1,721,213 research outputs found
"Overlapped" rhinitis: a real trap for rhinoallergologists
No full textUnder the broad heading of "vasomotor" rhinitis two big groups can be distinguished: allergic rhinitis (IgE-mediated), and nonallergic rhinitis. Since they are two separate nosological entities, they can co-exist in the same patient, classifying themselves in the group of "overlapped" rhinitis (OR). Although not absolutely rare (indeed it is estimated a 15-20% incidence among all vasomotor rhinopathies), this condition is not investigated and diagnosed, with significant implications in the clinical-diagnostic and therapeutic field
The clinical importance of the nasal valve
No full textThe nasal valve deserves relevant in patients presenting with nasal obstruction. In particular, the nasal valve plays an important role in nasal airflow control, it is relevant for the otolaryngologist to not only consider but also fully evaluate the nasal valve when seeing a patient with nasal obstruction. These data reported in this Supplement confirms the clinical relevance of the nasal valve in different groups of patients and normal subjects. In fact, an integrity of nasal valve is fundamental to ensure a physiological nasal breathing that in turn guarantees a correct pulmonary function. The possibility to use the non-surgical and well-accepted option constituted by the nasal internal dilator represent an interesting opportunity for both the physician and the patient
Open and clean: The healthy nose
No full textThe nose exerts many functions, mainly for the respiration and the olfaction and represents the first doorway for the oxygen, but also for pathogens. The present Supplement reports some clinical experiences concerning the use of a new internal nasal dilator in different settings, including nasal obstructive disorders, obstructive sleep apnea syndrome, continuous positive active pressure (CPAP), and sport activity. The outcomes support the concept that a healthy nose should be maintained ever patent and free from secretions, as impaired nasal function can significantly affect quality of life. Therefore, an “open and clean nose” contributes in a relevant way to the subjective wellness
Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR): new pragmatic insights in clinical practice
No full textGastroesophageal reflux (GER) is a common disease usually limited to the oesophagus. Laryngopharyngeal reflux (LPR) is an inflammatory reaction of the mucosa of pharynx, larynx, and other associated upper respiratory organs, caused by a reflux of stomach contents outside the oesophagus. LPR is considered to be a relatively new clinical entity with a vast number of clinical manifestations which are treated sometimes empirically and without a correct diagnosis. However, there is disagreement between specialists about its definition and management: gastroenterologists consider LPR to be a substantially rare manifestation of gastroesophageal reflux disease (GERD), whereas otolaryngologists believe that LPR is an independent, but common in their practice, disorder. Patients suffering from LPR firstly consult their general practitioners, but a multidisciplinary approach may be fruitful to define a unified strategy based on specific medications and behavioural changes. The present Supplement would review the topic, considering LPR and GER characteristics, pathophysiology, diagnostic work-up, and new therapeutic strategies also comparing different specialist points of view and patient populations. In particular, new insights derive from an interesting gel compound, containing magnesium alginate and E-Gastryal® (hyaluronic acid, hydrolysed keratin, Tara gum, and Xantana gum). In particular, two very large Italian surveys were conducted in real-world setting, such as outpatient clinics. The most relevant outcomes are presented and discussed in the current Issue. Actually, laryngopharyngeal reflux (LPR) is considered an extraesophageal manifestation of the gastroesophageal reflux disease (GERD). Both GERD and its extraesophageal manifestation are very common in clinical practice. Both disorders have a relevant burden for the society: about this topic most of pharmaco-economic studies were conducted in the United States. In population-based studies, 19.8% of North Americans complain of typical symptoms of GERD (heartburn and regurgitation) at least weekly (1). Also in the late 1990s, GERD accounted for 12.1 billion in direct annual healthcare costs in the United States, higher than any other digestive disease. As a result, acid-suppressive agents were the leading pharmaceutical expenditure in the United States. The prevalence of GERD in the primary care setting becomes even more evident when one considers that, in the United States, 4.6 million office encounters annually are primarily for GERD, whereas 9.1 million encounters include GERD in the top 3 diagnoses for the encounter. GERD is also the most frequently first-listed gastrointestinal diagnosis in ambulatory care visits (2, 3) Extraesophageal manifestations of reflux, including LPR, asthma, and chronic cough, have been estimated to cost 13,700 for 5 years
