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1.
J Assoc Physicians India ; 68(3): 43-47, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32138483

RESUMO

Introduction: Allergic rhinitis (AR) and asthma are closely linked atopic conditions, often termed as one airway one disease. Nasal airflow obstruction is a cardinal symptom of AR and objective assessment of resistance to nasal airflow in rhinitis can be measured by active anterior rhinomanometry. This study was aimed at correlating the degree of resistance to nasal airflow (NAR) with the clinical severity of allergic rhinitis. In addition, it aimed at determining the proportion of patients with latent lower airway involvement in AR and studying the impact of ARIA severity grade and NAR on this value. Materials and Methods: A prospective prevalence study was conducted wherein 32 patients diagnosed with allergic rhinitis underwent determination of nasal airway resistance by active anterior rhinomanometry and lung function evaluation by spirometry. If spirometry was normal; histamine challenge test was performed to check for bronchial hyper-reactivity. Results: 94% of patients with moderate- severe allergic rhinitis had significantly elevated nasal airway resistance compared to 56% of patients with mild rhinitis. (p=0.014). 71.9% of patients with allergic rhinitis but no symptoms of asthma had bronchial hyper-reactivity with a positive histamine challenge or airflow obstruction on lung functions. 87.5% patients with significantly elevated nasal airway resistance compared to 25% with lower values had lower airway involvement. (p=0.001). 94% of patients with moderate - severe rhinitis and 83% of patients with persistent rhinitis compared to 50% patients with mild and 44% with intermittent symptoms had lower airways involved. (p<0.05). Conclusion: Significantly greater proportion of patients with moderate-severe and persistent allergic rhinitis had elevated nasal airway resistance values. 72% patients with allergic rhinitis had lower airway involvement despite having no symptoms of asthma, prevalence being greater in patients with severe and persistent disease. Proportion of patients with lower airway hyper-responsiveness is significantly higher among patients with raised nasal airway resistance as determined by rhinomanometry. This study thus concludes that measurement of nasal airway resistance determined by active anterior rhinomanometry is a good objective tool to measure severity of nasal obstruction in allergic rhinitis with good correlation with the ARIA clinical severity grade .It may also be a promising tool to identify allergic rhinitis patients who are at a higher risk of having latent lower airway involvement.


Assuntos
Resistência das Vias Respiratórias , Obstrução Nasal , Rinite Alérgica , Humanos , Estudos Prospectivos , Rinite , Rinomanometria
2.
Medicine (Baltimore) ; 99(9): e18965, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118709

RESUMO

BACKGROUND: This study aims to assess the quality and safety of life in patients with chronic rhinosinusitis (CRS) treated by acupuncture. METHODS: An extensive database search was executed to find the randomized controlled trials on acupuncture vs. sham acupuncture, and any other treatments for patients with CRS. Review Manager 5 (RevMan) was used for the data analysis. A strict methodology was used when the meta-analysis was performed. RESULTS: This study systematically assesses the effectiveness and safety of acupuncture in patients with CRS. The primary outcomes include health-related quality of life, disease severity, treatment-related adverse events. The secondary outcomes are comprised of recurrence rate, endoscopic score, computerized tomography (CT) scan score and objective physiological measures. CONCLUSION: This article summarizes the current evidence base for the quality of life and safety of acupuncture in patients with CRS. SYSTEMATIC REVIEW REGISTRATION: International Prospective Register of Systematic Reviews PROSPERO (registration number CRD42018114432).


Assuntos
Terapia por Acupuntura , Rinite/terapia , Sinusite/terapia , Doença Crônica , Humanos , Qualidade de Vida , Revisão Sistemática como Assunto
3.
Artigo em Chinês | MEDLINE | ID: mdl-32086888

