RESUMEN
OBJECTIVE: To examine the hypothesis that pharmacologic treatment of nasal obstruction, specifically alpha-adrenergic nose drops, will decrease objective signs of respiratory distress in infants with bronchiolitis. STUDY DESIGN: Forty-one infants aged 3 weeks to 12 months hospitalized for viral bronchiolitis were enrolled in this double-blinded, placebo-controlled trial of topical 0.5% phenylephrine drops. The primary outcome measure was change in oxygen saturation. Secondary outcomes were changes in respiratory scores and vital signs. RESULTS: There were no statistical differences in any of the outcome measures between groups. No adverse events were observed. Overall, participants showed an average 1.6 percentage point increase in their oxygen saturations (P = .002) and a 0.5-point improvement in respiratory score (P = .003) over the 30 minutes of the study. CONCLUSIONS: Topical nasal phenylephrine did not produce significant short-term improvements in clinical status in infants hospitalized for acute bronchiolitis.
Asunto(s)
Bronquiolitis Viral/tratamiento farmacológico , Descongestionantes Nasales/uso terapéutico , Fenilefrina/uso terapéutico , Bronquiolitis Viral/fisiopatología , Método Doble Ciego , Femenino , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , Descongestionantes Nasales/farmacología , New Mexico , Consumo de Oxígeno/efectos de los fármacos , Fenilefrina/farmacología , Respiración/efectos de los fármacosRESUMEN
BACKGROUND: Vasoconstrictor drugs reduce nitric oxide (NO) production in vitro by inhibiting the enzyme involved in the regulation of inducible and constitutive NO synthases (iNOS and cNOS). Intranasal vasoconstrictors also decrease nasal NO concentration in vivo. It is as yet unclear if this last finding is due to the effects of the drug on the enzyme or on the vessels. Physical exercise also induces nasal vasoconstriction and reduces nasal resistance. OBJECTIVES: The aim of this study was to clarify the mechanisms involved in xylometazoline-induced reduction of nasal NO concentration. METHODS: We compared 2 randomized groups of patients with moderate--severe persistent allergic rhinitis. The first group (n = 24) underwent a physiological nasal vasoconstrictor stimulus (exercise) whereas the second group (n = 29) was treated with a nasal vasoconstrictor drug (topical xylometazoline). Nasal volume and NO were determined at baseline and 15 to 20 minutes after the end of each stimulus using acoustic rhinometry and chemiluminescence, respectively. RESULTS: Baseline values of nasal volume and NO did not differ between the 2 groups. Nasal volume increased by 57% (P = .0001) after exercise and 71% (P = .0001) after xylometazoline. Nasal NO decreased (25%, P = .001) after xylometazoline, but not after exercise. CONCLUSION: Physical exercise and topical xylometazoline cause vasoconstriction and similar effects on nasal volume. In contrast nasal NO decreased with xylometazoline but not after exercise. These findings suggest that vasoconstrictor drugs reduce nasal NO by mechanisms other than vasoconstriction.
Asunto(s)
Óxido Nítrico/metabolismo , Nariz/fisiología , Rinitis Alérgica Perenne/metabolismo , Vasoconstricción/fisiología , Ejercicio Físico , Femenino , Humanos , Imidazoles/farmacología , Masculino , Descongestionantes Nasales/farmacología , Óxido Nítrico/análisis , Nariz/efectos de los fármacosRESUMEN
UNLABELLED: Acoustic rhinometry allows an objective and non-invasive assessment of nasal geometry. AIM: The present study aimed at determining the volumes of specific segments of the nasal cavity in healthy adults including the nasopharynx, using acoustic rhinometry. STUDY DESIGN: A clinical prospective analysis. CASES AND METHOD: Thirty volunteers with no evidence of nasal obstruction, aged 18 to 30 years (14 males and 16 females) were analyzed. Volumes were measured at the nasal valve region (V1), the turbinates (V2), and the nasopharynx (V3), before and after application of a topical nasal vasoconstrictor. RESULTS: The mean volumes measured in 60 cavities before nasal decongestion, were: 1.81+/-0.35 cm(3) (V1), 4.02+/-1.41 cm(3) (V2), and 17.52+/-4.44 cm(3) (V3) for males, and 1.58+/-0.25 cm(3) (V1), 3.94+/-1.03 cm(3) (V2), and 17.80+/-2.73 cm(3) (V3) for females. Gender differences were only significant in V1 (p<0.05). After nasal decongestion, the volumes of all the analyzed segments were significantly larger (p<0.05), and the gender differences were significant for V1 and V2. CONCLUSION: Volumes of the three segments in adults with no evidence of nasal obstruction may be used as reference values for other studies.
