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1.
Rev. cient. Esc. Univ. Cienc. Salud ; 8(1): 5-11, ene-. jun. 2021. tab., graf.
Article in Spanish | LILACS, BIMENA | ID: biblio-1370900

ABSTRACT

La prevalencia de las enfermedades atópicas va en aumento de manera impor- tante, especialmente en la población infantil a nivel mundial según la Organización Mundial de la Salud. Dentro de estas enfermedades están incluidas el asma, rinitis y la dermatitis atópica. Objetivo: Determinar la prevalencia de asma, rinitis y dermatitis atópica en escolares de 6 a 12 años en San Pedro Sula, Honduras en el año 2000. Pacientes y Métodos: Estudio descrip- tivo, cuantitativo, no experimental. La muestra fue de 1500 escolares matriculados en diversas escuelas que fueron seleccionadas por un método no probabilístico por conveniencia. La reco- lección de datos se realizó mediante la aplicación de un instrumento tipo encuesta a escolares que cumplían con los criterios de inclusión y contaban con consentimiento informado. Los datos se tabularon en SPSS. Resultados: La prevalencia de asma fue 24.46% (367), rinitis 17% (255) y dermatitis atópica 11.69% (175). Se encontró que 15.73% (236) tenían asma y rinitis; 9.53% (143) asma y dermatitis; y 8.40% (126) padecían rinitis y dermatitis. Además, 7.93% (119) padecían de las tres enfermedades. Conclusión: Los datos de prevalencia de asma y de dermatitis atópica en Escolares de San Pedro Sula son mayores a los encontrados en estudios de prevalencia de dichas enfermedades en Latinoamérica. Sin embargo, la preva- lencia de rinitis en San Pedro Sula es menor en comparación a la señalada en estos estudios...(AU)


Subject(s)
Humans , Male , Female , Child , Asthma/diagnosis , Rhinitis/diagnosis , Dermatitis, Atopic/diagnosis , Data Collection/statistics & numerical data , Informed Consent/ethics
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.
Article in Chinese | WPRIM | ID: wpr-942575

ABSTRACT

Objective: To compare the value of 25-hydroxyvitamin D3 (25-(OH)D3) with other clinical parameters in the prediction and diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP). Methods: Eligible chronic rhinosinusitis with nasal polyps (CRSwNP) patients and healthy subjects in the Affiliated Hospital of Guizhou Medical University from January to April of 2021 were included for this study. The age, gender, past history and other basic characteristics of all subjects were recorded. The CRSwNP patients were classified into ECRSwNP and non-eosinophilic chronic rhinosinusitis with nasal polyps (nECRSwNP) endotypes by the percentage of tissue eosinophils. Serum 25-(OH)D3 levels measurements were performed in all subjects. Paranasal sinus CT scans, blood eosinophil counts, and determination of total immunoglobulin E (total IgE), Th1/Th2 plasma cytokines and nasal nitric oxide (nNO) levels were performed before surgery. Logistic regression analysis was used to evaluate the related factors of ECRSwNP. Receiver operating characteristic (ROC) curves was used to evaluate the predictive potential of the clinical parameters. Results: One hundred and twenty-seven CRSwNP patients and 40 healthy subjects were recruited, including 74 males and 93 females of the patients, with the age of (38.73±13.05) years. In patients with ECRSwNP, serum 25-(OH)D3 levels were significantly lower than those in nECRSwNP patients ((26.14±4.58) ng/ml vs (35.71±7.86) ng/ml, t=-8.564, P<0.01). The prevalence of asthma, prevalence of allergic rhinitis, peripheral blood eosinophil counts, total IgE levels, nNO levels and CT scores ratio for ethmoid sinus and maxillary sinus (E/M ratio) of ECRSwNP patients were significantly higher than those in nECRSwNP patients (all P<0.05). However, there was no significant difference in Th1/Th2 cytokines levels between the histological types of CRSwNP (all P>0.05). Among the predictive indicators, 25-(OH)D3 had the highest predictive value, with ROC area under curve (AUC) value of 0.882. The best cut-off point of 28.5 ng/ml for 25-(OH)D3 demonstrated a sensitivity of 0.871 and a specificity of 0.762 for ECRSwNP. Conclusion: Measurement of serum 25-(OH)D3 level may be used as an effective method to distinguish between ECRSwNP and nECRSwNP.


