scholarly journals Diagnosis and treatment of non-allergic rhinitis

2020 ◽  
Vol 19 (4) ◽  
pp. 27-33
Author(s):  
M. A. Zavaliy ◽  
◽  
T. A. Krylova ◽  
A. N. Orel ◽  
A. G. Balabantsev ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Diagnostic Algorithm ◽  
The United States ◽  
Diagnostic Value ◽  
Evidence Base ◽  
Convincing Evidence ◽  
Diagnostic Methods ◽  
Chronic Rhinitis ◽  
Icd 10 ◽  
Non Allergic Rhinitis

There is considerable disagreement in the views on the problem of rhinitis, which concerns classification issues, as well as the role and place of various treatment methods. There are no official statistics on non-allergic rhinitis in Russia yet, due to the absence of certain types of rhinitis in the ICD-10. The prevalence of non-allergic rhinitis is one third of the prevalence of allergic rhinitis, involving, for example, in the United States about 7% of the population. Against the background of a convincing evidence base and well-structured international reference documents for allergic rhinitis, other forms of rhinitis, especially non-allergic rhinitis, remain almost “white” spots in medicine, and this leads to numerous errors in the therapeutic approach to this disease. The purpose of this scientific study was to justify the conduct of pathogenic therapy of patients with chronic non-allergic rhinitis by using the differential diagnostic algorithm to establish the etiology of chronic rhinitis. The article formulates a treatment and diagnostic algorithm based on summation of the examination results of 1040 patients with chronic rhinitis. The prevalence and comorbidity of non-allergic rhinitis was determined, the diagnostic value for patients with pseudo-allergic rhinitis of various diagnostic methods (nasocytogramma, prik-test with allergens, biochemical markers of various types of pseudo-allergic rhinitis) was analyzed, and treatment approaches are systematized.

scholarly journals Role of inflammation in non-allergic rhinitis

2014 ◽  
Vol 52 (2) ◽  
pp. 142-149
Author(s):  
E. de Corso ◽  
M. Battista ◽  
M. Pandolfini ◽  
L. Liberati ◽  
S. Baroni ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Diagnostic Algorithm ◽  
Inflammatory Cell Infiltrate ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
Nasal Cytology ◽  
Non Allergic Rhinitis

Objective: To investigate the role of inflammation in non-allergic rhinitis (NAR) patients in a large series to establish the prevalence of different NAR-subtypes, clinical features and the role of nasal cytology in the diagnostic algorithm. Methodology: Patients were selected out of 3650 individuals who spontaneously presented at our institution. We consecutively enrolled 519 NAR-patients in an analytical cross-sectional study between November 2007 and June 2013 (level of evidence: 3b). All patients underwent rhinological evaluation including symptoms questionnaire, endoscopy, CT scan, allergy tests and nasal cytology. Results: The inflammatory cell infiltrate affects the severity of symptoms differently, allowing for identification of different phenotypes of NAR. We distinguished two groups: “NAR without inflammation”(NAR-) and “NAR with inflammation”(NAR+), in addition to different NAR-subtypes with inflammation. A significant difference was observed in terms of clinical symptoms and association with comorbidities (previously diagnosed asthma and aspirin intolerance) between NAR–, NAR+ and between different NAR+ subtypes. Conclusion: Our data suggest that NAR- and NAR with neutrophils behave similarly, showing lower symptom score values and a lower risk of association with comorbidities compared to NAR with eosinophils and mast cells (singularly or mixed). In our belief it is very important to establish the presence and type of inflammation in non-allergic rhinitis patients and nasal cytology is a very useful test in correct differential diagnosis.

Prevalence of Eustachian Tube Dysfunction in the US Elderly Population

2020 ◽  
Vol 163 (6) ◽  
pp. 1169-1177 ◽  
Author(s):  
Jakob L. Fischer ◽  
Charles A. Riley ◽  
Mei-Chin Hsieh ◽  
Michael J. Marino ◽  
Xiao-Cheng Wu ◽  
...  
Keyword(s):  
United States ◽  
Allergic Rhinitis ◽  
Eustachian Tube ◽  
Chronic Sinusitis ◽  
Acute Otitis Media ◽  
The United States ◽  
Eustachian Tube Dysfunction ◽  
Chronic Rhinitis ◽  
Tube Dysfunction ◽  
Inflammatory Processes

