RESUMEN
Chronic cough is a common medical problem. The aim of the study was to analyze chronic cough causes in non-smoking patients and to search for demographic factors associated with different cough reasons. The etiology of cough was determined by medical history, diagnostic tests and response to specific treatment. Patients with significant abnormalities in the chest radiograph or spirometry were not included. The study included 131 non-smoking patients; median age 54 years, 77 % female. The most frequent causes of cough were gastroesophageal reflux disease (GERD) (62 %) and upper airway cough syndrome (UACS) (46 %). Cough variant asthma and non-asthmatic eosinophilic bronchitis (NAEB) were diagnosed in 32 (25 %) and 19 (15 %) patients, respectively. Other cough causes were found in 27 patients (21 %). Asthma was a significantly more common cause of chronic cough in women than in men (31 % vs. 3 %, p = 0.005). A reverse relationship was demonstrated for UACS (39 % vs. 67 %, p = 0.01). Patients with chronic cough aged >50 yrs were more likely to be diagnosed with less common cough causes. In conclusion, the most common chronic cough reasons are GERD and UACS. Asthma-related cough is diagnosed more frequently in females, while UACS-related cough is more frequent in males.
Asunto(s)
Tos/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Asma/complicaciones , Bronquitis Crónica/complicaciones , Enfermedad Crónica , Tos/diagnóstico , Tos/diagnóstico por imagen , Femenino , Reflujo Gastroesofágico/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Radiografía Torácica , Factores Sexuales , Fumar , Espirometría , Adulto JovenRESUMEN
Chronic rhinosinusitis is one of the most common health care challenges, with significant direct medical costs and severe impact on lower airway disease and general health outcomes. The diagnosis of chronic rhinosinusitis (CRS) currently is based on clinical signs, nasal endoscopy and CT scanning, and therapeutic recommendations are focussing on 2 classes of drugs, corticosteroids and antibiotics. A better understanding of the pathogenesis and the factors amplifying mucosal inflammation therefore seems to be crucial for the development of new diagnostic and therapeutic tools. In an effort to extend knowledge in this area, the WP 2.7.2 of the GA(2)LEN network of excellence currently collects data and samples of 1000 CRS patients and 250 control subjects. The main objective of this project is to characterize patients with upper airway disease on the basis of clinical parameters, infectious agents, inflammatory mechanisms and remodeling processes. This collaborative research will result in better knowledge on patient phenotypes, pathomechanisms, and subtypes in chronic rhinosinusitis. This review summarizes the state of the art on chronic rhinosinusitis and nasal polyposis in different aspects of the disease. It defines potential gaps in the current research, and points to future research perspectives and targets.
Asunto(s)
Pólipos Nasales , Rinitis , Sinusitis , Enfermedad Crónica , Humanos , Hipersensibilidad/complicaciones , Hipersensibilidad/inmunología , Hipersensibilidad/patología , Pólipos Nasales/diagnóstico , Pólipos Nasales/inmunología , Pólipos Nasales/patología , Rinitis/diagnóstico , Rinitis/etiología , Rinitis/inmunología , Sinusitis/diagnóstico , Sinusitis/etiología , Sinusitis/inmunologíaRESUMEN
The objective of the present study was to evaluate the prevalence of chronic cough causes and to compare the efficacy of two diagnostic approaches used in ambulatory vs. hospitalized setting. Eighty patients with chronic cough, 40 in each group, were enrolled into the study. The etiology of cough was determined on medical history and on either basic (in out-patients) or detailed (in in-patients) investigations on most common causes of chronic cough. We diagnosed etiology of cough in all subjects. The most frequent causes of cough were gastroesophageal reflux disease (GERD) and upper airway cough syndrome (UACS). Nonasthmatic eosinophilic bronchitis (NAEB) and multiple cough causes were recognized more often in hospitalized patients (P<0.05). We conclude that the main causes of chronic cough were GERD and UACS. An extensive diagnostic approach allows recognizing NEAB more frequently and reveals the complex nature of chronic cough.
Asunto(s)
Tos/diagnóstico , Tos/etiología , Adulto , Anciano , Anciano de 80 o más Años , Bronquitis/complicaciones , Enfermedad Crónica , Tos/epidemiología , Eosinófilos/patología , Medicina Familiar y Comunitaria , Femenino , Reflujo Gastroesofágico/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Infecciones del Sistema Respiratorio/complicaciones , Insuficiencia del Tratamiento , Adulto JovenRESUMEN
UNLABELLED: The aim of the study was to estimate by means of acoustic rhinometry (AR) the nasal blockade in 37 patients (5-73 years old, mean 32) with upper airways infections treated by fusafungine. The examinations were carried out on the first (D1) and seventh day (D7) of observation. Cross-sectional area (CA) mean values of 3 cm sector laid back to C notch of AR curves (CA-C3) were selected to the analysis. RESULTS: The mean value of CA-C3: in all patients it was 2.61 cm2 on D1 and 2.8 cm2 on D7; in rhinitis and sinusitis patients--2.23 cm2, in others--3.16 cm2; without nasal discharge--3.48 cm2, in others (with severe or medium)--2.53 cm2 and 2.48 cm2 respectively. 29 patients had nasal blockade (78.4%) with mean CA-C3 = 2.34 cm2 (others--3.56, p < 0.05). During seven days the following enlargement of CA-C3 was reported: 14.9% in all patients (p < 0.01); in viral infections 24% (n = 14, p < 0.01), bacterial 14.3% (n = 11, NI); in nasal blockade patients--15.22%, others--13.55% (p < 0.01). Mean value of CA-C3 increased by 37.7% in patients who demonstrated, according to the physicians, "very good improvement", 5.7%--"good", 1.5%--"weak" (p < 0.05). There was also enlargement of nasal cavities in CA-C3 in non-sneezers (p < 0.05) and medium discharge symptom patients (p < 0.05). There was no statistical difference in clinical and acoustic rhinometry results between patients treated with fusafungine together with non-steroid anti-inflammatory drugs and patients treated with fusafungine. CONCLUSION: AR is a good instrument to be used in the objective assessment of the nasal blockade changes in people with infection of the nasal mucosa and showed positive efficacy of fusafungine in the treatment of upper airway infection.