Subject(s)
Adult , Calcifediol , Chronic Disease , Eosinophils , Female , Humans , Male , Maxillary Sinus , Middle Aged , Nasal Polyps/diagnosis , Rhinitis/diagnosis , Sinusitis/diagnosis
4.
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
6.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(3): 366-373, set. 2019. graf
Article in Spanish | LILACS | ID: biblio-1058709

ABSTRACT

RESUMEN La rinosinusitis fúngica invasiva aguda (RSFIA) es una enfermedad poco frecuente caracterizada por una infiltración fúngica de la submucosa y vasos sanguíneos de las cavidades nasal y paranasal. Afecta a pacientes con grados variables de inmunosupresión, destacando entre estas patologías subyacentes la diabetes mellitus y las neoplasias malignas hematológicas. Presenta una alta tasa de mortalidad, pudiendo reducirse significativamente si el diagnóstico y el tratamiento se realizan precozmente. Este artículo tiene por objetivo presentar una revisión actualizada de la literatura respecto a la presentación clínica, microbiología, factores de riesgos, métodos diagnósticos, tratamiento y pronóstico de la RSFIA, tanto en adultos como en niños.


ABSTRACT Acute invasive fungal rhinosinusitis (AIFS) is a rare disease characterized by fungal infiltration of the submucosa and blood vessels of the nasal y paranasal cavities. It affects almost exclusively patients with different degrees of immunosuppression, with underlying pathologies such as diabetes mellitus and hematological malignancies. AIFS has a high mortality rate, but it can be significantly reduced if the diagnosis and treatment are carried out early in the course of disease. This article aims to present an updated literature review regarding clinical presentation, microbiology, risk factors, diagnostic methods, treatment and prognosis of AIFS, both in adults and children.


Subject(s)
Humans , Child , Adult , Sinusitis/diagnosis , Sinusitis/microbiology , Sinusitis/therapy , Rhinitis/diagnosis , Rhinitis/microbiology , Rhinitis/therapy , Prognosis , Acute Disease , Risk Factors , Immunocompromised Host , Debridement , Mycoses , Antifungal Agents/therapeutic use
7.
Rev. méd. Maule ; 33(2): 35-39, sept. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1292514

ABSTRACT

Mucormycosis is an infrequent fungal infection This infection is difficult to diagnose and treat and have a high morbility and mortality and affects immunocompromised patients, especially those patients with decompensated diabetes mellitus. We report the case of a 60 years old diabetic patient with poor metabolic control who was admitted for diabetic ketoacidosis and days later present right periorbital swelling and pain, is diagnosed of mucomycosis and is successfully treated with amphoterin B and surgery.


Subject(s)
Humans , Male , Middle Aged , Rhizopus/isolation & purification , Rhinitis/diagnosis , Meningitis, Fungal/diagnosis , Diabetic Ketoacidosis/diagnosis , Mucormycosis/diagnosis , Tomography, X-Ray Computed , Amphotericin B/administration & dosage , Amphotericin B/therapeutic use , Clinical Laboratory Techniques
8.
Braz. j. otorhinolaryngol. (Impr.) ; 82(1): 105-111, Jan.-Feb. 2016. tab
Article in Portuguese | LILACS | ID: lil-775705

ABSTRACT

ABSTRACT INTRODUCTION: There is a controversy concerning the terminology and definition of rhinitis in pregnancy. Gestational rhinitis is a relatively common condition, which has drawn increasing interest in recent years due to a possible association with maternal obstructive sleep apnea syndrome (OSAS) and unfavorable fetal outcomes. OBJECTIVE: To review the current knowledge on gestacional rhinitis, and to assess its evidence. METHODS: Structured literature search. RESULTS: Gestational rhinitis and rhinitis "during pregnancy" are somewhat similar conditions regarding their physiopathology and treatment, but differ regarding definition and prognosis. Hormonal changes have a presumed etiological role, but knowledge about the physiopathology of gestational rhinitis is still lacking. Management of rhinitis during pregnancy focuses on the minimal intervention required for symptom relief. CONCLUSION: As it has a great impact on maternal quality of life, both the otorhinolaryngologist and the obstetrician must be careful concerning the early diagnosis and treatment of gestational rhinitis, considering the safety of treatment measures and drugs and their current level of evidence.


RESUMO INTRODUÇÃO: Há grande confusão quanto à terminologia e definição da rinite na gestação. A rinite gestacional é uma condição relativamente comum que vem ganhando importância nos últimos anos pela descoberta de sua associação com a SAOS materna e possíveis desfechos desfavoráveis ao feto. Há pouca evidência na literatura nacional sobre o tema. OBJETIVO: Revisar o conhecimento científico atual sobre a rinite na gestação e suas evidências disponíveis. MÉTODO: Revisão de literatura estruturada. RESULTADOS: A rinite gestacional e a rinite "durante a gestação" são condições com alguns pontos de fisiopatologia e tratamento semelhantes, mas com definições e prognósticos diferentes. O papel dos hormônios nessas condições vem sendo sugerido por muitos trabalhos, mas o conhecimento sobre a fisiopatogenia da rinite gestacional ainda é escasso. O manejo da rinite na gestação requer o mínimo de intervenção com o maior alívio sintomático possível. CONCLUSÃO: Dado o grande impacto na qualidade de vida da gestante, tanto o otorrinolaringologista quanto o obstetra devem estar atentos para o diagnóstico precoce e manejo desta entidade, considerando o perfil de segurança e o nível de evidência das medidas e medicamentos disponíveis atualmente.