RESUMO

Objective:To investigate the clinical efficacy of "Zhuyuan soup" by combination with fumigation and oral administration on chronic rhinosinusitis(CRS), further exploring effective Chinese medicine for the disease, and giving full play to the unique advantages of external treatment of traditional Chinese medicine. Method:By using randomized and positive drug controlled methods, patients with moderate-to-severe chronic rhinosinusitis were randomly divided into western medicine group and traditional Chinese medicine group, 30 cases in each group. In the western medicine group, the nasal spray hormone Budesonide was used, and the patients in the traditional Chinese medicine group were treated with the traditional Chinese medicine prescription"Zhuyuan soup"by combination with fumigation and oral administration. All of the above patients were followed up for 2 weeks, and 1 course for 1 month. Visual analogue scores were taken at each follow-up, and CT and nasal endoscopy were performed before and after treatment. Result:The total effective of "Zhuyuan soup" group was 67.1%, which was higher than that of western medicine group(59.6%), but there was no statistically significant difference(P>0.05). After treatment, there were no significant differences between the two groups with regard to the symptom of nasal congestion, dizziness, facial pain or fullness, dysosmia, nasal discharge or postnasal drip, total sensation, total symptom score(P>0.05). According to the total symptom score, the effect of the two groups of patients was not significantly correlated with the gender, age, course of disease, alcohol and tobacco hobbies, previous medication and surgery(P>0.05). Based on the results of the study, we found that the Chinese medicine group is superior to the western medicine group in improving the total feeling of the disease, dizziness or headache, facial pain or fullness, and postnasal drip, olfactory disorder. Conclusion:Both traditional Chinese medicine and western medicine are effective methods for treating chronic rhinosinusitis. Clinically, individualized comprehensive treatment should be carried out according to the patient's condition. The above methods may be applied alone or in combination with Chinese and Western medicine. Further optimization and improvement of the combination of traditional Chinese and Western medicine in chronic sinusitis can help improve the clinical efficacy and satisfaction of patients, which deserves further study.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fumigação , Medicina Tradicional Chinesa , Rinite/terapia , Sinusite/terapia , Budesonida/uso terapêutico , Doença Crônica , Endoscopia , Humanos
4.
Artigo em Chinês | MEDLINE | ID: mdl-32086890

RESUMO

The pathogenesis of chronic rhinosinusitis(CRS) is complex. There are differences in the clinical manifestations and therapeutic effects of CRS dominated by different causes. At present, there is a lack of uniform classification standards in clinical practice. In this paper, the research progress in the endotype of CRS in recent years was discussed.


Assuntos
Rinite/classificação , Sinusite/classificação , Doença Crônica , Humanos , Rinite/diagnóstico , Sinusite/diagnóstico
5.
Artigo em Chinês | MEDLINE | ID: mdl-32086908

RESUMO

Botulinum toxin A is a kind of neurotoxin produced by clostridium botulinum, and has been applied for nearly thirty years in China.The target of BTX-A is to selectively cleave the synaptosome-associated protein of 25 KD molecular mass, commonly abbreviated SNAP-25, thereby inhibiting neurotransmitter release and causing chemodenervation. The potential application of botulinum toxin A in treating the spasmodic dysphonia, hemifacial spasm, tinnitus, rhinitis has been confirmed both in clinical practice and previous studies. This paper is to review comprehensively the application status and the prospect of botulinum toxin A in otorhinolaryngological treatment.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Bloqueio Nervoso , China , Disfonia/terapia , Espasmo Hemifacial/terapia , Humanos , Rinite/terapia , Zumbido/terapia
6.
Allergol. immunopatol ; 48(1): 3-7, ene.-feb. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-186585

RESUMO

Background: Anaphylaxis is a sudden, severe, and potentially life-threatening allergic reaction, affecting a portion of allergic patients. Adrenaline is the first-line medication for anaphylaxis and available in many parts of the world as adrenaline autoinjectors (AAIs). Objective: Aim of this study was to determine attitudes and knowledge levels of patients/parents regarding the use of AAIs, frequency, and rate of appropriate AAI use and to give a standardized and better education by improving on mistakes during administration. Method: 190 patients aged 1-18 years who were prescribed AAIs for any reason between 2012 and 2017 in Hacettepe University Pediatric Allergy Unit. Demographic data were collected during face-to-face interview or by telephone. Parents completed a mini-survey regarding use, carriage, and storage of AAI. Results: Some 190 patients (64.7% male) aged 7.83 (4.99-12.08) years, median (inter-quartile), were included in the study. The indications for AAI prescription were food allergy (78.9%); venom allergy (14.2%); idiopathic anaphylaxis (3.7%); mastocytosis (2.1%); and drug allergy (1.0%). One-fourth of AAI-prescribed patients experienced anaphylaxis requiring the use of AAI within the past five years. However, only 30% of the patients dared to use AAI; only three-quarters of whom had managed to use it correctly. Conclusion: After prescription of AAI and initial training, patients and parents' concerns and fears should be taken into consideration and necessary support should be provided. At every opportunity and each clinical visit, not only should training sessions be repeated but also the patients and parents should be psychologically supported


