Efficacy of Montelukast in the Treatment of Nasal Polyposis

2005 ◽  
Vol 114 (12) ◽  
pp. 941-945 ◽  
Author(s):  
David A. Kieff ◽  
Nicolas Y. Busaba
Keyword(s):  
Symptom Score ◽  
Nasal Polyposis ◽  
Winter Season ◽  
Montelukast Sodium ◽  
Intranasal Steroids ◽  
Symptom Scores ◽  
Before And After ◽  
Perennial Rhinitis ◽  
Seasonal Allergies ◽  
Eosinophil Counts

Objectives: Twenty-four consecutive patients with symptomatic nasal polyposis and nonallergic or perennial rhinitis who were undergoing chronic nasal steroid therapy were prospectively evaluated for response to adjunctive oral montelukast sodium therapy. Methods: The patients were undergoing daily intranasal steroid sprays for a minimum of 6 months before being started on montelukast sodium 10 mg by mouth per day for 3 months while intranasal steroids were continued. The patients were given a validated symptom score survey at the start and end of therapy, with a lower score indicating fewer symptoms. The nasal polyps were submitted to biopsy before and after treatment to determine their degree of eosinophilia. Eosinophilia was graded in a blinded fashion by an independent pathologist on a scale of 0 to 3, with 3 being severe. Patients with seasonal allergies were excluded, and the studied patients were treated during the winter season to avoid confounding by potential seasonal allergic responses. Results: The patients tended to improve on montelukast therapy in terms of their symptom scores and polyp eosinophil counts. The symptoms improved in 17 patients (71%) and remained the same or worsened in 7 patients (29%). The symptom score for the group improved from a pretreatment value of 33.4 (SD, 7.73) to a posttreatment value of 23.3 (SD, 13.73; p < .001). In addition, the eosinophilia score improved from 2.3 (SD, 0.68) to 1.5 (SD, 0.82; p < .01). The improvement was most noticeable in the patients with perennial allergies. Conclusions: These results suggest that montelukast appears to be beneficial for some patients with nasal polyposis. Patients with perennial allergies and nasal polyposis seem more likely to respond to the treatment than those with nonallergic nasal polyposis.

The treatment of hyposmia with intranasal steroids

1996 ◽  
Vol 110 (2) ◽  
pp. 132-135 ◽  
Author(s):  
David G. Golding-Wood ◽  
Mats Holmstrom ◽  
Yvonne Darby ◽  
Glenis K. Scadding ◽  
Valerie J. Lund
Keyword(s):  
Nasal Obstruction ◽  
University Of Pennsylvania ◽  
Clear Correlation ◽  
Nasal Discharge ◽  
Initial Symptoms ◽  
Intranasal Steroids ◽  
Before And After ◽  
Perennial Rhinitis ◽  
Vas Scores ◽  
Analogue Scales

AbstractHyposmia is a neglected symptom in patients with rhinitis. We studied 25 patients presenting with perennial rhinitis. Fifteen patients expressed hyposmia as a significant symptom. University of Pennsylvania smell identification test (UPSIT) and visual analogue scales (VAS) were used to score the symptoms of hyposmia, nasal obstruction and nasal discharge before and after six weeks treatment with betamethasone sodium phosphate drops. Those patients with initial symptoms of hyposia significantly improved their UPSIT scores (p= 0.00009) and their VAS scores for hyposmia (p= 0.00133). Despite a significant decrease in the sensation of nasal obstruction, the non-hyposmics showed no increase in UPSIT scores after betamethasone therapy. There was no clear correlation between UPSIT results and other symptom scores. The judicious use of betamethasone drops in the treatment of rhinogenic hyposmia can be recommended.

