scholarly journals Klasifikacija hronicnih inflamacija gornjih disajnih puteva na bazi alergijskog statusa

2004 ◽  
Vol 51 (1) ◽  
pp. 88-92
Author(s):  
Ljiljana Janosevic ◽  
Slobodanka Janosevic ◽  
P. Stankovic ◽  
V. Djukic ◽  
S. Stosic-Divjak ◽  
...  
Keyword(s):  
Allergic Inflammation ◽  
Upper Airway ◽  
Provocation Test ◽  
Nasal Allergy ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Prick Test ◽  
Clinical Allergy ◽  
Inflammatory Conditions

Almost one third to one half of all patients in otorhinolaryngologic practice experience some kind of inflammation of the upper respiratory tract out of which allergic mechanisms, either as primary factors or secondary ones, appear in 30-40% of adults and 60-80% of children and adolescents. The objective of this study was to analyze inflammatory conditions of the upper airways on the basis of allergic state of the patient and to establish the classification that will respect the actual immunological alteration level (subclinical allergy, clinical allergy) and spreading (localized allergy, generalized allergy). Inclusion criteria for all sixty nine patients were the diagnosis of chronic upper airway inflammation and their exposition just lo ubiquitous allergens. Diagnostic procedure included anamnesis, physical examination and allergic in vivo testing of the skin and nasal mucosa to inhalant allergens. The certain categories of results were established for the skin prick-test (positive, negative, indefinite), specific nasal provocation test (positive, negative, hyperreactive) and nasal symptoms (present, absent). By using a strictly determined combination of results, we were able to define the six groups in our classification: nasal clinical allergy (30% of patients), non-nasal clinical allergy (19% of patients), localized nasal allergy (11% of patients), latent allergy (3% of patient), nonspecific nasal hyperreactivity (12% of patient) and non-allergic inflammation (25% of patients). Our classification takes into consideration the modem knowledge in the field of allergology and may bring an additional quality in respect to selection of therapy options, long-term follow-up of allergy status evolution in the individual person as well as intragroup and intergroup analysis of parameters important to evaluate the effects of antiallergic prevention or therapy.

scholarly journals Reassortment between Avian H5N1 and Human H3N2 Influenza Viruses in Ferrets: a Public Health Risk Assessment

2009 ◽  
Vol 83 (16) ◽  
pp. 8131-8140 ◽  
Author(s):  
Sara Jackson ◽  
Neal Van Hoeven ◽  
Li-Mei Chen ◽  
Taronna R. Maines ◽  
Nancy J. Cox ◽  
...  
Keyword(s):  
Upper Airway ◽  
Influenza Viruses ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Nasal Secretions ◽  
H5 Subtype ◽  
H3n2 Influenza ◽  
Human Viruses ◽  
Reassortant Viruses

ABSTRACT This study investigated whether transmissible H5 subtype human-avian reassortant viruses could be generated in vivo. To this end, ferrets were coinfected with recent avian H5N1 (A/Thailand/16/04) and human H3N2 (A/Wyoming/3/03) viruses. Genotype analyses of plaque-purified viruses from nasal secretions of coinfected ferrets revealed that approximately 9% of recovered viruses contained genes from both progenitor viruses. H5 and H3 subtype viruses, including reassortants, were found in airways extending toward and in the upper respiratory tract of ferrets. However, only parental H5N1 genotype viruses were found in lung tissue. Approximately 34% of the recovered reassortant viruses possessed the H5 hemagglutinin (HA) gene, with five unique H5 subtypes recovered. These H5 reassortants were selected for further studies to examine their growth and transmissibility characteristics. Five H5 viruses with representative reassortant genotypes showed reduced titers in nasal secretions of infected ferrets compared to the parental H5N1 virus. No transmission by direct contact between infected and naïve ferrets was observed. These studies indicate that reassortment between H5N1 avian influenza and H3N2 human viruses occurred readily in vivo and furthermore that reassortment between these two viral subtypes is likely to occur in ferret upper airways. Given the relatively high incidence of reassortant viruses from tissues of the ferret upper airway, it is reasonable to conclude that continued exposure of humans and animals to H5N1 alongside seasonal influenza viruses increases the risk of generating H5 subtype reassortant viruses that may be shed from upper airway secretions.

