ABSTRACT
Abstract Introduction: After post-septoplasty nasal packing removal, a certain proportion of nasal secretion occurs, leading to local and sometimes systemic infections. Objective: The aim was to determine if standardized dry ivy leaf extract application after nasal packing removal influences the reduction of nasal secretion and diminish the occurrence of local infections. Methods: The study included 70 post-septoplasty patients (divided into two equal groups) whose nasal packing was removed on the third day after the procedure. Group I was treated with standardized dry ivy leaf extract syrup along with regular nasal irrigation for the five days after the nasal packing removal whereas the Group II had only nasal lavage. On the sixth day after nasal packing removal, the quantity of nasal secretion was determined using a visual analog scale and nasal endoscopic examination. Results: The group treated with standardized dry ivy leaf extract syrup had significantly lesser nasal secretion both by subjective patients' assessment (p < 0.001) and by nasal endoscopic examination (p = 0.003). The post-surgical follow up examination on the sixth day after nasal packing removal showed no development of local infection in the Group I, while in the Group II a local infection was evident in five patients (14.29%) and antibiotic therapy was required. Conclusion: The use of the standardized dry ivy leaf extract after nasal packing removal significantly lowers the proportion of nasal secretion.
Resumo Introdução: Após a remoção do tampão nasal pós-septoplastia, ocorre produção de secreção nasal, predispondo infecções locais e, por vezes, sistêmicas. Objetivo: O objetivo foi determinar se a aplicação do extrato padronizado de folhas de hera seca após a remoção do tampão nasal influencia a redução da secreção nasal e diminui a ocorrência de infecções locais. Método: O estudo incluiu 70 pacientes pós-septoplastia (divididos em dois grupos iguais) cujo tampão nasal foi retirado no terceiro dia após o procedimento. O grupo I foi tratado com xarope padronizado de extrato de folha seca de hera juntamente com irrigação nasal regular por cinco dias após a remoção do tamponamento nasal, enquanto ao grupo II foi recomendado apenas lavagem nasal. No sexto dia após a remoção do tampão nasal, a quantidade de secreção nasal foi determinada pela escala EVA (escala visual analógica) e pelo exame endoscópico nasal. Resultados: O grupo tratado com xarope de extrato seco de folhas de hera apresentou secreção nasal significativamente menor tanto pela avaliação subjetiva dos pacientes (p < 0,001) quanto pelo exame endoscópico nasal (p = 0,003). O exame de acompanhamento pós-cirúrgico no sexto dia após a remoção do tampão nasal não mostrou desenvolvimento de infecção local nos pacientes do grupo I, enquanto que no grupo II, cinco apresentaram sinais de infecção local (14,29%) com necessidade de antibioticoterapia. Conclusão: O uso do extrato padronizado de folhas secas de hera após a remoção do tampão nasal reduz significativamente a produção de secreção nasal.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Postoperative Care/methods , Rhinoplasty/methods , Plant Extracts/therapeutic use , Hedera/chemistry , Nasal Septum/surgery , Epistaxis/prevention & control , Nose/microbiology , Plant Leaves/chemistry , Postoperative Hemorrhage/prevention & control , Phytotherapy , Anti-Bacterial Agents/therapeutic useABSTRACT
En la forma mucocutánea (LCM) y cutánea (LCL) de la leishmaniasis, se genera una respuesta inflamatoria cuyos mediadores (células y citocinas) se han involucrado en la severidad de las úlceras y en el daño tisular observado en estos pacientes, particularmente en los LCM. Por ello, nos propusimos identificar los grupos celulares predominantes en la secreción nasal de pacientes con LCL y LCM, y relacionarlos con citocinas proinflamatorias y reguladoras. Evaluamos en pacientes LCL (n=20), LCM (n=14) y 20 individuos sanos: a) La cuantificación de tipos de leucocitos en "frotis" de secreción nasal, úlceras cutáneas y sangre periférica teñidos con Giemsa empleando microscopía óptica, b) Concentraciones séricas de IL-8, IL-4 e IL-10 por citometría de flujo (CBA array) e IFN-γ, TNF-α e IL-17 por ELISA. El grupo celular predominante en la secreción nasal de pacientes con LCM fueron los neutrófilos (80,7%) y escasos eosinófilos (0,6%), comparados con los LCL y controles, en los que no se observaron estas células. Mientras que los "frotis" de las ulceras de los LCL presentaron 45,3% de neutrófilos y 43% de linfocitos. En contraste, en sangre periférica, de los pacientes se observó un incremento de neutrófilos y linfocitos junto a una frecuencia significativa de monocitos (LCM: 5,3; LCL: 6,3%) y eosinófilos (LCM: 8,2%; LCL: 5,2%). Todo esto sugiere la participación de los neutrófilos en la inmunopatogénesis en la LCM. Adicionalmente, se demostró una mayor (P=0,03) concentración sérica de IL-8 en los pacientes con LCL (18,5ρg/mL) y LCM (18,2ρg/mL) respecto a los individuos sanos, sugiriendo que esta citocina promueve el reclutamiento de neutrófilos al sitio de infección en los LCM, mientras que en los LCL contribuyen junto con los linfocitos T CD4+ de la subpoblación Th1 y productores de IFN-γ, en la activación de mecanismos leishmanicidas.