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Epinefrina/uso terapêutico , Autoadministração/métodos , Anafilaxia/tratamento farmacológico , Hipersensibilidade Alimentar/tratamento farmacológico , Asma , Rinite , Dermatite Atópica
7.
J Zoo Wildl Med ; 50(4): 1008-1011, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31926538

RESUMO

Curvularia spp. are globally distributed saprophytic fungi, classified in the literature as dematiaceous, or darkly pigmented fungi. These fungi have been increasingly recognized as causing cutaneous, ocular, respiratory, and central nervous system infections in humans, but have been infrequently documented as pathogens in the veterinary literature. A 5-yr-old male Chinese goral (Naemorhedus griseus) presented with bilateral fungal dermatitis of the pinnae, and subsequent pyogranulomatous rhinosinusitis. Clinical signs included epistaxis, mucosanguineous nasal discharge, and dyspnea. Sequential histologic examinations of cutaneous and nasal lesions revealed pyogranulomatous inflammation with extracellular and phagocytized nonpigmented yeasts. Fungal culture and polymerase chain reaction identified Curvularia sp. The absence of pigmentation in tissue in this case suggests that pigmentation may not be a consistent histologic finding for this fungus, emphasizing the importance of molecular identification to prevent misidentification. Despite intensive interventions in this goral, the disease progressed, and was ultimately fatal.


Assuntos
Dermatomiosite/veterinária , Rinite/veterinária , Sinusite/veterinária , Animais , Animais de Zoológico , Antifúngicos/uso terapêutico , Clotrimazol/uso terapêutico , Dermatomiosite/tratamento farmacológico , Dermatomiosite/microbiologia , Griseofulvina/uso terapêutico , Masculino , Rinite/tratamento farmacológico , Rinite/microbiologia , Ruminantes , Sinusite/tratamento farmacológico , Sinusite/microbiologia
8.
Ann Otol Rhinol Laryngol ; 129(3): 280-286, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31690091

RESUMO

OBJECTIVE: Functional endoscopic sinus surgery (FESS) and balloon sinus ostial dilation (BSD) are well-recognized minimally invasive surgical treatments for chronic rhinosinusitis without nasal polyps (CRSsNP) refractory symptoms to medical therapy. Patients on antiplatelet and anticoagulant therapies (AAT) usually are recommended to discontinue their medications around the period of endoscopic sinus surgery. The goal of this study is to assess the clinical experience of BSD in CRSsNP patients with concurrent anticoagulant or antiplatelet therapy. METHODS: A review of prospectively-collected clinical data from October 2012 to March 2017 were used to perform a cohort study of subjects with CRSsNP who met criteria for surgical intervention while on antiplatelet and anticoagulant therapy. Data were collected on demographics, details of the procedures, type of AAT used, pre- and postoperative 22-item Sino-Nasal Outcome Test (SNOT-22) scores, and complications. RESULTS: Thirty-five patients underwent in-office BSD while on antiplatelet and/or anticoagulant therapy. The mean difference in pre- and postoperative SNOT-22 scores of 9.9 (SD 14.4, P < .001) was both statistically significant and exceeded the minimal clinically important difference of 8.9. Absorbable nasal packing was used for persistent bleeding immediately post-procedure in two patients. Intraoperative bleeding was associated with aspirin 325 mg and warfarin. FESS was required for further management of chronic sinusitis in four patients after anticoagulant/antiplatelet therapy could be discontinued. There were no systemic complications. None of the patients experienced significant bleeding events postoperatively after leaving the office. CONCLUSION: In-office BSD appears to be a safe alternative to endoscopic sinus surgery in select patients who cannot discontinue antiplatelet and anticoagulant therapy. LEVELS OF EVIDENCE: IV.


