HEREDITARY ANGIOEDEMA – A PROBLEM AT THE INTERSECTION OF IMMUNOLOGY AND ALLERGOLOGY: ANALYSIS OF LITERATURE DATA AND DESCRIPTION OF A SERIES OF 34 CASES

2021 ◽  
Vol 100 (2) ◽  
pp. 49-57
Author(s):  
M.N. Guseva ◽  
◽  
E.I. Zinina ◽  
E.N. Suspitsyn ◽  
M.M. Kostik ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hereditary Angioedema ◽  
Positive Family History ◽  
Clinical Manifestations ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Peripheral Edema ◽  
Dominant Disease ◽  
Characteristic Features ◽  
Head Neck

Hereditary angioedema (HAE) is a rare autosomal dominant disease characterized by isolated recurrent angioedema (AE) of various localizations: skin, the submucosa in the gastrointestinale tract, the respiratory tract. The characteristic features of edema in HAE are the absence of itching, skin flushing, accompanying urticaria, as well as the absence of pronounced effect of systemic corticosteroid therapy, systemic antihistamines therapy and adrenaline. The aim of our study was to present a descriptive characteristics of the group of patients with HAE and to access efficacy and safety of treatment. Materials and methods: the retrospective multicenter continuous nonrandomized uncontrolled study included data on 34 patients: 19 men (56%) and 15 women (44%) with HAE. The diagnosis of HAE was based on clinical and laboratorial data, according to the clinical guidelines of the Russian Association of allergologists and clinical immunologists on HAE (2014). Results The age range of patients at the time of inclusion in the study was 5–82 years, median – 38,8 (20,6; 46,9) years. Median age of first HAE episode was 12,5 (5,8; 16,3) years, ranged from 2 to 40, 22/28 (79%) of the patients manifested before 18 years. HAE was diagnosed at the median age of 30 years (17,5; 44,8) years, in 14,0 (9,0; 25,0) years after onset of the clinical manifestations. Most of the observations described have a positive family history of HAE (91%), in total 9 families were described. In 67% of families the disease manifested itself in two generations and in 33% of families – in three generations. At the onset of HAE peripheral edema was in 29/31 (94%) of the patients, and 22/31 (71%) had edema confined to the distal extremities. 7/31 (29%) patients had peripheral edema combined with edema of other locations. Abdominal attacks were in 6/31 (19%), head, neck and upper airways edema were in 7/31 (23%). The frequency of swelling of head, neck, upper respiratory tract increased statistically significantly from 23% (7/31) to 35% (7/20, p=0,003). 24 patients have recieved Icatibant treatment. No deaths were recorded against the background of this treatment. Conclusions HAE is diagnosed with significant time delays. Icatibant treatment is safe and effective.

scholarly journals Peculiarities of the upper airways condition in patients with snoring and obstructive apnea during sleeping

2021 ◽  
pp. 12-18
Author(s):  
Yuriy V. Minin ◽  
Tetiana I. Kucherenko ◽  
Ganna Y. Minina
Keyword(s):  
Respiratory Tract ◽  
Sleep Disordered Breathing ◽  
Clinical Manifestations ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Anatomical Features ◽  
Obstructive Sleep ◽  
Severe Manifestation ◽  
Analysis Of Results ◽  
Upper Respiratory

Aim: study the anatomical features of the upper respiratory tract in patients with ronchopathy of varying degrees of clinical manifestations. Materials and methods: 60 patients with persistent snoring were under supervision. They were divided into four clinical groups depending on the degree of snoring and obstructive sleep apnea. All patients underwent clinical and instrumental examination, which included cardio-respiratory monitoring and MRI examination of the upper respiratory tract. Results: In the comparative analysis of results of clinical studies of the upper respiratory tract of patients with and without obstructive sleeping apnea, there was a statistically significant narrowing of the retroglossal space in 45,7% and 16%, respectively. In the analysis of morphometric parameters of the upper respiratory tract in patients with sleep-disordered breathing of varying severity, there was a narrowing of the retropalatinal and retroglossal lumens of the pharynx due to the increase in the soft palate and tongue with its dislocation posteriorly. It is stated that more pronounced narrowing of the lumen of the upper respiratory tract leads to respiratory disorders during sleeping. The most severe manifestation of respiration deterioration during sleeping were observed in the narrowing of the upper respiratory tract at several levels.

