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1.
Rev. colomb. anestesiol ; 49(3): e201, July-Sept. 2021. tab
Article in English | LILACS, COLNAL | ID: biblio-1280177

ABSTRACT

Abstract Introduction: Post-anesthetic complications, particularly respiratory complications, continue to be a source of concern due to their high frequency, particularly in pediatrics. Objective: To describe the incidence of respiratory complications in the post-anesthesia care unit of an intermediate complexity center during a six-month period, and to explore the variables associated with major respiratory complications. Materials and Methods: Retrospective cohort study based on clinical record reviews. The records of the post-anesthesia care unit of an intermediate complexity pediatric institution located in Medellin, Colombia, were reviewed. This center uses a nursing-based care model that includes patient extubation in the post-anesthesia care unit. Results: The records of 1181 patients were analyzed. The cumulative incidences of major complications were bronchospasm 1.44%, laryngospasm 0.68% and respiratory depression 0.59%. There were no cases of cardiac arrest or acute pulmonary edema. A history of respiratory infection less than 15 days before the procedure, rhinitis and female sex were associated with major respiratory complications. Conclusions: A low frequency of respiratory complications was found during care provided by nursing staff trained in anesthesia recovery and pediatric airway in the post-anesthesia care unit.


Resumen Introducción: Las complicaciones postanestésicas, especialmente las respiratorias, siguen siendo causa de preocupación por su alta frecuencia, en particular, en la población pediátrica. Objetivo: Describir la incidencia de complicaciones respiratorias en la unidad de cuidados postanestésicos de una institución de mediana complejidad, en un período de seis meses y explorar las variables relacionadas con las complicaciones respiratorias mayores. Materiales y métodos: Estudio de cohorte retrospectivo, basado en la valoración de historias clínicas. Se revisaron los registros de la unidad de cuidados postanestésicos de una institución pediátrica de mediana complejidad ubicada en Medellín. Esta institución utiliza un modelo de atención -basado en enfermería- que incluye la extubación del paciente en la unidad de cuidados postanestésicos. Resultados: Se analizaron los registros de 1181 pacientes. La incidencia acumulada de complicaciones mayores fue: broncoespasmo 1,44 %, laringoespasmo 0,68 % y depresión respiratoria 0,59 %. No se presentaron casos de paro cardiaco ni de edema agudo de pulmón. El antecedente de infección respiratoria menor a 15 días, rinitis y sexo femenino se asociaron con complicaciones respiratorias mayores. Conclusiones: Durante la atención en la unidad de cuidados postanestésicos por parte del personal de enfermería entrenado en la recuperación de la anestesia y de la vía aérea de los pacientes pediátricos, se encontró una baja frecuencia de complicaciones respiratorias.


Subject(s)
Humans , Male , Female , Pulmonary Edema , Respiratory Insufficiency , Anesthesia , Anesthetics , Bronchial Spasm , Rhinitis , Laryngismus , Cohort Studies , Colombia , Edema , Heart Arrest , Infections , Nursing Staff
2.
Arch. argent. pediatr ; 119(5): 331-338, oct. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1292091

ABSTRACT

Introducción. La obstrucción nasal (ON) es el síntoma más molesto de la rinitis crónica (RC). Los estudios que correlacionaron métodos subjetivos y objetivos de ON realizados en niños y adultos produjeron resultados contradictorios. Objetivos. Analizar la correlación entre escalas subjetivas de ON con determinaciones de pico flujo inspiratorio nasal (PFIN) y comparar la valoración subjetiva de la ON y el PFIN en niños según su edad. Población y métodos. Participaron pacientes con RC. Se estimó la correlación entre la evaluación subjetiva de la ON mediante una escala visual análoga (ON-EVA, por su sigla en inglés) y la Escala de evaluación de los síntomas de obstrucción nasal (NOSE, por su sigla en inglés) y medición del flujo aéreo nasal pre- y posvasoconstrictor, mediante PFIN. Se analizaron las diferencias entre los grupos de 8 a 11 años y los de 12 a 15 años para la valoración subjetiva de la ON y PFIN. Resultados. Se incluyeron 79 pacientes entre 8 y 15 años. No se comprobó correlación entre ON-EVA y PFIN antes y después del vasoconstrictor (r = -0,19; p = 0,11 y r = -0,18; p = 0,15 respectivamente) ni entre NOSE y PFIN basal (r = -0,23; p = 0,07). Hubo diferencias en el PFIN entre niños de 8-11 años y 12 a 15 años (p = <0,0001), pero no se demostraron diferencias en la percepción subjetiva por ON-EVA (p = 0,7591). Conclusión. No se demostró correlación entre puntajes subjetivos de ON y PFIN en niños y adolescentes con RC. Los niños mayores perciben menos la ON que los de menor edad. Las escalas subjetivas de ON no reemplazan su medición con PFIN en pacientes con rinitis.


Introduction. Nasal obstruction (NO) is the most irritating symptom of chronic rhinitis (CR). The results of studies that correlated subjective and objective methods of NO in children and adults were contradictory. Objectives. To analyze the correlation between subjective NO scales and peak nasal inspiratory flow (PNIF) measurements and compare the subjective NO assessment and PNIF in children by age. Population and methods. Participants were patients with CR. The correlation between the subjective NO assessment using a visual analog scale (NO-VAS) and the Nasal Obstruction Symptom Evaluation (NOSE) and nasal airflow measurement pre- and post-vasoconstrictor administration using the PNIF was estimated. The differences in the subjective NO assessment and PNIF between children aged 8-11 years and 12-15 years were analyzed. Results. A total of 79 patients aged 8-15 years were included. No correlation was established between the NO-VAS and the PNIF before and after vasoconstrictor administration (r = -0.19; p = 0.11 and r = -0.18; p = 0.15 respectively) or between the NOSE and the baseline PNIF (r = -0.23; p = 0.07). Differences were observed in the PNIF between children aged 8-11 years and 12-15 years (p = < 0.0001), but there were no differences in the subjective perception assessed with the NO-VAS (p = 0.7591). Conclusion. No correlation was demonstrated between the subjective NO score and the PNIF in children and adolescents with CR. Older children have a lower perception of NO than younger ones. Subjective NO scales cannot replace the PNIF measurement in patients with rhinitis


Subject(s)
Humans , Child , Adolescent , Nasal Obstruction/diagnosis , Nasal Obstruction/etiology , Respiratory Function Tests , Rhinitis/diagnosis , Prospective Studies , Visual Analog Scale
3.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 743-747, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142588