Comparison of montelukast and mometasone furoate in the prevention of recurrent nasal polyps

2011 ◽  
Vol 6 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Erkan Vuralkan ◽  
Cem Saka ◽  
Istemihan Akin ◽  
Sema Hucumenoglu ◽  
Binnur Uzmez Unal ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Nasal Spray ◽  
Peripheral Blood ◽  
Nasal Polyposis ◽  
Mometasone Furoate ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Snot 22

Background: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. Patients and methods: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A ( n = 25) received 10 mg montelukast per day and group B ( n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund–Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. Results: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate ( p < 0.05). Conclusions: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.

scholarly journals Comparing Sudden Stratospheric Warming Definitions in Reanalysis Data*

2015 ◽  
Vol 28 (17) ◽  
pp. 6823-6840 ◽  
Author(s):  
Froila M. Palmeiro ◽  
David Barriopedro ◽  
Ricardo García-Herrera ◽  
Natalia Calvo
Keyword(s):  
Seasonal Cycle ◽  
Winter Season ◽  
Reanalysis Data ◽  
Sudden Stratospheric Warming ◽  
Pronounced Increase ◽  
Future Studies ◽  
Common Peak ◽  
Before And After ◽  
The Mean ◽  
Large Case

Abstract Sudden stratospheric warmings (SSWs) are characterized by a pronounced increase of the stratospheric polar temperature during the winter season. Different definitions have been used in the literature to diagnose the occurrence of SSWs, yielding discrepancies in the detected events. The aim of this paper is to compare the SSW climatologies obtained by different methods using reanalysis data. The occurrences of Northern Hemisphere SSWs during the extended-winter season and the 1958–2014 period have been identified for a suite of eight representative definitions and three different reanalyses. Overall, and despite the differences in the number and exact dates of occurrence of SSWs, the main climatological signatures of SSWs are not sensitive to the considered reanalysis. The mean frequency of SSWs is 6.7 events decade−1, but it ranges from 4 to 10 events, depending on the method. The seasonal cycle of events is statistically indistinguishable across definitions, with a common peak in January. However, the multidecadal variability is method dependent, with only two definitions displaying minimum frequencies in the 1990s. An analysis of the mean signatures of SSWs in the stratosphere revealed negligible differences among methods compared to the large case-to-case variability within a given definition. The stronger and more coherent tropospheric signals before and after SSWs are associated with major events, which are detected by most methods. The tropospheric signals of minor SSWs are less robust, representing the largest source of discrepancy across definitions. Therefore, to obtain robust results, future studies on stratosphere–troposphere coupling should aim to minimize the detection of minor warmings.

scholarly journals Spatiotemporal variation in the fecal microbiota of mule deer is associated with proximate and future measures of host health

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Hyrum S. Eddington ◽  
Courtney Carroll ◽  
Randy T. Larsen ◽  
Brock R. McMillan ◽  
John M. Chaston
Keyword(s):  
Health Outcomes ◽  
Marker Gene ◽  
Management Strategies ◽  
Mule Deer ◽  
Winter Season ◽  
Fecal Microbiota ◽  
Food Sources ◽  
Nutrient Metabolism ◽  
Protein Levels ◽  
Before And After

Abstract Background Mule deer rely on fat and protein stored prior to the winter season as an energy source during the winter months when other food sources are sparse. Since associated microorganisms (‘microbiota’) play a significant role in nutrient metabolism of their hosts, we predicted that variation in the microbiota might be associated with nutrient storage and overwintering in mule deer populations. To test this hypothesis we performed a 16S rRNA marker gene survey of fecal samples from two deer populations in the western United States before and after onset of winter. Results PERMANOVA analysis revealed the deer microbiota varied interactively with geography and season. Further, using metadata collected at the time of sampling, we were able to identify different fecal bacterial taxa that could potentially act as bioindicators of mule deer health outcomes. First, we identified the abundance of Collinsella (family: Coriobacteriaceae) reads as a possible predictor of poor overwintering outcomes for deer herds in multiple locations. Second, we showed that reads assigned to the Bacteroides and Mollicutes Order RF39 were both positively correlated with deer protein levels, leading to the idea that these sequences might be useful in predicting mule deer protein storage. Conclusions These analyses confirm that variation in the microbiota is associated with season-dependent health outcomes in mule deer, which may have useful implications for herd management strategies.