Effect of sulfur baths on the upper respiratory tract and hearing organ

1927 ◽  
Vol 23 (8) ◽  
pp. 856-856
Author(s):  
N. Bobrovsky
Keyword(s):  
Respiratory Tract ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Hearing Organ ◽  
Upper Respiratory

The question of the effect of H2S on the mucosa of the upper respiratory tract and the hearing organ is currently not yet sufficiently developed. Observations of Dr. Mogilnitsky on patients with sulfur baths suggest that H2S acts directly on the mucosa of the upper airways, causing its hyperaemia, increased secretion and reduction of atrophic phenomena; long-term action of H2S, on the contrary, increases atrophic phenomena.

CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

2020 ◽  
pp. 72-79
Author(s):  
I. V. Аndrusovich
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Tract ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Second Phase ◽  
Upper Respiratory Tract

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

scholarly journals Experience in treatment and prevention of respiratory diseases relapses in children with the use of the phytotherapeutic complex «Alpicol»: feedback of doctors in Ukraine

2021 ◽  
pp. 12-22
Author(s):  
О.К. Koloskova ◽  
◽  
A.L. Kosakovskyi ◽  
T.M. Bilous ◽  
I.B. Horbatiuk ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Therapeutic Efficacy ◽  
Respiratory Diseases ◽  
Conflicts Of Interest ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Herbal Medicines ◽  
Upper Respiratory Tract ◽  
Treatment And Prevention ◽  
Parents And Children

Infectious and inflammatory diseases of the respiratory tract in children are the «leaders» among all pathologies of childhood. Optimization of therapeutic and prophylactic approaches for infectious and inflammatory pathologies of the respiratory system by reducing the frequency of unreasonable antibiotic therapy and eliminating polypragmatic use is a relevant problem of modern pediatrics and otolaryngology. According to WHO guidelines, modern standardized herbal medicines are not inferior in efficiency to synthetic ones. The aim — to analyze the results of assessment by doctors of the preventive and therapeutic efficacy of the remedy «Alpicol» on the basis of a questionnaire, as well as clinical examination of patients before using the medication and after completion of the course of treatment. Materials and methods. The advantages of «Alpicol» were analyzed through a questionnaire offered by first contact practitioners to children in order to receive feedback on the assessment of the preventive and therapeutic efficacy of this medication. Doctors from 9 regions of Ukraine were involved, and 6,093 questionnaires of children of different ages were analyzed. Results. The frequency of registration of a pronounced paediatric pain (3 scores) with the use of the «Alpicol» medication significantly decreased (23.7 times), a moderate manifestation of the disease (2 scores), was 17 times less at the same time, mild manifestations of paediatric pain remained at the same level. Patients with a comorbid pathology of the respiratory tract in the form of recurrent lesions of the upper and lower airways during the 2nd visit received a zero score (no symptoms) significantly less frequently than children with pathology of the upper respiratory tract with 62.6% of cases versus 72.2% of observations, respectively (p<0.05). As a result of the use of the course of «Alpicol» medication, a statistically significant decrease in the severity of the catarrhal symptom complex was achieved, since the proportion of the course of disease, assessed by the maximum number of scores, decreased by 29.6 times, moderate (score 2) — 13.3 times, and zero scores appeared 5.7 times more often. At the same time, the proportion of patients with a mild course of catarrh practically did not change. Conclusions. «Alpicol» has a multi;vector efficacy against the complex of symptoms that accompany infectious and inflammatory exacerbations of recurrent respiratory diseases. This is manifested by a decrease in the severity of clinical manifestations of the disease, as well as in an increase in cases of clinical stabilization of the patient's condition, which demonstrates the therapeutic and prophylactic effect of the drug «Alpicol» on the course of recurrent respiratory diseases in children. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was adopted by the Local Ethics Committee of all institutions indicated in this research. The informed consent of parents and children was obtained. The authors declare that they have no conflicts of interest. Key words: ecurrent respiratory diseases, treatment and prevention, children, phytocomplexes.

Evaluation of morphological relations between lower craniofacial skeletal structures and dimensions of upper respiratory tract in skeletal Classes I and III

2016 ◽  
Vol 69 (6) ◽  
pp. 647-658
Author(s):  
Karolina Stelmańska ◽  
Zbigniew Paluch ◽  
Marta Twardokęs ◽  
Katarzyna Ura-Sabat ◽  
Hanna Frelich ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Respiratory Tract ◽  
Orthodontic Treatment ◽  
Upper Respiratory Tract ◽  
Facial Skeleton ◽  
Upper Airways ◽  
Skeletal Class ◽  
The Face ◽  
Upper Respiratory ◽  
Cephalometric Measurements