Subject(s)
Female , Humans , Pregnancy , Pregnancy Complications/diagnosis , Rhinitis/diagnosis , Diagnosis, Differential , Pregnancy Complications/etiology , Pregnancy Complications/therapy , Risk Factors , Rhinitis/etiology , Rhinitis/therapy , Terminology as Topic
9.
Article in Portuguese | LILACS | ID: lil-774720

ABSTRACT

JUSTIFICATIVA E OBJETIVOS: A rinossinusite é o processoinflamatório do revestimento da cavidade paranasal. O objetivodo presente estudo foi estimar o rendimento do exame clínico nodiagnóstico da rinossinusite aguda, comparando-o com técnicasde imagem. MÉTODOS: Foi realizado um estudo transversal,incluindo 55 pacientes com suspeita clínica de rinossinusite. Aanamnese e o exame físico para o diagnóstico de rinossinusiteforam realizados por um avaliador. As imagens foram avaliadaspor dois radiologistas, sem conhecimento dos dados clínicos.RESULTADOS: Dos 55 pacientes, 30 (45,5%) eram do sexomasculino, com média de idade de 35 anos (DP±13). O Rx deseios paranasais apresentou uma sensibilidade de 76%, especificidadede 29%, acurácia de 63%, tomando-se como padrãoáureo a tomografia computadorizada. O índice de concordânciaKappa entre os dois exames foi de 0,31. A dor à palpação dosseios da face apresentou a melhor acurácia (74%). Dos critériosmaiores, os mais frequentes foram o peso na face (100%) e ador facial (94%). Quanto aos critérios menores, a febre esteveausente nos pacientes estudados, cefaleia esteve presente em97% e tosse em 83%. O gotejamento pós-nasal esteve presenteem 58% dos indivíduos, e o gotejamento pós-nasal associado aopeso na face à inclinação do tronco presente em 63%. CONCLUSÕES:A anamnese e o exame físico apresentam boa acuráciano diagnóstico da rinossinusite aguda. O Raio X de seiosda face não apresentou bom rendimento diagnóstico quandocomparado com sinais e sintomas e com a Tomografia Computadorizadade seios da face.(AU)


BACKGROUND AND OBJECTIVES: Rhinosinusitis isinflammation of the lining of the paranasal sinus. The aim of thisstudy was to estimate the performance of clinical examinationin the diagnosis of acute rhinosinusitis, compared with imagingtechniques. METHODS: A cross-sectional study was performed, including 55 patients with suspected rhinosinusitis. The historyand physical examination for the diagnosis of rhinosinusitiswas conducted by an appraiser. The images were evaluated bytwo radiologists blinded to the clinical data. RESULTS: Ofthe 55 patients, 30 (45.5%) were male, with mean age 35 years(SD±13). The Rx of the paranasal sinuses showed a sensitivity of76%, specificity of 29%, and accuracy of 63%, with computedthomography by gold standard. Kappa index between the twoexams was 0.31. The symptom of pain on palpation of thesinus of the face showed the highest accuracy (74%). The mostcommon major criterion were the weight on the face (100%)and facial pain (94%). As for the minor criteria, fever was absentin the patients, headache was present in 97% and cough in 83%.The post-nasal drip was present in 58% of subjects, and postnasaldrip associated with weight in relation to inclination of thetrunk present in 63%. CONCLUSIONS: The clinical historyand physical examination show good accuracy in the diagnosisof acute rhinosinusitis. The X-ray doesn´t show good accuracycompared with signs, symptoms and computed tomography.(AU)


Subject(s)
Humans , Paranasal Sinuses/diagnostic imaging , Sinusitis/diagnosis , Rhinitis/diagnosis , Physical Examination/instrumentation , Radiography/instrumentation , Tomography, X-Ray Computed/instrumentation , Cross-Sectional Studies/instrumentation , Medical History Taking
11.
J. bras. pneumol ; 41(1): 65-76, Jan-Feb/2015. tab, graf
Article in English | LILACS | ID: lil-741555