scholarly journals Upper Airway Findings and Markers of Lung Disease Progression in Patients with Cystic Fibrosis

2020 ◽  
Vol 24 (04) ◽  
pp. e434-e437
Author(s):  
Luciane Mazzini Steffen ◽  
Luise Sgarabotto Pezzin ◽  
Natassia Sulis ◽  
Nedio Steffen ◽  
Leonardo Araujo Pinto
Keyword(s):  
Cystic Fibrosis ◽  
Lung Disease ◽  
Disease Progression ◽  
Nasal Polyps ◽  
Nasal Swab ◽  
Statistical Significance ◽  
Upper Airway ◽  
Forced Expiratory Volume ◽  
Upper Respiratory Tract ◽  
Upper Airways

Abstract Introduction Cystic fibrosis (CF) is a genetic disease that limits the quality of life mainly due to respiratory symptoms. The relationship between findings of the upper airways and CF lung disease is not yet completely understood. Objective The aim of the present study is to describe the most frequent nasal findings and pathogens in patients with CF and investigate the association between the findings of the upper respiratory tract and markers of lung disease progression. Methods Retrospective study in patients with CF from the Pediatric Pulmonology Department who underwent otorhinolaryngological evaluation between 2015 and 2017. Nasal endoscopy and nasal swab collection were part of the evaluation. The severity markers used were: percentage of predicted forced expiratory volume in the first second (FEV1%), body mass index (BMI) and the Shwachman-Kulczycki (SK) clinical score. Results A total of 48 patients with CF were included. The mean of the predicted percentage of FEV1% was 83.36 ± 30.04. The average 14 and SK score 89.11 ± 10.50. The bacteriology of the nasal swab was positive in 27 (54.1%) patients. Staphylococcus aureus was positive in 18 patients, Pseudomonas aeruginosa in 5, Pseudomonas cepacea in 3 and Stenotrophomonas maltophila in 1 patient. Nasal polyps were found in nine participants. Nasal polyps were found in nine participants and were associated with lower SK score. Conclusion The pathogens found in the upper airway were, in order: S. aureus, P. aeruginosa, P. cepacea e S. maltophila. The presence of polyps in the nasal cavity showed statistical significance and appears to have association with the prognostic factor measured by the SK score.

Sino-Nasal Characteristics in Asthmatic Patients

2012 ◽  
Vol 147 (5) ◽  
pp. 950-957 ◽  
Author(s):  
Wenche Moe Thorstensen ◽  
Vegard Bugten ◽  
Malcolm Sue-Chu ◽  
Nils Petter Wold Fossland ◽  
Pål Richard Romundstad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Air Flow ◽  
Clinical Importance ◽  
Upper Airway ◽  
Upper Airways ◽  
Asthma Control Questionnaire ◽  
Tertiary Referral Center ◽  
Prick Test ◽  
Asthmatic Patients

Objective The Unified Airways Hypothesis suggests an involvement of the upper airways in asthma. We aimed to evaluate the association between subjective sino-nasal complaints, nasal air flow, and sino-nasal quality of life (QOL) in patients with asthma compared with nonasthmatic subjects. Study Design Case-control study. Setting A tertiary referral center. Subjects and Methods Symptoms, quality of life, and nasal airflow were assessed in 91 asthmatics and 95 nonasthmatic controls with Visual Analog Scale (VAS, 0-100), Sino-Nasal Outcome Test (SNOT-20), and Peak Nasal Inspiratory Flow (PNIF), respectively. Asthma and allergy status were assessed by Asthma Control Questionnaire (ACQ) and skin prick test or specific IgE. Results Asthmatic patients (men/women, 37/54; mean age, 43.7 years; range, 19-64 years) reported significantly more nasal obstruction (mean VAS, 37 mm; SD = 26, 95% CI, 32-43 vs 9 mm, SD = 11, 95% CI, 7-11, P < .001) and lower sino-nasal quality of life (mean SNOT-20, 1.3; SD = 0.8, 95% CI, 1.1-1.5 vs 0.4, SD = 0.5, 95% CI, 0.3-0.5, P < .001) than controls (men/women, 42/53; mean age, 43.8 years; range, 20-65 years). PNIF was significantly lower in asthmatic patients than controls (mean PNIF, 84 l/min; SD = 24, 95% CI, 79-89 vs 100 l/min SD = 24, 95% CI, 95-105, P < .001). Conclusion Both allergic and nonallergic asthma were associated with increased sino-nasal symptoms, reduced sino-nasal QOL, and reduced inspiratory nasal air flow compared to controls. This provides further evidence of the clinical importance of the upper airway in the diagnostic and therapeutic management of asthma patients beyond the scope of allergy.