Objective To investigate the prevalence of eustachian tube dysfunction (ETD) in elderly adults in the United States and its association with other upper aerodigestive inflammatory processes. Study Design Cross-sectional study. Setting Population based. Subjects and Methods In total, 147,805 patients without malignancy were compared to 13,804 demographically matched patients with malignancy of the upper aerodigestive tract (UADT) by querying the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database for patients aged 66 to 99 years between 2003 and 2011. The prevalence of ETD and inflammatory diseases among these patients was compared. Association between ETD, other upper aerodigestive inflammatory processes, and UADT malignancies was evaluated. Results The prevalence of ETD was 5.44% among patients without malignancy and 9.08% in those with cancer (odds ratio [OR], 1.73; 95% CI, 1.63-1.84). Patients with ETD in the control population were more likely (OR, 95% CI) to be diagnosed with chronic rhinitis (5.00, 4.70-5.33), chronic sinusitis (4.20, 3.98-4.43), allergic rhinitis (4.27, 4.08-4.47), and gastroesophageal reflux disease (GERD) (2.42, 2.31-2.53). Patients with ETD and chronic rhinitis (1.43, 1.24-1.65), chronic sinusitis (1.57, 1.38-1.78), and acute otitis media (1.33, 1.08-1.65) were associated with higher rates of UADT malignancy. Conclusion Over 5% of patients older than 65 in the United States are diagnosed with ETD in the absence of UADT malignancy. Associations between ETD and chronic rhinitis, chronic sinusitis, allergic rhinitis, and GERD in the absence of UADT malignancy suggest that some patients may benefit from treatment of inflammatory disease as a cause of ETD.

scholarly journals Diagnostic aspects of closed abdominal injuries

2016 ◽  
Vol 97 (6) ◽  
pp. 892-897
Author(s):  
I S Malkov ◽  
V A Filippov ◽  
V N Korobkov ◽  
Kh M Khalilov ◽  
M R Tagirov ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Diagnostic Algorithm ◽  
Diagnostic Value ◽  
Diagnostic Techniques ◽  
Diagnostic Methods ◽  
Abdominal Injury ◽  
Abdominal Injuries ◽  
Surgical Department ◽  
Abdominal Organs ◽  
Radiologic Study

Aim. To study diagnostic value of various diagnostic methods for patients with closed abdominal injury, to develop a diagnostic algorithm to make a reasonable conclusion about the amount and severity of injuries of the abdomen.Methods. Various diagnostic methods used in closed abdominal injuries from 120 patients admitted to Surgical Department №2 of Kazan city clinical hospital №7 from 2007 to 2015 were analyzed. Majority of victims (65%) with closed abdominal trauma were males aged 20 to 50 years.Results. Efficiency of diagnostic program for patients with closed abdominal injury used in clinical practice was studied. In a closed abdominal trauma, injury of abdominal organs was detected in 52.5% of patients. 71.4% of those injuries were isolated and 28.6% were concomitant. According to frequency of injuries liver took the first place 15 (23.8%), followed by spleen on the second place (14; 22.2%) and kidneys (12; 19.1%) and intestine (12; 19.1%) on the third, bladder on the fourth (7; 11.1%), and pancreas on the fifth place (3; 4.8%). Importance of radiological methods and laparoscopy was demonstrated. Clinical examination and laboratory diagnostic techniques allow making a timely diagnosis in only 40% of victims. Informativity of radiologic study was 64%. The accuracy of ultrasound in damaged kidneys was 100%, that in rupture of liver was 72%, of spleen, 69%, and of the intestine (0%). Diagnostic accuracy of laparoscopy was 98.9%.Conclusion. Experience and extensive acquaintance with modern literature allowed the authors to present the algorithm of examination of patients with suspected closed abdominal trauma.

scholarly journals How to Diagnose and Treat Local Allergic Rhinitis: A Challenge for Clinicians

2019 ◽  
Vol 8 (7) ◽  
pp. 1062 ◽  
Author(s):  
Ibon Eguiluz-Gracia ◽  
Natalia Pérez-Sánchez ◽  
Gádor Bogas ◽  
Paloma Campo ◽  
Carmen Rondón
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Practice ◽  
Allergen Challenge ◽  
Diagnostic Algorithm ◽  
Specific Ige ◽  
Common Disease ◽  
Reliable Technique ◽  
Prick Test ◽  
Chronic Rhinitis ◽  
Local Allergic Rhinitis