Gastric reflux: comparison between the gastroenterologist and the otorhinolaryngologist’s approach. Pragmatic conclusive remarks
No full textGastroesophageal reflux (GER) is a normal physiological process that usually happens after eating in healthy infants, children, young people and adults. In contrast, gastroesophageal reflux disease (GERD) occurs when the effect of GER leads to symptoms severe enough to merit medical treatment. In clinical practice, it is difficult to differentiate between GER and GERD, and health professionals and families use the terms interchangeably alike. There is no simple, reliable and accurate diagnostic test to confirm whether the condition is GER or GERD, and this in turn affects research and clinical decisions (1-6). Furthermore, the term GERD covers a number of specific conditions that have different effects and present in different ways. This makes it difficult to identify the person who genuinely has GERD, and to estimate the real prevalence and burden of the problem
Treatment of allergic and vasomotor rhinitis: The role of beclomethasone dipropionate and hyaluronic acid (with high molecular weight)
No full textInflammatory rhinitis is a very common disorder. It includes allergic rhinitis (AR) and non-allergic rhinitis (NAR). Nasal inflammation is shared by both disorders. So, anti-inflammatory treatment is indicated for both. Beclomethasone dipropionate (BDP) is a corticosteroid that is long time available both as intranasal spray and aerosol solution. BDP is a corticosteroid with proved efficacy in the treatment of rhinitis, both as spray and aerosol. Safety issue has been satisfactory explored, thus BDP is usually safe and well tolerated. Hyaluronic acid (HA) with high molecular weight has anti-inflammatory activity associated with wetting-lubricating effect. BDP may be usefully employed in acute forms, HA may be also used in chronic ones
Ciliocytophthoria of nasal epithelial cells after viral infection: A sign of suffering cell
No full textCiliocytophthoria (CCP) defines a degenerative process of the ciliated cells consequent to viral infections, and it is characterized by typical morphological changes. We evaluated the distinct and characteristic phases of CCP, by means of the optical microscopy of the nasal mucosa (nasal cytology), in 20 patients (12 males and 8 females; aged between 18 and 40 years). Three phases of CCP by nasal cytology are detected. This outcome confirms that CCP represents a sign of suffering nasal epithelial cell
Clinical picture of rhinusinusitis and management of out-patients [Inquadramento clinico della rinosinusite e gestione del paziente in ambulatorio]
No full textRhinosinusitis is generally due to the propagation of a nasal inflammation and may involve one or more paranasal sinuses. Depending on how long the disturbance lasts, it is classified as acute, acute recurrent and chronic. The acute and acute recurrent forms are resolved with appropriate medical therapy and there is no permanent damage to the mucosa, unlike the chronic form the pharmacological therapy of which does not determine complete anatomical pathological cure and for which the sole treatment is surgical. The incidence of this pathology lies in a range of between 0.5% and 10% depending on which author is reporting. Usually secondary to a viral infection (Rhinovirus, parainfluenzal virus 1, 2, 3, syncytial respiratory virus, adenovirus, enterovirus) it complicates following bacterial attack (S. pneumoniae, H. influenzae, M. Catarrhalis, anaerobic Streptococchi and Bacteroides). Runny nose, cephalea, slight persistent fever, cough, halitosis are the symptoms that characterise nasosinus phlogistic pathology although they are not exclusive to these conditions and can occur in other infectious situations (mucopurulent rhinitis, rhinoadenoiditis). Standard X-ray pictures do not provide constantly reliable diagnostic elements; by contrast, computed tomography (CT), magnetic resonance (MR) and optical fibre nasal endoscopy can provide precise information in view, for example, of a surgical programme. Antibiotic therapy is the cornerstone of the medical treatment of nasosinus infectious pathology. Among the antibiotics of choice we find amoxicillin clavulanate, the 2nd or 3rd generation oral cephalosporins, the ketolides and the quinolones. Other important therapeutic aids are those aimed at facilitating the reduction of the mucous oedema of the osteo-meatal complexes and drainage of secretions from the paranasal cavities and use of nasal washing with physiological solution, decongestion agents, mucolytics and possibly antihistaminics (allergic patients). Topical corticosteroids as shown by recent clinical studies most certainly represent a useful class of drugs for the management of rhinosinusitis. Surgical therapy is used on chronic and acutely complicated forms
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