scholarly journals The modern view of treatment of allergic rhinitis and it’s combination with bronchial asthma

2021 ◽  
pp. 92-98
Author(s):  
D. S. Smirnov ◽  
O. M. Kurbacheva
Keyword(s):  
Allergic Rhinitis ◽  
Bronchial Asthma ◽  
Inflammatory Diseases ◽  
Nasal Congestion ◽  
Combined Therapy ◽  
Correct Diagnosis ◽  
Economic Problem ◽  
Atrophic Rhinitis ◽  
Significant Treatment ◽  
Adequate Treatment

In recent years, there has been a significant increase in the prevalence of diseases of the nose and paranasal sinuses. Inflammatory diseases of the mucous membrane nasal cavities (rhinitis) are most commonly characterized as a syndrome in which the patient experiences some combination of persistent nasal symptoms, including rhinorrhea, sneezing, nasal congestion, itching and burning in the nasal cavity. Among the chronic forms of rhinitis, allergic rhinitis occupies a large place along with vasomotor, infectious, hypertrophic, catarrhal and atrophic rhinitis. Allergic rhinitis is a significant social and medico-economic problem, since it significantly reduces the quality of life of patients and requires significant treatment costs. This nosology is found in the practice of doctors of all specialties, however, the correct diagnosis and the appointment of adequate therapy can take many months and years. Currently, the concept of “common airways” is widely discussed, which demonstrates the close relationship between allergic rhinitis and bronchial asthma and proves that the inflammatory response can be supported and enhanced by interrelated mechanisms. Therefore, patients with allergic rhinitis should be examined for the presence of bronchial asthma. In turn, patients with bronchial asthma need to diagnose allergic rhinitis, and treatment should be aimed at suppressing allergic inflammation in both the upper and lower respiratory tract. This article discusses modern diagnostic and therapeutic approaches to patients with these diseases, which make it possible to efficiently and timely identify allergic rhinitis and initiate appropriate adequate treatment. The article also discusses the feasibility of using combined therapy with levocetirizine and montelukast in the above nosologies.

Mast cell stabilizers

1992 ◽  
Vol 107 (6_part_2) ◽  
pp. 841-844 ◽  
Author(s):  
Hueston C. King
Keyword(s):  
Allergic Rhinitis ◽  
Mast Cell ◽  
Cell Membrane ◽  
Nasal Mucosa ◽  
Nasal Polyps ◽  
Nasal Congestion ◽  
Correct Diagnosis ◽  
Vasomotor Rhinitis ◽  
Ige Mediated ◽  
Exercise Induced

The precise mode of action of the well-studied cromolyn sodium and the newer nedocromil sodium has not been completely elucidated. Because the drugs do not pass the cell membrane and enter the cell, they are virtually not metabolized, do not exert a systemic action, and therefore are associated with only minimal systemic toxicity. To be effective either drug must be applied topically and directly to the nasal mucosa. Proper contact with the nasal mucosa is essential for efficacy; in patients with nasal congestion and secretions, vasoconstrictors or saline lavages are indicated before cromolyn or nedocromil use. Both products are highly effective in patients who have IgE-mediated allergic rhinitis but must be administered prophylactically before exposure to an allergen to prevent development of the allergic event. Neither drug is effective in vasomotor rhinitis, exercise-induced rhinitis, or in the management of nasal polyps. Correct diagnosis is essential before therapy.

scholarly journals From clinical guidelines to practice. Clinical experience in treatment of patients with allergic rhinitis

2021 ◽  
pp. 62-67
Author(s):  
A. Y. Ovchinnikov ◽  
N. A. Miroshnichenko ◽  
E. M. Khon ◽  
N. P. Jimsheleishvili ◽  
V. A. Simsovа ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Seasonal Allergic Rhinitis ◽  
Inflammatory Diseases ◽  
Nasal Congestion ◽  
Controlled Study ◽  
Double Blind ◽  
Entire Treatment Period ◽  
Treatment Groups ◽  
Histamine H1 Receptors ◽  
To Receive