In mucocutaneous (MCL) and cutaneous (LCL) leishmaniasis, the inflammatory mediators (cytokines and cells) have been associated with ulcers severity and tissue damage observed in these patients, particularly in MCL. Therefore, we decided to identify the predominant cell groups in the nasal secretion of LCL and MCL patients, and related pro-inflammatory and regulatory cytokines. It was evaluated in LCL (n = 20), MCL patients (n = 14) and 20 healthy volunteers: a) Differential leukocyte count by optical microscopy performed in: smear of a runny nose, skin ulcers and peripheral blood dyed with Giemsa, b) serum levels of IL-8, IL-4 and IL-10 using cytometric bead array (CBA) assay and IFN-γ, TNF-α and IL-17 by ELISA. In MCL patients, neutrophils (80.7%) were the most abundant cellular group in nose secretion, followed by a small amount of eosinophils (0.6%) compared to the LCL and controls, where no such cells were observed. In contrast, in peripheral blood from ACL patients were observed an abundant amount of neutrophils and lymphocytes together with a significant frequency of monocytes (MCL:5.3%; LCL: 6.3%) and eosinophils (MCL:8.2%; LCL:5.2%). While the smear from skin ulcers of LCL patients showed 45.3% of neutrophils and 43% lymphocytes. All of these indicate that neutrophils might play a role in the MCL immunopathogenesis. Moreover, an increased serum levels of IL-8 (P=0.03) were found in LCL (18.5ρg/mL) and MCL (18.2ρg/mL) patients, suggesting that this cytokine promotes the recruitment of neutrophils to the infection site in MCL; while in LCL patients may contribute with CD4 + Th1 (IFN-γ) cells in the activation of leishmanicida mechanisms.
ABSTRACT
BACKGROUND AND OBJECTIVES: Nasal mucosal pH have a direct effect on the alteration of the physio-chemical characteristics of the nasal mucosa. Previous studies have reported the normal mucosal pH to be within the range of 5.3-7.0, mucosal pH with sinusitis to be within 6.8-7.6 and mucosal pH with rhinitis to be within 7.2-8.3. However, no consideration was paid to the conditions that influence the pH and there were no measured pH value by different methods. This study was therefore designed with the latest trend method in pH measurement with the purpose of evaluating pH in nasal secretion and creating an objective parameter for a beneficial manifestation of mucosa. MATERIALS AND METHODS: We measured the pH values from 30 normal control group (group 1), 30 patients with chronic sinusitis (group 2), and 30 patients with allergic rhinitis (group 3). Nasal secretion was obtained through filter paper absorption method and, using a micro pH electrode with pH meter, pH was measured in nasal secretion. RESULTS: pH in nasal secretion in this study was higher than the nasal mucosal pH from previously reported studies. pH values in nasal secretion showed a significant difference between three groups (group 1:7.86, group2:8.06, group 3:8.24) in this study (p<0.01). CONCLUSION: The measurement of pH in nasal secretion seems to be a useful parameter for monitoring and assessing the state of nasal mucosa. And we recommend this study as a method for obtaining an objective parameter for pH measurement in nasal cavity.
Subject(s)
Humans , Absorption , Electrodes , Hydrogen-Ion Concentration , Nasal Cavity , Nasal Mucosa , Rhinitis , Rhinitis, Allergic, Perennial , SinusitisABSTRACT
BACKGROUND AND OBJECTIVES: The diagnosis of allergic rhinitis due to specific antibody is essentially dependent upon the patients' clinical histories, physical examinations, skin test results, and especially on the immunological technique in vitro used for the detection for specific IgE antibody in serum. However, some patients with positive results from nasal provocation tests with allergen can have the negative results from skin tests and the immunological technique in vitro. Therefore, systemic allergic reactions are not completely correlative to those of the localized allergy. MATERIALS AND METHODS: This study was therefore designed to explore the relationship between RAST (radioallergosorbent test) results in nasal secretion of 6 localized allergic patients and 10 controls (5 systemic allergic and 5 non-allergic patients). The nasal secretion was collected by nasal suction method each in three groups before and 20 minutes after antigen (Dermatophagoides pteronyssinus) nasal spray, respectively. RESULTS: There were negative RAST results in nasal secretion of localized allergic patients and controls (5 non- allergy patients) before the antigen nasal spray but, positive RAST results in those of localized allergic patients and controls (5 systemic allergic patients) after the antigen nasal spray. This means that there was statistically a significant difference between localized allergic patients and controls of non-allergy patients after the antigen nasal spray (p<0.01). CONCLUSION: We suggest that localized al1ergic reaction is a specific antigen-antibody allergic immunologic reaction and RAST in nasal secretion is good assistant diagnostic technique in localized allergy.
Subject(s)
Humans , Diagnosis , Hypersensitivity , Immunoglobulin E , Immunologic Techniques , Nasal Provocation Tests , Physical Examination , Rhinitis , Skin Tests , Skin , SuctionABSTRACT
BACKGROUND AND OBJECTIVES: Inflammatory cells in nasal secretions could reflect pathologic conditions occurring in the mucosa of the nasal and paranasal sinuses. But the cytologic investigation of the nasal secretions has not been fully accepted as a clinical examination. The aim of this study was to evaluate the quantitive cytologic study of various nasal diseases and the clinical value of cytologic examination of nasal secretions. MATERIALS AND METHODS: We studied 8 patients with chronic sinusitis, 8 patients with nasal polyposis, 23 patients with allergic rhinitis, and 11 patients with hypertrophic rhinitis. The nasal secretions were treated with dithiothreitol and examined at a magnification of 400X under a light microscope. The differential cell count and frequency of appearance of individual cell type was evaluated. RESULTS: The majority of inflammatory cells were eosinophil in allergic rhinitis and hypertrophic rhinitis. In chronic sinusitis and nasal polyposis, the majority were neutrophil. Eosinophils and lymphocytes appear very frequently in nasal polyposis. CONCLUSION: The result suggests that the cytologic study of nasal secretion is a simple and useful method to determine cell populations under various conditions.