[The effectiveness of complex drugs in the treatment of acute rhinitis]. / Effektivnost' kompleksnykh preparatov v terapii ostrogo rinita.

Purpose of the study. Generalization of data on the value of alternative and additional treatment of acute infectious rhinitis with Korizalia. MATERIAL AND METHODS: The material of scientific publications included in the Cochrane Library, information bases of the RSCI, MEDLINE, PubMed was used as a data source. The choice of material was carried out using the key words: colds, acute rhinitis, herbal medicine, homeopathic remedies. RESULTS: Analysis of published clinical trial descriptions suggests the potential value of homeopathic medicines, in particular Korizalia, in improving the effectiveness of the treatment of acute rhinitis. The use of Korizalia in acute infectious rhinitis was more effective in relation to the main symptoms of ARI compared with placebo. CONCLUSION: The lack of optimal drugs for the etiotropic treatment of viral acute respiratory infections determines the relevance of alternative and complementary methods of treatment using drugs of natural origin. The drug Korizalia can be used for acute respiratory infections (acute infectious rhinitis) as an alternative drug or in combination with other drugs.

[Adjuvant electrostimulation therapy for chronic rhinosinusitis]. / Adjuvante Elektrostimulationstherapie bei chronischer Rhinosinusitis.

BACKGROUND: Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in Germany and is often accompanied by years of chronic rhinosinusitis. According to the current German guideline "Rhinosinusitis", the nasal application of salt solutions, topical corticosteroids and in individual cases also systemic corticosteroids appear useful for a symptomatic therapy of CRS. The evidence for other therapeutic procedures such as acupuncture, homeopathy and phytotherapeutics is seen as insufficient. The aim of the present study was to investigate whether anti-inflammatory effects of electrostimulation therapy can also be demonstrated in CRS. METHODOLOGY: randomized, prospective single center study, primary setting; 16 patients with moderate chronic rhinosinusitis with polyps (cRScNP), corresponding to a Lund / Mackay score of 6-12; home based electrostimulation therapy (EST) with amplitude modulated current (base frequency of 4000 Hz, frequency band of 100-250 Hz) over 2 weeks adjuvant to a concurrent sinusitis therapy with topical corticosteroids; measurement of nasal nitric oxide concentration and self-assessment of complaints with the questionnaire instrument SNOT-20 GAV; survey points t0 before EST, t1 after EST, t2 6 weeks after t1. RESULTS: Home based EST was performed by 16 patients. The results indicate that the positive effects of electrostimulation therapy in inflammatory processes also exist in CRS. DISCUSSION: Adjuvant transsinuidal electrostimulation could thus enrich the conservative therapy of CRS. Further studies with larger collectives are desirable.

Nasal saline irrigations for the symptoms of acute and chronic rhinosinusitis.

The use of saline nasal irrigation (SNI) in the treatment of nasal and sinus disorders has its roots in the yoga tradition and homeopathic medicine. In recent years, SNI has been increasingly observed as concomitant therapy for acute (ARS) and chronic rhinosinusitis (CRS). Various devices are employed, such as nasal douches, neti pots or sprays. The saline solutions used vary in composition and concentration. This article gives a current overview of literature on the clinical efficacy of SNI in the treatment of ARS and CRS. It then answers frequent questions that arise in daily clinical routine (nasal spray vs. nasal irrigation, saline solution composition and concentration, possible risks for patients). SNI has been an established option in CRS treatment for many years. All large medical associations and the authors of systematic reviews consistently conclude that SNI is a useful addition for treating CRS symptoms. SNI use in ARS therapy, however, is controversial. The results of systematic reviews and medical associations' recommendations show the existing but limited efficacy of SNI in ARS. For clinical practice, nasal douches are recommended-whatever the form of rhinosinusitis-along with isotonic and hypertonic saline solutions in CRS (in ARS to a limited extent). To prevent infections, it is essential to clean the nasal douche thoroughly and use the proper salt concentration (2-3.5 %). Conclusive proof of the efficacy of SNI in the treatment of ARS is still pending. In CRS, SNI is one of the cornerstones of treatment.

