1,721,018 research outputs found
Transtympanic iontophoresis: personal experience
No full textAfter having described the method of application used for iontophoresis and the results of previous studies carried out by other authors in the hope of finding a definite use for its clinical application, the authors present their personal experience carried out with the use of various chemical substances applied to both the guinea pig and to man. The chemicals taken into consideration were those used in the treatment of otitis media: anti-inflammatory, antibiotic, and mucolytic products. Iontophoresis proved to be a simple and effective method for the treatment of certain middle ear diseases, and offered a more rapid recovery in comparison with subjects treated uniquely by traditional methods
Role of imaging in allergic rhinology
No full textRhinitis is an underestimated clinical condition, which has a considerable impact on the quality of life of the affected patients. The subject of this review focuses on three fundamental aspects: the development of knowledge concerning anatomic landmarks, the development of radiological imaging technology, and developments that can make a difference in the treatment of allergic rhinitis. The anatomical study of paranasal sinuses has been conducted since the time of the ancient Egyptians. Development of radiological equipment from the early 1900s has helped to improve information on the morphology of paranasal sinuses, sufficient to be considered valuable information regarding frontal anatomy and its variability. Imaging has become increasingly important in the diagnosis and treatment of inflammatory diseases of the paranasal sinuses. In recent decades, radiology has helped to study this region as we have progressed from plain radiography to high-resolution Computed Tomography (HRCT). Subsequently, from radiologic imaging, digital volume tomography (DVT) has been developed, in high resolution and narrow section width. Currently, experience with third generation Cone-Beam Computed Tomography (CBCT) technologies provides useful information about bones, and it is now possible to highlight anatomical variants that involve bone structures. We still lack the ability to make a qualitative evaluation of soft tissues, as there are no Hounsfield levels in CBCT. However, this is a new area of research, and its application is evolving in an interesting manner, especially for soft-tissue allergic-inflammatory diseases
Mechanisms of allergic diseases in otorhinolaryngology
No full textAllergic Rhinitis (AR) is an IgE-mediated hypersensitivity disease caused by inhalation of an allergen to which the patients is sensitized. Etiopathogenesis of AR comprises a sensitization phase, an immediate phase and a late phase. In the sensitization phase, inhaled allergens are processed in peptides and come into contact with the nasal mucosa cells. Antigen-Presenting Cells (APCs), especially represented by Dendritic Cells (DCs), capture them through the interaction with their own MHC class II complexes and migrate to lymph nodes. Then, allergenic peptides are presented to naïve CD4+ T lymphocytes and a differentiation of T cells in Th2 subset takes place. After Th2 lymphocyte induction due to allergen exposure, the most relevant cytokines that are produced are represented by IL-3, IL-4, IL-5, IL-9, IL-10, and IL-13 that are able to promote IgE synthesis and mast cell proliferation. The allergen reaction, when allergen meets its specific IgEs on mast cells surface, causes an early inflammatory reaction determined by mast cells and basophils degranulation with release of preformed mediators from the intracellular granules, resulting in symptoms such as rhinorrhea, itching and sneezing. This phase is followed by a late phase characterized by the release of newly formed mediators, like leukotrienes, chemokines and adhesion molecules, and by the recruitment of eosinophils, neutrophils, macrophages, mast cells, lymphocytes B and T in the nasal mucosa. Such mechanism is responsible for continuing inflammation sustained by chemoattractants, cytokines and adhesion receptors that induce cellular infiltration of eosinophils, basophils, Th2 lymphocytes and mast cells and is clinically mirrored by the prevalence of nasal congestion over sneezing, itching and rhinorrhea
Mucociliary flow in the nose during general and epidural anesthesia
No full textBy means of the coloured indicator transport test (phenol red 3% in calcium-hydrogen-phosphate), mucociliary function in nose and pharynx was studied in 50 patients who underwent general or ocular surgery and in 10 healthy adult subjects. Patients were anesthetized with halothane, enflurane, NLA, and epidural analgesia. At the end of surgery, mucociliary function was significantly depressed (p less than 0.001) after halothane or enflurane anesthesia, but not after NLA or epidural analgesia. Six hours following enflurane anesthesia we still found a significant depression (p less than 0.001) of mucociliary function. No difference between halothane or enflurane was noted
Allergic rhinitis
No full textAllergic rhinitis (AR) was long considered a quite trivial disease, but the advance in epidemiological and clinical knowledge, with a major role for Allergic rhinitis and its Impact on Asthma (ARIA) initiative, substantially changed the scene. Now we know that AR has significant effects on patients quality of life and also has a relevant economic burden. The ARIA phenotypes related to the duration of symptoms and to the severity of AR are very useful in establishing the optimal strategy in each patient with AR, also according to the kind of allergens that cause rhinitis. When traditional allergy testing, including skin prick tests and in vitro of specific IgE antibodies are not sufficient for the diagnosis, modern techniques such as molecular diagnostics may be used. Also the management of AR may be tailored to single patients according to the clinical expression of AR, that may vary from mild to moderate-severe stage, with the aim of achieving the best possible control of the disease
Laboratory tests for allergy diagnosis
No full textThe introduction of highly purified natural and recombinant single allergenic molecules represented an important improvement in the diagnosis of IgE sensitization. The identification of specific IgE against cross-reacting molecules such as profilin, lipid transfer proteins, calcium binding proteins or against genuine molecules, represents an added value and allows to distinguish between true and false polysensitization. In vitro tests add information to recognize patients with sensitization to genuine molecules that cause allergic diseases and to evaluate in childhood the spreading of sensitization for each molecule in order to choose the best treatment and to identify the ideal patient for allergen immunotherapy. Also, in order to detect patients with sensitization to pan-allergens it is important to manage the risk of anaphylaxis for patients allergic to latex and to identify IgE to particular molecules involved in occupational allergy. In patients with negative skin prick tests (SPT), that results in a lower sensitivity compared with in vitro tests, the negative test may be caused by the lack of some important allergenic molecules in the extract used for SPT
Urea to calculate the dilution of nasal secretum collected by lavage
No full textUrea, creatinine (24 cases) and albumin (22 cases) were determined in nasal secretum and in serum in 50 subjects. The correlation between the values in the secretum and in the serum significative only for urea and creatinine. The regression coefficient of urea was particularly high and we suggest that the values of urea in nasal secretum may be calculated as 1, 3 times its serum levels. This relationship may be useful to calculate the dilution of the samples of respiratory secretum collected by lavage, utilizing the ratio between the actual urea in the sample and its theorical value
Human nasal immune system: a special site for immune response establishment
No full textThe mucosal immune system located in correspondence to the olfactory organs in adult humans is not well identifiable but has proven important in establishing an effective immune response against inhaled antigens, including the generation of Helper 1 (TH1)- and TH2-cells, cytotoxic T lymphocytes (CTLs), plasma cells (PCs) and memory B cells. It is constituted by a diffused network of cells of epithelial and immune origin, as well as organized lymphoid tissue, where each component has a role in the initiation and maintenance of a long-lasting immune response, which is evoked not only in the oral and nasal cavities but also in the respiratory, intestinal and genito-urinary tracts. These peculiarities, in association to the easy anatomical accessibility of such immunological site, render the nasal mucosa a good candidate for the development of vaccine, even if a better understanding of the mechanism of the immune response induction as well as finding a safe adjuvant are necessary
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