ABSTRACT

Although cystic fibrosis (CF) is an irreversible genetic disease, advances in treatment have increased the life expectancy of CF patients. Upper airway involvement, which is mainly due to pathological changes in the paranasal sinuses, is prevalent in CF patients, although many are only mildly symptomatic (with few symptoms). The objective of this literature review was to discuss the pathophysiology and current therapeutic management of chronic rhinosinusitis (CRS) in CF patients. The review was based on current evidence, which was classified in accordance with the Oxford Centre for Evidence-Based Medicine criteria. When symptomatic, CRS with nasal polyps can affect quality of life and can lead to pulmonary exacerbations, given that the paranasal sinuses can be colonized with pathogenic bacteria, especially Pseudomonas aeruginosa. Infection with P. aeruginosa plays a crucial role in morbidity and mortality after lung transplantation in CF patients. Although clinical treatment of the upper airways is recommended as initial management, this recommendation is often extrapolated from studies of CRS in the general population. When sinonasal disease is refractory to noninvasive therapy, surgery is indicated. Further studies are needed in order to gain a better understanding of upper airway involvement and improve the management of CRS in CF patients, with the objective of preserving lung function and avoiding unnecessary invasive procedures.


A fibrose cística (FC) é uma doença genética irreversível, mas os avanços no tratamento têm aumentado a expectativa de vida dos pacientes. O acometimento das vias aéreas superiores, principalmente por alterações patológicas dos seios paranasais, é prevalente nesses pacientes, embora muitos apresentem poucos sintomas. O objetivo desta revisão é discutir a fisiopatologia e o manejo terapêutico atual da rinossinusite crônica (RSC) na FC. A revisão fundamentou-se nas evidências mais recentes, classificadas em conformidade com os critérios do Oxford Centre for Evidence-Based Medicine. Quando sintomática, a RSC com pólipos nasais pode afetar a qualidade de vida e as exacerbações pulmonares, já que os seios paranasais podem ser colonizados por bactérias patogênicas, principalmente a Pseudomonas aeruginosa. Essa bactéria tem papel crucial na morbidade e mortalidade após o transplante pulmonar em pacientes com FC. Embora o tratamento clínico das vias aéreas superiores seja indicado no manejo inicial, a indicação é muitas vezes extrapolada de estudos sobre RSC na população geral. A cirurgia é a alternativa quando o quadro nasossinusal é refratário à terapia não invasiva. Mais estudos são necessários para compreender melhor o acometimento das vias aéreas superiores e melhorar o manejo da RSC na FC, a fim de preservar a função pulmonar e evitar procedimentos invasivos desnecessários.


Subject(s)
Humans , Cystic Fibrosis/complications , Nasal Polyps/diagnosis , Nasal Polyps/therapy , Rhinitis/diagnosis , Rhinitis/therapy , Sinusitis/diagnosis , Sinusitis/therapy , Chronic Disease , Evidence-Based Medicine , Nasal Polyps/etiology , Paranasal Sinuses , Rhinitis/etiology , Tomography, X-Ray Computed
12.
Article in English | WPRIM | ID: wpr-214109

ABSTRACT

BACKGROUND/AIMS: We sought to increase our understanding of the rhinitis-asthma relationship and improve strategies for the treatment of patients with these diseases. The aim of this study was to identify a connection between upper airway inflammation and lower airway responsiveness. METHODS: We counted eosinophils on nasal smears, and performed spirometry, allergic skin tests, and methacholine challenge tests in 308 schoolchildren plus a questionnaire on respiratory symptoms. The methacholine concentration causing a 20% fall in forced expiratory volume in 1 second (PC20 0.05). No difference in BHR was detected when comparing subjects with and without nasal eosinophils. There were significant differences in the PC20 between subjects with greater than 50% nasal eosinophils and without nasal eosinophils (11.01 +/- 2.92 mg/mL vs. 17.38 +/- 0.61 mg/mL; p < 0.001). CONCLUSIONS: These findings demonstrated that nasal eosinophilic inflammation might contribute to lower airway responsiveness in schoolchildren, based on an epidemiological survey.


Subject(s)
Adolescent , Age Distribution , Age Factors , Asthma/diagnosis , Bronchial Hyperreactivity/diagnosis , Bronchial Provocation Tests , Child , Eosinophilia/diagnosis , Eosinophils/immunology , Female , Health Surveys , Humans , Intradermal Tests , Leukocyte Count , Lung/physiopathology , Male , Nasal Mucosa/immunology , Republic of Korea/epidemiology , Rhinitis/diagnosis , Spirometry , Surveys and Questionnaires
13.
Rev. Assoc. Med. Bras. (1992) ; 60(4): 357-364, Jul-Aug/2014. tab, graf
Article in English | LILACS | ID: lil-720990