Homeopathy for seasonal allergic rhinitis: rationale, design and methods of the three-armed randomized controlled HOMEOSAR trial.

BACKGROUND: Patients with seasonal allergic rhinitis (SAR) frequently use homeopathic therapy. Although there is some evidence that homeopathy may be effective in treating symptoms of SAR, there is a lack of high-quality clinical trials. Therefore, the aim of the homeopathy for SAR (HOMEOSAR) trial is to determine the efficacy of individualized or standardized homeopathic drug treatment compared to placebo regarding rhinitis-related quality of life in patients with SAR. METHODS: This randomized, placebo-controlled, double-blind, three-armed intervention study will be conducted at two university hospital outpatient clinics for complementary and integrative medicine in Berlin and in 12 office-based practices specializing in homeopathic treatment in Germany. A total of 270 patients with clinical symptoms of SAR and positive allergy test to birch and grass pollen will receive homeopathic anamnesis and subsequently be randomized into (a) standardized homeopathic drug treatment with Galphimia Glauca (potency D6), (b) individualized homeopathic drug treatment (D6), or (c) placebo. All three groups can receive on-demand rescue medication as needed. Treatment will consist of two consultations and daily intake of the study medication for 4 weeks during the pollen season. The primary outcome is the mean overall score of the Rhinitis Quality of Life Questionnaire (RQLQ) in weeks 3 and 4, analyzed using analysis of covariance (adjusted for baseline RQLQ overall score and study center). A closed testing procedure will be used to control the overall type I error comparing the 3 treatment groups. Secondary outcomes include the overall RQLQ and its seven domain scores, responder status (decrease in RQLQ overall score of at least 0.5 points compared to the baseline value), use of rescue medication, intensity of total and individual SAR symptoms based on visual analog scale, generic health-related quality of life, safety, utilization of health care resources and associated costs. In addition, a qualitative data analysis is planned. CONCLUSION: The results of our study will contribute to clarifying the possible therapeutic effects of homeopathic drug treatment for patients with SAR. TRIAL REGISTRATION: This study has been registered in the German Clinical Trial Registry with trial ID DRKS00018081 on June 09, 2020.

A randomized, double-blind, parallel trial comparing capsaicin nasal spray with placebo in subjects with a significant component of nonallergic rhinitis.

OBJECTIVE: To investigate the efficacy and safety of ICX72 or Sinus Buster, a proprietary homeopathic preparation of Capsicum annum and Eucalyptol, versus placebo administered continuously over 2 weeks in subjects with a significant component of nonallergic rhinitis (NAR). METHODS: Forty-two consented subjects meeting inclusion/exclusion criteria were randomized to ICX72 (n = 20) or control (n = 22) administered twice daily over 2 weeks. The primary endpoint was change in total nasal symptom scores (TNSS) from baseline to end of study. Secondary endpoints included changes in individual symptom scores (ISS) over 2 weeks and average time to first relief. Mean TNSS and ISS were recorded after single dosing at different intervals over 60 minutes. Rhinitis quality-of-life, rescue medication, and safety endpoints were analyzed. RESULTS: ICX72 versus placebo subjects exhibited significant differences in changes from baseline to end of study for TNSS and each ISS (P < .01), had an average time to first relief of 52.6 seconds (P < .01), and improvement in nasal congestion, sinus pain, sinus pressure, and headache at 5, 10, 15, and 30 minutes, persisting at 60 minutes for nasal congestion and sinus pain (P < .05). No difference between groups in adverse events or rescue medication was observed. ICX72 versus placebo subjects experienced no rebound congestion or impaired olfaction at the end of the study. CONCLUSION: This is the first controlled trial demonstrating intranasal capsaicin, when used continuously over 2 weeks, rapidly and safely improves symptoms in rhinitis subjects with a significant NAR component.

Alternative therapies for sinusitis and rhinitis: a systematic review utilizing a modified Delphi method.

