Search

To explore the efficacy of mild moxibustion plus loratadine tablets for children with allergic rhinitis (AR). A total of 80 children were randomized into a control group and an observation group, with 40 cases in each group. The control group was treated with loratadine tablets, and the observation group was treated with mild moxibustion plus loratadine tablets. Before and after treatment, the total nasal symptom score (TNSS) was evaluated, and the serum eosnophils (EOS) count, and the interleukin (IL)-27 and macrophage migration inhibitory factor (MIF) levels were measured. Clinical efficacy was evaluated after treatment. The total effective rate of the observation group was higher than that of the control group (P 0.05), and the serum MIF level decreased after treatment (P

This systematic review was conducted to answer the following 3 questions: ‘Does nasal pathology affect CPAP use?’, ‘What is the effect of CPAP on the nose?’ and ‘Does treatment of nasal pathology affect CPAP use?’. Pubmed and Scopus databases were searched for articles relevant to the study questions up to October 2020. Sixty-three articles were selected, of which a majority were observational studies. Most studies identified a correlation between larger nasal cross-sectional area or lower nasal resistance and higher CPAP compliance or lower CPAP pressures; however, nasal symptoms at baseline did not appear to affect CPAP use. The effect of CPAP on the nose remains uncertain: while most studies suggested increased mucosal inflammation with CPAP, those investigating symptoms presented contradictory results, with some reporting an increase and others an improvement in nasal symptoms. Evidence is clearer for nasal surgery leading to an increase in CPAP compliance and a decrease in CPAP pressures, whereas there is little evidence available for the use of topical nasal steroids. There appears to be a link between nasal volumes or nasal resistance and CPAP compliance, an increase in nasal inflammation caused by CPAP and a beneficial effect of nasal surgery on CPAP usage, but no significant effect of CPAP on nasal patency or effect of topical steroids on CPAP compliance. Results are more mitigated with regard to the effect of nasal symptoms on CPAP use and vice versa, and further research in this area would help identify patients who may benefit from additional support or treatment alongside CPAP.

Nasal pathologies are characterized by a symptomatology that hardly allows to distinguish allergic rhinitis (AR), non-allergic rhinitis (NAR), and chronic rhinosinusitis (CRS). Nasal cytology (NC) has shown increasing importance in helping the clinician to differentiate the various phenotypes of rhinitis. NC allows us to evaluate nasal cellularity by distinguishing AR and various types of NAR. The objective of the study is to assess the diagnostic performance of the NC by evaluating its sensitivity, specificity, and predictive value. We recruited 387 patients with persistent rhinitis symptoms, and nasal cytology was performed. The rhinocytogram was obtained by reading for fields and the cellular count was made using quantitative and semi-quantitative grading together. Two hundred and fifteen patients (55.5%; 38 had acute rhinitis, 24 acute sinusitis, 153 chronic rhinosinusitis) out of 387 referred nasal symptoms. Cytological specimen showed a mean of 94 ± 4% ciliated cells, 29 ± 0.2% mucinous cells, 16 ± 0.1% neutrophils, 11 ± 0.08% eosinophils, 4 ± 0.03 lymphocytes, 4 ± 0.03% mast cells, and 4 ± 0.01% other cells. NC was positive in 271 cases (70%). After revision of medical history, 153 patients (39%) were considered positive for NAR. Test sensibility was 100% (95% CI 97–100), specificity was 49.6% (95% CI 43–56%). Positive predictive value (PPV) was 56% (95% CI 50–62%), and negative predictive value (NPV) was 100% (95% CI 96–100%). The positive likelihood ratio was 1.98 (95% CI 1.75–2.25). Accuracy of the test was 69.5% (95% CI 64.6–74.0%). Our data showed ability to identify the true-positive patients with NAR but a low ability to identify the true-negative patients, with a global accuracy of 69.5%.

To evaluate the efficacy and safety of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farinae (Df) drops in monosensitized and polysensitized patients with allergic rhinitis (AR) and to analyze the adverse events (AEs).A retrospective analysis was performed using data for 68 patients with AR who received SLIT. The patients were divided into a monosensitized group (36 cases) and a polysensitized group (32 cases) based on serum-specific IgE test results. In the two groups of patients, total nasal symptoms score (TNSS), total medication score (TMS), visual analog scale (VAS) score, and AEs before treatment and at 1, 3, 6, and 12 months of treatment were evaluated.Compared with that before treatment, the TNSS, TMS, and VAS score in the monosensitized and polysensitized groups all decreased significantly at 3, 6, and 12 months of SLIT (all P 0.05). There were no significant differences in treatment efficacy indicators between the two groups at all treatment time points (all P 0.05). In terms of safety, compared with 1 month after initiating SLIT, the incidence of AEs in the monosensitized and polysensitized groups at 6 and 12 months of treatment significantly decreased (all P 0.05). There was a statistically significant decrease in the incidence of AEs in both groups at 6 months compared with 3 months of treatment (χSLIT with standardized Df drops has similar efficacy and safety for monosensitized and polysensitized patients with AR. AEs mostly occurred during the first 3 months of SLIT in both the monosensitized and polysensitized groups, and the incidence of AEs gradually decreased as the course of treatment extended.