Chronic rhinitis is a very common disease that can be divided in various phenotypes. Historically, the condition has been classified into the allergic rhinitis (AR) and non-allergic non-infectious rhinitis (NAR) forms, based on the results of the classical biomarkers of atopy: skin prick test and serum allergen-specific IgE However, this classification does not reflect the complexity of the rhinitis syndrome, as illustrated by the existence of non-atopic rhinitis patients who display a nasal reactivity to environmental allergens. This new phenotype has been termed local allergic rhinitis (LAR) and can be only recognized if an additional test such as the nasal allergen challenge (NAC) is integrated in the diagnostic algorithm for chronic rhinitis. Recent data shows that the NAC is a very safe and reliable technique ready for the clinical practice. LAR is a differentiated rhinitis phenotype which often commences during childhood and quickly progresses towards a clinical worsening and the association of comorbidities in other mucosal organs. Recent evidence supports the existence of a bronchial counterpart of LAR (local allergic asthma), which highlights the pathophysiological links between the upper and lower airways and reinforces the united airways concept. Importantly, several controlled studies have demonstrated the ability of allergen immunotherapy to control LAR symptoms while the therapy is being administered. This review emphasizes the need to implement the NAC in the clinical practice in order to facilitate the recognition of LAR patients, allowing for an early prescription of specific therapies with disease-modifying potential.

scholarly journals Diagnosis of Functional Gastrointestinal Disorders and Choice of Treatment Regimen in Constipation Patients

2021 ◽  
Vol 31 (3) ◽  
pp. 7-16
Author(s):  
I. V. Maev ◽  
A. N. Kazyulin ◽  
Yu. A. Kucheryavy ◽  
S. V. Cheryomushkin ◽  
A. Yu. Goncharenko ◽  
...  
Keyword(s):  
Functional Gastrointestinal Disorders ◽  
Diagnostic Algorithm ◽  
Functional Constipation ◽  
Gastrointestinal Disorder ◽  
Diagnostic Value ◽  
Diagnostic Methods ◽  
Rectal Sensation ◽  
Choice Of Treatment ◽  
Balloon Expulsion ◽  
Functional Defecation Disorders

Aim. A practical review of functional gastrointestinal disorder diagnosis in constipation patients and the rationale for opting treatment.Key points. Functional constipation commonly afflicts different ages and negatively impacts the quality of life. The current diagnostic algorithm in chronic constipation includes the disease identification according to Rome Criteria IV, red-flag symptom detection and instrumental laboratory examination. Functional constipation is notably often associated with anorectal abnormalities that bear a diagnostic value to elaborate an apt treatment strategy. Anorectal manometry, rectal sensation and balloon expulsion tests are the well-studied and significant probing techniques for objective anorectal zone sensorimotor function assessment in patients with functional constipation. The article reviews modern diagnostic methods in functional defecation disorders.Conclusion. The examination and treatment algorithms presented will help improve diagnosis and apply the most suitable management in a constipation-associated functional digestive pathology.

THE ROLE OF PHAGE THERAPY IN THE FORMATION OF THE INTESTINAL MICROECOSYSTEM

2020 ◽  
pp. 183-191
Author(s):  
Gladkov S.F. ◽  
Perevoshchikova N.K. ◽  
Chernykh N.S. ◽  
Pichugina Yu.S. ◽  
Surkova M.A.
Keyword(s):  
Intestinal Microbiota ◽  
Allergic Diseases ◽  
Evidence Base ◽  
Immunological Tolerance ◽  
Convincing Evidence ◽  
Selective Decontamination ◽  
Genetic Characteristics ◽  
Treatment And Prevention ◽  
Intestinal Infections ◽  
The Individual

The current adverse situation associated with the presence of a pandemic of allergic diseases is due to the lack of a scientifically based concept of treatment and prevention. The increased interest of researchers from different countries in the formation of immunological tolerance by modeling the intestinal microbiota is of high importance. Methods of influence on the microbial communities of the child's intestine should be as delicate as possible, taking into account the individual genetic characteristics of the microecosystem and the possibility of anaphylaxis. Until now, probiotic drugs have been widely used to correct dysbiosis, but data is gradually accumulating that there is no convincing evidence base for their use for the treatment and prevention of atopy. The use of bacteriophages is very relevant and one of the promising, actively studied areas of correction of intestinal biocenosis today, which are an alternative to antibiotic and probiotic medications. Selective decontamination of representatives of opportunistic flora, as the main factor in the implementation of the atopic phenotype, makes it possible to preserve and accelerate the formation of a unique and individual composition of the intestinal microbiota of the child, which can form an immunoregulatory balance. More than a century of experience in the use of bacteriophages indicates the safety of their use. Today, bacteriophages are actively used in various fields of practical medicine − obstetrics-gynecology, perinatology, urology, pediatric otorhinolaryngology, in the treatment of purulent-septic and intestinal infections. In some cases, bacteriophages are very effective against antibiotic-resistant pathogens. The active personalized use of bacteriophages in real clinical practice will make it possible to solve a number of serious, long-standing health problems in the Russian Federation and to win a world priority in this direction.