ABSTRACT

Abstract Introduction: Chronic rhinosinusitis with nasal polyps, a prevalent disease affecting around 2% of the world population, is characterized by symptomatic inflammation of the nasal mucosa and impairment of quality of life. Chronic rhinosinusitis with nasal polyps has a multifactorial etiology, involving a dysfunctional host response to environmental factors. Thus, inflammatory models may be useful to shed light on the pathophysiology of this disease. Micronucleus count has been used to screen DNA damage in various tissues. Objective: To investigate the association between frequency of micronucleus in exfoliated cells from the nasal cavity of patients with chronic rhinosinusitis with nasal polyps and disease severity. Methods: This cross-sectional study included 21 patients with chronic rhinosinusitis with nasal polyps and 19 controls without disease. None of the participants were smokers. Results: Mean micronucleus count was 3.690 per 1000 cells (±2.165) in individuals with vs. 1.237 per 1000 cells (±0.806) in controls; (Student's t test = 4.653, p< 0.001). Nasal surgery in the past 5 years and aspirin-exacerbated respiratory disease were not associated with nicronucleus count (p= 0.251). Conclusion: Micronucleus count seems to be linked to chronic rhinosinusitis with nasal polyps, providing a new perspective for the evaluation of this disorder.


Resumo Introdução: A rinossinusite crônica com pólipos nasais, doença prevalente que afeta cerca de 2% da população mundial, é caracterizada por inflamação sintomática da mucosa nasal e comprometimento da qualidade de vida. A rinossinusite crônica com pólipos nasais tem etiologia multifatorial, envolvendo resposta disfuncional do hospedeiro a fatores ambientais. Assim, modelos inflamatórios podem ser úteis para esclarecer a fisiopatologia dessa doença. A contagem de micronúcleos tem sido usada para rastrear danos no DNA em vários tecidos. Objetivo: Investigar a associação entre a frequência de micronúcleos em células esfoliadas da cavidade nasal de pacientes com rinossinusite crônica com pólipos nasais e a gravidade da doença. Método: Estudo transversal que incluiu 21 pacientes com rinossinusite crônica com pólipos nasais e 19 controles sem doença. Nenhum dos participantes era fumante. Resultados: A contagem média de micronúcleos foi de 3,690 por 1.000 células (± 2,165) nos indivíduos doentes e 1,237 por 1.000 células (± 0,806) nos controles (teste t de Student = 4,653; p < 0,001). A cirurgia nasal nos últimos 5 anos e a doença respiratória exacerbada por aspirina não foram associadas à contagem de micronúcleos (p = 0,251). Conclusão: A contagem de micronúcleos parece estar ligada à rinossinusite crônica com pólipos nasais, proporcionando uma nova perspectiva para a avaliação dessa doença.


Subject(s)
Humans , Sinusitis/complications , Rhinitis/complications , Nasal Polyps/complications , Quality of Life , Chronic Disease , Cross-Sectional Studies , Epithelial Cells
4.
Braz. j. otorhinolaryngol. (Impr.) ; 86(5): 639-646, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132645

ABSTRACT

Abstract Introduction: Currently, several different concentrations of saline are recommended for use in nasal irrigation. Increasing studies show that nasal irrigation with hypertonic saline is more effective than traditional saline in the treatment of rhinosinusitis, but there have been few systematic analyses of the effect of nasal irrigation with hypertonic saline on chronic rhinosinusitis. Objective: We sought to compare the effects of hypertonic saline and isotonic saline in the treatment of rhinosinusitis in order to provide a reference for clinical nasal irrigation for chronic rhinosinusitis treatment. Methods: Medline, cochrane library, EMBASE, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database, and other databases were searched, and the searching was supplemented by manual searches for relevant references to treatment of rhinosinusitis by saline nasal irrigation. The last retrieval date was March 2018. The included studies were evaluated for quality, and data were extracted for meta-analysis using RevMan 5.3. Results: Seven studies were included. Effects favoring hypertonic saline on nasal symptoms were greater in 4 subgroups. These were (1) patients with nasal secretion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (2) patients with congestion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (3) patients with headache (SMD = 0.82; 95% CI: 0.38, 1.26; p < 0.01), (4) patients with overall symptomatic relief (SMD = 1.63; 95% CI: 0.83, 2.44; p < 0.01). However, no difference was shown in smell improvement (SMD = 0.47; 95% CI: −0.65, 1.59; p = 0.41) and radiologic scores improvement (SMD = 2.44; 95% CI: -3.14, 8.02; p < 0.01). Besides, hypertonic saline showed greater improvement in mucociliary clearance time scores than did the isotonic saline group (SMD = 1.19; 95% CI: 0.78, 1.60; p < 0.01). Hypertonic saline brought greater minor adverse effects. Conclusion: Compared with isotonic saline, hypertonic saline nasal irrigation for the treatment of chronic rhinosinusitis is significantly more effective and has mild side effects in improving nasal symptoms and ciliary movement, but there is no significant difference in imaging findings and smell improvement. Although hypertonic saline is worthy of widespread use in clinical practice, it is still necessary to further study the exact manner and concentration of nasal irrigation.


Resumo Introdução: Atualmente, o uso de várias concentrações diferentes de solução salina é recomendado na irrigação nasal. Um número crescente de estudos mostra que a irrigação nasal com solução salina hipertônica é mais eficaz do que a solução salina tradicional no tratamento de rinossinusite, mas existem poucas análises sistemáticas do efeito da irrigação nasal com solução salina hipertônica em rinossinusite crônica. Objetivo: Comparar os efeitos da solução salina hipertônica com a solução salina isotônica no tratamento da rinossinusite, para fornecer uma referência clínica de irrigação nasal no tratamento da rinossinusite crônica. Método: Foram pesquisados os bancos de dados Medline, Cochrane Library, Embase, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database e outros, e a pesquisa foi complementada por pesquisas manuais de referências relevantes ao tratamento da rinossinusite por irrigação nasal com solução salina. A data da última recuperação de dados foi março de 2018. Os estudos incluídos foram avaliados quanto à qualidade e os dados foram extraídos para a metanálise com o software RevMan 5.3. Resultados: Sete estudos foram incluídos. Os efeitos favoráveis à solução salina hipertônica nos sintomas nasais foram maiores em quatro subgrupos. Esses foram (1) pacientes com secreção nasal (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (2) pacientes com congestão (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (3) Pacientes com dor de cabeça (DMP = 0,82; IC95%: 0,38, 1,26; p ˂ 0,01); (4) Pacientes com alívio sintomático geral (DMP = 1,63; IC95%: 0,83, 2,44; p ˂ 0,01). Entretanto, não houve diferença na melhoria do olfato (DMP = 0,47; IC95%: -0,65, 1,59; p = 0,41) e na melhoria dos escores radiológicos (DMP = 2,44; IC95%: -3,14, 8,02; p < 0,01). Além disso, o grupo solução salina hipertônica mostrou maior melhoria nos escores do tempo de clearence mucociliar do que o grupo solução salina isotônica (DMP = 1,19; IC95%: 0,78, 1,60; p ˂ 0,01). A solução salina hipertônica causou efeitos adversos menores. Conclusão: Em comparação com a solução salina isotônica, a irrigação nasal com solução salina hipertônica para o tratamento da rinossinusite crônica é significantemente mais eficaz e apresenta efeitos colaterais mais leves, melhoria mais acentuada dos sintomas nasais e no movimento ciliar, mas não há diferença significante nos achados de imagem e na melhoria do olfato. Embora a solução salina hipertônica seja digna de uso generalizado na prática clínica, ainda são necessários mais estudos sobre a forma de uso e a concentração ideal da solução nasal.