Purpose Nasal irrigation is an effective method for alleviating several nasal symptoms and regular seawater-based nasal irrigation is useful for maintaining nasal hygiene which is essential for appropriate functioning of the nose and for preventing airborne particles including some pollutants, pathogens, and allergens from moving further in the respiratory system. However, safety studies on seawater-based nasal irrigation are scarce. In this study, the safety and efficacy of a diluted isotonic seawater solution (Stérimar Nasal Hygiene, SNH) in maintaining nasal homeostasis were evaluated in vitro. Methods Safety was assessed by measuring tissue integrity via transepithelial electrical resistance (TEER). Efficacy was measured by mucociliary clearance (MCC), mucin secretion, and tissue re-epithelization (wound repair) assays. All assays were performed using a 3D reconstituted human nasal epithelium model. Results In SNH-treated tissues, TEER values were statistically significantly lower than the untreated tissues; however, the values were above the tissue integrity limit. SNH treatment significantly increased MCC (88 vs. 36 µm/s, p p Conclusion SNH did not compromise the integrity of the nasal epithelium in vitro. Furthermore, SNH was effective for removal of foreign particles through MCC increase and for enhancing wound repair on nasal mucosa.

Recalcitrance of allergic rhinitis (AR) to medical management may be reflective of patient-specific impact of AR symptoms. To understand the relationship between AR symptoms and general health-related quality of life (QOL) or AR control, based on treatment status. Cross-sectional cohort study of 130 adult participants—65 using no allergy medications and 65 consistently using intranasal corticosteroid sprays (ICS) in the last 3 months—presenting with persistent AR. General health-related QOL was measured using the EuroQol 5-dimensional visual analog scale (EQ-5D VAS). Severity and control of AR symptoms were measured using the 22-item Sinonasal Outcome Test (SNOT-22) and the Rhinitis Control Assessment Test (RCAT), respectively. We compared associations between AR symptoms and general health-related QOL and AR control in patients presenting with persistent AR with and without ICS use. Severity of AR symptoms was similar between cohorts. In participants using no allergy medications, extranasal AR symptom severities were most dominantly associated with decreased EQ-5D VAS and RCAT score. In participants using ICS, only nasal symptom severities were associated with decreased EQ-5D VAS and RCAT scores. Consistently, only in participants on ICS was a deviated septum associated with decreased EQ-5D VAS (β = − 12.1, 95% CI − 21.1 to − 3.1, p = 0.011) and poorly controlled AR (OR = 4.27, 96% CI 1.27 to 14.33; p = 0.019). In persistent AR despite consistent ICS use, nasal symptoms may be the dominant drivers of AR-associated decreased general health-related QOL in contrast to persistent AR on no medication, when extranasal symptoms of AR are most significant. Longitudinal study is needed to investigate whether these results are predictive of responsiveness to ICS.

The objective of this study were to assess the pulmonary function in patients with ethmoidal polyposis who did not respond to medical treatment; to evaluate the effect of Functional Endoscopic Sinus Surgery on the lung function of these patients and to compare the total nasal symptom score in these patients. A prospective observational study was conducted in Department of ENT, KMC Manipal on 50 subjects with ethmoidal polyposis who were unresponsive to medical treatment and hence underwent FESS. Pulmonary function tests were assessed using spirometry and nasal symptoms were scored as per TNSS system prior to surgery and 3 months post-surgery and compared with the pre-operative values and analysed. Pre operatively majority (35 patients) had TNSS value of 6–9 whereas post operatively the score was reduced to 2–3 in many patients (38 patients). The mean TNSS was 7.24 before surgery which declined to 2.82 after surgery with a p value

