scholarly journals Pengaruh pemberian vitamin E terhadap eosinofil mukosa hidung dan kualitas hidup penderita rinitis alergi

2019 ◽  
Vol 49 (20) ◽  
Author(s):  
Nanchy Christy ◽  
Rus Suheryanto ◽  
Mohammad Dwijo Murdiyo

Latar belakang: Penyakit rinitis alergi (RA) banyak dijumpai dan memberi dampak negatif terhadap produktivitas, kualitas hidup, gangguan tidur, aktivitas di luar rumah, serta gangguan sekolah pada anak. Vitamin E bekerja sebagai antioksidan pada membran sel dan berikatan dengan radikal bebas dengan cara menghambat peroksidasi Poly Unsaturated Fatty Acid (PUFA). Tujuan: Mengetahui pengaruh vitamin E terhadap jumlah eosinofil mukosa hidung dan perbaikan klinis pada penderita rinitis alergi persisten sedang berat. Metode: Menggunakan Randomized Clinical Trial, double blind, pre and post control group dengan perlakuan pemberian terapi semprot hidung triamcinolone acetonide, cetirizine 10 mg, dan vitamin E 400IU selama 4 minggu. Dilakukan penilaian Visual Analogue Scale (VAS) dan Total Nasal Symptom Score (TNSS), serta pemeriksaan eosinofil mukosa hidung pada awal dan 4 minggu setelah perlakuan. Hasil: Didapatkan perbedaan bermakna antara jumlah eosinofil mukosa hidung sebelum dan sesudah pemberian vitamin E pada kelompok perlakuan (p=<0,001). Penurunan jumlah eosinofil mukosa hidung lebih besar dan bermakna pada kelompok perlakuan dibandingkan dengan kelompok kontrol (p=<0,001). Didapat perbaikan kualitas hidup berdasarkan perbaikan nilai VAS dan TNSS yang bermakna setelah perlakuan pada kelompok kontrol maupun perlakuan (p=<0,001), serta didapatkan perbaikan kualitas hidup berdasarkan nilai VAS dan TNSS pada kedua kelompok dengan selisih nilai perbaikan gejala yang lebih besar pada kelompok perlakuan, namun dari perhitungan statistik tidak didapatkan perbedaan yang bermakna. Kesimpulan: Vitamin E 400IU menurunkan jumlah eosinofil mukosa hidung secara bermakna pada pasien rinitis alergi persisten sedang berat. Perbaikan nilai TNSS pada penggunaan vitamin E 400IU lebih baik dibandingkan subjek yang mendapat plasebo, walaupun tidak berbeda secara bermakna.Kata kunci: rinitis alergi, Vitamin E, Total Nasal Symptom Score ABSTRACT Background: Allergic rhinitis (AR) is an allergic disease frequently found and has a negative impact on productivity, quality of life, sleep disorder, outdoors activities, and school disruption in children. Vitamin E works as an antioxidant in cell membranes through binding free radicals by inhibiting peroxidation of Poly Unsaturated Fatty Acids (PUFA). Purpose: To find out the effect of vitamin E administration on nasal mucosa eosinophil counts and the clinical improvement in patients with moderate severe persistent AR. Methods: A double blind randomized clinical trial, pre and post control group, given therapy of triamcinolone acetonide nasal spray, cetirizine 10 mg, and vitamin E 400 IU orally for 4 weeks. Evaluation by Visual Analogue Scale (VAS) and Total Nasal Symptom Score (TNSS), as well as nasal mucosal eosinophils count at baseline and 4 weeks after treatment. Results: There was a significant difference on the number of nasal mucosal eosinophils before and after vitamin E administration in the treatment group (p = <0.001). A greater and more significant decrease in the number of nasal mucosal eosinophils in the treatment group compared to control group (p = <0.001). Significant improvement of VAS and TNSS after treatment in the control and treatment groups (p = <0.001) and quality of life improvement based on VAS and TNSS values in both control and treatment groups, but the statistical calculations showed no significant differences between the two groups. Conclusion: Vitamin E 400IU significantly reduce the number of nasal mucosal eosinophils in patients with moderate severe persistent AR.

