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Background: The allergic rhinitis and its impact on asthma (ARIA) guidelines provide a new classification of allergic rhinitis, but a quantitative analysis for severity assessment is lacking. Objective: To study whether a visual analog scale (VAS) for global rhinitis symptoms could be used to assess the disease severity according to ARIA. Methods: Three thousand fifty-two allergic rhinitis patients seen in primary care were tested. Fifty three per cent had an objective diagnosis of allergy and 58% of the patients were treated. Patients were categorized according to ARIA guidelines. The severity of nasal symptoms was assessed using a VAS. Quality of life was measured using the rhinoconjunctivitis quality of life questionnaire (RQLQ). Results: Severity had more impact on VAS levels than duration: mild intermittent rhinitis (3.5, 2.4–5.0 cm), mild persistent rhinitis (4.5, 3.2–5.6 cm), moderate/severe intermittent rhinitis (6.7, 5.3–7.7 cm) and moderate/severe persistent rhinitis (7.2, 6.1–8.2 cm). The receiver operating characteristic curve results showed that patients with a VAS of under 5 cm could be classified as ‘mild’ rhinitis (negative predictive value: 93.5%) and those with a VAS of over 6 cm as ‘moderate/severe’ rhinitis (positive predictive value: 73.6%). Receiver operating characteristic curves and a logistic regression showed that current treatment and allergy diagnosis have no effect on the assessment of rhinitis severity using VAS. Visual analog scale and the RQLQ global score were significantly correlated ( ρ = 0.46; P < 0.0001). Conclusion: A simple and quantitative method (VAS) can be used for the quantitative evaluation of severity of allergic rhinitis. [ABSTRACT FROM AUTHOR]

Background: All recent guidelines recommend a search for asthma utilizing both specific interrogation and pulmonary function tests in patients suffering from allergic rhinitis. Although the mandatory place of spirometry has not been confirmed, a self-questionnaire containing nine specific questions on asthma symptoms in different daily life situations was found to be capable of discriminating asthmatics from nonasthmatics in a rhinitic population. Objective: We addressed the questions of prevalence of asthma using a validated self-questionnaire and what might be the risk factors of being asthmatic according to that specific self-questionnaire. Methods: Between April 2003 and September 2004, nearly 12 000 rhinitis patients were enrolled by more than 2300 physicians (78% general practitioners, 22% ear nose and throat specialists). Patients were consulting for an exacerbation of chronic rhinitis and did not have a previous diagnosis of asthma. Both doctors and patients filled out a specific questionnaire on rhinitis and asthma. Results: Almost 30% of the patients had at least three positive answers to the self-questionnaire and could possibly be considered as asthmatics. We found five independent clinical risk factors for having ≥3 positive answers to the self-questionnaire. Severity of rhinitis (moderate-severe vs mild, OR = 1.84; 95% CI = 1.68–2.00), diagnosis of allergy (yes vs no) (OR = 1.86; 95% CI = 1.68–2.00), body mass index (≤18.5 vs >30) (OR = 0.51; 95% CI = 0.39–0.66), type of rhinitis (persistent vs intermittent) (OR = 1.25; 95% CI = 1.15–1.37), and patient age (≤25 vs >47) (OR = 0.73; 95% CI = 0.65–0.80). Conclusion: Asthma symptoms are frequent in rhinitics without a prior history of asthma. Several variables were shown to be predictive of asthma in these patients. [ABSTRACT FROM AUTHOR]

Background: Epidemiological and pathophysiologic studies have shown that allergic rhinitis and asthma often occur in combination. The internationally developed ARIA position paper (Allergic Rhinitis and its Impact on Asthma) recently offered recommendations on allergic rhinitis. As part of this new report and prior to its diffusion, we investigated the management of rhinopathies in asthma patients by pulmonologists in their everyday practice. Methods: From March to June 2000, 477 (48%) French pulmonologists in office-based practice participated in the survey. They were asked to include their first five asthmatic adult patients. In addition to descriptive statistics, univariate and multivariate analyzes were performed. Results: We studied 1623 patients with varying severity of asthma (sex ratio 0.9; median age 35 years). The pulmonologists reported rhinopathy in 76.6% of these, with a chronic course in 91%. Among the patients, 67.1% reported rhinopathy. The diagnosis was allergic rhinitis in 66.2% of participants and nasal polyposis in 10.1%. Examination of the nasal cavities was performed by the pulmonologists themselves in 56.2% of patients. Imaging of the sinuses was performed radiographically in 55.3% of enrolled patients and/or by computed tomography in 17.2%. Referral to an ENT specialist occurred for 21.6% of patients, being more common for patients with rhinitis that failed to respond to medical therapy (although some pulmonologists referred their patients routinely). Conclusions: The high prevalence of rhinopathies in asthma patients requires that these conditions are recognized and managed by pulmonologists. Thus, our findings support one of the central messages contained in the new ARIA guidelines—asthma patients should be investigated routinely for rhinitis and other rhinopathies. [ABSTRACT FROM AUTHOR]

Objective: To assess time trends in symptoms of asthma, allergic rhinitis and atopic eczema among adolescents in Languedoc Roussillon, France. Methods: Two cross-sectional surveys were conducted 7 years apart using the same protocol. School-based samples of 3383 participants in the 1995 survey and 1642 participants in the 2002 survey respectively were recruited. Results: There was a tendency towards stagnation in current symptoms of asthma, rhinoconjunctivitis and eczema. Indices related to lifetime diagnosis of asthma, hay fever and eczema increased. For all the conditions, indices of severity also showed a decrease in the 7-year study period. Conclusions: Our study shows that symptoms of asthma, allergic rhinitis and eczema were stable, supporting the effectiveness of national asthma prevention and management guidelines for such diseases. The increase in indices related to lifetime diagnosis could be the result of increased public and professional awareness of the diseases and changes in diagnostic labelling in recent years. [ABSTRACT FROM AUTHOR]

Investigates the role of spirometry in the diagnosis of asthma in those suffering from allergic rhinitis. Combination of the results of a self-administered questionnaire and pulmonary function tests; Correlation between the self-questionnaire outcomes and the final diagnosis; Occurrence of asthma-related symptoms in rhinitis patients.