Introduction. Antihistamines are the most commonly prescribed class of medications for the treatment of allergic rhinitis (AR). However, they are also widely used in the treatment of inflammatory diseases of the ENT organs. One such drug is levocytirizine, (R) an enantiomer of cetirizine, which is a selective antagonist of peripheral histamine H1-receptors. This article analyzes the properties of levocytirizine in terms of safety and efficacy in allergic rhinitis.Aim of the study is to assess the efficacy of levocetirizine in patients with seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR) versus placebo, and safety for patients with allergic rhinitis.Materials and methods. In this, double-blind, placebo-controlled study, 52 patients with year-round allergic rhinitis and 28 patients with seasonal allergic rhinitis were randomized to receive levocetirizine 5 mg/day once or placebo. Mean overall measures of five symptoms (nasal congestion, nasal itching, itchy eyes, rhinorrhea, and sneezing) were compared between treatment groups at 1, 2, and 4 weeks. All individual symptom scores were also examined.Results. Levocetirizine showed a significant improvement in the condition of patients with CAR and SAR over the entire treatment period compared to placebo. Assessment of individual symptoms showed statistically significant differences in favor of levocetirizine. Conclusion. Levocetirizine is an effective, safe, and well-tolerated drug for the treatment of allergic rhinitis.

Effect of Shadbindu Taila and Haridra Khanda in Pratishyaya (Allergic Rhinitis)

The Healer ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 58-60
Author(s):  
Sadhana Parajuli ◽  
Pramod Bhatta ◽  
D.L Bharkher
Keyword(s):  
Immune Response ◽  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Significant Role ◽  
Vital Sign ◽  
Nasal Congestion ◽  
Combined Therapy ◽  
Nasal Discharge ◽  
Before And After ◽  
Airborne Allergens

Allergic rhinitis (AR) is an immune response of the nasal mucosa to airborne allergens and involves nasal congestion, watery nasal discharge, itching of the nose, and sneezing. Ayurveda describes Pratishyaya as one of the most important diseases among the 31 Nasarogas. Acharya Sushruta clearly mentioned that Pratishyaya is the condition in which vata kapha dusti was observed. Haridra Khanda is one of the prominent anti allergic drugs mentioned in ayurveda. Pratimarsha nasya has significant role in the prevention of urdhvajatrugata rogas. Ancient acharya has told to try shadbindu taila and Haridra khanda both locally and systematically in the management of pratishyaya. Here 30 patients were selected open randomly in shalakya opd of ayurveda campus kirtipur. They were given pratimarsha nasya with sadhbindu taila and internally haridra khanda for 30 days. The vital sign and symptom of pratishyaya like nasa srava, nasa kandu, kshavatu, nasa kandu and shira shula were studied before and after the treatment. The result of the study indicated that the combined therapy of internally Haridra Khanda and external pratimarsha narsha with sadbindu tail has given significant result in the treatment of Allergic Rhinitis (Pratishyaya).

scholarly journals New opportunities for the combined therapy of allergic rhinitis in real clinical practice

2019 ◽  
Vol 16 (1) ◽  
pp. 85-89
Author(s):  
E V Nazarova
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Practice ◽  
Nasal Congestion ◽  
Combined Therapy ◽  
Nasal Breathing ◽  
Interferon Alpha 2B ◽  
Eye Symptoms ◽  
Low Incidence ◽  
The Given ◽  
Real Clinical Practice

This paper assesses the efficacy of the original combined medication Allergoferon® beta (betamethasone + interferon alpha-2b) in real clinical practice among patients with seasonal allergic rhinitis (AR). The research program results demonstrated a good efficacy of the given medication: there were a decrease in nasal congestion as well as restoration of nasal breathing and in patients with concomitant allergic conjunctivitis - a reduction in the severity of eye symptoms. A low incidence of side effects was observed. It was shown that Allergoferon® beta can be recommended as monotherapy for patients with mild and moderate AR and in complex therapy for patients with severe AR.

scholarly journals The influence of atopy on sICAM-1 serum levels in patients with allergic rhinitis and bronchial asthma

2004 ◽  
Vol 23 (4) ◽  
pp. 355-359
Author(s):  
Aleksandra Peric-Popadic ◽  
Mirjana Bogic ◽  
Zikica Jovicic ◽  
Sanvila Raskovic ◽  
Vesna Tomic-Spiric ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Bronchial Asthma ◽  
Inflammatory Diseases ◽  
Serum Levels ◽  
Healthy Controls ◽  
Atopic Status ◽  
Significant Difference ◽  
Healthy Control ◽  
Adhesive Molecules ◽  
Important Marker