Assuntos
Assistência Ambulatorial , Dilatação , Rinite/terapia , Sinusite/terapia , Idoso , Anticoagulantes/uso terapêutico , Doença Crônica , Estudos de Coortes , Feminino , Hemorragia/etiologia , Hemorragia/terapia , Humanos , Masculino , Inibidores da Agregação de Plaquetas/uso terapêutico , Tampões Cirúrgicos
9.
Ann Otol Rhinol Laryngol ; 129(2): 164-169, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31581795

RESUMO

OBJECTIVE: The objective of this study was to determine whether patients with rhinitis medicamentosa (RM) have an increased odds of having an opioid use disorder (OUD) and which characteristics may predict this association. METHODS: The authors conducted a retrospective case control study of patients 18 years and older who presented to the otolaryngology clinic at an academic medical center from January 2013 through December 2017. Cases, defined as patients who presented with excessive decongestant nasal spray usage based on history, were matched to control patients who presented with chronic rhinitis and did not report regular nasal decongestant usage. The charts were reviewed for patients that carried a problem of opioid abuse, identified using ICD-9 codes 304.XX or ICD-10 codes F11.XX. The primary outcome of this study was the odds of having an OUD. Secondary outcomes were assessed by summary statistics. RESULTS: One hundred and thirty-one cases of RM were matched to 1871 controls of chronic rhinitis. Seven cases (5.3%) and 24 (1.3%) controls had a diagnosis of OUD, consistent with an odds ratio of 3.98 for opioid abuse in patients with RM (95% CI: 1.47-9.71). Oxymetazoline was used by 85.5% (n = 112) of patients with RM. Thirty-six patients (27.1%) with RM underwent nasal surgery following a diagnosis of RM, of which twenty patients (55.6%) were prescribed opioids following the procedure. CONCLUSIONS: RM is associated with increased odds of having an OUD.


Assuntos
Descongestionantes Nasais/administração & dosagem , Transtornos Relacionados ao Uso de Opioides/complicações , Rinite/induzido quimicamente , Rinite/complicações , Administração Tópica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Descongestionantes Nasais/efeitos adversos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Estudos Retrospectivos , Rinite/epidemiologia , Adulto Jovem
10.
Int Arch Allergy Immunol ; 181(1): 51-55, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31752005

RESUMO

BACKGROUND: Allergic rhinitis is an allergic inflammation of the nasal airways, and chronic rhinosinusitis is an inflammation of the paranasal sinuses. It can be induced by infection, allergy, or autoimmune problems. Diagnosis of these two diseases is made primarily based on clinical symptoms, allergen test, and imaging. The allergen test is invasive and expensive. The imaging test is harmful to children. Measurement of nasal nitric oxide (NNO) was noninvasive, without radiation, and inexpensive. This study was to evaluate the clinical significance of NNO in preschool children with nasal inflammatory diseases. METHODS: A total of 55 cases of allergic rhinitis, including 35 mild cases and 20 moderate to severe cases, and 33 cases of chronic rhinosinusitis, including 18 mild cases and 15 moderate to severe cases were selected as the experimental group. Fifty healthy preschool children were chosen as the control group. The levels of NNO in all children were measured. The differences in the levels of NNO among allergic rhinitis, chronic rhinosinusitis, and the control group were compared. The levels of NNO in the control group were also analyzed. RESULTS: The levels of NNO were significantly higher in preschool children with allergic rhinitis than in the control group, and the differences were significant. However, the levels of NNO in preschool children with chronic rhinosinusitis were lower than in the control group. In the control group, the levels of NNO were not significantly different between genders, and no significant correlation between NNO levels and the children's height was found. CONCLUSION: As a noninvasive method for detecting nasal inflammatory diseases, measuring the levels of NNO had a high clinical significance in preschool children.