Subject(s)
Humans , Sinusitis , Rhinitis , Saline Solution, Hypertonic , Sodium Chloride , Chronic Disease , Nasal Lavage
5.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(3): 352-359, set. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144900

ABSTRACT

Resumen Los pacientes trasplantados presentan mayor vulnerabilidad a complicaciones infecciosas, no solo debido al uso de drogas inmunosupresoras, sino que también, a las enfermedades subyacentes que presentan y a la falla de órganos primarios. A pesar de que las infecciones otorrinolaringológicas no son frecuentes en estos pacientes, es importante establecer un adecuado estudio y tratamiento de ellas. A través del siguiente artículo se aportan directrices en el estudio pretrasplante desde un enfoque otorrinolaringológico, generando recomendaciones de acuerdo a la patología del paciente y el órgano a trasplantar. Si bien, las recomendaciones se realizan según evaluación rinosinusal, otológica y faringoamigdalina, una adecuada anamnesis y examen físico son los pilares de la evaluación pretrasplante en otorrinolaringología, reservándose el estudio con imágenes para aquellos pacientes con alteraciones sospechosas.


Abstract Transplanted patients have higher frequency of infectious complications, not only due to the use of immunosuppressive drugs, but also the underlying diseases that present and the failure of primary organs. Although ear, nose and throat (ENT) infections are not frequent in these patients, it is important to establish an adequate study and treatment of them. Through the following article, guidelines are provided in the pretransplant study from an ENT approach, generating recommendations according to the pathology of the patient and the organ to be transplanted. Although, the recommendations are made according to rhinosinusal, otological and pharyngotonsiline evaluation, adequate anamnesis and physical examination are the pillars of the pretransplant evaluation in otolaryngology, reserving the study with images for patients with suspicious alterations.


Subject(s)
Humans , Otorhinolaryngologic Diseases/surgery , Organ Transplantation , Transplantation Conditioning/methods , Otitis Media/therapy , Sinusitis/therapy , Rhinitis/therapy , Surgical Clearance/methods , Infections
6.
Braz. j. otorhinolaryngol. (Impr.) ; 86(4): 434-442, July-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132612

ABSTRACT

Abstract Introduction The extent of epithelial lesion in allergic and non-allergic rhinitis and its association with inflammatory changes in nasal lavage has not been clarified. Objective To verify the association between the inflammatory cells in the nasal lavage, epithelial lesion extent and basement membrane thickness, in the nasal mucosa of patients with rhinitis; to determine the cutoff point of the percentage of eosinophils in the nasal lavage associated with the atopic patients. Methods Patients with rhinitis and indication for septoplasty and (or) turbinectomy for turbinate hypertrophy were selected, and were submitted to allergy skin tests, nasal lavage with measurement of albumin and interleukin-8 levels, total and differential counting of cells, and mucosal histopathological analysis to determine the extent of epithelial lesion, and degree of basement membrane thickening. Results Fifty-six patients with a median age of 24.5 years and a diagnosis of allergic rhinitis (n = 36) and non-allergic rhinitis (n = 20) were studied. In atopic subjects, allergy skin tests were positive for Dermatophagoides pteronyssinus in 35 (97.0%) and Lolium perenne in 18 (50.0%). Atopic subjects showed a higher clinical score index of rhinitis compared to non-atopic ones. The total count of cells, neutrophils, and levels of albumin and IL-8 were not different in the nasal lavage of atopic and non-atopic subjects. The cutoff point for eosinophil count in nasal fluid for the distinction between allergic rhinitis and non-allergic rhinitis was 4%. Some degree of epithelial lesion was more frequent in allergic rhinitis (94%) than in non-allergic rhinitis (65%) patients. In the presence of basement membrane thickness, as a marker of remodeling, there was no difference in the nasal lavage of patients with allergic rhinitis and non-allergic rhinitis. Conclusion In this series, 4% was the cutoff point for the number of eosinophils in the nasal lavage, for atopy differentiation. Upper airway remodeling accessed by basement membrane thickness showed similar inflammatory cell infiltrate in the nasal lavage, regardless of the presence of atopy.


Resumo Introdução A extensão da lesão epitelial na rinite alérgica e não alérgica e sua associação com alterações inflamatórias no lavado nasal ainda não estão esclarecidas. Objetivo Verificar a relação entre o processo inflamatório no lavado nasal, extensão da lesão epitelial e espessamento da membrana basal na mucosa nasal de pacientes com rinite; determinar o ponto de corte do percentual de eosinófilos no lavado nasal associado à presença de atopia. Método Foram selecionados pacientes com rinite e indicação de septoplastia e (ou) turbinectomia por hipertrofia de conchas nasais, os quais foram submetidos aos testes cutâneos alérgicos, lavado nasal com determinação das concentrações de albumina, interleucina-8 (IL-8), contagem total e diferencial de células, análise da extensão da lesão epitelial, e grau de espessamento da membrana basal por meio de histopatologia da mucosa. Resultado Foram estudados 56 pacientes, mediana de 24,5 anos com diagnóstico de rinite alérgica (n = 36) e rinite não alérgica (n = 20). Nos atópicos os testes cutâneos alérgicos foram positivos para D. pteronyssinus em 35 (97,0%) e L. perenne em 18 (50,0%). Atópicos apresentaram maior índice de escore clínico para rinite em comparação a não atópicos. A contagem total de células, neutrófilos e níveis de albumina e IL-8 não foi diferente entre o lavado nasal de atópicos e não atópicos. O ponto de corte da contagem de eosinófilos no fluido nasal para a distinção de rinite alérgica e rinite não alérgica foi de 4%. Algum grau de lesão epitelial foi mais frequente em pacientes com rinite alérgica (94%) do que em pacientes com rinite não alérgica (65%). Na presença de espessamento da membrana basal, como marcador de remodelamento, não houve diferença no lavado nasal entre pacientes com rinite alérgica e não alérgica. Conclusão Nesta casuística, 4% foi o ponto de corte do número de eosinófilos no lavado nasal, para diferenciação de atopia. Remodelamento da via aérea superior pelo espessamento da membrana basal revelou infiltrado semelhante de células inflamatórias no lavado nasal, independentemente da presença de atopia.