BACKGROUND: Sinusitis and rhinitis are common diseases for which patients seek medical attention. Alternative therapies constitute a multibillion-dollar industry despite poorly established efficacy and safety profiles. This study was designed to identify and grade the evidence for alternative therapies purported to treat sinusitis and rhinitis. METHODS: A modified Delphi method was used to establish a consensus opinion among rhinology experts of the current evidence for efficacy, potential harm, and future research needs for alternative therapies in sinusitis and rhinitis. Following the initial Delphi round of discussion, a Google search query was performed to identify topics and review online reports of benefit. Subsequent rounds established search criteria and inclusion/exclusion criteria for a systematic literature review utilizing PubMed, EMBASE, and Cochrane databases. Centre for Evidence-Based Medicine (CEBM) and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria were used to assess levels of evidence and recommendations. Final Delphi rounds were performed until consensus opinions could be reached. RESULTS: Over 60 potential alternative therapies for sinusitis and rhinitis were identified. The literature review included 2066 titles with 220 full-text articles found to be relevant. Most of the therapies had little to no scientific evidence; however, acupuncture, capsaicin, bromelain, and butterbur extract currently have low to moderate-high GRADE rating. Allergic rhinitis was the most common disease studied. CONCLUSION: Some alternative therapies show promise as potential treatments for sinusitis and rhinitis, mostly compared to placebo. Comparisons to traditional therapies are lacking. For other alternative therapies, many websites included unsubstantiated claims of benefit and ignored potential side effects for which patients should be warned appropriately.

Complementary and Alternative Medicine in Chronic Rhinosinusitis: A Systematic Review and Qualitative Analysis.

BACKGROUND: Complementary and alternative medicine (CAM) is frequently used in the treatment of chronic rhinosinusitis (CRS) in developed countries. With a plethora of CAM therapies available, their effectiveness and safety are poorly understood in the context of CRS. OBJECTIVES: This article aims to critically appraise the evidence for CAM use in CRS through a systematic review of current literature that investigate the effects of CAM on symptoms and clinical status of adults with CRS. STUDY DESIGN: Systematic review and qualitative analysis. REVIEW METHODS: A comprehensive systematic review of the literature was conducted by the authors using 5 databases from inception to July 2017: CINAHL, Cochrane, Embase, PubMed, and SCOPUS. Inclusive medical subject headings and keywords consisted of, but were not limited to, sinusitis and complementary therapies, naturopathy, or traditional Chinese medicine. PRISMA guideline was followed. Using templates by Cochrane Public Health Group and Newcastle-Ottawa Scale, each author extracted data, assessed bias, and computed minimal clinically important difference. Any conflicts were resolved through discussion. RESULTS: In total, 7 of 7141 articles from 1995 to 2016 were included. Three randomized controlled trials and 4 observational studies were organized into 4 categories of CAM: naturopathy, Chinese medicine, homeopathy, and others. Limited evidence supported the use of Pimpinella anisum and crenotherapy for CRS. Data available on Chinese medicine, homeopathy, and liposomal therapy in CRS were inconclusive due to inherent flaws in the studies. CONCLUSION: Overall, there is very limited evidence to support the use of CAM in the treatment of CRS. No significant adverse effects have been found. Given its widespread use, more rigorous data from high-quality research are needed before it can be routinely recommended.

How healthy are chronically ill patients after eight years of homeopathic treatment?--Results from a long term observational study.