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Justina Šematonytė ◽  
Ieva Bajoriūnienė ◽  
Brigita Šitkauskienė

Žinoma, kad fototerapija teigiamai veikia imuninius procesus gleivinėje. Yra duomenų, kad intranazalinė fototerapija (IF), skleidžianti UV-A (25 proc.), UV-B (5 proc.) ir regimąją šviesą (70 proc.), gali būti veiksminga gydant alerginį rinitą (AR) nepriklausomai nuo simptomus sukėlusio alergeno, taip pat gali būti taikoma ieškant alternatyvų medikamentiniam gydymui. Tyrimo tikslas. Įvertinti intranazalinės fototerapijos poveikį klinikiniams alerginio rinito simptomams ir gyvenimo kokybei pacientų, sergančių nuolatiniu AR. Tyrimo metodai. Tyrimas atliktas Lietuvos sveikatosmokslų universiteto ligoninės Kauno klinikų Imunologijos ir alergologijos klinikoje. Jame dalyvavo sergantieji nuolatiniu vidutinio sunkumo arba sunkiu AR (ARIA diagnostiniai kriterijai). Alerginis įsijautrinimas patvirtintas odos dūrio mėginiais ir (arba) specifinio imunoglobulino E (Ig E) antikūnų įkvėpiamiems alergenams nustatymu kraujo serume. IF procedūros kartotos tris kartus per savaitę, dviejų savaičių laikotarpiu didinant dozę. Standartinis AR gydymas tyrimo metu nebuvo tęstas. Prieš ir po IF gydymo gyvenimo kokybė vertinta pagal E. Juniper adaptuotą klausimyną (angl. the Rhinoconjunctivitis Quality of Life Questionnaire, standardized version, RQLQ(s)), įvertintas bendrasis nosies simptomų balas (angl. Total Nasal Symptom Score, TNSS). Kiekvienos procedūros metu, naudojant vizualinę atitikmens skalę (angl. Visual Analogue Scale, VAS), įvertintas AR klinikinių simptomų sunkumas. Tyrimo rezultatai. 73 proc. tiriamųjų IF poveikį įvertino teigiamai. Nustatyta, kad po IF gydymo pagerėjo tiriamųjų gyvenimo kokybė, nes statistiškai reikšmingai sumažėjo Klausimyno (RQLQ(s)) visų poskalių balai. Po gydymo statistiškai reikšmingai sumažėjo visi TNSS skalės balai: nosies užgulimas, rinorėja, čiaudulys, miego sutrikimai, bendrieji simptomai. VAS skalės balai po gydymo taip pat sumažėjo statistiškai reikšmingai. Išvados. Intranazinė fototerapija gali palengvinti AR simptomus ir pagerinti pacientų gyvenimo kokybę.


2018 ◽  
Vol 47 (2) ◽  
pp. 123
Author(s):  
Woro Safitri ◽  
Dwi Reno Pawarti ◽  
Titiek Hidayati Ahadiah