Cyclic Adenosine Monophosphate Stimulation of Mucociliary Activity in the Upper Airways in Vivo

1995 ◽  
Vol 104 (5) ◽  
pp. 388-393 ◽  
Author(s):  
Anders Cervin ◽  
Sven Lindberg ◽  
Jan Dolata ◽  
Ulf Mercke
Keyword(s):  
Upper Airway ◽  
Cyclic Adenosine Monophosphate ◽  
Adenosine Monophosphate ◽  
Airway Disease ◽  
Maxillary Artery ◽  
Dibutyryl Camp ◽  
Upper Airways ◽  
Maximum Increase ◽  
Xanthine Derivatives

Xanthine derivatives are known to accelerate mucociliary transport in the lower airways, probably by preventing degradation of cyclic adenosine monophosphate (cAMP) and thereby increasing its intracellular concentration. The purpose of this study was to investigate the effects of cAMP on mucociliary activity in the upper airways. The effect on the mucociliary activity in the rabbit maxillary sinus of the xanthine derivatives theophylline and enprophylline was compared to that of the cAMP analog dibutyryl cAMP. The compounds were administered into the maxillary artery, and the response was recorded with a photoelectric technique. Infusions of theophylline (1.0 and 10 mg/kg) increased mucociliary activity (22.8% ± 5.9%, n = 6, and 21.6% ± 4.9%, n = 7, p < .05, respectively). Infusions of enprophylline (1.0 and 10.0 mg/kg) accelerated mucociliary activity (at the highest dosage tested, 24.3% ± 4.1%). Infusions of dibutyryl cAMP (0.1 and 1.0 mg/kg) stimulated mucociliary activity, with the maximum increase (20.1% ± 3.0%, n = 13, p < .05) being observed at a dosage of 0.1 mg/kg. The infused substances increased mucociliary activity within 1 minute after the start of the infusion, the duration of the response being approximately 20 minutes for theophylline, 22 minutes for enprophylline, and 12 minutes for dibutyryl cAMP. The present results support the view that cAMP is involved in regulating mucociliary activity in the upper airways. It remains to be elucidated whether xanthines such as theophylline and enprophylline are beneficial in upper airway disease in which mucociliary function is impaired (eg, chronic sinusitis).

scholarly journals INCREASING THE UPPER AIRWAY SPACE USING ORAL APPLIANCES IN PATIENTS WITH MILD SLEEP APNOEA CAUSED BY STOMATOGNATHIC DYSFUNCTIONS

2016 ◽  
Vol 60 (2) ◽  
Author(s):  
Halina Ey-Chmielewska ◽  
Iwona Teul ◽  
Jacek Lorkowski
Keyword(s):  
Upper Airway ◽  
Anatomical Variations ◽  
Sleep Apnoea ◽  
Oral Appliances ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Stomatognathic System ◽  
Different Types ◽  
Abnormal Breathing ◽  
Upper Respiratory

Introduction: Abnormal breathing can be caused by developmental malformations or anatomical variations in the upper airways. Stomatognathic diseases may significantly impair the patency of the upper respiratory tract. Treatment of advanced stomatognathic dysfunctions is difficult due to their multifactorial aetiology, and often involves many phases. Sleep apnoea is one of the most bothersome complications. The mainstay therapeutic strategy relies on modifying the position of the mandible against the maxilla, achieved by using different types of oral appliances.Material and methods: The study was carried out in 2006–2010 on 92 patients (mean age 42.5 years) with diagnosed advanced dysfunction of the stomatognathic system. The treatment relied on the use of an orthodontic appliance (54 patients) or combined multi­‍‑phase therapy with splints used in the first phase (22 patients). Two different appliances were used (one of them was modified by the authors). Parameters assessed in the study included time to resolution of pain, reduction in the incidence of sleep apnoea, and improvement in nasal breathing.Results: Change in the protrusion of the mandible not only relieved problems with the stomatognathic system, but also improved breathing in patients. The use of modified oral appliances reduced treatment duration and improved patients’ comfort. Therefore, it may be useful in the treatment of patients with mild sleep apnoea.