BACKGROUND: Homeopathy is a highly debated but often used medical treatment. With this cohort study we aimed to evaluate health status changes under homeopathic treatment in routine care. Here we extend former results, now presenting data of an 8-year follow-up. METHODS: In a prospective, multicentre cohort study with 103 homeopathic primary care practices in Germany and Switzerland, data from all patients (age >1 year) consulting the physician for the first time were observed. The main outcome measures were: The patients' perceived change in complaint severity (numeric rating scales from 0 = no complaint to 10 = maximal severity) and quality of life as measured by the SF-36 at baseline, and after 2 and 8 years. RESULTS: A total of 3,709 patients were studied, 73% (2,722 adults, 72.8% female, age at baseline 41.0 +/- 12.3; 819 children, 48.4% female, age 6.5 +/- 4.0) contributed data to the 8-year follow-up. The most frequent diagnoses were allergic rhinitis and headache in adults, and atopic dermatitis and multiple recurrent infections in children. Disease severity decreased significantly (p < 0.001) between baseline, 2 and 8 years (adults from 6.2 +/- 1.7 to 2.9 +/- 2.2 and 2.7 +/- 2.1; children from 6.1 +/- 1.8 to 2.1 +/- 2.0 and 1.7 +/- 1.9). Physical and mental quality of life sores also increased considerably. Younger age, female gender and more severe disease at baseline were factors predictive of better therapeutic success. CONCLUSION: Patients who seek homeopathic treatment are likely to improve considerably. These effects persist for as long as 8 years.

[Complementary medicine in treatment of asthma and respiratory tract infections].

Patients with respiratory tract infections are frequently treated by complementary and alternative medicine (CAM) modalities. This editorial reviews current literature on the most popular CAM modalities used by these patients: acupuncture, herbal therapy, vitamins and homeopathy. Several good quality trials in acupuncture, herbal therapy and homeopathy have reported positive effects in allergic rhinitis and asthma. However, overall mixed results and methodological flaws, when analyzed by systematic reviews, lead to the conclusion that, as yet, there is insufficient evidence to reliably assess the possible role of these treatments for rhinitis and asthma. Safety issues of herbal therapies require special attention. Further good quality research and subsequent meta-analysis of the trials are required.

[Monotherapy of rhinitis of various etiology].

The article describes various forms of rhinitis and principles of their management; results of monotherapy of patients with different forms of acute rhinitis (viral, allergic) using homeopathic drug corisalium.

Nasal saline irrigations for the symptoms of chronic rhinosinusitis.

BACKGROUND: The use of nasal irrigation for the treatment of nose and sinus complaints has its foundations in yogic and homeopathic traditions. There has been increasing use of saline irrigation, douches, sprays and rinsing as an adjunct to the medical management of chronic rhinosinusitis. Treatment strategies often include the use of topical saline from once to more than four times a day. Considerable patient effort is often involved. Any additional benefit has been difficult to discern from other treatments. OBJECTIVES: To evaluate the effectiveness and safety of topical saline in the management of chronic rhinosinusitis. SEARCH STRATEGY: Our search included the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4 2006), MEDLINE (1950 to 2006) and EMBASE (1974 to 2006). The date of the last search was November 2006. SELECTION CRITERIA: Randomised controlled trials in which saline was evaluated in comparison with either no treatment, a placebo, as an adjunct to other treatments or against treatments. The comparison of hypertonic versus isotonic solutions was also compared. DATA COLLECTION AND ANALYSIS: Trials were graded for methodological quality using the Cochrane approach (modification of Chalmers 1990). Only symptom scores from saline versus no treatment and symptom and radiological scores from the hypertonic versus isotonic group could be pooled for statistical analysis. A narrative overview of the remaining results is presented. MAIN RESULTS: Eight trials were identified that satisfied the inclusion criteria. Three studies compared topical saline against no treatment, one against placebo, one as an adjunct to and one against an intranasal steroid spray. Two studies compared different hypertonic solutions against isotonic saline. There is evidence that saline is beneficial in the treatment of the symptoms of chronic rhinosinusitis when used as the sole modality of treatment. Evidence also exists in favour of saline as a treatment adjunct. No superiority was seen when saline was compared against a reflexology 'placebo'. Saline is not as effective as an intranasal steroid. Some evidence suggests that hypertonic solutions improve objective measures but the impact on symptoms is less clear. AUTHORS' CONCLUSIONS: Saline irrigations are well tolerated. Although minor side effects are common, the beneficial effect of saline appears to outweigh these drawbacks for the majority of patients. The use of topical saline could be included as a treatment adjunct for the symptoms of chronic rhinosinusitis.