Assuntos
Testes Respiratórios/métodos , Óxido Nítrico/análise , Rinite Alérgica/diagnóstico , Rinite/diagnóstico , Sinusite/diagnóstico , Criança , Pré-Escolar , Doença Crônica , Expiração , Feminino , Humanos , Masculino
12.
Ann Otol Rhinol Laryngol ; 129(3): 245-255, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31646875

RESUMO

OBJECTIVES: Diesel exhaust particles (DEP)s are notorious ambient pollutants composed of a complex mixture of a carbon core and diverse chemical irritants. Several studies have demonstrated significant relationships between DEP exposure and serious nasal inflammatory response in vitro, but available information regarding underlying networks in terms of gene expression changes has not sufficiently explained potential mechanisms of DEP-induced nasal damage, especially in vivo. METHODS: In the present study, we identified DEP-induced gene expression profiles under short-term and long-term exposure, and identified signaling pathways based on microarray data for understanding effects of DEP exposure in the mouse nasal cavity. RESULTS: Alteration in gene expression due to DEP exposure provokes an imbalance of the immune system via dysregulated inflammatory markers, predicted to disrupt protective responses against harmful exogenous substances in the body. Several candidate markers were identified after validation using qRT-PCR, including S100A9, CAMP, IL20, and S100A8. CONCLUSIONS: Although further mechanistic studies are required for verifying the utility of the potential biomarkers suggested by the present study, our in vivo results may provide meaningful suggestions for understanding the complex cellular signaling pathways involved in DEP-induced nasal damages.


Assuntos
Expressão Gênica , Rinite/induzido quimicamente , Emissões de Veículos/toxicidade , Animais , Peptídeos Catiônicos Antimicrobianos/genética , Peptídeos Catiônicos Antimicrobianos/metabolismo , Antígeno B7-1/genética , Antígeno B7-1/metabolismo , Biomarcadores/metabolismo , Calgranulina A/genética , Calgranulina A/metabolismo , Calgranulina B/genética , Calgranulina B/metabolismo , Interleucinas/genética , Interleucinas/metabolismo , Camundongos Endogâmicos BALB C , Modelos Animais , Testes de Provocação Nasal , Análise de Sequência com Séries de Oligonucleotídeos , RNA/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Rinite/metabolismo , Transdução de Sinais , Membro 9 da Superfamília de Receptores de Fatores de Necrose Tumoral/genética , Membro 9 da Superfamília de Receptores de Fatores de Necrose Tumoral/metabolismo
13.
Environ Pollut ; 256: 113426, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31672368

RESUMO

BACKGROUND: The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China. METHODS: In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values. RESULTS: We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from -5.76% (95%CI: -7.74%, -3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare. CONCLUSIONS: Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children.


Assuntos
Asma/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Rinite/epidemiologia , Pequim , Criança , Pré-Escolar , China/epidemiologia , Culinária , Estudos Transversais , Feminino , Humanos , Hipersensibilidade , Estilo de Vida , Masculino , Gravidez , Prevalência , Sons Respiratórios , Fatores de Risco , População Rural
14.
Vet Clin North Am Small Anim Pract ; 50(2): 311-329, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31879130

RESUMO

The etiology of feline chronic rhinitis is incompletely understood and often is a diagnosis of exclusion. History, clinical signs, and investigations performed to reach this diagnosis are discussed. Several treatment options are provided, although cure of this frustrating disease is rarely achieved.


Assuntos
Doenças do Gato , Rinite/veterinária , Animais , Anti-Infecciosos/uso terapêutico , Doenças do Gato/diagnóstico , Doenças do Gato/tratamento farmacológico , Doenças do Gato/etiologia , Doenças do Gato/cirurgia , Gatos , Prognóstico , Rinite/diagnóstico , Rinite/etiologia , Rinite/terapia
15.
Med Clin North Am ; 104(1): 95-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757240

RESUMO

Asthma affects approximately 300 million people worldwide and approximately 7.5% of adults in the United States. Asthma is characterized by inflammation of the airways, variable airflow obstruction, and bronchial hyperresponsiveness. The diagnosis of asthma is a clinical one with the history and physical examination being significant, but objective measures, such as pulmonary function testing, can be used to aid in the diagnosis. There are multiple associated comorbidities with asthma, including rhinitis, sinusitis, gastroesophageal reflux disease, obstructive sleep apnea, and depression. There is often an allergic component of asthma, and patient education is vital.