It has been shown that adhesive molecules are involved in inflammatory diseases of the lungs such as bronchial asthma. The purpose of the study was to measure and establish possible difference in serum levels of soluble ICAM-1 in 42 atopic patients (patients with allergic rhinitis and patients with bronchial asthma) in comparison with 28 patients without atopy (patients with asthma without rhinitis); whether there is a difference in sICAM-1 levels between groups of 26 patients with allergic rhinitis and asthma in comparison with group of 16 patients with allergic rhinitis only and also in comparison with 10 healthy controls. Results of the study have substantiated statistically significant difference in sICAM-1 levels between all groups of patients in comparison to healthy control, but no statistically significant difference in sICAM-1 levels between patients with and without atopy (Z=-1.738) or between patients with allergic rhinitis and bronchial asthma in comparison with group of patients with allergic rhinitis only (Z=0.00). ICAM-1 is an important marker of inflammation in patients with allergic rhinitis as well as in those with bronchial asthma. Atopic status does not influence differences in sICAM-1 levels. Although mean sICAM-1 levels were higher in patients with allergic rhinitis and bronchial asthma (312.71 ng/mL) in comparison with mean sICAM-1 levels in patients with allergic rhinitis only (279.69 ng/mL), no statistically significant difference was noted in sICAM-1 levels between these groups of subjects, i.e. asthma itself did not contribute to statistically significant increase of sICAM-1 levels.

Optical coherence tomography in diagnosing inflammatory diseases of ENT

2014 ◽  
Vol 3 (4) ◽  
Author(s):  
Alina Meller ◽  
Maria Shakhova ◽  
Yuriy Rilkin ◽  
Alexey Novozhilov ◽  
Mikhail Kirillin ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Optical Coherence Tomography ◽  
Inflammatory Diseases ◽  
Differential Diagnostics ◽  
Atrophic Rhinitis ◽  
Optical Coherence ◽  
Tympanic Cavity ◽  
Inflammatory Processes ◽  
Two Stages ◽  
Nose And Throat

AbstractThe object of the study was to demonstrate the abilities of optical coherence tomography (OCT) technique in diagnostics of inflammatory processes in ear, nose, and throat (ENT). When used in diagnostics of the nose and pharynx, OCT facilitates differential diagnostics of rhinitis enabling differentiation between the normal state, two stages of allergic rhinitis, vasomotor and atrophic rhinitis and diagnostics of pharyngitis. This paper also demonstrates the ability of OCT to monitor changes in pharynx induced by cryotherapy. In diagnostics of the tympanic cavity the ability of OCT to differentiate between different stages of chronic otitis and retraction of the tympanic membrane is demonstrated. Finally a correlation is discussed between morphologic alterations induced by inflammatory processes and changes in diagnostic OCT images.

scholarly journals Rhinitis: differential diagnosis and treatment principles

2020 ◽  
pp. 102-108
Author(s):  
A. L. Guseva ◽  
M. L. Derbeneva
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Nasal Congestion ◽  
Atrophic Rhinitis ◽  
Vasomotor Rhinitis ◽  
Allergen Specific Immunotherapy ◽  
Acute Viral Infection ◽  
Mixed Rhinitis ◽  
Non Allergic Rhinitis ◽  
Saline Solutions

Rhinitis is inflammation of the mucous membrane inside the nose. The clinical symptoms of this disease include nasal congestion, sneezing, itching of the nose and roof of mouth, rhinorrhea, and mucus draining down the back of the throat. Both allergic and non-allergic factors can play a role in the development of rhinitis. The most commonly used classification of rhinitis includes allergic rhinitis, non-allergic rhinitis, infectious rhinitis, and its specific forms. Allergic rhinitis is classified into the intermittent or persistent types, and may also be classified as mild, moderate and severe according to the severity of symptoms. Treatment of allergic rhinitis includes elimination of contact with allergen, allergen-specific immunotherapy and pharmacotherapy, which is selected depending on the severity of the symptoms. Infectious rhinitis develops in acute viral infection, and rhinitis symptoms are present in acute and chronic rhinosinusitis. Non-allergic rhinitis comprises conditions ranging from vasomotor rhinitis and gustatory rhinitis to non-allergic rhinitis with eosinophilia syndrome. Mixed rhinitis has components of allergic and non-allergic rhinitis. In addition, there are CPAP rhinitis, occupational rhinitis, medication rhinitis, rhinitis in systemic administration of drugs, rhinitis of pregnant women, atrophic rhinitis, rhinitis in systemic diseases. The type of rhinitis is diagnosed based on the patient’s complaints, anamnesis and clinical picture, some cases require laboratory tests and CT scan of the paranasal sinuses to differentiate the diagnosis. Approaches to the treatment of rhinitis depend on its type and include elimination of allergens or provoking factors, administration of saline solutions, intranasal glucocorticosteroids, systemic antihistamines, intranasal cromones, decongestants, antibacterial drugs may be prescribed to treat infectious rhinitis. Rhinitis should be differentiated from structural abnormalities, including congenital features, acquired conditions, neoplasms, gastroesophageal reflux, nasal liquorrhea.