To evaluate the frequency of nasal symptoms termed nasal vestibulitis, including nasal dryness, crusting, bleeding, and pain, among patients receiving systemic, antineoplastic therapy. Patients undergoing systemic antineoplastic therapy were interviewed regarding the presence of nasal symptoms. In an explorative approach, Fisher’s exact tests were used to identify groups in which frequencies of nasal symptoms were higher than the comparator arm. To account for potential confounding factors, including demographic variables and concurrent therapies, logistic regression analyses were performed, and estimated proportions with their standard errors (SEs) and odds ratios (ORs) were reported. Forty-one percent of the 100 surveyed patients had nasal symptoms, including dryness, pain, bleeding, and scabbing. Higher frequencies were reported among those who had received taxanes (71%) and VEGF-related therapies (78%). For the patients who had received taxanes, after controlling for other factors, the odds of experiencing nasal symptoms were 4.86 times higher than those for patients who did not receive taxanes (90% CI 2.01, 11.76). For patients who received VEGF-related therapies, after controlling for other factors and exposure to taxanes, the odds of experiencing nasal symptoms were 7.38 (90% CI 1.68, 32.51) times higher than those for patients who did not. Sixty-one percent of patients with symptoms said they reported them to their provider, but only 41% of chart notes contained documentation of such; 49% of patients reported treating their symptoms. Nasal vestibulitis is common among patients receiving taxane- and VEGF-related therapies; these symptoms are infrequently recorded or treated by healthcare providers.

Background To investigate the relationship between symptom of attention-deficit/hyperactivity disorder (ADHD) and allergic rhinitis (AR) in AR children of different genders and ages. Methods Four hundred and sixty-five allergic rhinitis children aged 6–12 years old were recruited in this study. Skin-prick test, Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), Total Nasal Symptoms Score (TNSS) and the Swanson, Nolan, and Pelham version IV scale (SNAP-IV) were recorded. Patients were divided into AR with ADHD and AR without ADHD, according to the SNAP-IV scale results. Results Children with the inattention/hyperactivity scale (IHS) > 1.25 accounted for 26.4% of all children with AR. The TNSS with IHS > 1.25 group were significantly higher than the IHS ≤ 1.25 group. Univariate analysis showed that age, gender, duration of AR symptoms, skin index, and PRQLQ subscales were associated with symptoms of hyperactivity and attention deficit (IHS > 1.25). After normalizing the age and gender factors, duration of AR symptoms and skin index correlated with IHS > 1.25. After stratifying age and gender, the correlation between IHS > 1.25 and skin index and PRQLQ subscales was mainly found in male children, and the association between the duration of AR symptoms and IHS > 1.25 was reflected in each group. Conclusions ADHD in children with AR is associated with severity, duration, and skin index of AR, and this association is more pronounced in male children. Electronic supplementary material The online version of this article (10.1186/s13052-019-0703-1) contains supplementary material, which is available to authorized users.

To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy (groups A) versus septoplasty alone (groups B) and to assess the improvement of nasal symptoms in both surgical groups before and after surgery by NOSE scale. This Tertiary Hospital based study was carried out between August 2012 and April 2014. 60 cases with septal deviation and contralateral inferior turbinate hypertrophy. Nasal Obstruction Symptom Evaluation (NOSE) scale for evaluating nasal symptoms. Patients were alternatively divided into two surgical groups, group A. Septoplasty with partial inferior turbinectomy and group B septoplasty alone. Post-operative patient’s symptoms evaluated by NOSE scale at 1, 3 and 6 months. Data analysed using tables, graph and percentage and test of significance like paired t test, Friedman test, Chi square test used. Post operative improvement following both group A septoplasty with partial inferior turbinectomy and group B in those undergoing septoplasty alone was highly significant (p

Allergic rhinitis is considered to be a major health problem that impairs quality of life. A possible relationship with psychological stress may exist. The aim of this study is to verify the relationship between persistent allergic rhinitis (PAR) and psychological stress aiming to improve treatment and thereby quality of life (QOL) of patients. Patients with PAR (166) were diagnosed then analyzed using the Kessler Psychological Distress Scale. Patients with allergic rhinitis and who were positive on the Kessler scale (122) were randomly divided equally into a control group which received levocetirizine and a study group which received levocetirizine and imipramine. Nasal symptom assessment and QOL assessment were performed in all patients after treatment. Of the 166 patients with PAR, 122 (73.5 %) were positive on the Kessler Psychological Distress Scale. There was a marked improvement in the study group compared with the control group as regards nasal symptoms with better QOL in the study group (6.93) compared with the control group (2.13). Psychological stress has a strong impact on persistent allergic rhinitis. When stress is controlled by a combined treatment of imipramine and levocetirizine, allergic rhinitis symptoms improved and a better QOL was obtained. Level of evidence: 3b.

