nasopharyngeal region and then out. After opening the paranasal sinuses, it turned out that only a small amount of methylene blue had penetrated into the maxillary sinuses; There was also no staining of the mucosa within the ethmoid cells, the frontal sinus or the sphenoid sinus. Rinsing the nasal cavities again in the same position, but after the ethmoidectomy, showed poor penetration of methylene blue into the ethmoid region, the frontal sinus ostium and the sphenoid sinus ostium. The re-rinsing of the nasal cavities with the head tilted forward by at least 60 degrees and to the side by 45 degrees resulted in a stronger staining of the rush top and the staining of the entrance to the frontal sinus with methylene blue. Conclusions: The way the head is positioned when using Zatoxin Rinse should be adapted to the disease, and in the case of surgical treatment, to the type of surgery performed and to which sinuses are affected by the disease, so that the solution reaches the required regions.

Aim: The aim of this study was to assess the effect of nasal irrigation with isotonic sodium chloride and sodium bicarbonate solution in the form of Zatoxin Rinse kit on the process of postopera-tive wound healing and resolution of inflammation in patients who undergo surgery of the nasal cavity or paranasal sinuses. Moreover, our study also compared the effectiveness of na-sal irrigation with Zatoxin Rinse kit to the use of saline spray, when applied for 4 weeks after nasal septum surgery. Material and methods: Multicenter observational studies were conducted with the use of a questionnaire which was filledout on two consecutive visits, scheduled with a 1-month interval. These questionnaires applied to patients who underwent endoscopic surgical intervention in the nasal cavity and paranasal sinuses and were therefore qualified for this study. The study group included 71 patients (mean age: 42.87 ± 13.22 years; 29 female and 42 male) suffering from the following disorders: chronic rhinosinusitis (CRS) with polyps, n = 25; CRS without polyps, n = 19; de-viated septum, n = 27. The control group included 7 patients with deviated septum (using saline nasal products/seawater spray). Based on the questionnaire results and ENT examina-tion, the severity of inflammation and effectiveness of wound healing were assessed with the use of: SNOT-22 (sino-nasal outcome score), Visual Analogue Scale (VAS) and endoscopic examination of nasal cavities. Results: The median value for results obtained from the SNOT-22 questionnaire was 38 points (IQR = 36) in CRS without polyps, 33 points (IQR = 24) in CRS with polyps and 26 points (IQR = 19) in deviated septum. The median values for all scores recorded in specific subgroups after 4 weeks of applying Zatoxin Rinse were as follows: patients with CRS with polyps: 7 points (IQR = 9.5), patients with CRS without polyps: 5 points (IQR = 13), patients with deviated septum: 6 points (IQR = 9). Postoperative nasal discharge was observed to be the most fre-quent in patients with CRS: among patients suffering from CRS with polyps, the median VAS scale result was 6 points (IQR = 4), while the median for patients diagnosed with CRS without polyps was 6 points (IQR = 5) and 3 points (IQR = 4) in the group with deviated septum. The feeling of impaired nasal patency in the postoperative period was reported to be the strongest in patients diagnosed with CRS without polyps: 8 points (IQR = 5), as com-pared to 5 points (IQR = 4.5) in patients with CRS with polyps and 5 points (IQR = 7) in the deviated septum group. Postoperative smell disorders were observed to be expressed as more severe among patients with CRS without polyps: 6 points (IQR = 4) and less severe in pa-tients with CRS with polyps: 4 points (IQR = 7). After 4 weeks of healing aided by irrigation of paranasal sinuses with the use of Zatoxin Rinse kit, patients from all subgroups experienced a statistically significant reduction in the severity of all parameters assessed by the VAS scale. In the endoscopic assessment of nasal cavities with the use of Lund-Kennedy scoring system, conducted prior to irrigating nasal cavities with the Zatoxin Rinse kit, the highest results were recorded in patients diagnosed with CRS with polyps: 10 points (IQR = 9.5), as compared to 8 points (IQR = 6) in patients with CRS without polyps and 6 points (IQR = 5) in patients with deviated septum. After 4 weeks, the median result in CRS with polyps group was 3 points (IQR = 3.5), while the CRS without polyps and deviated septum groups recorded the same median result of 3 points (IQR = 3). Conclusions: (1) Nasal irrigation with Zatoxin Rinse is characterized by good tolerability and is easy to per-form. No adverse effects of nasal irrigation were identified among 71 examined individuals and patients were satisfied with the application method provided by the Zatoxin Rinse kit; (2) Zatoxin Rinse promotes healing of postoperative wounds in patients who undergo surgical intervention in the paranasal sinuses or in the nasal septum, as compared to the use of saline spray.