scholarly journals Treatment of acute upper respiratory tract infections in children

2002 ◽  
Vol 55 (9-10) ◽  
pp. 397-400 ◽  
Author(s):  
Nevenka Roncevic-Babin ◽  
Jelena Popadic ◽  
Aleksandra Stojadinovic
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Upper Airway ◽  
Previous Treatment ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Antimicrobial Drugs ◽  
Airway Infections ◽  
Tract Infections

Introduction Acute respiratory tract infections are the most common diseases of childhood. A preschool child suffers up to 5-7 infections of upper airways during a year. Upper airway infections make 80 - 90% of all respiratory infections. Etiology and treatment In 75% of all cases respiratory infections are of viral etiology, 15% of bacterial and 10% are caused by mycoplasma, rickettsiae, fungi, parasites. The treatment of respiratory infections includes antimicrobial therapy (causal), relief of symptoms (symptomatic) and application of general principles of child treatment. The choice of antimicrobial drug is based on the evidence of agents and their sensitivity to antimicrobial drugs, age, patient's condition, previous treatment and possible allergic reactions to the drug. In cases where adequate specimen cannot be obtained for microbiologic tests, when these tests do not reveal the agent, or therapy must start before evidence of the agent is available, we must decide about the therapy, taking in consideration the most frequent agents, and those that would cause the most devastating clinical picture. This therapy can be modified later, according to the isolated agent and its sensitivity to the drug. Considering the incidence and importance of respiratory infections in morbidity and mortality of children, the aim of this article was to present guidelines in treatment of respiratory infections. The main point remains that the treatment should take into consideration the individual patient before all.

scholarly journals Innate lymphoid cells in the upper airways: importance of CD117 and IL-1RI expression

2018 ◽  
Vol 52 (6) ◽  
pp. 1800742 ◽  
Author(s):  
Koen Van Crombruggen ◽  
Sylvie Taveirne ◽  
Gabriele Holtappels ◽  
Georges Leclercq ◽  
Claus Bachert
Keyword(s):  
Nasal Polyps ◽  
Upper Airway ◽  
Innate Lymphoid Cells ◽  
Lymphoid Cells ◽  
Type I ◽  
Upper Airways ◽  
Airway Mucosa

Although type 1, 2 and 3 innate lymphoid cells (ILC1s, ILC2s and ILC3s, respectively) are emerging as important cell populations regulating tissue homeostasis, remodelling and inflammation, a vast majority of our knowledge stems from in vitro and murine experiments, and requires thorough confirmation in human diseases.Relative levels of ILCs were evaluated by means of flow cytometry in freshly resected human upper airways mucosa of patients with chronic rhinosinusitis without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP), taking into account the patient's clinical parameters and disease comorbidities.We report that the CD117 and interleukin-receptor type I (IL-1RI) expression status of human ILC2s depends on the local tissue environment. Only CD117+ IL-1RI+ ILC2s, exclusively present in CRSwNP, possess an interrelationship with type 2 T-helper cell cytokine and eosinophil levels in human upper airway mucosa. In CRSsNP, mainly CD117−IL-1RI− ILC2s are increased, yielding lower eosinophilia in this disease despite the high levels of ILC2s.These data unveil that the CD117− and CD117+ fractions within the native human ILC2 population are not a random phenomenon, in contrast to what could be concluded from in vitro data, and that the IL-1RI expression is not ubiquitous in ILC2s in vivo in humans, which cannot be assessed via in vitro and murine experiments.

scholarly journals Permeabilization surgery of the upper respiratory tract and its effects on sleep fragmentation and REM sleep

2017 ◽  
Vol 7 (25) ◽  
pp. 47-56 ◽  
Author(s):  
Ionut Tanase ◽  
Claudiu Manea ◽  
Codrut Sarafoleanu
Keyword(s):  
Sleep Disorders ◽  
Surgical Procedures ◽  
Rem Sleep ◽  
Slow Wave Sleep ◽  
Upper Airway ◽  
Sleep Fragmentation ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Falling Asleep ◽  
Before And After

