Mometasone furoate nasal spray in Italian children with seasonal allergic rhinitis: a comprehensive assessment

Objective: Seasonal allergic rhinitis (SAR) is a common disease of childhood and is charac-terized by type 2 inflammation, bothersome symptoms, and impaired quality of life (QoL). Intranasal corticosteroids are effective medications in managing SAR. In addition, mometa-sone furoate nasal spray (MFNS) is a well-known therapeutic option. However, the literature provided no data about the effects of MFNS in European children with SAR. Thus, this study addressed this unmet requirement.Methods: MFNS was compared to isotonic saline. Both treatments were prescribed: one drop of spray per nostril, twice a day, for 3 weeks. Nasal cytology, total symptom score (TSS), visual analogic scale concerning the parental perception of severity of symptoms, and the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) were assessed at baseline, after 7 and 21 days, and 1 month after discontinuation. Results: MFNS significantly reduced eosinophil and mast cell counts, improved QoL, and relieved symptoms, as assessed by doctors and perceived by parents. These effects persisted over time, even after discontinuation. Both treatments were safe and well-tolerated.Conclusions: The present study documented that a 3-week MFNS treatment was able to signifi-cantly dampen type 2 inflammation, improve QoL, and reduce severity of symptoms in Italian children with SAR, and was safe (AU)

An age-adjusted instruction video enhances the correct use of nasal corticosteroid sprays in children

INTRODUCTION AND OBJECTIVES: Allergic rhinitis is a common disorder. Intranasal corticosteroid sprays are used to control symptoms. However, incorrect use of these sprays can decrease efficacy and lead to side effects such as nose bleeding. We studied if watching an age-adjusted instruction video is effective to improve administration technique. MATERIALS AND METHODS: We invited children who used intranasal corticosteroid sprays. We examined their administration technique before, directly after, and one month after showing them an age-adjusted instruction video. We compared their administration technique with the instructions in the patient information leaflet. We assessed whether the children performed the seventeen maneuvers mentioned in the patient information leaflet and the eight we considered essential. RESULTS: Of the 99 eligible children, 23 (15 boys, median age nine years) participated. Before watching the instruction video none of them administered according to all maneuvers in the patient information leaflet or showed all essential maneuvers. One month after seeing the instruction video, three children demonstrated correct inhalation as per the patient information leaflet. Three performed the essential maneuvers. When a 75% threshold level for carrying out all 17 maneuvers was used, still none showed 75% of all or of the essential maneuvers before watching the video. Yet, after one month 12 children showed sufficient administration technique (52%, 95% confidence interval (CI) 31%-73%, p = 0.004). Nine showed all essential manoeuvres (47%, 95%CI 24%-71%, p = 0.004). CONCLUSIONS: An age-adjusted instruction video is a useful and easy method to teach children to administer nasal intranasal corticosteroid sprays correctly

No disponible

Mometasone furoate intranasal spray is effective in reducing symptoms and adenoid size in children and adolescents with adenoid hypertrophy / El aerosol nasal de mometasona furoato es efectivo para reducir los síntomas y el tamaño de las adenoides en niños y adolescentes con hipertrofia adenoidea

INTRODUCTION: The use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation. MATERIAL AND METHOD: A prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients' aged 7-11-years old used 1 spray in each nostril once daily, while patients aged 12-17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12). RESULTS: A total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms' score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms' score (p < 0.001). AH significantly reduced in size from week 0 (2.89±.87) to week 12 (1.88±.83) (p < 0.001). CONCLUSION: MF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered

INTRODUCCIÓN: El papel del aerosol nasal de mometasona furoato (MF) para tratar la hipertrofia adenoidea (HA) tiene un resultado variable, debido a los diferentes métodos de evaluación del tamaño de las adenoides. El objetivo de nuestro estudio fue evaluar el efecto del aerosol nasal de MF en niños y adolescentes con HA, utilizando una evaluación endoscópica fiable y consistente. MATERIAL Y MÉTODO: Se llevó a cabo un estudio prospectivo intervencionista. La evaluación se realizó durante la primera visita (semana 0) y la segunda visita (semana 12). Se valoraron los síntomas de obstrucción nasal, rinorrea, tos y ronquidos, obteniéndose una puntuación de síntomas totales globales. Se realizó un examen nasoendoscópico rígido utilizando un sistema de clasificación del tamaño adenoideo, con valores de 1 a 4. Los pacientes fueron tratados con aerosol intranasal de MF durante 12 semanas. Los pacientes con edades comprendidas entre 7 y 11 años utilizaron 1 pulverización en cada fosa nasal una vez al día, mientras que los pacientes de 12 a 17 años utilizaron 2 pulverizaciones en cada fosa nasal una vez al día. La re-evaluación se realizó durante la segunda visita (semana12). RESULTADOS: Reunimos a un total de 74 pacientes. Se produjeron mejoras significativas de la semana 0 a la 12 en cuanto a puntuación de los síntomas de obstrucción nasal, rinorrea, tos y ronquidos, incluyendo la puntuación total de síntomas nasales (p < 0,001). Se redujo significativamente el tamaño de HA de la semana 0 (2,89 ±0,87) a la semana 12 (1,88 ±0,83) (p < 0,001). CONCLUSIÓN: El aerosol intranasal de MF es efectivo para mejorar los síntomas atribuidos a HA, así como reducir el tamaño de las adenoides. Se propone el uso de dicho aerosol intranasal como opción de tratamiento, antes de considerarse la adenoidectomía