Introduction: Surgical orbital decompression involves removal of one or more orbital bony walls in order to gain space for overgrown muscles and adipose tissue, which results in a reduction in pressure on the eye. This observational study aims to perform an endocrinological assessment of the surgical treatment outcomes of thyroid eye disease (TED) patients before and after orbital decompression. Material &Methods: This retrospective study included 51 TED patients (84 orbits) who underwent endoscopic orbital decompression (EOD) or balanced orbital decompression.The effect of surgical treatment was evaluated via the clinical activity score (CAS), modified NOSPECS and EUGOGO classification. Results: Before orbital decompression, the average CAS index was 3.83+/–1.86 points, whereas the modified NOSPECS score was 3.31+/–0.97 points. After surgical intervention, the values were as follows: 2.07+/–1.84 points for CAS and 2.5+/–0.97 points for modified NOSPECS. The EUGOGO classification before surgery showed that Graves’ orbitopathy (GO) was mild, moderate to severe and sight-threatening in 1%, 25% and 74% of the orbits, respectively. After surgery, GO was determined to be mild, moderate to severe and sight-threatening in 24%, 57% and 19% of the orbits. Statistical analysis was performed using the R 3.6.2 statistical environment. Inference about the statistical reliability of the parameter was made by calculating the mean and the 95% credibility interval (CI). Conclusions: The severity of TED decreased after orbital decompression. The CAS, modified NOSPECS and EUGOGO classification showed a statistically reliable postoperative reduction. The drop in activity of the disease after orbital surgery requires careful follow-up.

Many current Marxist debates point to a crisis of imagination as a challenge to emancipatory thoughts and actions. The naturalisation of the capitalist mode of production within the production of subjectivity is among the chief reasons behind this state of affairs. This article contributes to the debate by focusing on the notion of imagination, marked by a deep ambivalence capable of both naturalising and denaturalising social relations constitutive of the established order. Such an understanding of imagination is constructed from within the framework of historical materialism, and it draws on Spinoza and Marx, taking advantage of the similarities between the two with respect to the constitution of the subject. From this stems an investigation into the imagination as a material force that partakes both in subjection and liberation. This is further demonstrated in regard to juridical forms of subjectivation and the possibility of subverting these forms through imagination.

Defects in the phosphoinositide 3-kinase (PI3K) pathway are shared characteristics in several brain disorders, including the inherited intellectual disability and autism spectrum disorder, fragile X syndrome (FXS). PI3K signaling therefore could serve as a therapeutic target for FXS and other brain disorders. However, broad inhibition of such a central signal transduction pathway involved in essential cellular functions may produce deleterious side effects. Pharmacological strategies that selectively correct the overactive components of the PI3K pathway while leaving other parts of the pathway intact may overcome these challenges. Here, we provide the first evidence that disease mechanism-based PI3K isoform-specific inhibition may be a viable treatment option for FXS. FXS is caused by loss of the fragile X mental retardation protein (FMRP), which translationally represses specific messenger RNAs, including the PI3K catalytic isoform p110β. FMRP deficiency increases p110β protein levels and activity in FXS mouse models and in cells from subjects with FXS. Here, we show that a novel, brain-permeable p110β-specific inhibitor, GSK2702926A, ameliorates FXS-associated phenotypes on molecular, cellular, behavioral, and cognitive levels in two different FMRP-deficient mouse models. Rescued phenotypes included increased PI3K downstream signaling, protein synthesis rates, and dendritic spine density, as well as impaired social interaction and higher-order cognition. Several p110β-selective inhibitors, for example, a molecule from the same chemotype as GSK2702926A, are currently being evaluated in clinical trials to treat cancer. Our results suggest that repurposing p110β inhibitors to treat cognitive and behavioral defects may be a promising disease-modifying strategy for FXS and other brain disorders.