CIRCULATING EOSINOPHILS IN CHILDREN IN HEALTH AND DISEASE

PEDIATRICS ◽  
1951 ◽  
Vol 7 (3) ◽  
pp. 408-414
Author(s):  
KATHARINE HAIN
Keyword(s):  
Atopic Eczema ◽  
Prognostic Significance ◽  
Acth Test ◽  
Normal Range ◽  
Normal Children ◽  
Before And After ◽  
Health And Disease ◽  
Insulin Test ◽  
Allergic Manifestations ◽  
Eosinophil Counts

A total of 351 circulating eosinophil counts were done on 75 children. The range of circulating eosinophils for 18 normal children was 109 to 359. In 12 patients with nonfebrile miscellaneous diseases the circulating eosinophil counts ranged from 84 to 599, and in three patients with mild febrile illnesses, from 170 to 341. A possible explanation for the fact that these counts fell within the normal range was discussed. In 29 patients with acute febrile illnesses the initial circulating eosinophil counts ranged from 0 to 97. Serial counts during convalescence on three of these patients are presented and the prognostic significance discussed. In 10 patients with various allergic manifestations there was a range of 393 to 2665. Serial counts on one case of acute atopic eczema treated with ACTH are presented. Serial counts on one patient before and after laparotomy are presented. Results of the "ACTH test," the "epinephrine test" and the "insulin test" on a group of children with miscellaneous diseases are presented.

scholarly journals Influence of Virtual Reality on Visual Fuctions: Immersive Versus Non-Immersive Mode

2019 ◽  
Author(s):  
Hyeon Jeong Yoon ◽  
Jonghwa Kim ◽  
Sang Woo Park ◽  
Hwan Heo
Keyword(s):  
Virtual Reality ◽  
Correlation Analysis ◽  
Subjective Symptom ◽  
Subjective Symptoms ◽  
Dynamic Methods ◽  
Symptom Scores ◽  
Before And After ◽  
Accommodative Lag

Abstract Background To investigate differences in refraction, accommodative factors, ocular parameters, and subjective symptoms after using two types of virtual reality (VR) content with different perception depths. Methods Twenty-three volunteers, who played VR games in two modes (immersive and non-immersive) for 30 min, were enrolled. Ocular parameters were examined before and after using VR. Accommodative factors were measured using static and dynamic methods, and subjective symptoms were assessed using a questionnaire. Differences according to VR content and correlations between each ocular parameter were analyzed. Results There were no changes in refraction and accommodative factors after use of the VR. However, there was a significant increase in near point accommodation (NPA), near point convergence (NPC), and subjective symptom scores after using the immersive mode. Correlation analysis revealed that NPA and accommodative lag were increased in subjects with exophoria, and that subjects with high NPA or NPC were more likely to exhibit an increase in mean accommodative lag. Conclusions The use of VR for 30 min reduced NPA and NPC especially after the immersive mode was used. In addition, using VR could further increase accommodation lag and reduce the amplitude of accommodation and convergence in subjects with exophoria.

scholarly journals Patient Reported Symptoms and Tryptase Levels in WHO-Defined Systemic Mastocytosis (SM) Versus Mast Cell Activation Syndrome (MCAS) Versus Neither

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3204-3204
Author(s):  
Darci Zblewski ◽  
Ramy A. Abdelrahman ◽  
Dong Chen ◽  
Joseph H. Butterfield ◽  
Ayalew Tefferi ◽  
...  
Keyword(s):  
Mast Cell ◽  
Symptom Score ◽  
Cell Activation ◽  
Total Symptom Score ◽  
Mast Cell Activation ◽  
Median Score ◽  
Serum Tryptase ◽  
Tryptase Level ◽  
Patient Reported ◽  
Symptom Scores