Subject(s)
Humans , Young Adult , Rhinitis , Eosinophils , Nasal Lavage , Nasal Mucosa
7.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(2): 237-246, jun. 2020.
Article in Spanish | LILACS | ID: biblio-1115840

ABSTRACT

La rinosinusitis crónica (RSC) en niños corresponde a la inflamación de la mucosa de la cavidad nasal y senos paranasales, presentando síntomas como obstrucción nasal, descarga nasal, presión o dolor facial y tos, presentes por más de 12 semanas. Conlleva una gran carga de morbilidad para quienes la padecen, y un alto costo económico. Su diagnóstico constituye un desafío debido a la sobreposición de síntomas con infecciones respiratorias altas y otras condiciones no infecciosas. En los últimos años se han dilucidado nuevos factores contribuyentes como los biofilms , disfunción del microbioma, y el creciente papel de mecanismos inflamatorios no infecciosos. El estudio imagenológico de elección es la tomografía computarizada, preferentemente en casos de duda diagnóstica, falta de respuesta a tratamiento o sospecha de complicaciones. El tratamiento de primera línea es el manejo médico, basado en irrigación nasal, posible uso de antibióticos prolongados y corticoides nasales. Para casos refractarios se plantean intervenciones quirúrgicas, siendo la adenoidectomía la primera elección, principalmente en niños menores; otras intervenciones incluyen la cirugía endoscópica de cavidades paranasales. Nuevas terapias biológicas están siendo estudiadas basadas en los mecanismos inflamatorios no infecciosos de la RSC y su relación con comorbilidades como el asma.


Chronic rhinosinusitis (CRS) in children is the inflammation of the nasal and sinus mucosa, presenting symptoms such as obstruction, nasal discharge, pressure or facial pain and cough, which extends for more than 12 weeks. It represents a great burden for those affected, with high economic cost. Its diagnosis constitutes a challenge due to the overlap of symptoms with other upper respiratory infections and other non-infectious conditions. In recent years, new contributing factors have been elucidated, such as biofilms, microbiome dysfunction, and the growing role of noninfectious inflammatory mechanisms. Diagnosis depends on the recognition of characteristic symptoms and their duration. The imaging study of choice is computed tomography, especially in cases of diagnostic doubt, lack of response to treatment or suspicion of complications. First-line treatment of is based on nasal irrigation, possible use of prolonged antibiotics and nasal corticosteroids. For refractory cases, surgical intervention is proposed, with adenoidectomy being the first choice, mainly in younger children; other interventions include endoscopic sinus surgery. New biological therapies are being studied based on noninfectious inflammatory mechanisms of CRS and its comorbidities such as asthma.


Subject(s)
Humans , Child , Sinusitis/diagnosis , Sinusitis/therapy , Rhinitis/diagnosis , Rhinitis/therapy , Sinusitis/etiology , Sinusitis/physiopathology , Rhinitis/etiology , Rhinitis/physiopathology , Chronic Disease
8.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 281-286, May-June 2020. tab
Article in English | LILACS | ID: biblio-1132589

ABSTRACT

Abstract Introduction: Clinicians rely on clinical presentations to select therapeutic agents for acute bacterial rhinosinusitis. Streptococcus pneumoniae and Haemophilus influenzae are common in acute bacterial rhinosinusitis. Drug resistant Streptococcus pneumoniae and Haemophilus influenzae require different antibiotics. Objective: This study aimed to evaluate the associations between clinical features of acute bacterial rhinosinusitis and pathogenic bacteria. Methods: Sixty-four patients with acute bacterial rhinosinusitis were enrolled. Clinical features including nasal obstruction, discolored discharge, facial pain, smell disturbance, fever and laboratory findings of patients with acute bacterial rhinosinusitis were collected. The bacterial cultures of endoscopic middle meatal swabs were used as a reference. Results: Serum C-reactive protein level elevation correlated with the bacterial species (p = 0.03), by which was increased in 80.0% of Haemophilus influenzae rhinosinusitis and 57.1% of Streptococcus pneumoniae rhinosinusitis. The elevated C-reactive protein was the significant predictor for Haemophilus influenzae rhinosinusitis with the Odds Ratio of 18.06 (95% CI 2.36-138.20). The sensitivity of serum C-reactive protein level elevation for diagnosing Haemophilus influenzae rhinosinusitis was 0.80 (95% CI 0.49-0.94). Conclusion: Elevation of serum C-reactive protein level was associated with and predicted acute bacterial rhinosinusitis caused by Haemophilus influenzae.


Resumo: Introdução: Os médicos se baseiam nas características clínicas para a escolha dos agentes terapêuticos para o tratamento da rinossinusite bacteriana aguda. Streptococcus pneumoniae e Haemophilus influenzae são agentes comuns na rinossinusite bacteriana aguda. Streptococcus pneumoniae e Haemophilus influenzae resistentes a antibióticos requerem medicamentos diferentes. Objetivo: Avaliar as associações entre as características clínicas da rinossinusite bacteriana aguda e bactérias patogênicas. Método: O estudo incluiu 64 pacientes com rinossinusite bacteriana aguda. Foram coletadas e registradas as características clínicas, inclusive obstrução nasal, secreção com cor alterada, dor facial, distúrbios do olfato, febre e achados laboratoriais de pacientes com rinossinusite bacteriana aguda. As culturas bacterianas obtidas por swab endoscópico do meato médio foram usadas como referência. Resultados: A elevação do nível sérico de proteína C-reativa estava correlacionada com a espécie bacteriana (p = 0,03); ela estava aumentada em 80,0% das rinossinusites por Haemophilus influenzae e em 57,1% das rinossinusites por Streptococcus pneumoniae. A proteína C-reativa elevada foi um significativo fator preditor de rinossinusite por Haemophilus influenzae, com razão de probabilidade de 18,06 (IC 95% 2,36-138,20). A sensibilidade da elevação dos níveis séricos de proteína C-reativa para o diagnóstico de rinossinusite por Haemophilus influenzae foi de 0,80 (IC 95% 0,49 ± 0,94). Conclusão: A elevação dos níveis séricos de proteína C-reativa é um preditor de rinossinusite bacteriana aguda causada por Haemophilus influenzae.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Sinusitis/microbiology , Rhinitis/microbiology , Gram-Positive Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/microbiology , Acute Disease , Cross-Sectional Studies
9.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(2): 147-156, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1115829

