New Ringer's lactate gel formulation on nasal comfort and humidification / Nova formulação de Ringer lactato gel no conforto e umidificação nasal

Abstract Introduction: The use of saline irrigation for nasal washes is a well established procedure in the treatment of sinonasal inflammation and infection. In addition to saline solutions, Ringer's lactate is also an efficient option for nasal washes and humidification. Objective: To assess the comfort, humidification and tolerance regarding stinging sensation, provided by sodium chloride nasal gel at the concentrations of 4.5 mg/g and 6.0 mg/g through questionnaires answered by the patients. Methods: A total of 60 patients, 56 females, aged between 22 and 66 years old (mean age of 47) and 4 males, aged between 36 and 66 years (mean age of 49), were included in the study for a period of 17 days (±2 days) treatment. The patients were monitored by a general practitioner throughout the study period. They were instructed to apply each product in both nostrils twice a day during a 7-day period (±2 days). The patients were evaluated prior to the use of the first product at visit 0 (V0), after 7 days of treatment (±2 days) at visit 1 (V1), after 3 days of product discontinuation at visit 2 (V2) and after 7 days (±2 days) of treatment with the second product, in visit 3 (V3). Results: A significant difference (5% significance) was observed regarding comfort and stinging sensation between the two different concentrations; comfort was higher and stinging was lower with the 6.0 mg/g concentration gel. No difference in humidification was observed between the two treatments. Conclusion: Ringer's lactate at the concentration of 6.0 mg/g was superior to that at 4.5 mg/g for parameters comfort and stinging sensation. No statistical difference was observed between the two products regarding nasal humidification.

Resumo Introdução: O uso de soluções salinas para lavagem nasal está consagrado no tratamento de quadros inflamatórios e infecciosos nasossinusais. Além das soluções salinas, o ringer lactato é uma importante opção tanto para lavagem quanto para a hidratação nasal. Objetivo: Avaliar a tolerabilidade (ardência e conforto) e umidificação do produto gel nasal cloreto de sódio 4,5 mg/g em relação ao ringer lactato 6,0 mg/g, por meio de questionários respondidos pelos pacientes. Método: Foram incluídos 60 pacientes, 56 mulheres (22-66 anos; média: 47 anos) e quatro homens (36-66 anos; média: 49 anos) foram incluídos no estudo de 17 dias (± 2 dias) de tratamento. Os pacientes foram supervisionados por um clínico geral durante todo o período do estudo. Os pacientes usaram os produtos com uma borrifada em cada narina duas vezes ao dia, durante sete dias (± 2 dias). As formulações foram avaliadas antes do uso do primeiro produto na visita 0 (V0), após sete dias (± 2 dias) de tratamento na visita 1 (V1), após três dias de interrupção do primeiro tratamento na visita 2 (V2) e após sete dias (± 2 dias) de uso do segundo produto na visita 3 (V3). Resultados: Foi observada diferença significante para o conforto das vias nasais, (significância de 5%), na comparação entre os tratamentos nos atributos de conforto e ardência. O conforto das vias nasais foi superior e a ardência inferior para o gel nasal ringer lactato 6,0 mg/g em comparação ao gel cloreto de sódio 4,5 mg/g. Não foi observada diferença significante para a umidificação entre os tratamentos. Conclusão: O gel ringer lactato 6,0 mg/g foi superior ao produto gel cloreto de sódio 4,5 mg/g nos quesitos conforto e ardência. Não foi observada diferença estatisticamente significante entre os tratamentos em relação à umidificação das vias nasais.

The curative effect of nasal flush combined budesonide suspension liquid atomizing inhaled treatment in infant allergic rhinitis / 中国基层医药

Objective To observe the nasal flush combined budesonide suspension liquid atomizing inhaled treatment of allergic rhinitis in infants,explore the allergic rhinitis treatments in infants. Methods 137 cases diagnosed as allergic rhinitis were collected and randomly divided into 70 cases as the treatment group and 67 patients as the control group. The patients in control group were washed the nasal cavity with 2.8% warm sodium chloride solution using 50ml and 0.5% metronidazole injection 30ml by turn. At the first week, 1 time/d, then one time every other day,while according to age,body mass the patients were given to loratadine, 1 time/d. Treatment group were used budesonide nasal inhalation of 1 ml at the base of treatment of the control group. Before and after the treatment , nasal congestion,sneezing, flow clear nose, sleep snoring and sleep quality score index were observed and compared.Results 70%of the treatment group the nasal congestion,sneezing,flow clear in 3 times after treatment with ease.The children sleep quality improved and the snoring fewer over night,only 56.7% of the control group of these symptoms improved. After the treatment the efficiency evaluation of treatment group and control group respectively was 95.1% and 77.7% ,there was statistically significant difference( x2 =9.83 ,P ＜0. 01 ). 137 cases of patients without a side effects. Conclusion curative effect of nasal flush combined budesonide suspension liquid nasal spray inhaled treatment of allergic rhinitis was distinct,infant effect-acting quickly,without side effects,easy to use.