Asunto(s)
Cavidad Nasal/anatomía & histología , Descongestionantes Nasales/farmacología , Nasofaringe/anatomía & histología , Rinometría Acústica , Adolescente , Adulto , Femenino , Humanos , Masculino , Cavidad Nasal/efectos de los fármacos , Estudios Prospectivos , Valores de Referencia , Factores SexualesRESUMEN
A rinometria acústica permite aferir a geometria nasal de forma objetiva e não-invasiva. OBJETIVO: O presente estudo teve por finalidade determinar os volumes de segmentos específicos da cavidade nasal, incluindo a nasofaringe, de adultos sadios por rinometria acústica. Forma de Estudo: Clínico prospectivo. CASUíSTICA E MÉTODO: Foram analisados 30 voluntários sem evidências de obstrução nasal com idade entre 18 e 30 anos, sendo 14 homens e 16 mulheres. Os volumes foram medidos nos segmentos correspondentes à região da válvula nasal (V1), cornetos (V2) e nasofaringe (V3), antes e após a aplicação tópica de vasoconstritor nasal. RESULTADOS: Os volumes médios aferidos em 60 cavidades, antes da vasoconstrição nasal foram os seguintes: 1,81±0,35cm³ (V1), 4,02±1,41cm³ (V2) e 17,52±4,44cm3 (V3) no grupo masculino, e, 1,58±0,25cm³ (V1), 3,94±1,03cm³ (V2) e 17,80±2,73cm³ (V3) no grupo feminino. As diferenças entre os sexos foram significantes apenas para V1 (p<0,05). Após a vasoconstrição nasal, os volumes de todos os segmentos analisados foram significantemente maiores (p<0,05), sendo as diferenças entre os sexos significantes para V1 e V2. CONCLUSÃO: Os volumes dos três segmentos da cavidade nasal determinados em adultos sem evidências de obstrução nasal podem ser utilizados como valores de referência para outros estudos.
Acoustic rhinometry allows an objective and non-invasive assessment of nasal geometry. AIM: The present study aimed at determining the volumes of specific segments of the nasal cavity in healthy adults including the nasopharynx, using acoustic rhinometry. Study design: A clinical prospective analysis. CASES AND METHOD: Thirty volunteers with no evidence of nasal obstruction, aged 18 to 30 years (14 males and 16 females) were analyzed. Volumes were measured at the nasal valve region (V1), the turbinates (V2), and the nasopharynx (V3), before and after application of a topical nasal vasoconstrictor. RESULTS: The mean volumes measured in 60 cavities before nasal decongestion, were: 1.81±0.35cm³ (V1), 4.02±1.41cm³ (V2), and 17.52±4.44cm³ (V3) for males, and 1.58±0.25cm³ (V1), 3.94±1.03cm³ (V2), and 17.80±2.73cm³ (V3) for females. Gender differences were only significant in V1 (p<0.05). After nasal decongestion, the volumes of all the analyzed segments were significantly larger (p<0.05), and the gender differences were significant for V1 and V2. CONCLUSION: Volumes of the three segments in adults with no evidence of nasal obstruction may be used as reference values for other studies.