scholarly journals Clinical and anamnestic characteristics and results of allergological testing in children with bronchial asthma and allergic rhinitis in case of allergy to house dust mites

2021 ◽  
pp. 40-48
Author(s):  
Olga Valerevna Trusova ◽  
Andrei Viacheslavovich Kamaev ◽  
Natalia Leonidovna Liashenko ◽  
Irina Vadimovna Makarova
Keyword(s):  
Allergic Rhinitis ◽  
Bronchial Asthma ◽  
House Dust ◽  
Nasal Congestion ◽  
Water Soluble ◽  
House Dust Mites ◽  
Dust Mites ◽  
Persistent Symptoms ◽  
Mite Allergy

House dust mites (HDM) are a common cause of allergies, however, it is not always easy to suspect a mite allergy from a patient's history. Objective: to determine clinical characteristics of patients, tactics for demonstrating the role of HDM sensitization in pediatric patients with allergic rhinitis (AR) and bronchial asthma (BA) with domestic sensitization. Materials and methods. The study included 420 patients, 256 boys, 164 girls, aged 5 to 17,9 years (mean 8,44 ± 3,06 years), with AR (100%) and AR in combination with BA (41,9%). The prick test on the forearm skin with water-soluble extracts was carried out and evaluated according to the standard method. The test was considered positive with a maximum wheal diameter of ≥3 mm 15 minutes after applying the prick. Results. Among patients with HDM sensitization (n=268), sensitization to both mites was detected in 218 cases (81,3%), and in 139 cases (51,9%) polysensitization to HDM allergens, house dust and epidermal allergens (cat, dog) was found. Patients noted persistent symptoms of nasal congestion, and rhinorrhea; the provoking factor was not determined by history in 46% of cases. In 69,8% of cases (97 children), it was impossible to isolate the leading allergen according to the history, since patients had contact with cats, dogs, dust, and polysensitization according to the prick tests. Nasal provocation test (NPT) with HDM allergens was performed in 92 children. Positive NPT was obtained in 83 cases (90,2%), negative in 9 cases (9,8%). Conclusions. With HDM sensitization, often (46%) the provoking factor is not determined by history. Monotonous symptoms are characteristic with the absence of obvious relationships with allergens, the location and activities of the child. In terms of frequency, the leading variant is sensitization to both mites D.pteronyssinus, D.farinae (81,3%), and polysensitization to HDM, house dust and cat and dog allergens (51,9%). NPT allows in 90% of cases to show the causal role of HDM allergens in polysensitized patients with insufficiently convincing anamnesis data.

scholarly journals Effect of intranasal fluticasone propionate on respiratory obstruction in pollen allergy

2021 ◽  
Vol 23 (3) ◽  
pp. 244-249
Author(s):  
Natalia G. Astafieva ◽  
◽  
Irina A. Perfilova ◽  
Ekaterina N. Udovichenko ◽  
◽  
...  
Keyword(s):  
Fluticasone Propionate ◽  
Nasal Congestion ◽  
Combined Therapy ◽  
Pollen Allergy ◽  
Controlled Study ◽  
Lower Airway ◽  
Bronchial Obstruction ◽  
External Respiration ◽  
Adequate Treatment ◽  
Therapeutic Benefits