Tratamiento médico de la rinosinusitis crónica / Medical treatment of chronic rhinosinusitis: literature review

La rinosinusitis crónica (RSC) es actualmente una de las patologías crónicas de mayor prevalencia en nuestra sociedad. Se distinguen dos formas clínicas: la RSC con pólipos (RSCCP) y la RSC sin pólipos (RSCSP). Es considerada, en términos generales, como una inflamación de la cavidad nasal y senos paranasales de una duración superior a 12 semanas. En la actualidad, los posibles mecanismos fisiopatológicos involucrados ubican al componente inflamatorio como entidad central en su etiología. La relación entre inflamación y poliposis nasal es aún objeto de gran debate. Existen distintos tratamientos médicos con evidencia científica de diferentes niveles de calidad, dentro de los cuales se encuentran antibióticos, corticoides, lavados nasales y antileucotrienos. El uso de macrólidos en bajas dosis y por períodos prolongados de tiempo surge como una eficaz alternativa tanto en el control de síntomas como de parßmetros objetivos, principalmente en pacientes con RSCSP. Este artículo efectúa una exposición respecto al tratamiento médico actualmente disponible, su eficacia y evidencia científica, tanto para la RSCP como para la RSCSP.

Chronic rhinosinusitis (CRS) is currently one of the most prevalent chronic pathologies in Chile. Two forms are distinguishable: Polyp CRS and non-polyp CRS. CRS is condidered, generally speaking, an inflammation of the nasal cavities and paranasal sinuses lasting longer than 12 weeks. Current possible physiopathological mechanisms involved establish inflammation as a central entity in CRS etiology. The relationship between inflammation and nasal polyposis is still a matter of great debate. Several treatment options are available, supported by heterogeneous scientific evidence; among these are antibiotics, corticoids, nasal rinses and antileucotriens. Prolonged treatment with low-dose macrolides treatment has become a good alternative, effectively controlling both symptoms and objective parameters, mainly in non-polyp CRS. This article reviews the CRS medical treatment currently available, its efficacy and the scientific evidence supporting it, both for the polyp and non-polyp types.

A Comparison of Serum & Nasal Wash Fluid ECP According to Their Ages in Asthmatic Children / 소아알레르기및호흡기학회지

PURPOSE: Asthma features not only infiltration of various inflammatory cells including eosinophils into bronchus but increased bronchial hyperresponsiveness which comes from bronchial epithelial cells damaged by toxic granular protein like MBP and ECP released from the activated eosinophils. Recently, several authors have reported that nasal mucosa histologic findings are similar to an inflammatory change of lower airway in respiratory allergic diseases. Based on the latter, we performed this study to compare serum ECP with nasal wash fluid ECP by their ages and to find out contribution of eosinophils in infants and children with wheezing. METHODS: The 62 patients in age from 6 months to 14 years who were admitted due to acute asthma from June 1995 to May 1996 were divided into 3 groups by their ages as follows : group A for less than 2 years old, group B for 2-4 years old and group C for 5-14 years old. The 32 children with no previous history of wheezing or no respiratory symptoms on admission were enrolled as control subject. Serum ECP & nasal wash fluid ECP from each age group with asthma were measured and compared with control, and the relationship between serum ECP and atopic findings were studied. RESULTS: 1) The geometric mean level of serum ECP were significantly higher in wheezing children than in control in all three age group as follows : 16.5+/-7.1micorgram/l for group A, 28.9+/-18.7micorgram/l for group B, 45.9+/-34.8micorgram/l for group C. 2) The geometric mean level of nasal wash fluid ECP were significantly higher in wheezing children than in control in all age group as follows : 11.3+/-7.1micorgram/l for group A, 21.3+/-15.2micorgram/l for group B, and 30.2+/-18.2micorgram/l for group C. 3) Serum ECP had correlation with nasal wash fluid ECP & blood eosinophils in group B and C, except group A. CONCLUSION: On acute asthma attack, the mean ECP level of serum & nasal wash fluid from all children including infancy were significantly higher than control and this suggests that the role of eosinophils to airway inflammation in many wheezing infants may be the same as that in older children with asthma.