ABSTRACT

INTRODUCCIÓN: La rinosinusitis crónica odontogénica (RSCO) es un proceso inflamatorio/infeccioso de la mucosa nasal y senos paranasales (SPN) de origen dental. Corresponde a una patología subdiagnosticada en la actualidad. El gold standard diagnóstico es la tomografia computarizada. Los tratamientos difieren, desde tratamiento médico aislado hasta médico-quirúrgico de SPN o combinados. OBJETIVO: Caracterizar los resultados clinicos e imagenológicos de pacientes con RSCO en función del tratamiento recibido, para establecer recomendaciones terapéuticas. Describir la frecuencia de subdiagnóstico de esta patología. MATERIAL Y MÉTODO: Estudio descriptivo, retrospectivo. Se incluyeron pacientes con diagnóstico clínico e imagenológico de RSCO entre los años 2013-2017 en un centro de atención médico privado, a los que se realizó una tomografía computarizada cone beam de control. Fueron excluidos aquellos con rinosinusitis crónica, cirugía endoscópica funcional (CEF) previa, cáncer, embarazadas, rechazo a tomografía computarizada cone beam, ausencia de imágenes preoperatorias y menores de 18 años. RESULTADOS: De un total de 27 pacientes, en los operados de CEF (n =24; 89%) la resolución total de los síntomas se logró en 20/24 (83%), resolución parcial 3/24 (12,5%) y persistencia de los síntomas 1/24 (4%). Discusión: De los pacientes con RSCO 22/27 (81%) no tenían reportado el foco dental en el informe radiológico a pesar de ser visible. Aquellos pacientes con sintomatologia postratamiento, hubo factores identificados como la bilateralidad, mala dentadura general, falta de combinación de tratamiento dental y CEF. CONCLUSIONES: La CEF combinada con tratamiento dental concomitante, tiene un alto grado de éxito radiológico y clínico en esta patología. No fue posible demostrar si siempre es requerida la exodoncia con cierre de fístula oro-antral o si se pueden seleccionar pacientes para un tratamiento más conservador.


INTRODUCTION: Chronic odontogenic rhinosinusitis (CORS) is an inflammatory/infectious process of the nasal mucosa and sinuses of dental origin. Actually, it corresponds to an underdiagnosed pathology. The gold standard diagnosis is computed tomography. The treatments differ, from isolated medical treatment to medical-surgical sinuses or combined. AIM: To characterize the clinical and imaging results of patients with CORS according to the treatment received, to establish therapeutic recommendations. In addition to describing the frequency of subdiagnosis of this pathology. MATERIAL AND METHOD: Descriptive, retrospective study. Patients with clinical and imaging diagnosis of CORS between 2013-2017 were included in a private medical care center, to whom a cone beam computed tomography control was performed. Those with chronic rhinosinusitis, previous functional endoscopic sinus surgery (FESS), cancer, pregnant women, rejection of cone beam computed tomography, absence of preoperative images and those under 18 years were excluded. RESULTS: Of all patients operated on FESS (n =24; 89%) the total resolution of the symptoms was 20/24 (83%), partial resolution 3/24 (12.5%) and persistence of the symptoms a 1/24 (4%). Discussion: 22/27 (81%) of patients with CORS had not reported the dental focus in the radiological report despite being visible. Those patients with post-treatment symptoms had identified factors such as bilaterality, general bad teeth, lack of combination of dental treatment and FESS. CONCLUSION: The FESS combined with concomitant dental treatment, has a high degree of radiological and clinical success in this pathology. It was not possible to demonstrate whether exodontia with closure of oroantral fistula is always required or if patients can be selected for a more conservative treatment.


Subject(s)
Humans , Male , Female , Sinusitis/surgery , Rhinitis/surgery , Sinusitis/diagnostic imaging , Rhinitis/diagnostic imaging , Retrospective Studies , Treatment Outcome , Endoscopy , Cone-Beam Computed Tomography , Focal Infection, Dental/complications
10.
Int. j interdiscip. dent. (Print) ; 13(1): 35-39, abr. 2020. graf
Article in Spanish | LILACS | ID: biblio-1114891

ABSTRACT

La cirugía de elevación de seno maxilar se considera como la técnica de aumento óseo más predecible. Sin embargo, no está exenta de complicaciones las cuales deben ser manejadas adecuadamente. Se presenta un caso clínico rehabilitado, con un seguimiento de 3 años, en el cual se realizó un manejo multidisciplinario y resolutivo de complicaciones asociadas a la técnica quirúrgica de elevación de membrana sinusal vía ventana lateral. Frente a una infección postoperatoria, como la presentada en el caso, hay que considerar iniciar un tratamiento antibiótico en el momento adecuado para impedir el agravamiento del cuadro clínico o un cambio de esquema en caso de resistencia antimicrobiana.


Maxillary sinus lift surgery is considered the most predictable bone augmentation technique. However, this procedure is not without complications, which must be handled properly. We present a rehabilitated clinical case, with a 3-year follow-up, in which a multidisciplinary and resolutive management of complications associated with the surgical technique of sinus lift procedure, using lateral window approach, was performed. In case of postoperative infection, such as the one presented in this report, it is necessary to consider starting an antibiotic treatment at the adequate moment to prevent the aggravation of the illness or change the pharmacological treatment in case of antimicrobial resistance.