ABSTRACT

Objective: to evaluate the prevalence of rhinitis symptoms among 6 and 7-year old schoolchildren in Fortaleza, Brazil. Methods: a cross-sectional study using the rhinitis module of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. The sample included 2,020 students from public and private schools, in 2010. Results: the prevalence of cumulative rhinitis, active rhinitis, allergic rhinoconjunctivitis and physician-diagnosed rhinitis was 49.9%, 42%, 15.4% and 28.1%, respectively, being significantly more prevalent among private school students (OR = 0.55, 95CI: 0.46 - 0.66, p < 0.001; OR = 0.50, 95CI: 0.41 - 0.60, p < 0.001; OR = 0.67, 95CI: 0.52 - 0.85, p < 0.001; OR = 0.15, 95CI: 0.12 - 0.19, p < 0.001, respectively), without differences between genders. Interference with daily activities was reported by 25.3%, while 5.7% reported to be moderately or severely affected, without a difference between genders. Conclusion: the prevalence of rhinitis symptoms and associated morbidity among 6-7-year old schoolchildren in Fortaleza was above the Brazilian average, with predominance among private school students, without difference between genders. It was observed that rhinitis was underdiagnosed in this population. .


Objetivo: avaliar a prevalência de sintomas de rinite em crianças de 6 e 7 anos de idade, em Fortaleza. Métodos: foi aplicado o questionário ISAAC (International Study of Asthma and Allergies in Childhood), módulo rinite, em estudo de desenho transversal de base populacional, com amostragem probabilística de 2.020 escolares de escolas públicas e privadas, em 2010. Resultados: a prevalência de rinite cumulativa, rinite ativa, rinoconjuntivite alérgica e rinite diagnosticada foi, respectivamente, 49,9, 42, 15,4 e 28,1%, com predomínio de forma significativa entre as crianças das escolas particulares (RC = 0,55, IC95%: 0,46 a 0,66, p < 0,001; RC = 0,50, IC95%: 0,41 a 0,60, p < 0,001; RC = 0,67, IC95%: 0,52 a 0,85, p < 0,001; RC = 0,15, IC95%: 0,12 a 0,19, p < 0,001, respectivamente), e sem diferença entre os gêneros. Interferência dos sintomas com as atividades diárias foi relatada por 25,3% dos pesquisados, e 5,7% relataram ser moderada ou intensamente afetados, sem diferença entre os gêneros. Conclusão: a prevalência de sintomas de rinite e da morbidade associada, entre crianças de 6 e 7 anos de idade, em Fortaleza, mostrou-se acima da média nacional, com predomínio no grupo das escolas privadas, e sem diferença entre os gêneros. Observou-se também que rinite é subdiagnosticada entre as crianças de 6 e 7 anos de idade, em Fortaleza. .


Subject(s)
Child , Female , Humans , Male , Rhinitis/epidemiology , Students/statistics & numerical data , Brazil/epidemiology , Prevalence , Rhinitis/classification , Rhinitis/diagnosis , Socioeconomic Factors , Surveys and Questionnaires , Urban Population
14.
Braz. j. otorhinolaryngol. (Impr.) ; 80(4): 285-289, Jul-Aug/2014. tab, graf
Article in English | LILACS | ID: lil-721411

ABSTRACT

INTRODUCTION: hematopoietic stem cell transplantation (HSCT) is associated with more respiratory infections due to immunosuppression. OBJECTIVE: this study aimed to verify the frequency of rhinosinusitis after HSCT, and the association between rhinosinusitis and chronic graft vs. host disease (GVHD) and type of transplantation, clinical treatment, surgical treatment, and survival. METHODS: this was a retrospective study in a tertiary university hospital. A total of 95 patients with hematological diseases undergoing HSCT between 1996 and 2011 were selected. RESULTS: chronic myeloid leukemia was the most prevalent disease. The type of transplant most often performed was the allogenic type (85.26%). The frequency of rhinosinusitis was 36%, with no difference between the autologous and the allogenic types. Chronic GVHD occurred in 30% of patients. Patients with GVHD had a higher frequency and recurrence of rhinosinusitis, in addition to more frequent need for endoscopic sinusectomy and decreased overall survival. CONCLUSION: there was a higher frequency of rhinosinusitis in HSCT and GVHD. The type of transplant does not appear to predispose to the occurrence of rhinosinusitis. GVHD seems to be an aggravating factor and requires a more stringent treatment. .


INTRODUÇÃO: O transplante de células troncas hematopoiéticas (TCTH) associa-se a mais infecções respiratórias devido a imunossupressão. OBJETIVO: Este trabalho tem o objetivo de verificar a frequência das rinossinusites pós-TCTH, a associação entre a rinossinusite e a doença do enxerto contra hospedeiro (DECH) crônico e o tipo de transplante e o tratamento clinico e o tratamento cirúrgico e a sobrevida. MÉTODO: Estudo retrospectivo em hospital universitário terciário. Foram selecionados 95 pacientes com doença hematológica submetidos a TCTH entre 1996 a 2011. RESULTADOS: A leucemia mieloide crônica foi a doença mais prevalente. O tipo de transplante mais realizado foi o alogênico (85,26%). A frequência de rinossinusite foi de 36%, sem diferença entre os tipos de transplante autólogo e alogênico. A DECH crônica ocorreu em 30% dos pacientes. Os pacientes com DECH tiveram maior frequência e recorrência de rinossinusite, além de mais necessidade de sinusectomia endoscópica e de diminuição da sobrevida global. CONCLUSÃO: Houve maior frequência de rinossinusite no TCTH e DECH. O tipo de transplante não parece predispor a ocorrência da rinossinusite. A DECH parece ser um fator agravante e necessita de tratamento mais rigoroso. .