Assuntos
Asma/epidemiologia , Adulto , Asma/diagnóstico , Depressão/epidemiologia , Refluxo Gastroesofágico/epidemiologia , Humanos , Testes de Função Respiratória , Rinite/epidemiologia , Sinusite/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Estados Unidos/epidemiologia
16.
Am J Rhinol Allergy ; 34(1): 141-142, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31510758
17.
Vestn Otorinolaringol ; 84(5): 48-54, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31793527

RESUMO

INTRODUCTION: Allogenic transplantation of hemopoetic stem cells (allo-THSC) is one of the most effective treatment methods for Hurler syndrome, aimed at maximal correction of complications related to the genetic disorder. Presence of infection in the recipient is an adverse risk factor, affecting the possibility of starting the conditioning regimen and THSC peforming in general. AIM: To assess the condition of the nasal cavity and paranasal sinuses in Hurler syndrome patients before the allo-THSC, dynamics of these changes after the transplantation taking into account the correction of alpha-L-iduronidase enzyme level with donor blood cells. MATERIAL AND METHODS: From February 2012 to December 2017, In the Raisa Gorbacheva Research Institute of Child Oncology, Hematology and Transplantology of the Pavlov First Saint Petersburg State Medical University, eighteen Hurler syndrome patients (10 girls and 8 boys) received an allo-THSC. Median age at the time of the procedure was 23,5 months (min - 3,4; max - 24,8). Each patient with the shadowing of paranasal sinuses, rhinitis or nasal breathing difficulty received a standard rhinosinusitis treatment before the transplantation, effect of which was insignificant. Symptoms of rhinitis, condition of pharyngeal tonsil and paranasal sinuses were assessed before and auto the allo-THSC. RESULTS: In the post-allo-THSC, with the correction of alpha-L-iduronidase level each evaluated parameter has improved reliably (p-value < 0,05). Comparative analysis of the condition of the nasal cavity and pharyngeal tonsil before and after THSC was conducted on 14 patients out of 18. Rhinitis symptoms decreased in 9 (64,2%) patients; in 11 patients (78,5%) adenoids size reduced. Comparative analysis of the condition of paranasal sinuses was possible in 12 patients out of 18. Sinuses aeration improved in eight (66,6%) if patients. CONCLUSION: Nasal cavity and paranasal sinuses changes in Hurler syndrome patients before and after allo-THSC is poorly studied. Our experience demonstrates the normalization of nasal cavity, pharyngeal tonsila and paranasal sinuses symptoms in the majority of the patients receiving allo-THSC. These symptoms are, it seems a consequence of the underlying disease.


Assuntos
Mucopolissacaridose I , Rinite , Sinusite , Pré-Escolar , Feminino , Células-Tronco Hematopoéticas , Humanos , Lactente , Masculino , Mucopolissacaridose I/terapia
18.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(11): 813-818, 2019 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-31795541