Subject(s)
Humans , Female , Adult , Sinusitis/therapy , Bacterial Infections/therapy , Rhinitis/therapy , Sinus Floor Augmentation/adverse effects , Postoperative Complications/rehabilitation , Sinusitis/etiology , Sinusitis/microbiology , Bacterial Infections/etiology , Dental Implants , Rhinitis/etiology , Rhinitis/microbiology , Acute Disease , Follow-Up Studies , Treatment Outcome
12.
Rev. bras. anal. clin ; 52(1): 42-47, 20200330. tab, graf
Article in Portuguese | LILACS | ID: biblio-1104463

ABSTRACT

Objetivo: Avaliar a prevalência de doenças respiratórias e atopia em duas amostras distintas de Caxias do Sul-RS. Métodos: Estudo de delineamento transversal descritivo e analítico em uma população caracterizada como urbana e outra como rural do município de Caxias do Sul-RS, no período de março a junho de 2018. Para caracterização da amostra e avaliação de doenças respiratórias, foi aplicada uma entrevista estruturada sobre o tema, juntamente com o teste de alergia cutânea imediata (Skin Prick Test), contendo nove dos principais reagentes desencadeantes de doenças alérgicas respiratórias. Resultados: Participaram do estudo 100 indivíduos, sendo 57% pertencentes à zona urbana e 43% pertencentes à zona rural. Do total, 71% dos avaliados eram do sexo feminino, com idade média de 43,3±15,7 anos. A prevalência de asma total foi de 10%, com maior frequência na população urbana (80%), além de maior índice de recorrência da doença (100%), visitas médicas (87,5%) e utilização de medicamentos (75%) nos últimos 12 meses. Na avaliação da atopia, houve positividade de 62% no quadro geral, não havendo diferença entre os grupos avaliados (p=0,579). Os índices de positividade foram maiores entre o grupo de ácaros da poeira domiciliar (Dermatophagoide pteronyssinus, 31%; Dermatophagoide farinae, 15%; Blomia tropicalis, 19%), seguido pelo epitélio de gato e mix de gramíneas (ambas 13%). Conclusão: A prevalência de asma possui maior frequência na zona urbana, mas sem diferenciação na prevalência de atopia. Entre os grupos, os ácaros da poeira domiciliar foram os reagentes mais prevalentes, seguidos de epitélio de gato e gramíneas.


Objective: To evaluate the prevalence of respiratory diseases and atopy in two distinct samples of Caxias do Sul-RS. Methods: A descriptive-analytical cross-sectional study was carried out in a population characterized as urban and rural in the municipality of Caxias do Sul, RS, from March to June 2018. For characterization of the sample and evaluation of respiratory diseases, a structured interview on the subject, along with the Skin Prick Test, containing nine of the leading triggers for allergic respiratory diseases. Results: 100 individuals participated in the study, 57% belonging to the urban area and 43% belonging to the rural area. Of the total, 71% of the evaluated women are female, with a mean age of 43.3±15.7 years. The prevalence of total asthma was 10%, with a higher frequency in the urban population (80%), and a higher recurrence rate (100%), medical visits (87.5%) and medication use (75%). in the last 12 months. In the evaluation of atopy, there was a positive 62% in the general setting, and there was no difference between the groups evaluated (p=0.579). The positivity indexes were higher among the house dust mite group (Dermatophagoide pteronyssinus, 31%, Dermatophagoide farinae, 15%, Blomia tropicalis, 19%), followed by cat epithelium and grass mix (both 13%). Conclusion: The prevalence of asthma has a higher frequency in the urban zone, but without differentiation in the prevalence of atopy. Among the groups, house dust mites are the most prevalent reagents, followed by cat and grass epithelium.


Subject(s)
Humans , Male , Female , Asthma , Rhinitis , Hypersensitivity , Mites , Respiratory Tract Diseases
13.
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 56-62, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089365

ABSTRACT

Abstract Introduction Chronic rhinosinusitis is a broad clinical syndrome characterized by mucosal inflammation of the nose and paranasal sinuses. In order for the paranasal sinuses to maintain their physiological functions; the ostiomeatal complex drainage pathways must be open. Surgical procedures are an important treatment option in patients who do not respond adequately to medical treatment. Although the methods and instruments used in functional endoscopic sinus surgery have continued to improve in recent years, the scar tissue formed during operation disrupts the drainage of the sinuses and reduces postoperative success. The natural ostiodilatation method, which is performed by balloon sinoplasty method, has become more and more popular in recent years. Objectives To compare the technique of balloon sinoplasty with the classical functional endoscopic sinus surgery method by considering the severity of chronic sinusitis on the same patient. Methods Total of 61 chronic sinusitis patients was included in the study. Paranasal sinus tomography of the patients was taken and according to the Lund-Mackay scoring, chronic sinusitis levels were determined. Cases were divided into two groups: Group 1 (severe chronic sinusitis group) and Group 2 (mild chronic sinusitis). Results There was no statistically significant difference in the results of comparison of sinuses which underwent balloon sinoplasty and classical functional endoscopic sinus surgery in Group 2 after Lund-Mackay scores. However in Group 1, the results of the comparison of postoperative Lund-Mackay scores of the balloon sinoplasty and the classical endoscopic operation were statistically significantly lower than those of the face half operated with the classical functional endoscopic sinus surgery. Conclusion The success of balloon sinoplasty in patients with mild sinusitis is the same as in classic functional endoscopic sinus surgery. However, as the severity of sinusitis increases, the efficacy of balloon sinoplasty decreases.


Resumo Introdução A rinossinusite crônica é uma síndrome clínica ampla, caracterizada por inflamação da mucosa nasal e seios paranasais. Para que os seios paranasais mantenham suas funções fisiológicas, as vias de drenagem do complexo ostiomeatal devem estar abertas. Os procedimentos cirúrgicos são uma importante opção de tratamento em pacientes que não respondem adequadamente ao tratamento clínico. Embora os métodos e instrumentos utilizados na cirurgia endoscópica funcional dos seios paranasais tenham melhorado continuamente, o tecido cicatricial formado durante a cirurgia interrompe a drenagem dos seios nasais e reduz o sucesso pós-operatório. O método natural de dilatação ostial, que é aplicado por meio da técnica de sinuplastia com balão, tem se tornado cada vez mais popular nos últimos anos. Objetivos Comparar a técnica de sinuplastia com balão com o método convencional de cirurgia endoscópica, no mesmo paciente, considerando a gravidade da rinossinusite crônica. Método Foram incluídos no estudo 61 pacientes com rinossinusite crônica. Por meio de tomografia dos seios paranasais e de acordo a escala de Lund-Mackay foram determinados os graus da rinossinusite crônica. Os casos foram divididos em dois grupos: Grupo 1 (grupo com rinossinusite crônica grave) e Grupo 2 (rinossinusite crônica leve). Resultados No Grupo 2 não houve diferença estatisticamente significante, segundo a escala de Lund-Mackay, no resultado da comparação dos seios paranasais nos quais foram realizadas a sinuplastia com balão e por cirurgia endoscópica convencional. No entanto, no Grupo 1, os resultados da comparação dos escores pós-operatórios de Lund-Mackay mostraram-se estatística e significativamente melhores naqueles submetidos à cirurgia endoscópica funcional dos seios paranasais. Conclusão O sucesso da sinuplastia com balão em pacientes com rinossinusite leve é o mesmo da cirurgia endoscópica funcional dos seios da face tradicional. No entanto, à medida que a gravidade da rinossinusite aumenta, a eficácia da sinuplastia com balão diminui.