Subject(s)
Humans , Graft vs Host Disease , Hematologic Diseases/surgery , Hematopoietic Stem Cell Transplantation/adverse effects , Rhinitis/etiology , Sinusitis/etiology , Chronic Disease , Retrospective Studies , Rhinitis/diagnosis , Sinusitis/diagnosis
15.
J. bras. med ; 102(1)jan.-fev. 2014.
Article in Portuguese | LILACS | ID: lil-712212

ABSTRACT

Resfriado comum e gripe são habitualmente confundidos, principalmente se o resfriado for mais intenso. Coriza é rotulada tanto como alergia como sinusite. Os processos inflamatórios das vias aéreas superiores envolvidos nessas entidades clínicas conjugam fatores comuns, embora tenham etiologias diferentes. Graças a isso, diagnósticos equivocados geram tratamento inadequado, geralmente com emprego desnecessário de antibióticos. O resfriado comum e a gripe (influenza) são infecções virais do trato respiratório, assim como a maioria das rinossinusites. Já a rinite é, em sua maior parte, manifestação da atopia respiratória.


Common cold and flu are usually confused, especially if the cold is more intense. Many times, coryza is labeled as being allergy or sinusitis. The inflammation of the upper airways involved in these clinical entities combine common factors, although they have different etiologies. As a result, misdiagnosis generates inadequate treatment, usually with unnecessary use of antibiotics. The common cold and the flu (influenza) are viral infections of the respiratory tract, as well as most cases of rhinosinusitis. On the other hand, rhinitis is, most of the time, a manifestation of respiratory atopy.


Subject(s)
Humans , Male , Female , Influenza, Human/diagnosis , Common Cold/diagnosis , Rhinitis/diagnosis , Sinusitis/diagnosis , Bacterial Adhesion , Diagnosis, Differential , Clinical Diagnosis , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology , Oseltamivir/administration & dosage , Influenza A virus/pathogenicity , Zanamivir/administration & dosage
16.
J. bras. pneumol ; 39(3): 296-305, jun. 2013. tab, graf
Article in English | LILACS | ID: lil-678246

ABSTRACT

OBJECTIVE: To determine the prevalence of atopy and to evaluate clinical, laboratory, and radiological profiles in patients with COPD. METHODS: This was a cross-sectional study involving outpatients with stable COPD (defined by the clinical history and a post-bronchodilator FEV1/FVC < 70% of the predicted value). The patients completed a questionnaire regarding clinical characteristics and atopy, after which they underwent nasal lavage cytology, skin prick testing, chest X-rays, arterial blood gas analyses, and determination of total serum IgE. RESULTS: Of the 149 subjects studied, 53 (35.6%), 49 (32.8%), and 88 (59.1%) presented with nasal eosinophilia, a positive skin prick test result, and symptoms of allergic rhinitis, respectively. Correspondence analysis confirmed these findings, showing two distinct patterns of disease expression: atopy in patients with COPD that was less severe; and no evidence of atopy in those with COPD that was more severe (reduced FEV1 and hyperinflation). There was a statistically significant association between nasal eosinophilia and a positive bronchodilator response. CONCLUSIONS: Using simple and reproducible methods, we were able to show that there is a high frequency of atopy in patients with COPD. Monitoring inflammation in the upper airways can be a useful tool for evaluating respiratory diseases in the elderly and in those with concomitant asthma and COPD, a clinical entity not yet fully understood. .