Background Nasal nitrous oxide (nNO) is increased in allergic rhinitis (AR), but not in asthma, and is a non-invasive marker for inflammation in the nasal passages. Methods Levels of nNO were measured and compared in healthy children and children with mild and moderate-to-severe AR. Levels of nNO before and after treatment with steroids and/or antihistamine were then compared in the 2 AR groups. Their relationship to quality of life and nasal symptom and reactivity to outdoor and outdoor allergens were examined. Results nNO levels were higher in mild AR than in healthy children and higher in moderate-to-severe AR than in mild AR. One month steroid and/or antihistamine treatment lowered nNO levels to control levels in mild AR and approximately halfway to control levels in moderate-to-severe AR. nNO levels had a weak correlation to quality of life questions and a fair correlation to nasal symptom scores before treatment. This correlation was weakened or lost after treatment, and no correlation was seen between nNO levels and responses to indoor or outdoor allergens. Conclusion nNO levels in children with AR may be useful for assessing the response to treatment. Their relationship to quality of life, nasal symptoms, and sensitivity to specific allergens needs further study.

The purpose of the study was to analyze the patient's satisfaction following nasal septal surgery based on their subjective opinion and to study whether the SNOT-22 can be used as a reliable outcome measure for successful septal surgery.Between Oct 2005-July 2007, sixty consecutive adult patients who underwent nasal septal surgery and met the study criterion were enrolled. The patients were asked to fill in the SNOT-22 questionnaire both prior to and at regular follow up periods after the surgery.The mean total preoperative SNOT score (of all 22 items) was 20.67 and the mean total postoperative SNOT-22 score was 10.48 (t = 8.8135, p0.001 highly significant). On further analysis, improvement was seen in subcategories of Nasal Symptoms (t = 8.0825, p0.001 highly significant), Non Nasal Symptoms (t = 3.0913, p0.0025 significant), General health symptoms (t = 4.8602, p0.001 highly significant) and Nasal Obstruction (t = 7.7652, p0.001 highly significant).The SNOT-22 score is a useful and reliable tool in nasal septal surgery in that it combines both nasal specific and quality of life related questions, which can be assessed individually and together both pre and post operatively.

Summary Background: There is increasing interest in the possibility that rhinitis and asthma are intricately interlinked. The aim of this baseline audit was to investigate the prevalence and characteristics of rhinitis symptoms in a large-scale UK primary care-based survey of patients with asthma. Methods: A questionnaire about the presence/absence and type of nasal symptoms, seasonal variations, and trigger factors was developed and piloted. This was then distributed among approximately 10,500 patients with clinician-diagnosed asthma via a national database of practice nurses. Results: We achieved a response from 7,129 patients (68%). Of these, 76% ( n = 5,420) had symptoms indicative of rhinitis as shown by the presence of more than one of the following: nasal blockage; runny nose; sneezing; and itchy eyes, ears or palate. 58% reported predominantly seasonal symptoms and 42% predominantly perennial symptoms. Sneezing was reported in a significantly greater proportion of patients with seasonal (66%) than perennial (58%) symptoms, together with itchy eyes/ears/palate (seasonal 60%, perennial 48%) and rhinorrhoea (56%, 51%) (all p ≤ 0.001). Symptoms of nasal blockage were more commonly reported in the group with perennial symptoms (perennial 61%, seasonal 53%) ( p Conclusions: In this large national baseline survey, 76% of patients with asthma reported symptoms indicative of rhinitis. In view of the very high prevalence of rhinitis among people with asthma, we suggest that the diagnosis of rhinitis is considered in all those with asthma.

Grading the severity of rhinitis symptoms is essential for the evaluation of drug efficacy. However, a uniform grading system has not been standardized. A review of 44 journal articles and symposia from Japan, Copenhagen, and the World Health Organization indicates major differences among systems. All except the World Health Organization used a sum of rhinitis scores. The lack of standardization limits comparisons of subjective symptom changes after comparable treatments. Corrective measures include the use of evidence-based definitions of independent nasal symptoms, avoidance of biases in evaluation, and establishment of international consensus for a standardized scale in this era of globalization.