Diagnostic Value of Non-Invasive Prenatal Screening of β-thalassemia by Cell Free Fetal DNA and Fetal NRBC

2019 ◽  
Vol 19 (2) ◽  
pp. 105-111
Author(s):  
Nadia Shafei ◽  
Mohammad Saeed Hakhamaneshi ◽  
Massoud Houshmand ◽  
Siavash Gerayeshnejad ◽  
Fardin Fathi ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Multiple Displacement Amplification ◽  
Diagnostic Value ◽  
Diagnostic Methods ◽  
Beta Thalassemia ◽  
Non Invasive ◽  
Fetal Dna ◽  
Prenatal Diagnostic ◽  
Cell Free Fetal Dna ◽  
Invasive Techniques

Background: Beta thalassemia is a common disorder with autosomal recessive inheritance. The most prenatal diagnostic methods are the invasive techniques that have the risk of miscarriage. Now the non-invasive methods will be gradually alternative for these invasive techniques. Objective: The aim of this study is to evaluate and compare the diagnostic value of two non-invasive diagnostic methods for fetal thalassemia using cell free fetal DNA (cff-DNA) and nucleated RBC (NRBC) in one sampling community. Methods: 10 ml of blood was taken in two k3EDTA tube from 32 pregnant women (mean of gestational age = 11 weeks), who themselves and their husbands had minor thalassemia. One tube was used to enrich NRBC and other was used for cff-DNA extraction. NRBCs were isolated by MACS method and immunohistochemistry; the genome of stained cells was amplified by multiple displacement amplification (MDA) procedure. These products were used as template in b-globin segments PCR. cff-DNA was extracted by THP method and 300 bp areas were recovered from the agarose gel as fetus DNA. These DNA were used as template in touch down PCR to amplify b-globin gen. The amplified b-globin segments were sequenced and the results compared with CVS resul. Results: The data showed that sensitivity and specificity of thalassemia diagnosis by NRBC were 100% and 92% respectively and sensitivity and specificity of thalassemia diagnosis by cff-DNA were 100% and 84% respectively. Conclusion: These methods with high sensitivity can be used as screening test but due to their lower specificity than CVS, they cannot be used as diagnostic test.

Questionnaire as an alternative ofskin prick tests to differentiate allergic from non‐allergic rhinitis in epidemiological studies

Allergy ◽  
2021 ◽  
Author(s):  
Marine Savouré ◽  
Jean Bousquet ◽  
Emilie Burte ◽  
Jocelyne Just ◽  
Isabelle Pin ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Epidemiological Studies ◽  
Non Allergic Rhinitis

scholarly journals Clostridioides difficile Infection, Still a Long Way to Go

2021 ◽  
Vol 10 (3) ◽  
pp. 389
Author(s):  
Eleftheria Kampouri ◽  
Antony Croxatto ◽  
Guy Prod’hom ◽  
Benoit Guery
Keyword(s):  
Fecal Microbiota Transplantation ◽  
Diagnostic Algorithm ◽  
Fecal Microbiota ◽  
Diagnostic Methods ◽  
Special Focus ◽  
Surveillance Systems ◽  
Main Question ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
The Right

Clostridioides difficile is an increasingly common pathogen both within and outside the hospital and is responsible for a large clinical spectrum from asymptomatic carriage to complicated infection associated with a high mortality. While diagnostic methods have considerably progressed over the years, the optimal diagnostic algorithm is still debated and there is no single diagnostic test that can be used as a standalone test. More importantly, the heterogeneity in diagnostic practices between centers along with the lack of robust surveillance systems in all countries and an important degree of underdiagnosis due to lack of clinical suspicion in the community, hinder a more accurate evaluation of the burden of disease. Our improved understanding of the physiopathology of CDI has allowed some significant progress in the treatment of CDI, including a broader use of fidaxomicine, the use of fecal microbiota transplantation for multiples recurrences and newer approaches including antibodies, vaccines and new molecules, already developed or in the pipeline. However, the management of CDI recurrences and severe infections remain challenging and the main question remains: how to best target these often expensive treatments to the right population. In this review we discuss current diagnostic approaches, treatment and potential prevention strategies, with a special focus on recent advances in the field as well as areas of uncertainty and unmet needs and how to address them.

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