Eficacia de un inhalador descongestionante específico con película protectora en el manejo de la rinitis alérgica. Estudio multicéntrico aleatorizado y controlado / Effectiveness of a specific descongestionant inhaler with protective film in the management of allergic rhintis. A multi-centre, randomized, controlled study

INTRODUCCIÓN: Las terapias no farmacológicas en el tratamiento de la rinitis alérgica (RA) son de gran importancia, sobre todo en los niños. El uso adyuvante de irrigaciones ayuda a eliminar los potenciales alérgenos y la mucosidad, y mejora la sintomatología de rinitis. MATERIAL Y MÉTODOS: Estudio piloto, multicéntrico, aleatorizado (2:1) y controlado, sobre el uso de un inhalador con ácido hialurónico al 0,2%, dexpantenol y goma xantana para aliviar la congestión nasal en pacientes pediátricos con RA, con un seguimiento de 45 días. RESULTADOS: Se incluyeron 80 pacientes de 6-11 años de edad (51 en el grupo de estudio y 29 en el grupo control). La congestión nasal y la dificultad para respirar sólo disminuyeron significativamente (p <0,0001) en el grupo de estudio. La rinorrea y la frecuencia de los estornudos mejoraron en ambos grupos (p <0,05). No obstante, la respiración bucal, la intensidad de los estornudos, el picor nasal y faríngeo, la anosmia y los síntomas oculares sólo mejoraron con el uso del inhalador. En el registro diario de los padres, durante la primera y la tercera semana, los síntomas de RA sólo disminuyeron significativamente en el grupo de estudio (p <0,0001). Al final del estudio, en la escala de Impresión Clínica Global el médico consideró mejoría en el 93,9% de los sujetos del grupo de estudio frente a un 52,4% en el grupo control. CONCLUSIONES: En comparación con el tratamiento habitual, el uso del inhalador con película protectora de la mucosa como medida adyuvante contribuye a mejorar de forma significativa la sintomatología de la RA, incluidos los síntomas oculares acompañantes

INTRODUCTION: Non-pharmacological therapies in the treatment of allergic rhinitis (AR) are of great importance, particularly in children. The adjuvant use of nasal irrigations helps eliminate potential allergens and mucus and may improve the symptoms of rhinitis. MATERIAL AND METHODS: Pilot study, multicenter, randomized (2:1) and controlled with placebo, on the use of an inhaler with 0.2% hyaluronic acid, dexpanthenol and xanthan gum vs non-use of the inhaler to relieve nasal congestion in pediatric patients with AR, with 45 day follow-up. RESULTS: 80 patients between 6 and 11 years old were included 51 in the study group and 29 in the control group). Nasal congestion and difficulty breathing only decreased significantly (p <0.0001) in the study group. Rhinorrhea and frequency of sneezing improved in both groups (p <0.05). However mouth breathing, sneezing intensity, nasal and pharyngeal itching, anosmia and eye symptoms only improved with the use of the inhaler. In the daily record of the parents during the first and third week, the symptoms of AR only decreased significantly in the study group (p <0.0001). At the end of the study, the physician's Global Clinical Impression was improvement in 93.9% of the subjects in the study group compared to 52.4% in the control group. CONCLUSIONS: Compared to the usual treatment the use of the inhaler with a mucosal protective film as an adjuvant measure, contributes to a significant improvement in the symptoms of AR, including the accompanying ocular symptoms

Optimal management of breakthrough cancer pain (BCP)

Breakthrough cancer pain (BCP) is common in patients with cancer, causing a negative impairment in quality of life. Recent diagnostic criteria allow for differentiation of background chronic pain and BCP, for which proportion of unpredictable episodes is very high. Five characteristics define BCP: rapid onset, high intensity, maximum intensity (minutes), mean duration 30 min, and unpredictable onset. Fentanyl is a synthetic opioid characterized by rapid absorption and start of the analgesic effects. In addition to comparing some of the marked differences between the four pharmaceutical forms of fentanyl marketed in Spain, this paper discusses the data collected in a comprehensive clinical trial program with fentanyl pectin nasal spray (FPNS), a formulation that takes advantage of the intranasal route and the PecSys™ technology. The FPNS formulation achieves analgesic action 5 min after application and significant pain relief at 10 min. FPNS, therefore, has key features to be an optimal treatment for BCP (AU)