Homeopathic and conventional treatment for acute respiratory and ear complaints: a comparative study on outcome in the primary care setting.

BACKGROUND: The aim of this study was to assess the effectiveness of homeopathy compared to conventional treatment in acute respiratory and ear complaints in a primary care setting. METHODS: The study was designed as an international, multi-centre, comparative cohort study of non-randomised design. Patients, presenting themselves with at least one chief complaint: acute (< or = 7 days) runny nose, sore throat, ear pain, sinus pain or cough, were recruited at 57 primary care practices in Austria (8), Germany (8), the Netherlands (7), Russia (6), Spain (6), Ukraine (4), United Kingdom (10) and the USA (8) and given either homeopathic or conventional treatment. Therapy outcome was measured by using the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' in each treatment group. The primary outcome criterion was the response rate after 14 days of therapy. RESULTS: Data of 1,577 patients were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment. The majority of patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H: 86.9%; C: 86.0%; p = 0.0003 for non-inferiority testing). In the per-protocol set (H: 576 and C: 540 patients) similar results were obtained (H: 87.7%; C: 86.9%; p = 0.0019). Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H: 88.5%; C: 84.5%) and adults (H: 85.6%; C: 86.6%). The unadjusted odds ratio (OR) of the primary outcome criterion was 1.40 (0.89-2.22) in children and 0.92 (0.63-1.34) in adults. Adjustments for demographic differences at baseline did not significantly alter the OR. The response rates after 7 and 28 days also showed no significant differences between both treatment groups. However, onset of improvement within the first 7 days after treatment was significantly faster upon homeopathic treatment both in children (p = 0.0488) and adults (p = 0.0001). Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C: 7.6%; H: 3.1%, p = 0.0032), whereas in children the occurrence of adverse drug reactions was not significantly different (H: 2.0%; C: 2.4%, p = 0.7838). CONCLUSION: In primary care, homeopathic treatment for acute respiratory and ear complaints was not inferior to conventional treatment.

[Homeopathy in acute rhinosinusitis: a double-blind, placebo controlled study shows the efficiency and tolerability of a homeopathic combination remedy]. / Homöopathie bei akuter Rhinosinusitis: Eine doppelblinde, placebokontrollierte Studie belegt die Wirksamkeit und Verträglichkeit eines homöopathischen Kombinationsarzneimittels.

BACKGROUND: The efficacy and tolerability of a homeopathic combination remedy for the treatment of acute rhinosinusitis was investigated. PATIENTS AND METHODS: A total of 144 patients with acute rhinosinusitis were treated in a randomized, double-blind study either with a homeopathic remedy (n=72) or placebo (n=72). At the control examinations after 7, 14 and 21 days, five sinusitis-typical symptoms were measured with scores from 0 (absent) to 4 (very strong). The change of sum score of the sinusitis-typical symptoms (max. 20 points) during the treatment served as the primary efficacy criterion. RESULTS: In the homeopathic treatment group, the average sum score dropped from initially 12.1+/-1.6 to 5.9+/-2.0 points after 7 days. In the placebo group it decreased from 11.7+/-1.6 to 11.0+/-2.9 points (p<0.0001). The homeopathic treatment resulted in freedom from complaints in 90.3% of the patients and improvement in a further 8.3%, whereas in the placebo group, the complaints remained unchanged or became worse in 88.9% of the patients. Only one adverse event occurred in one patient from the placebo group. CONCLUSION: The homeopathic product allows an effective and tolerable treatment of acute rhinosinusitis.

[Wirksamkeit und Verträglichkeit eines homöopathischen Komplexmittels (Sinusitis Hevert SL) bei akuter, unkomplizierter Rhinosinusitis: Eine multizentrische, randomisierte, doppelblinde, placebokontrollierte Studie an erwachsenen Patienten].