In Melbourne, Australia, grass pollen is the predominant cause of hayfever in late spring and summer. The grass pollen season has been monitored in Melbourne, using a Burkard spore trap, for 13 years (1975–1981, 1985 and 1991–1997). Total counts for grass pollen were highly variable from one season to the next (approximately 1000 to >8000 grains/m3). The daily grass pollen counts also showed a high variability (0 to approximately 400 grains/m3). In this study, the grass pollen counts of the 13 years (12 grass pollen seasons, extending from October to January) have been compared with meteorological data in order to identify the conditions that can determine the daily amounts of grass pollen in the air. It was found that the seasonal total of grass pollen was directly correlated with the rainfall sum of the preceding 12 months (1 September–31 August): seasonal total of grass pollen (counts/m3)=18.161 × rainfall sum of the preceding 12 months (mm) −8541.5 (r s=0.74,P

In this study, air pollutants such as NO 3 − and SO 4 −2 which were found deposited on Japanese cedar pollen in a mountainous area (Tsukechi-cho), and in an urban area (Mizuho Ward, Nagoya City) were measured by ion-chromatography in March 1987 and again in March 1991. An investigation of the pollinosis rate in about 400 Junior High School students in both areas was undertaken during the same periods through both a questionnaire study, and a physical examination. Information was also gathered on the number of vehicles passing through the corresponding areas. The results of this research are as follows: (1) The quantity of NO 3 − deposited on the pollen of Japanese cedar was about 2.3 and 2.0 times greater in the urban area than in the mountainous area (1987 and 1991, respectively). The concentration of SO 4 −2 was about 7.8 and 3.6 times higher in the urban area than in the mountainous area (1987 and 1991, respectively). (2) The results of a questionnaire study taken at the two Junior High Schools from the different districts showed a lower incidence of nasal symptoms in the mountainous area than in the urban area for 1987. The percentage of pollinosis shown by physical examination in the mountainous area rose from 20.1% in 1987 to 30.0% in 1991, and this corresponds to a rise in the number of motor vehicles in the area. Comparatively, in the urban area, the questionnaire results and physical examinations revealed no changes from 1987 to 1991.

Serial nasal peak expiratory flow rate (PEFRN) recordings and symptom ratings were used on 39 woodwork teachers exposed mainly to wood dust and on 31 control subjects (other school personnel) during a working week. The objective was to study whether the peak flow method is useful for the assessment of work-related nasal obstructive symptoms. By comparison with the controls, the woodwork teachers reported a higher level of nasal blockage, with a pattern of gradual increase during the working week, over which period the PEFRN deteriorated gradually. The method is considered useful for detecting work-related nasal obstruction in groups with exposure to airborne irritants and can be recommended for such purposes. But because of the great variability of peak flow values, many measurements on a great number of individuals must be performed.

Our study of fifty two hay fever patients included twenty six solely allergic to grass pollen and twenty six exhibiting allergy to various pollen species, such as hazel, birch, oak, poplar, andArtemisia. Their total and specific IgE response was evalutated by the immunoenzymatic method, while clinical reactivity was assessed by recording nasal and bronchial symptom scores between mid-March and mid-July. Simultaneously pollen counts were made. Polysensitized patients showed significantly higher levels of both total and specific IgE, which testifies to the enhanced quantitative and qualitative IgE. Multisensitized patients reacted earlier than patients sensitized to grass pollen only, which confirms that non-grass plants flowering only in the spring cause the priming effect on the nasal and bronchial mucosa. The early symptoms may be attributable to tree pollen sensitivity or may refletct higher grass pollen IgE levels in the polysensitized group. Characteristically, nasal symptoms preceded bronchial symptoms of several weeks.

Platelet activating factor (PAF) is known to have a wide range of biological activities. In the lower airways PAF has been suggested as the biochemical mediator partly responsible for the bronchial hyperreactivity which is a feature of asthma. In order to study whether PAF has a similar effect in the upper airways, we carried out a double blind, placebo-controlled cross-over study in twelve patients with strictly seasonal allergic rhinitis. The study was performed in pollen-free winter months. 26 micrograms PAF or placebo was sprayed into each nasal cavity 8 h and 1 h before a nasal allergen challenge. The nasal response to PAF and the allergen challenge that followed was monitored by repeated measurements of nasal expiratory peak flow rate and symptom scores. PAF induced only minor changes in nasal patency and nasal symptoms as compared to placebo. However, pretreatment with PAF induced an increase in responsiveness of the nasal vasculature to the allergen challenge that followed. This was registered as a small, but statistically significant increase in the symptom scores for nasal blockage, from 1.7 (0.3; SEM) after placebo pretreatment to 2.4 (0.36; SEM) after PAF (p less than 0.05). A similar trend was also noted for the measurements of nasal peak flow. The other response parameters, sneezes and secretion, remained identical. These results suggest that PAF may play a role in human nasal hyperreactivity, but it appears that PAF is not a major mediator involved in the induction of this phenomenon.