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 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.

Possibilities of cardiovascular events in patients with chronic obstructive pulmonary disease and newly diagnosed tuberculosis, including those associated with HIV infection, when prescribing long-acting β2-agonists

MedAlliance ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 32-39
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Tb Treatment ◽  
Long Acting ◽  
Β2 Agonists

Chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis (TB) are a common pathology among respiratory diseases. Both conditions may have common risk factors, aggravating each other, accom-panied by the development of bronchial obstructive syndrome, requiring mandatory medical correction to increase the effectiveness of therapy for both the main and concomitant pathologies. The aim of the study was to study the effectiveness of treatment of TB in patients with COPD first diagnosed with tuberculosis, including those associated with HIV when prescribing long-acting β2-agonists. Materials and methods. A simple com-parative study included 60 patients of a TB dispensary aged 30–65 years. Patients were divided into 2 groups of 30 people (TB+COPD and TB+COPD+HIV), each of whom for 2 months received a long-acting β-agonist (indacaterol) as an accompanying therapy for the cor-rection of bronchial obstructive syndrome (BOS), with subsequent assessment of the effectiveness of therapy. Results. Subjectively, patients of both groups noted the rapid development of positive dynamics (short-ness of breath decreased from 1–3 days of taking the drug, coughing — within a week, tolerance to physical exertion improved), which was confirmed by indica-tors of the function of external respiration (FEV1). The state of the cardiovascular system was assessed by the results of daily monitoring of blood pressure (BPM). In the COPD+TB group, there is a certain average daily systolic blood pressure (SBP) with a tendency to nor-malize indicators, which is possibly associated with a decrease in the severity of hypoxia during bronchodi-lator therapy. In the COPD+TB+HIV group, the average daily level of SBP increased by 1 mm Hg, but given the very low starting rates, the increase in blood pressure had a positive effect on the patients' condition. The average heart rate (HR) during bronchodilator thera-py did not tend to increase. The best TB treatment re-sults were obtained in the TB+COPD group. In terms of the closure rate of TB+COPD decay cavities — 26.6%, TB+COPD+HIV — 20.0%), the TB+COPD+HIV group had longer periods of abacillation and closure of decay cav-ities, which is associa ted with the severity of the under-lying and associated diseases. The drug was well toler-ated in both groups. Conclusion. The use of 300 mcg long-acting β-adrenomimetics in the complex therapy of β2-adrenergic agonists for patients with TB+COPD and TB+ COPD+HIV can reduce the severity of bronchial obstruction syndrome, improve quality of life, increase adherence to TB treatment, thereby shortening hospi-talization and reduce the likelihood of disability of pa-tients, without the development of side effects from other organs and systems.

scholarly journals The effects of nasal breathing on the development of snoring and apnea

2020 ◽  
pp. 89-94
Author(s):  
Svetlana E. Yaremchuk
Keyword(s):  
Sleep Quality ◽  
Nasal Congestion ◽  
Upper Airway ◽  
Case Control Studies ◽  
Nasal Breathing ◽  
Adequate Treatment ◽  
Randomized Controlled ◽  
Breathing Disorders ◽  
Nasal Steroids ◽  
Improve Sleep Quality

Since the nose is the entrance gate of the upper airway, its stuffiness can contribute to sleep disturbance. The results of a number of case-control studies have shown that nasal congestion frequency associated with snoring and mild OSA. However, there is no strong correlation between the degree of nasal obstruction and the severity of OSA. Randomized controlled trials have shown that in patients with rhinitis, both allergic and non-allergic, the use of nasal steroids can improve sleep quality and may be useful for patients with mild OSA, but they themselves are not an adequate treatment. Surgical correction of nasal breathing disorders also reduces the apnea index and improves sleep quality.

scholarly journals Comparison of tiotropium plus fluticasone propionate/salmeterol with tiotropium in COPD: A randomized controlled study

2012 ◽  
Vol 106 (3) ◽  
pp. 382-389 ◽  
Author(s):  
Ki Suck Jung ◽  
Hye Yun Park ◽  
So Young Park ◽  
Se Kyu Kim ◽  
Young-Kyoon Kim ◽  
...  
Keyword(s):  
Fluticasone Propionate ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled

scholarly journals The prevalence of respiratory symptoms among residents of the Russian Far North

2017 ◽  
Vol 95 (3) ◽  
pp. 260-263 ◽  
Author(s):  
S. V. Andronov ◽  
A. A. Lobanov ◽  
A. I. Popov ◽  
A. V. Emelyanov
Keyword(s):  
Respiratory Function ◽  
Respiratory Symptoms ◽  
Bronchial Obstruction ◽  
External Respiration ◽  
Cross Sectional ◽  
Open Flame ◽  
Far North ◽  
Open Fire ◽  
Sputum Production ◽  
At Home

Aim: to study the frequency of respiratory symptoms among the reindeer herders of the Yamal region in the Far North of Russia. We conducted a cross-sectional study of the occurrence of respiratory symptoms among 500 subjects of the tundra Nenets population (28.1% of the adult Nenets population in the district), of which 38.3% were men and 61.7% women (average age 40.1 years). All patients were matched for age and occupation. Medical examination was carried out by a pulmonologist with the use of the GARD questionnaire (WHO, 2004) and spirometry. Spirometry was performed with a SpiroUSB device (UK) according to a unified standard and the criteria of ATS/ERS 2005. The frequency of respiratory symptoms among the tundra population was estimated at 71.8%. Cough with expectoration and dyspnea were found in 22.8% of the respondents. 70.0% of the examined subjects worked in the cold, 33% were exposed to the open flame at home, and 34.4% smoked. Respiratory symptoms developed in 16.3% of those working in the cold and in 37% exposed to open fire. The combination of such complaints as cough and sputum production occurred in smokers twice as frequently as in non-smokers (54.1%) (p<0.01).The combination of such complaints as cough and sputum production was twice as likely note in his those who smoked (54.1% vs 20.2%) (p<0.01). The combination of these problems dyspnea was three times more common in the smokers (23,3%vs 7,3%) (p<0.001). At presence at patients of such a factor as work in the cold and the absence of other only 16.3% of them have respiratory symptoms. When using at home the open flame and the absence of other factors leading up 37.0% of the individuals with symptoms of chronic bronchitis. Cough, sputum and dyspnea are formed only among 26.3% of the smokers face when smoking is the only risk factor. If the surveyed residents of all three negative factors respiratory symptoms met at 62.1%. Disorders of respiratory function according to spirometry were not observed in none of the study participants. Respiratory symptoms developed in 62.1% of the subjects exposed to all three risk factors. External respiration indices remain normal in all he examine subjects. It is concluded that residents of the Far North frequently suffer respiratory symptoms without disorders in the external respiratory function. In most cases they associated with three factors (work in the cold, exposure to open fire at home, and smoking). Compensatory stimulation of lung functions may create additional difficulties for diagnostics of bronchial obstruction.

Sign in / Sign up

Export Citation Format

Share Document