Abstract Introduction: The utility of patient reported symptoms and serum tryptase levels in distinguishing those with systemic mastocytosis (SM) versus mast cell activation syndrome (MCAS) versus those not meeting formal diagnostic criteria for SM or MCAS has not been systematically examined. Methods: This study was approved by our institutional review board. Patients were referred for suspected SM based on symptoms of mast cell activation, osteopenia, skin rash, etc., or had an established diagnosis of SM. All patients were given a Mastocytosis Symptom Assessment Form (MastSAF) to complete at their initial evaluation. The MastSAF is comprised of 36 symptom questions to be graded on a scale of 0 (absent) to 10 (worst imaginable), and is organized around 9 symptom clusters: gastrointestinal (8 questions), constitutional (3 questions), musculoskeletal (5 questions), cutaneous (4 questions), neuropsychological (6 questions), genitourinary (3 questions), respiratory (4 questions), angioedema (1 question), and cardiovascular (2 questions). All patients underwent bone marrow biopsy and serum tryptase level assessment. SM was diagnosed by 2008 WHO criteria. In the presence of characteristic symptoms, if clonal or abnormal mast cells were not identified, and if serum/urine mast cell mediator levels were increased, then non-SM associated, non-monoclonal MCAS was diagnosed. Results: A total 53 patients were studied. 1) SM: Of 28 patients, 13 had indolent SM (ISM), 9 aggressive SM (ASM) and 6 SM with associated hematological disease (SM-AHD) The median total symptom score was 47 (range 8-159). The median (range) for SM subgroups was: ISM 51 (9-159), ASM 55 (19-157) and SM-AHD 27 (8-131) (p=0.2). The normalized median score for individual symptom categories (total median score/no. of symptoms per category) in order of severity was cutaneous 1.9, gastrointestinal 1.8, constitutional 1.7, neuropsychological 1.3, respiratory 1.3, musculoskeletal 0.9, cardiovascular 0.3, genitourinary 0.3, and angioedema 0. Symptom severity was not significantly different among the 3 SM subgroups, except for constitutional symptoms (median score ASM 9, ISM 4, SM-AHD 2.5, p=0.02). The median (range) tryptase level was 48.4 ng/mL (8.8-282); four patients (14%) had a baseline level <20 ng/mL. The median (range) tryptase level among SM subgroups was: ISM 46.9 (8.8-225), ASM 103 (29.4-282), and SM-AHD 43.5 (28.5-233) (p=0.1). When considering patients with tryptase level ≥50 versus <50 ng/mL, symptom scores were not significantly higher in the former group with the exception of constitutional (p=0.02) and genitourinary symptoms (p=0.04). 2) MCAS: 15 patients The median total symptom score was 127 (range 2-248). The normalized median score for individual symptom categories in order of severity was neuropsychological 4.5, musculoskeletal 4.2, cutaneous 4.0, constitutional 3.3, gastrointestinal 2.1, respiratory and cardiovascular 2.0 each, genitourinary 1.7, and angioedema 1.0. The median (range) serum tryptase level at referral was 12.7 ng/mL (1.7-25.8); five patients (33%) had a baseline level >20 ng/mL. 3) Neither SM/MCAS: 10 patients The median total symptom score was 119 (range 45-177). The normalized median score for individual symptom categories in order of severity was musculoskeletal 4.2, gastrointestinal 3.6, constitutional 3.3, neuropsychological 3.3, cutaneous 3.0, cardiovascular and genitourinary 2.0 each, respiratory 1.3, and angioedema 0. The median (range) serum tryptase level at referral (n=9) was 4.8 ng/mL (2.9-6.6). 4) Comparison: MCAS vs. SM: Symptom scores were significantly higher in MCAS as compared to SM (p<0.05), except for genitourinary and respiratory symptoms, which were not significantly different. ‘Neither SM/MCAS’ vs. SM: Symptom scores (total, gastrointestinal, constitutional, musculoskeletal, cutaneous, and neuropsychological) were significantly higher in the former group (p<0.05). Other symptom scores were not significantly different. Conclusions: The spectrum and severity of patient reported symptoms was broadly similar among WHO subcategories of SM, and serum tryptase level had limited if any correlation with symptom scores. Despite the significantly higher overall symptom burden in MCAS versus SM, tryptase levels in the former group were significantly lower with values >30 ng/mL unusual. Despite overlap, the top ranked symptoms in the 3 groups were different. Disclosures No relevant conflicts of interest to declare.

scholarly journals Energy conservation by retrofitting of dwellings

2019 ◽  
Vol 111 ◽  
pp. 03010
Author(s):  
Imrich Sánka ◽  
Dušan Petráš
Keyword(s):  
Large Scale ◽  
Thermal Environment ◽  
Winter Season ◽  
Residential Building ◽  
Indoor Environmental Quality ◽  
Air Exchange Rate ◽  
Energy Auditing ◽  
Before And After ◽  
The Impact

This article investigates the impact of energy renovation on the indoor environmental quality of apartment building during heating season. The study was performed in one residential building before and after its renovation. Energy auditing and classification of the selected building into energy classes were carried out. Additionally, evaluation of indoor air quality was performed using objective measurements and subjective survey. Thermal environment and concentration of CO2 was measured in bedrooms. Higher concentrations of CO2 was observed in the residential building after its renovation. The concentrations of CO2, in some cases exceeded the recommended maximum limits, especially after implementing of energy saving measures on the building. The average air exchange rate was visible higher before renovation of the building. The current study indicates that large-scale of renovations may reduce the quality of the indoor environment in many apartments, especially in the winter season.