Introduction. Review of the literature indicates the relationship between upper airways patency and lower jaw morphology. Aim of the study. To design multidimensional models to describe morphological relations of the linear and angular dimensions of hard tissues of the lower facial skeleton and the cervical spine (independent variables) with the linear dimensions of the upper respiratory tract (dependent variables). The obtained models took into consideration the age, gender and the skeletal Class I and III of the evaluated individuals. Material and method. The patients represented two skeletal classes: I (n = 97; 42.4%) and III (n = 53; 23.1%). Prior to orthodontic treatment, lateral cephalometric radiography (LCR) was performed in all patients. The obtained cephalometric measurements were evaluated statistically. Results. The statistical analysis pointed to significant differences between variables of the URT and dimensions of the facial skeleton and the cervical spine. It also revealed significant differences between variables of the URT and dimensions of the facial skeleton and the cervical spine. The independent variable Co-Gn emerged as an important predictor in regression of the nasopharynx. The anteroinferior height of the face and mandibular inclination were the factors relevant for oropharynx. Variables of the cervical spine were significant predictors in laryngopharyngeal models. Conclusions. The results illustrating morphological interrelations between the lower face and dimensions of the URT air space may prove helpful in planning orthodontic treatment, with or without teeth extraction, as well as orthognathic surgeries.

scholarly journals Related Factors to Streptococcus pneumoniae Invasive Infection and Clinical Manifestations: The Potential Role of Nasopharyngeal Microbiome

2021 ◽  
Vol 8 ◽  
Author(s):  
Beatriz Dietl ◽  
Desirée Henares ◽  
Lucía Boix-Palop ◽  
Carmen Muñoz-Almagro ◽  
Javier Garau ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Respiratory Tract ◽  
Potential Role ◽  
Respiratory Health ◽  
Clinical Manifestations ◽  
Community Acquired Pneumonia ◽  
Invasive Infection ◽  
Upper Respiratory Tract ◽  
Related Factors

Infections of the lower respiratory tract, such as pneumonia, are one of the leading causes of death worldwide. Streptococcus pneumoniae might colonize the upper respiratory tract and is the main aetiological agent of community-acquired pneumonia (CAP). In the last decades, several factors related to the host, the microorganism and the antibiotic therapy have been investigated to identify risk factors associated with the development of invasive pneumococcal disease (IPD). Nevertheless, these factors themselves do not explain the risk of developing disease or its severity. Recently, some studies have focused on the importance of nasopharyngeal (NP) microbiome and its relation to respiratory health. This review presents existing evidence of the potential role of NP microbiome in the development of IPD.

scholarly journals Lump in the Throat – an Algorithm for the Actions of a Physician

2020 ◽  
Vol 27 (2) ◽  
pp. E2020211
Author(s):  
Diana Orishchak ◽  
Nataliia Vasyliuk ◽  
Ostap Orishchak
Keyword(s):  
Clinical Study ◽  
Respiratory Tract ◽  
Clinical Manifestations ◽  
Endoscopic Examination ◽  
Medical Advice ◽  
Upper Respiratory Tract ◽  
Psychosomatic Disorders ◽  
Emotional Status ◽  
Comprehensive Examination ◽  
Upper Respiratory

Diagnosis and treatment of patients with complaints of the “lump in the throat” remain a complex multidisciplinary problem. This is due to the polyetiology of factors causing similar symptoms and an empirical approach to the treatment. “Lump in the throat” is one of the clinical manifestations of upper respiratory tract paresthesia. According to the literature data, there is the reason for referral to an otolaryngologist in 4.1 to 5.0% of cases. The objective of the research was to optimize and improve the diagnosis and pathogenetic approach to the “lump in the throat” treatment. Materials and Methods. To achieve the specified objective, a comprehensive examination of 38 patients who sought an otolaryngologist’s medical advice, complaining of a “lump in the throat” at the age of 18-45 years (26 women and 12 men), was performed. For the purpose of optimal diagnostics, general clinical examination, examination of ENT organs, endoscopic examination of the nasal cavity and nasopharynx, microlaryngoscopy were performed; the condition of patients’ psycho-emotional status was assessed (consultation of psychologist and psychiatrist). Results. A comprehensive clinical study of 38 patients with complaints of the “lump in the throat” at the age of 18-45 years was performed. Psychosomatic disorders were detected in 26 patients; ENT organ diseases were present in 12 patients. All patients received treatment depending on the diagnosed somatic, otorhinolaryngological and psychosomatic pathology.

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.

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