RESUMO

Objective: To investigate the prevalence and radiographic characteristics of ethmomaxillary sinus (EMS) in chronic rhinosinusitis (CRS) patients by CT scan, as well as their endoscopic surgical significance in antrostomy. Methods: A retrospective analysis of 111 CRS patients who were prepared for surgery in Department of Otorhinolaryngology Head and Neck Surgery of Peking University People's Hospital from February to December of 2017 was performed. In all CRS patients, 79 patients were bilateral CRS and 32 were unilateral. The patients were divided into two groups according to whether they had history of surgery. Only the sides with CRS were analyzed. There were 98 patients (167 sides) in the non-surgical history group and 13 patients (23 sides) in the surgical history group. The prevalence of EMS in CRS sides in the two groups was counted by analyzing the CT images. The CT image features and anatomical variations associated with EMS in CRS sides in the non-surgical history group were also analyzed. SPSS 22.0 software was used for statistic analysis. Results: The prevalence of EMS in CRS sides was 21.7% (5/23) in the surgical history group and 12.0% (20/167) in the non-surgical history group. No statistically significant difference in the prevalence of EMS was found between the two groups (χ(2)=0.940, P>0.05). The medial-lateral diameters of the EMS ranged from 8.50 to 14.10 mm with an average of (10.38±1.69) mm (Mean±SD). The shape of the bony septum between the EMS and maxillary sinus was divided into three types: convex toward to the EMS (2 sides), convex toward to maxillary sinus (5 sides) and flat (13 sides). The Lund-Mackay (LM) scores of the maxillary sinuses in patients with and without EMS showed no statistically significant difference (1.60±0.50 vs 1.40±0.62, Z=1.285, P>0.05). The EMS obstructed the drainage of maxillary sinus posteriorly, medially and superiorly. All the EMS in diseased sides were dissected endoscopicly to improve drainage. In the non-surgical history group, the EMS coexisting anatomic variations were the Onodi cell (7/20), Haller cell (3/20), concha bullosa (6/20) and maxillary sinus hypoplasia (3/20). Conclusions: There is relatively high prevalence of the EMS in CRS patients. This is adjacent to the orbit, overpneumatizes laterally and obstructs the drainage of the maxillary sinus. Complete dissection of the EMS is helpful to improve the drainage of maxillary sinus.


Assuntos
Seio Etmoidal/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Sinusite/diagnóstico por imagem , Sinusite/cirurgia , Doença Crônica , Endoscopia , Humanos , Procedimentos Cirúrgicos Nasais , Estudos Retrospectivos , Rinite/diagnóstico por imagem , Rinite/cirurgia , Tomografia Computadorizada por Raios X
19.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(11): 850-856, 2019 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-31795547

RESUMO

Objective: To explore the expression of amphiregulin (AREG) in nasal polyps patients with different degrees of eosinophil infiltration, and to analyze the correlation between AREG and tissue remodeling. Methods: Forty-eight patients underwent endoscopic sinus surgery in the Department of Otorhinolaryngology Head and Neck Surgery, Remin Hospital, Wuhan University from July 2017 to August 2018 were recruited, including 40 males and 8 females, aged from 16 to 60 years old. The subjects were divided into three groups: control group (n=14), eosinophilic chronic sinusitis with nasal polyps (ECRSwNP) group (n=19) and noneosinophilic chronic rhinosinusitis with nasal polyps (non-ECRSwNP) group (n=15). The relative expression of AREG in nasal mucosa was detected by Western blot assay and immunohistochemical staining. Tissue remodeling was detected by HE staining, AB-PAS staining and Masson staining. Kruskal-Wallis test was used for comparison among multiple groups, and Spearman correlation analysis was conducted between the expression level of AREG and the related indexes of tissue remodeling. Results: The expression of AREG in ECRSwNP group was significantly higher than that in non-ECRSwNP group and control group (median protein expression of Western blot was 1.592 vs 0.617 vs0.582, all P<0.05). The degree of epithelial injury and goblet cell metaplasia in ECRSwNP group was significantly higher than that in control group (all P<0.05), the percentage of collagen fibrosis area in ECRSwNP group was significantly lower than that in control group (P=0.01). In chronic rhinosinusitis with nasal polyps (CRSwNP) patients, the area of mucous glands was negatively correlated with the expression of AREG (r=-0.616, P<0.05), and the percentage of collagen fibrosis area was negatively correlated with the expression of AREG (r=-0.738, P<0.05). Conclusion: The expression of AREG is higher in ECRSwNP patients, which is related to the process of tissue remodeling.


Assuntos
Anfirregulina/biossíntese , Eosinófilos/metabolismo , Mucosa Nasal/metabolismo , Pólipos Nasais/metabolismo , Rinite/metabolismo , Sinusite/metabolismo , Adolescente , Adulto , Doença Crônica , Feminino , Fibrose/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/patologia , Mucosa Nasal/cirurgia , Pólipos Nasais/patologia , Pólipos Nasais/cirurgia , Rinite/patologia , Rinite/cirurgia , Sinusite/patologia , Sinusite/cirurgia , Adulto Jovem
20.
Arerugi ; 68(10): 1188-1191, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31827025
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