Subject(s)
Humans , Male , Female , Middle Aged , Sinusitis/surgery , Rhinitis/surgery , Dilatation/methods , Endoscopy/methods , Nasal Surgical Procedures/methods , Postoperative Period , Otorhinolaryngologic Surgical Procedures , Severity of Illness Index , Tomography, X-Ray Computed , Chronic Disease , Treatment Outcome
14.
Asia Pacific Allergy ; (4): 9-2020.
Article in English | WPRIM | ID: wpr-785456

ABSTRACT

BACKGROUND: Recently, the prevalence of food allergies during childhood is increasing, with fruits being common allergens. However, data on allergens that cause fruit and vegetable allergies and pollen-food allergy syndrome (PFAS) in childhood are relatively few. This study aimed to examine the allergens in fruit and vegetable allergies in pediatric patients and to determine the association between fruit and vegetable allergies and PFAS.OBJECTIVE: This study aimed to examine the current status of fruit and vegetable allergies in Japanese children.METHODS: This was a multicenter case series observational study. The participants included children aged <15 years who developed allergic symptoms after eating fruits and vegetables and subsequently received treatment in the Pediatric Department of 6 hospitals in the Osaka Prefecture in Japan during the study period from August 2016 to July 2017. Participants' information was obtained using a questionnaire, and data were obtained by performing several types of allergy tests using blood samples.RESULTS: A total of 97 children (median age, 9 years; 56 males) were included in the study. Apple was the most common allergen, followed by peach, kiwi, cantaloupe, and watermelon. A total of 74 participants (76%) exhibited allergic symptoms due to PFAS; moreover, pathogenesis-related protein-10 (PR-10) was the most common allergen superfamily. On the contrary, in the group where neither PR-10 nor profilin was sensitized, kiwi and banana were the most common allergens, and the age of onset was lower than that in the PFAS group. Specific antibody titer was significantly associated with Birch for Bet v1 and latex for Bet v2 (r = 0.99 and r = 0.89).CONCLUSION: When we examine patients with fruit and vegetable allergies, we should first consider PFAS even in childhood specifically for children greater than 4 years old.


Subject(s)
Age of Onset , Allergens , Asian Continental Ancestry Group , Betula , Child , Citrullus , Clinical Study , Cucumis melo , Eating , Food Hypersensitivity , Fruit , Humans , Hypersensitivity , Japan , Latex , Musa , Observational Study , Prevalence , Profilins , Prunus persica , Rhinitis , Rhinitis, Allergic, Seasonal , Vegetables
15.
Article in Korean | WPRIM | ID: wpr-785352

ABSTRACT

PURPOSE: Allergic rhinitis is the most common atopic disease and the most common chronic disease of children. Eosinophil count and percentage in nasal smear are useful for differential diagnosis of allergic rhinitis. The aim of this study is to investigate the correlation between nasal eosinophil count and percentage.METHODS: Between January 2017 and August 2018, 221 children patients with a clinical history of rhinitis were tested at the outpatient respiratory and allergy unit of the Department of Pediatrics, School of Medicine, The Catholic University of Korea. Nasal secretion was collected by swabbing a children's nasal inferior turbinate 3–4 times with a cotton swab and then placed on to a glass slide. Later, the smear was stained by Giemsa stain.RESULTS: This is the first study to assess the comparison of nasal eosinophil count and percent. There is a positive correlation between nasal eosinophil count and percent Y=1.02 X+2.82 (Y=Eosinophil count, X=Eosinophil percentage). To determine the usefulness of nasal eosinophil count and percentage in the diagnosis of allergic rhinitis, we analyzed receiver operating characteristic curves. The cutoff value of the nasal eosinophil count was 6.5/high-power field, and that of the nasal eosinophil ratio was 3% for the diagnosis of allergic rhinitis.CONCLUSION: In patients with suspected rhinitis, one of the values of nasal eosinophil count or percentage can be used in clinical practice.


Subject(s)
Azure Stains , Child , Chronic Disease , Diagnosis , Diagnosis, Differential , Eosinophils , Glass , Humans , Hypersensitivity , Korea , Outpatients , Pediatrics , Rhinitis , Rhinitis, Allergic , ROC Curve , Turbinates
16.
Article in Korean | WPRIM | ID: wpr-785351

ABSTRACT

PURPOSE: Recently, the prevalence of allergic rhinitis (AR) in Korean children has been increased. The aim of this study was to investigate the clinical characteristics of rhinitis and to compare clinical parameters between AR and nonallergic rhinitis (NAR) in children.METHODS: We retrospectively reviewed the medical records of 1,034 children under 18 years of age who visited Korea University Anam Hospital for rhinitis symptoms from January 2008 to December 2017. Clinical data, including clinical features, comorbidities, blood test results, allergen sensitization profile, and pulmonary function test parameters, were collected.RESULTS: Among the 1,034 children with rhinitis, 737 (71.3%) were AR and 297 (28.7%) were NAR. The prevalence of AR gradually increased with age. The median levels of eosinophil count (4.1%), serum total IgE (204.4 IU/L), eosinophil cationic protein (ECP) concentration (17.9 µg/L), and fractional exhaled nitric oxide (FeNO) (22.0 ppb) were significantly higher in children with AR than in those with NAR. The sensitization rate to the inhalant allergens increased with age; however, food allergen sensitization rate tended to decrease. Median levels of eosinophil count, total IgE, ECP, and FeNO were significantly higher in the poly-sensitized group than in the mono-sensitized and nonsensitized groups.CONCLUSION: More than 70% of Korean children who have rhinitis symptoms are AR. Children with AR more likely to have higher levels of FeNO and bronchial asthma. Poly-sensitized children showed increased rates of atopic dermatitis and bronchial asthma.