Latar belakang: Rinitis alergi (RA) adalah suatu penyakit inflamasi mukosa hidung yang diperantara oleh imunoglobulin E (IgE), setelah mukosa hidung terpapar alergen. Tujuan: Mengidentifikasi efektivitas cuci hidung salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung total (SGHT) pada penderita RA. Metode: Penelitian dilaksanakan pada bulan Juli hingga Desember 2016 di Poli Telinga Hidung Tenggorok – Bedah Kepala Leher Rumah Sakit Dr. Soetomo Surabaya. Uji klinis acak terkontrol pada 2 kelompok dengan desain control group in clinical trial. Pengambilan sampel dilakukan secara consecutive sampling. Uji korelasi yang digunakan adalah uji t berpasangan dan uji Wilcoxon. Hasil: Didapatkan sampel 42 penderita, yaitu 21 penderita pada kelompok loratadin, serta 21 penderita pada kelompok loratadin dan cuci hidung salin hipertonik. Didapatkan rerata penurunan transpor mukosiliar kelompok loratadin dan cuci hidung salin hipertonik lebih bermakna daripada kelompok loratadin (p=0,001). Penurunan transpor mukosiliar kelompok loratadin didapatkan rerata -2,30 (SD=2,77), kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -6,27 (SD=3,91). Penurunan SGHT kelompok loratadin didapatkan rerata -2,48 (SD=1,72), sedangkan kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -4,3 (SD=1,20). Kesimpulan: Penambahan cuci hidung salin hipertonik pada terapi loratadin lebih efektif dibandingkan terapi tunggal loratadin dalam menurunkan transpor mukosiliar dan SGHT pada penderita RA. Kata kunci: Loratadin, cuci hidung salin hipertonik, transpor mukosiliar, skor gejala hidung total, rinitis alergi ABSTRACT Background: Allergic rhinitis (AR) is a nasal mucous membrane inflamatory which mediated by Imunoglobulin E (IgE) after allergen exposure in nasal mucosa. Purpose: To identify the effectiveness of nasal hypertonic saline irrigation on reduction of mucociliary transport time (MCTT) and total nasal symptom score (TNSS) in AR patients. Methods: The was conducted from July until December 2016 in Oto Rhino Laryngology - Head and Neck Surgery of Dr. Soetomo Hospital Surabaya. The study was randomized controlled clinical trials on two groups, with the control group in clinical trial design. Paired t and Wilcoxon test was used as the correlation test. Results: There was 42 patients, 21 patients in loratadine group, and 21 patients in loratadine with hypertonic nasal saline group. The average of mucociliary transport time decrease of loratadine with hypertonic nasal saline group was more significant than loratadine group (p=0.001). The mean of decreasing mucociliary transport time in loratadine group was -2.30 (SD=2.77) and loratadine with hypertonic nasal saline group was -6.27 (SD=3.91). The mean of decreasing TNSS in loratadin group was -2.48 (SD=1.72), and loratadin with hypertonic nasal saline group was -4.3 (SD=1.20). Conclusions: The addition of hypertonic nasal saline in loratadine was more effective, compared to monotherapy of loratadine in decreasing mucociliary transport time and TNSS in patient with AR. Keywords: Loratadine, hypertonic nasal saline, mucociliary transport, total nasal symptom score, allergic rhinitis


1998 ◽  
Vol 5 (6) ◽  
pp. 455-460 ◽  
Author(s):  
William H Yang ◽  
Jerry Dolovich ◽  
Michel A Drouin ◽  
Paul Keith ◽  
Jennifer Haddon ◽  
...  

OBJECTIVE: To compare the effect of budesonide Turbuhaler 400 µg/day with budesonide aqua 256 µg/day in the treatment of seasonal allergic rhinitis (SAR). Secondarily to ascertain patients' preferences for the two nasal devices and to assess quality of life.DESIGN: Randomized, multicentre, double-blind, double- dummy, parallel groups study.SETTING: Private practices and hospital clinics in Ontario, Quebec and Manitoba.POPULATION: Two hundred and eighty-four out-patients with SAR, who were symptomatic during the ragweed season, volunteered for enrolment (243 randomized).RESULTS: Mean daily nasal symptom scores were significantly reduced with treatment. There were no statistically significant changes from baseline for eye symptoms. Most patients (more than 80%) achieved substantial control of their symptoms with budesonide. The most common nasal and non-nasal adverse events for both groups were epistaxis and headache. Turbuhaler was easier to use and more convenient to carry, had less of an unpleasant taste, and caused less nasal irritation than the aqua spray. More than twice as many patients preferred Turbuhaler to the aqua spray (69% versus 31%). Improvement in quality of life from baseline to clinic visits was statistically significant in both groups.CONCLUSION: Once daily use of 256 mg of budesonide aqua and 400 mg of budesonide Turbuhaler are equally safe and efficacious in the treatment of SAR. Patients preferred the budesonide powder formulation delivered via Turbuhaler two to one over the aqua formulation.