Hintergrund: In der vorliegenden Studie wurden die Wirksamkeit und Verträglichkeit des homöopathischen Arzneimittels Sinusitis Hevert SL an Patienten mit akuter Rhinosinusitis untersucht. Methoden: In einer randomisierten, placebokontrollierten klinischen Studie wurden 314 Patienten mit bis zu 3 Tagen bestehenden Symptomen, leichtem bis moderatem Gesichtsschmerz und einem Major Rhinosinusitis Symptom Score (MRSS) ≥ 8 und ≤ 14 für 15 Tage (Tag 0 erster Arztbesuch plus 14 Tage Behandlung) eingeschlossen und mit Sinusitis Hevert SL oder Placebo behandelt. Den primären Endpunkt bildeten die Responderrate im MRSS (Reduktion ≥ 50%) bei der Abschlussvisite sowie die Rate der Remissionen (komplettes Abklingen aller 5 Hauptsymptome). Sekundäre Zielkriterien bildeten die Einschätzung der Wirksamkeit durch den Prüfer (auf einer 4-Punkte-Skala) und der Sino-Nasal Outcome Test 20 German Adapted Version (SNOT-20 GAV; Selbsterhebung durch die Patienten). Ergebnisse: 314 Patienten wurden in die Studie eingeschlossen. Davon wurden 308 mit der Studienmedikation behandelt: 153 mit Sinusitis Hevert SL und 155 mit Placebo. 265 Patienten schlossen die Studie vollständig und valide ab (Valid Completers). Die MRSSpat-Responderrate aller Patienten war für Sinusitis Hevert SL nicht signifikant besser (85,6% vs. 80,6%; p = 0,243), die Rate der Remissionen war mit 31,4% für Sinusitis Hevert SL und 37,4% für Placebo in beiden Gruppen nicht signifikant unterschiedlich (p = 0,2641). In der sekundären Completer-Analyse zeigte sich eine signifikante Differenz der Responderraten von 92,1% versus 83,5% zugunsten von Sinusitis Hevert SL (p = 0,032). Weiter war die Zeit bis zur Verbesserung der Rhinorrhoe signifikant kürzer (4,0 vs. 6,0 Tage; p = 0,040). Vor allem relevante nasale Symptome des SNOT-20 und die Lebensqualität verbesserten sich unter Behandlung mit Sinusitis Hevert SL signifikant deutlicher. Schlussfolgerungen: Es zeigte sich in dieser Studie bei akuter Rhinosinusitis und hoher Placebo-Ansprechrate keine Überlegenheit für Sinusitis Hevert SL in der Gesamtresponder- und Remissionsrate. Es fand sich ein Nutzen von Sinusitis Hevert SL in der Auswertung der Valid Completers für die Response sowie für spezifische Verbesserungen klinisch relevanter Symptome und die Abheilungsgeschwindigkeit der akuten Rhinosinusitis bei guter Verträglichkeit.

Novel, Alternative, and Controversial Therapies of Rhinitis.

Rhinitis is a multifactorial disease characterized by sneezing, rhinorrhea, postnasal drip, and nasal congestion. This condition affects 10% to 40% of the population and is responsible for billions of spent health care dollars and impairment in quality of life for those affected. Currently available medical and vaccine therapies are effective for a large segment of this population; however, a subset of patients still has difficult-to-control rhinitis. This article reviews the current progress being made in novel drug and vaccine development and delves into alternative medical, surgical, and homeopathic strategies that may be promising adjunctive treatments for the difficult-to-treat rhinitis patient.

[Treatment of inflammatory diseases of the upper respiratory tract -- comparison of a homeopathic complex remedy with xylometazoline]. / Behandlung von Entzündungen im Bereich der oberen Atemwege -- Vergleich eines homöopathischen Komplexpräparates mit Xylometazolin.