Asunto(s)
Acústica , Antibacterianos/uso terapéutico , Obstrucción Nasal/diagnóstico , Senos Paranasales/fisiología , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Adolescente , Adulto , Aerosoles/uso terapéutico , Anciano , Niño , Preescolar , Depsipéptidos , Femenino , Fusarium , Humanos , Masculino , Persona de Mediana Edad , Obstrucción Nasal/etiología , Infecciones del Sistema Respiratorio/complicaciones , Infecciones del Sistema Respiratorio/diagnóstico , Rinitis/complicaciones , Rinitis/diagnóstico , Rinitis/tratamiento farmacológico , Sinusitis/diagnóstico , Sinusitis/tratamiento farmacológicoRESUMEN
The authors have studied the effect of azelastine nasal spray in the treatment of seasonal allergic rhinitis. The trial was a double-blind, placebo controlled study, with 33 allergic subjects (17 female, 16 male), 15-40 years old. The patients were randomized into two parallel groups, to receive daily 0.56 mg of azelastine intranasally or placebo during two weeks. Before and after treatment severity of nasal symptoms such as: sneezing, itching, nasal blockage, nasal discharge and general feeling were evaluated by patients according to VAS (visual analogue scale). At the same time the physician's evaluation of nasal oedema, nasal discharge and general patient's condition were performed (VAS). Additionally during the treatment patients noted possible adverse events. Patient's and physician's evaluations showed clinical efficacy in the azelastine group and no evident efficacy in the placebo group--between those two groups statistical significances were noted for all evaluated parameters (p < 0.001). The bitter taste in the mouth was the only serious side effect in some patients in azelastine group, although this was quite well accepted. Generally the treatment was well-tolerated. Azelastine nasal spray is an effective and well-tolerated drug in the treatment of seasonal allergic rhinitis.
Asunto(s)
Antagonistas de los Receptores Histamínicos H1/farmacología , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Ftalazinas/farmacología , Ftalazinas/uso terapéutico , Rinitis Alérgica Estacional/tratamiento farmacológico , Administración Intranasal , Adolescente , Adulto , Femenino , Antagonistas de los Receptores Histamínicos H1/administración & dosificación , Humanos , Masculino , Ftalazinas/administración & dosificaciónRESUMEN
Acute subglottic laryngitis (pseudocroup) is caused by viral infection and usually occurs in children from 6 months to 4 years of age. Obese children are considered to be more susceptible to the disease. In order to evaluate the influence of nutritional status on acute subglottic laryngitis occurrence, an analysis of 193 patients was performed. A group of 70 age-matched healthy children served as the control subjects. The nutritional status of children (body weight and height) was assessed and their percentile positions on the weight and weight-height charts were determined. The recurrence of pseudocroup coexistence of allergy and breast-feeding history were considered in the study. Results of statistical analysis indicate no significant difference in weight and weight-height percentile distribution between patients group and controls. The recent changes in child nutrition might be the explanation of decreased susceptibility to pseudocroup among overfed children.
Asunto(s)
Antropometría , Fenómenos Fisiológicos Nutricionales Infantiles , Crup/epidemiología , Crup/etiología , Enfermedad Aguda , Distribución por Edad , Estatura , Peso Corporal , Estudios de Casos y Controles , Niño , Preescolar , Crup/diagnóstico , Susceptibilidad a Enfermedades , Femenino , Humanos , Incidencia , Lactante , Masculino , Valores de Referencia , Factores de Riesgo , Distribución por SexoRESUMEN
Twelve cases selected from the group of 123 chronic rhinosinusitis patients are presented in the paper. Severe headaches were noted as the most typical complaints of the clinical picture of the disease. The most cases were accompanied by rhinitis and paranasal sinusitis symptoms. The best diagnostic method of mucocele is MRI. The endoscopic sinus surgery is a safe and effective method of the treatment in a case of mucocele.
Asunto(s)
Endoscopía , Mucocele/cirugía , Enfermedades de los Senos Paranasales/cirugía , Adulto , Enfermedad Crónica , Cefalea/etiología , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Mucocele/complicaciones , Mucocele/diagnóstico , Enfermedades de los Senos Paranasales/diagnóstico , Rinitis/etiología , Sinusitis/etiología , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Five ethmoiditis cases with orbital complications in children aged 3.5 to 6 years were analysed. All were treated at almost at the same time in Warsaw hospitals in October 1994. Among the five presented cases, four were treated surgically. The value of CT examination in diagnosing ethmoiditis is stressed by the authors.