Subject(s)
Allergens , Asthma , Child , Comorbidity , Dermatitis, Atopic , Eosinophil Cationic Protein , Eosinophils , Hematologic Tests , Humans , Immunoglobulin E , Korea , Medical Records , Nitric Oxide , Prevalence , Respiratory Function Tests , Retrospective Studies , Rhinitis , Rhinitis, Allergic
17.
Article in English | WPRIM | ID: wpr-785343

ABSTRACT

The reference sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) were renewed in 2019. The DG Santé good practice Mobile Airways Sentinel networK was reviewed to meet the objectives of the EIP on AHA. It included 1) Management of care process, 2) Blueprint of digital transformation, 3) EIP on AHA, innovation to market, 4) Community for monitoring and assessment framework, 5) Political, organizational, technological and financial readiness, 6) Contributing to European co-operation and transferability, 7) Delivering evidence of impact against the triple win approach, 8) Contribution to the European Digital Transformation of Health and Care and 9) scale of demonstration and deployment of innovation


Subject(s)
Asthma , Masks , Mobile Applications , Rhinitis
18.
Article in English | WPRIM | ID: wpr-762184

ABSTRACT

PURPOSE: Various immune cells, including eosinophils and neutrophils, are known to contribute to the development of chronic rhinosinusitis with nasal polyps (CRSwNP). However, the current understanding of the role of neutrophils in the development of CRSwNP still remains unclear. Therefore, we investigated risk factors for refractoriness of CRSwNP in an Asian population. METHODS: Protein levels of 17 neutrophil-related mediators in nasal polyps (NPs) were determined by multiplex immunoassay, and exploratory factor analysis using principal component analysis was performed. Immunofluorescence analysis was conducted to detect human neutrophil elastase (HNE) or myeloperoxidase (MPO)-positive cells. Tissue eosinophilic nasal polyp (ENP) and tissue neutrophilia (Neu(high)) were defined as greater than 70 eosinophils and 20 HNE-positive cells, otherwise was classified into non-eosinophilic nasal polyp (NENP) and absence of tissue neutrophilia (Neu(low)). RESULTS: In terms of disease control status, NENP-Neu(low) patients showed the higher rate of disease control than NENP-Neu(high) and ENP-Neu(high) patients. Linear by linear association demonstrated the trend in refractoriness from NENP-Neu(low) to NENP-Neu(high) or ENP-Neu(low) to ENP-Neu(high). When multiple logistic regression was performed, tissue neutrophilia (hazard ratio, 4.38; 95% confidence interval, 1.76-10.85) was found as the strongest risk factor for CRSwNP refractoriness. Additionally, exploratory factor analysis revealed that interleukin (IL)-18, interferon-γ, IL-1Ra, tumor necrosis factor-α, oncostatin M, and MPO were associated with good disease control status, whereas IL-36α and IL-1α were associated with refractory disease control status. In subgroup analysis, HNE-positive cells and IL-36α were significantly upregulated in the refractory group (P = 0.0132 and P = 0.0395, respectively), whereas MPO and IL-18 showed higher expression in the controlled group (P = 0.0002 and P = 0.0009, respectively). Moreover, immunofluorescence analysis revealed that IL-36R⁺HNE⁺-double positive cells were significantly increased in the refractory group compared to the control group. We also found that the ratio of HNE-positive cells to α1 anti-trypsin was increased in the refractory group. CONCLUSIONS: Tissue neutrophilia had an influence on treatment outcomes in the Asian CRSwNP patients. HNE-positive cells and IL-36α may be biomarkers for predicting refractoriness in Asians with CRSwNP. Additionally, imbalances in HNE and α1 anti-trypsin may be associated with pathophysiology of neutrophilic chronic rhinosinusitis.


Subject(s)
Asian Continental Ancestry Group , Biomarkers , Eosinophils , Fluorescent Antibody Technique , Humans , Immunoassay , Interleukin 1 Receptor Antagonist Protein , Interleukin-18 , Interleukins , Leukocyte Elastase , Logistic Models , Nasal Polyps , Necrosis , Neutrophils , Oncostatin M , Peroxidase , Principal Component Analysis , Rhinitis , Risk Factors , Sinusitis
19.
Article in English | WPRIM | ID: wpr-762183

ABSTRACT

PURPOSE: The effect of air pollution-related particulate matter (PM) on epithelial barrier function and tight junction (TJ) expression in human nasal mucosa has not been studied to date. This study therefore aimed to assess the direct impact of PM with an aerodynamic diameter less than 2.5 μm (PM2.5) on the barrier function and TJ molecular expression of human nasal epithelial cells. METHODS: Air-liquid interface cultures were established with epithelial cells derived from noninflammatory nasal mucosal tissue collected from patients undergoing paranasal sinus surgery. Confluent cultures were exposed to 50 or 100 µg/mL PM2.5 for up to 72 hours, and assessed for 1) epithelial barrier integrity as measured by transepithelial resistance (TER) and permeability of fluorescein isothiocyanate (FITC) 4 kDa; 2) expression of TJs using real-time quantitative polymerase chain reaction and immunofluorescence staining, and 3) proinflammatory cytokines by luminometric bead array or enzyme-linked immunosorbent assay. RESULTS: Compared to control medium, 50 and/or 100 µg/mL PM2.5-treatment 1) significantly decreased TER and increased FITC permeability, which could not be restored by budesonide pretreatment; 2) significantly decreased the expression of claudin-1 messenger RNA, claudin-1, occludin and ZO-1 protein; and 3) significantly increased production of the cytokines interleukin-8, TIMP metallopeptidase inhibitor 1 and thymic stromal lymphopoietin. CONCLUSIONS: Exposure to PM2.5 may lead to loss of barrier function in human nasal epithelium through decreased expression of TJ proteins and increased release of proinflammatory cytokines. These results suggest an important mechanism of susceptibility to rhinitis and rhinosinusitis in highly PM2.5-polluted areas.


Subject(s)
Asthma , Budesonide , Claudin-1 , Cytokines , Enzyme-Linked Immunosorbent Assay , Epithelial Cells , Fluorescein , Fluorescein-5-isothiocyanate , Fluorescent Antibody Technique , Humans , Interleukin-8 , Mucous Membrane , Nasal Mucosa , Occludin , Particulate Matter , Permeability , Polymerase Chain Reaction , Rhinitis , RNA, Messenger , Tight Junctions
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