AbstractUsually, patients with sleep disorders may complain of tiredness, fatigue, daytime sleepiness, difficulty in concentrating, and can reach up to falling asleep in inappropriate situations – condition known as the Pickwick syndrome. To avoid these unpleasant symptoms, a series of surgical procedures regarding the anatomical structures involved in sleep apnea were developed.The article is a general review regarding the sleep disorders and the influence of upper airways permeability on the quality of sleep and the sleep staging distribution. Also, we present some preliminary data obtained in a clinical study underwent in CESITO Centre “Sfanta Maria” Hospital, Bucharest, involving patients with sleep pathology that had polysomnographic evaluations before and after various surgical procedures of nasal and pharyngeal permeabilization.AIMS.To determine that permeabilization surgery of the upper airway tract may be used successfully in order to decrease the sleep fragmentation and increase the time of slow-wave sleep.CONCLUSION.6 months after the permeabilization surgery of the upper airway tract, the polysomnography reveals that the arousals index decreased and the sleep architecture undergoes changes that consist in decreasing the Stage 1 and Stage 2 sleep, therefore REM sleep reaches a better score.

Sensory mechanisms in the upper respiratory tract affect the inhalation of cigarette smoke in man

1986 ◽  
Vol 71 (1) ◽  
pp. 117-119 ◽  
Author(s):  
S. G. N. Grant ◽  
G. Woodman ◽  
S. P. Newman ◽  
D. Pavia ◽  
S. W. Clarke
Keyword(s):  
Cigarette Smoke ◽  
Upper Airway ◽  
Sensory Receptors ◽  
Topical Anaesthesia ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
The Mean ◽  
Upper Respiratory ◽  
Sensory Mechanisms ◽  
Stimulation Of

1. Cigarette puffing parameters (puff volume, puff duration, number of puffs, total smoking time) and inhaled smoke volume (by a radiotracer techique) have been measured in a group of 11 asymptomatic smokers, once after topical anaesthesia of the upper airways and once without anaesthesia. 2. Topical anaesthesia significantly reduced the mean inhaled smoke volume per puff for the group from 41.1 ml to 30.6 ml (P < 0.05) and the total inhaled smoke volume from 575 ml to 528 ml (P = 0.05), but cigarette puffing parameters were unchanged. 3. It is concluded that stimulation of upper airway sensory receptors, probably sensitive to nicotine, may be an important mechanism in determining the amount of cigarette smoke inhaled by smokers.

scholarly journals Polysomnography outcomes on patients with obstructive sleep apnea after upper airways repermeabilization surgery

2018 ◽  
Vol 8 (30) ◽  
pp. 103-115
Author(s):  
Ionut Tanase ◽  
Claudiu Manea ◽  
Codrut Sarafoleanu
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Respiratory Events ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep ◽  
The Right

Abstract BACKGROUND. Sleep apnea is a pathology with an ever-increasing spread, the causes being the most diverse. In this study we focus on sleep breathing disorders caused by nasal obstruction and also by soft palate and uvula anatomical changes. The right treatment recommended in this pathology according to the American Academy Sleep Medicine (AASM) is non-invasive ventilation – positive airway pressure (CPAP). A substantial percentage of patients with obstructive sleep apnea seek alternatives to CPAP and the solution for this can be upper airway surgery. OBJECTIVE. The attempt to demonstrate the viability of upper respiratory tract surgery as an alternative to CPAP treatment, demonstrating objectives by pre- and postoperative polysomnographic control. RESULTS. Aggregating the data from all 54 patients with nasal obstruction and pharyngeal modifications, we observed a decrease in AHI from 20.406/h to 15.86/h, representing 32.36%, an improvement in sleep architecture and especially REM sleep from 41.5 minutes initially to 67.8 minutes (increased value with 63.37 percent). CONCLUSION. The benefits of nasopharyngeal repermeabilization surgery are represented by decreasing the severity of respiratory events and, second to this, lowering the number of arousals. By reducing the number of arousals, one will obtain a better percentage regarding the deep sleep phase - REM, having a beneficial effect on reducing the daytime sleepiness – which is a major symptom that patients are present.

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