OBJETIVO: Determinar a prevalência de atopia e avaliar o perfil clínico, laboratorial e radiológico de pacientes com DPOC. MÉTODOS: Estudo de corte transversal com pacientes ambulatoriais portadores de DPOC estável (definida pela história clínica e relação VEF1/CVF < 70% do previsto após broncodilatador). Os pacientes responderam um questionário clínico e de atopia e foram submetidos a citologia de lavado nasal, teste cutâneo de alergia, radiografia de tórax, hemogasometria arterial e dosagem de IgE total. RESULTADOS: Dos 149 indivíduos avaliados, 53 (35,6%), 49 (32,8%) e 88 (59,1%), respectivamente, apresentavam eosinofilia no lavado nasal, teste cutâneo positivo e sintomas de rinite alérgica. A análise de correspondência confirmou esses achados, evidenciando dois perfis distintos de doença: a presença de atopia em pacientes com estágios mais leves de DPOC, e a ausência de características de atopia em pacientes com aspectos de doença mais grave (VEF1 reduzido e hiperinsuflação). Houve uma associação estatisticamente significante entre eosinofilia no lavado nasal e prova farmacodinâmica positiva. CONCLUSÕES: Este estudo identificou uma alta frequência de atopia em pacientes com DPOC, utilizando ferramentas simples e reprodutíveis. A monitorização inflamatória de vias aéreas parece ser uma ferramenta útil para avaliar as doenças respiratórias em idosos, assim como em pacientes com sobreposição de asma e DPOC, entidade clínica ainda pouco compreendida. .


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Hypersensitivity, Immediate/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Asthma/therapy , Bronchitis, Chronic/diagnosis , Cross-Sectional Studies , Eosinophilia/diagnosis , Hypersensitivity, Immediate/therapy , Nasal Lavage Fluid/cytology , Pulmonary Disease, Chronic Obstructive/therapy , Risk Factors , Rhinitis/diagnosis , Surveys and Questionnaires , Skin Tests/methods
17.
Rev. otorrinolaringol. cir. cabeza cuello ; 73(1): 39-44, abr. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-679041

ABSTRACT

Introducción: La recirculación de moco entre el ostium natural del seno maxilar y otras aberturas en el seno, altera el transporte mucociliar normal, favorece su acumula-ción y sobreinfección, perpetuando el fenómeno inflamatorio. Objetivo: Describir nuestra experiencia en el diagnóstico y tratamiento de pacientes con rinosinusitis maxilar crónica y/o aguda recurrente cuyo estudio reveló recirculación maxilar. Material y método: Estudio retrospectivo descriptivo. Se revisaron historias clínicas, nasofibroscopías, informes radiológicos y hallazgos operatorios. Resultados: Ocho pacientes con edad promedio de 43 años. El 100%% presentó antecedente de cirugía que involucraba el seno maxilar. Todos se presentaron como rinosinusitis maxilar crónica y/o aguda con reagudizaciones frecuentes (3 episodios/ año). El diagnóstico se realizó mediante nasofibroscopía que evidenció recirculación de moco entre ostium natural y accesorio. Cinco pacientes se sometieron a cirugía endoscópica para unir el ostium accesorio (OA) al natural, disminuyendo el número de exacerbaciones. Conclusión: La recirculación maxilar se debe sospechar en pacientes con diagnóstico de rinosinusitis maxilar crónica y/o aguda recurrente con antecedente de cirugías que involucren el seno maxilar. Su diagnóstico se basa en la observación de recirculación de moco a la nasofibroscopía. El manejo es quirúrgico y dependerá de la ubicación del OA y de la permeabilidad del ostium natural.


Introduction: Recirculation of mucus between the maxillary sinus natural ostium and adjacent openings disturbs mucociliary clearence leading to secretions accumulation and persistent infection, perpetuating the inflammatory phenomenon. Aim: Describe our experience in the diagnosis and treatment ofpatients with maxillary rhinosinusitis (chronic or acute recurrent) and maxillary recirculation. Material and method: Descriptive and retrospective study. Clinical records, radiologic characteristic, nasal endoscopies and surgical findings were reviewed. Results: 8 patients, mean age of 43 years. All of them had prior history of maxillary sinus surgery. Clinical presentation was maxillary rhinosinusitis, chronic or acute, with frequent episodes ofreagudization (3 episodes/year). The diagnosis was made by endoscopic nasal examination that showed mucus recirculation between natural and accessory ostium. Endoscopic sinus surgery was done in 5patients in order to communicate the accessory to the natural ostium, leading to a decrease in the number of exacerbations. Conclusions: Maxillary recirculation must be suspected in patients with maxillary rhinosinusitis (chronic or acute recurrent) who have had prior surgical procedures that involve the maxillary sinus. The diagnosis is based on the observation of the recirculation phenomenon in the nasal endoscopy. The treatment is surgical and depends on the location of the accessory ostium and the permeability of the natural ostium.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Maxillary Sinusitis/diagnosis , Maxillary Sinusitis/therapy , Rhinitis/diagnosis , Rhinitis/therapy , Recurrence , Maxillary Sinusitis/physiopathology , Rhinitis/physiopathology , Mucociliary Clearance , Acute Disease , Chronic Disease , Retrospective Studies , Follow-Up Studies , Endoscopy , Mucus
18.
Article in English | IMSEAR | ID: sea-147331