INTRODUCTION: The primary objective of treatment of inflammatory diseases of the upper respiratory tract (rhinitis, uncomplicated sinusitis) with local decongestants is to relieve obstruction and to improve associated symptoms. Restoration of unrestricted respiration and drainage of the nasal sinuses reduce the risk of further complications (i.e. chronicity). OBJECTIVE: To determine whether the therapeutic effects of the homeopathic complex remedy Euphorbium compositum nasal drops SN are comparable to those of xylometazoline with respect to efficacy and tolerability. METHODS: Open, multicenter, prospective, active-controlled cohort study in patients with inflammatory processes and diseases of the upper respiratory tract. The primary outcome was to demonstrate non-inferiority of the homeopathic complex remedy to xylometazoline. RESULTS: Clinically relevant reductions in the intensities of disease-specific symptoms were observed with both therapies. Non-inferiority of the homeopathic complex remedy to xylometazoline could be shown for all studied variables and in no case did the lower boundary of the 95% confidence interval cross the threshold of 0.5 score points. Tolerability was good with for both therapies. CONCLUSIONS: This cohort study indicates a comparable efficacy and tolerability profile of the homeopathic complex remedy Euphorbium compositum nasal drops SN and the reference substance xylometazoline in patients with inflammatory processes and diseases of the upper respiratory tract.

Luffa operculata effects on the epithelium of frog palate: histological features.

UNLABELLED: Luffa operculata is the botanical name of buchinha-do-norte or cabacinha, which is a medicinal plant widely used for the treatment of rhinitis and rhinosinusitis. In Europe and USA, it is available in homeopathic medicines. In Brazil, Luffa operculata dry fruit infusion is inhaled or instilled into the nose releasing profuse mucous secretion, thus relieving nasal symptoms. Nevertheless, this often may cause irritation, epistaxis or anosmia. STUDY DESIGN: Experimental. MATERIAL AND METHOD: The effects of Luffa operculata were evaluated in different concentration infusions, in isolated frog palate preparation, testing 46 palates after immersion. Four groups (n = 10) were tested with the infusion prepared with frog Ringer (isotonic): control; 60 mg/L; 600 mg/L; and 1200 mg/L. An additional group was tested using the infusion with water (600 mg/L H2O, n = 6). Epithelial samples were harvested to be studied under light microscopy and electron transmission microscopy. RESULTS: In treated palates, light microscopy findings were dose-dependent standard toxic changes. Electron transmission microscopy showed enlargement of intercellular spaces and tight junctions disruption, pointing to ion-fluid transport abnormalities. CONCLUSIONS: Luffa operculata infusion in currently used doses can promote significant structural and ultrastructural changes in the epithelium of this ex vivo model of respiratory mucosa.

Alternative therapies among adults with a reported diagnosis of asthma or rhinosinusitis : data from a population-based survey.

BACKGROUND: Asthma and rhinosinusitis are common medical conditions among adults. Alternative treatments could have important impacts on health status among those individuals with these conditions, but specific prevalence data for these treatments are limited. OBJECTIVE: To estimate the prevalence of specific alternative treatment modalities, including herbal agents, ingestion of caffeinated beverages, homeopathy, acupuncture, and massage therapies. DESIGN: Random population telephone sample. SETTING: Northern California. PARTICIPANTS: Three hundred adults aged 18 to 50 years with self-report of a physician diagnosis of asthma (n = 125) or rhinosinusitis without concomitant asthma (n = 175). MEASUREMENTS: Structured telephone interviews covering demographics and clinical variables, including the following alternative treatments used in the previous 12 months: herbal agents; caffeine-containing products; homeopathy; acupuncture; aromatherapy; reflexology; and massage. RESULTS: Any alternative practice was reported by 127 subjects (42%; 95% confidence interval [CI], 36 to 48%). Of these, 33 subjects (26%; 95% CI, 21 to 31%) were not current prescription medication users. Herbal use was reported by 72 subjects (24%), caffeine treatment by 54 subjects (18%), and other alternative treatments by 66 subjects (22%). Taking into account demographic variables, subjects with asthma were more likely than those with rhinitis alone to report caffeine self-treatment for their condition (odds ratio, 2.5; 95% CI, 1.4 to 4.8%), but herbal use and other alternative treatments did not differ significantly by condition group. CONCLUSION: Alternative treatments are frequent among adults with asthma or rhinosinusitis and should be taken into account by health-care providers and public health and policy analysts.