Negative Symptoms at Discharge and Outcome in Schizophrenia

1995 ◽  
Vol 166 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Hai-Gwo Hwu ◽  
Happy Tan ◽  
Chu-Chang Chen ◽  
Ling-Ling Yeh
Keyword(s):  
Clinical Outcome ◽  
Social Functioning ◽  
Symptom Score ◽  
Negative Symptoms ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Symptom Scores ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

BackgroundThe clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.MethodOf schizophrenic patients fulfilling DSM–III criteria, 113 were recruited for this study. Personal, social and psychopathological data were collected and all cases were followed up at one and two years after discharge.ResultsThe presence of positive symptoms (64 cases), without concomitant negative symptoms, did not predict the follow-up social function and positive symptom score. Conversely, the presence of negative symptoms (31 cases) predicted worse social functioning (P < 0.05 to P < 0.005) and higher positive symptom scores (P < 0.01) at follow-up using MANOVA. Eighteen cases (15.9%) had neither positive nor negative symptoms and had the best clinical outcome.ConclusionsNegative, but not positive, symptoms assessed at discharge are an important predictor of poor outcome. In addition, negative symptoms may themselves expose a biological vulnerability to the presence of positive symptoms.

P90 TRACTION ON THE SEPTUM DURING TRANSORAL SEPTOTOMY FOR ZENKER DIVERTICULUM IMPROVES THE FINAL OUTCOME

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
L Provenzano ◽  
R Salvador ◽  
C Cutrone ◽  
L Moletta ◽  
E Pierobon ◽  
...  
Keyword(s):  
Symptom Score ◽  
Final Outcome ◽  
Barium Swallow ◽  
Complication Rates ◽  
Duration Of Symptoms ◽  
Zenker Diverticulum ◽  
Before And After ◽  
Study Population ◽  
Classic Technique ◽  
Additional Procedure

Abstract Background Transoral Diverticulostomy/Septotomy has become a popular treatment for patients with Zenker Diverticulum (ZD) because of the low complication rates, reduced procedure time, and shorter hospital stay. However, the outcome of this procedure is not, so far, as positive as the open techniques. In order to improve the results of transoral septotomy (TS), a modification of the technique by tractioning the septum with stiches, has been introduced. In this study we aimed to compare the final outcome of a Modify Transoral Septotomy (MTS) with those of the Traditional Transoral Septotomy (TTS) in patients with ZD. Methods Seventy-seven consecutive patients with ZD underwent Transoral Septotomy between 2010-2019. Patients who had already been treated with surgical or endoscopic procedures were excluded. TTS was performed with the classic technique. Since 2015, we adopted a MTS, by positioning 2 sutures at the lateral edges of the septum, for traction. Symptoms were collected and scored using a detailed questionnaire; barium-swallow (to assess the size of the pouch), endoscopy and manometry were performed before and after surgical treatment. Failures were defined when a patient needed an additional procedure for recurrent symptoms. Results Of the 52 patients representing the study population (M:F=49:28), 25 had TTS and 52 had MTS. The patients’ demographic and clinical parameters (sex, age, symptom-score, duration of symptoms, diverticulum size) were similar in both groups. Only two intraoperative mucosal lesions were detected and mortality was nil. The median time of the procedure was 25 min (IQR:22-35) in the TTS and 30 min (IQR:25-36) in the MTS (p<0.07). The median follow-up was 85 months in the TTS and 24 months in the MTS. All the patients in both groups had a reduction in the symptom score after the procedure but the failure rate was 32% (8/25) in the TTS and 1.9% (1/52) in the MTS (p<0.01). At the univariate and multivariate analyses, the surgical procedure was the only factor predictive of a positive final result. Conclusions Transoral Septotomy improves the final outcome of this treatment in patients with ZD.

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