Background. Allergic rhinitis (AR) remains the most common manifestation of pollen allergy, with nasal congestion as the leading symptom. About half of patients with AR have comorbidity with bronchial asthma (BA). Intranasal corticosteroids (INC) have a positive effect on the manifestations of rhinitis and concomitant comorbid pathology. The choice of adequate treatment, rejection of ineffective combinations, polypharmacy remains a widely demanded area of research in real clinical practice. Aim. To evaluate the effect of monotherapy of INC with fluticasone propionate (FP) on nasal and bronchial obstruction in pollen comorbid AR and BA and the possibility of obtaining therapeutic benefits from additional administration of systemic antihistamines (AH). Materials and methods. A prospective 5-week, double-blind, placebo-controlled study of monotherapy with INC FP and combined therapy of FP with the non-sedative AH loratadine in patients with concomitant AR and BA was carried out. The study included 72 patients with the first diagnosis of AR, with existing BA and sensitization to plant pollen. Two comparable patient groups were formed with different therapeutic approaches. Examination, allergy testing, ECHRS questionnaire, symptom severity scale were used to assess symptoms. Active anterior rhinomanometry and spirometry were used to assess the level of obstruction of the upper and lower airways. Results. A high level of polysensitization was found in the examined persons with comorbid pathology. Significant reduction in nasal congestion was found both in the group receiving FP and in the group with combination therapy. However, the use of antihistamines in addition to FP did not significantly affect on congestion symptom. After treatment, there was a decrease in nasal resistance in both groups. The total nasal volumetric flow significantly increased in both groups. The change in the parameters of external respiration is shown. Significant changes in peak expiratory flow rate and forced expiratory volume in the first second after the completion of treatment were found in both groups. Conclusion. A high incidence of polysensitization has been shown in patients with AR and BA. The efficacy and safety of FP has been proven by subjective assessment and objective instrumental methods for studying upper and lower airway obstruction. The addition of AH did not significantly change the effectiveness of therapy.

scholarly journals ETHIOPATHOGENETIC ASPECTS ACUTE ODONTOGENIC INFECTION

2021 ◽  
Vol 17 (2) ◽  
pp. 19-26
Author(s):  
Said Ksembaev ◽  
Elena Nesterova ◽  
Ol'ga Torgashova ◽  
Elima Agatieva ◽  
Dinar Busheev
Keyword(s):  
Molecular Mechanisms ◽  
Inflammatory Diseases ◽  
Correct Diagnosis ◽  
Anaerobic Bacteria ◽  
Odontogenic Infection ◽  
Main Stage ◽  
Nonspecific Resistance ◽  
Local Immunity ◽  
Adequate Treatment ◽  
Pathogenic Factors

Subject. A review of the literature on the topical problem of dentistry — the etiology and pathogenesis of acute odontogenic purulent-inflammatory diseases is presented. The purpose of the research is to study the materials of publications. dedicated to the etiopathogenetic aspects of acute odontogenic infection. Methodology. The etiology and pathogenesis of acute odontogenic purulent-inflammatory diseases are described in detail, in the light of modern concepts. Results. The unfavorable factors influencing the increase in the frequency of acute odontogenic purulent-inflammatory diseases and the worsening of the clinical course are presented. It is noted that these diseases are explained by the effect of microbial associations, one of the frequent representatives of which are anaerobic bacteria, which significantly worsen the clinical picture of the disease. All theories of the pathogenesis of jaw osteomyelitis (vascular, allergic and neuro-trophic) are considered. At the same time, it was noted that the vascular, allergic and neuro-reflex components in the emergence and development of osteomyelitis of the jaws are realized against the background of a decrease in the level of general immunological and specific reactivity of the whole organism, as well as the failure of local immunity. Particular importance is attached to disorders of the systems of neuroregulation and microcirculation. It is noted that sensitization and neuroreflex effects on the inflammation focus are factors contributing to the transition of the reversible phase of inflammation (osteitis) to the irreversible one (osteomyelitis), and microcirculation disorders in the inflammation focus are characterized as the main stage in the chain of pathophysiological processes leading to irreversible changes. Attention is drawn to the fact that in recent years, great importance in maintaining homeostasis in acute odontogenic pyoinflammatory diseases has been given to the antioxidant system, which is directly involved in the regulation of the molecular mechanisms of nonspecific resistance of the organism to the damaging action of various pathogenic factors. Findings. The results of the review indicate that knowledge of the peculiarities of the etiology and pathogenesis of acute odontogenic pyoinflammatory diseases is necessary for correct diagnosis, timely and adequate treatment, prognosis and prevention of complications. However, it should be recognized that this problem continues to remain relevant to this day due to the complexity of its study.

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