ABSTRACT

Objective. The present study was designed to estimate the prevalence of rhinitis symptoms among secondary school students in Saudi Arabia Methods. A cross-sectional study was conducted among children from secondary schools in the city of Riyadh. The study utilised the International Study of Asthma and Allergies in Children (ISAAC) questionnaire. Results. Among the 3073 students (1504 boys and 1569 girls), the prevalence of life-time rhinitis, rhinitis in the past 12 months, and hay fever were 43.8%, 38.6% and 21.3%, respectively. There was a significant difference between boys and girls in the prevalence of life-time rhinitis (41% versus 46.5%, p=0.02) and the prevalence of rhinitis in the past 12 months (35.1% versus 41.9%, p=0.001). There was no significant difference between boys and girls in the prevalence of hay fever (22.5% versus 20.2%, p=0.144). The prevalence of asthma symptoms among students with life-time rhinitis and hay fever were 35.4% and 39.9%, respectively. Asthma symptoms were strongly linked with life-time rhinitis (Odds Ratio [OR]=2.5, p<0.001) and hay fever (OR=2.4, p value<0.001). Conclusions. The prevalence of rhinitis symptoms is high among 16 to 18 years old adolescents in Saudi Arabia, and symptoms are more common in girls compared to boys. Rhinitis symptoms are also associated with a high frequency of asthma symptoms.


Subject(s)
Adolescent , Asthma/epidemiology , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Rhinitis/diagnosis , Rhinitis/epidemiology , Saudi Arabia/epidemiology , Sex Factors
19.
Article in English | WPRIM | ID: wpr-93093

ABSTRACT

The prevalence of asthma is approximately 5% to 10% in the general population. Of these, approximately 5% to 10% are severe asthmatics who respond poorly to asthmatic drugs, including high-dose inhaled steroids. Severe asthmatics have persistent symptoms, frequent symptom exacerbation, and severe airway obstruction even when taking high-dose inhaled steroids. The medical costs of treating severe asthmatics represent ~50% of the total healthcare costs for asthma. Risk factors for severe asthma are genetic and environmental, including many kinds of aeroallergens, beta-blockers, and anti-inflammatory drugs. Gastroesophageal reflux disease and factors such as denial, anxiety, fear, depression, socioeconomic status, and alcohol consumption can exacerbate asthma. Rhinitis and asthma usually occur together. There is increasing evidence that allergic rhinitis and rhinosinusitis may influence the clinical course of asthma. This review discusses the role of rhinosinusitis in severe asthma.


Subject(s)
Asthma/diagnosis , Comorbidity , Humans , Prognosis , Rhinitis/diagnosis , Risk Factors , Severity of Illness Index , Sinusitis/diagnosis
20.
J. bras. med ; 100(4): 41-56, Set.-Out. 2012.
Article in Portuguese | LILACS | ID: lil-670540

ABSTRACT

A rinossinusite (RS), uma das afecções mais prevalentes das vias aéreas superiores, caracteriza-se pela inflamação da mucosa do nariz e cavidades paranasais. A classificação das rinossinusites, decorrentes de processos infecciosos virais, bacterianos e fúngicos, vem sendo sistematicamente modificada nos últimos anos, assim como os sinais, sintomas e achados de exames a serem levados em consideração para o diagnóstico. A rinossinusite aguda (RSA), infecciosa por natureza, tem duração de menos de quatro semanas, enquanto a rinossinusite crônica (RSC), com duração de mais de 12 semanas, é considerada multifatorial. Evidências crescentes na literatura mostram que a RSC representa uma resposta imunológica e inflamatória do hospedeiro em adição a uma infecção inicial. O tratamento sintomático e o seguimento compõem a estratégia inicial para pacientes com sintomas leves.


Rhinosinusitis, one of the most prevalent diseases of the upper airway, characterized by inflammation of the nasal mucosa and paranasal cavities. The classification of rhinosinusitis, due to infectious processes viral, bacterial, fungal, has been systematically modified in recent years, as well as the signs, symptoms and findings of tests to be considered for the diagnosis. The acute rhinosinusitis, infectious in nature, lasts less than four weeks, while chronic rhinosinuisitis, lasting more than 12 weeks in considered multifactorial. Mounting evidence in the literature show that CSR represents an immune and inflammatory response of the host in addition to an initial infection. Symptomatic treatment and follow up the initial strategy for patients with mild symptoms.


Subject(s)
Humans , Male , Female , Rhinitis/diagnosis , Rhinitis/drug therapy , Sinusitis/diagnosis , Sinusitis/drug therapy , Acute Disease , Anti-Bacterial Agents/therapeutic use , Chronic Disease , Adrenal Cortex Hormones/administration & dosage , Respiratory Tract Infections/complications , Polymerase Chain Reaction , Nasal Polyps/therapy , Paranasal Sinuses , Paranasal Sinuses , Tomography, X-Ray Computed
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