2015 ◽  
Vol 122 (4) ◽  
pp. 833-842 ◽  
Author(s):  
Matthew L. Carlson ◽  
Oystein Vesterli Tveiten ◽  
Colin L. Driscoll ◽  
Frederik K. Goplen ◽  
Brian A. Neff ◽  
...  

OBJECT The optimal treatment for sporadic vestibular schwannoma (VS) is highly controversial. To date, the majority of studies comparing treatment modalities have focused on a narrow scope of technical outcomes including facial function, hearing status, and tumor control. Very few publications have investigated health-related quality of life (HRQOL) differences between individual treatment groups, and none have used a disease-specific HRQOL instrument. METHODS All patients with sporadic small- to medium-sized VSs who underwent primary microsurgery, stereotactic radiosurgery (SRS), or observation between 1998 and 2008 were identified. Subjects were surveyed via postal questionnaire using the 36-Item Short Form Health Survey (SF-36), the 10-item Patient-Reported Outcomes Measurement Information System short form (PROMIS-10), the Glasgow Benefit Inventory (GBI), and the Penn Acoustic Neuroma Quality-of-Life (PANQOL) scale. Additionally, a pool of general population adults was surveyed, providing a nontumor control group for comparison. RESULTS A total of 642 respondents were analyzed. The overall response rate for patients with VS was 79%, and the mean time interval between treatment and survey was 7.7 years. Using multivariate regression, there were no statistically significant differences between management groups with respect to the PROMIS-10 physical or mental health dimensions, the SF-36 Physical or Mental Component Summary scores, or the PANQOL general, anxiety, hearing, or energy subdomains. Patients who underwent SRS or observation reported a better total PANQOL score and higher PANQOL facial, balance, and pain subdomain scores than the microsurgical cohort (p < 0.02). The differences in scores between the nontumor control group and patients with VS were greater than differences observed between individual treatment groups for the majority of measures. CONCLUSIONS The differences in HRQOL outcomes following SRS, observation, and microsurgery for VS are small. Notably, the diagnosis of VS rather than treatment strategy most significantly impacts quality of life. Understanding that a large number of VSs do not grow following discovery, and that intervention does not confer a long-term HRQOL advantage, small- and medium-sized VS should be initially observed, while intervention should be reserved for patients with unequivocal tumor growth or intractable symptoms that are amenable to treatment. Future studies assessing HRQOL in VS patients should prioritize use of validated disease-specific measures, such as the PANQOL, given the significant limitations of generic instruments in distinguishing between treatment groups and tumor versus nontumor subjects.


2021 ◽  
Vol 8 (1) ◽  
pp. e000680
Author(s):  
Kathy Weisel ◽  
Nicola Scott ◽  
Scott Berger ◽  
Susanne Wang ◽  
Kurt Brown ◽  
...  

ObjectiveTumour necrosis factor signalling via the receptor-interacting protein kinase 1 (RIPK1) pathway regulates colonic inflammation suggesting that RIPK1 inhibition may be a potential therapeutic target in ulcerative colitis (UC). This phase IIa, randomised, double-blind experimental medicine study investigated the safety, pharmacokinetics (PK), pharmacodynamics (PD) and preliminary efficacy of the RIPK1 inhibitor GSK2982772 in patients with active UC.DesignIn part A, prior to a protocol amendment, one patient was randomised to receive GSK2982772 60 mg twice daily for 42 days. After the amendment, patients were randomised 2:1 to receive GSK2982772 60 mg or placebo three times daily for 42 days. In part B, all patients switched to open-label GSK2982772 60 mg three times daily for 42 days. Safety, PK, PD biomarkers, histological disease activity, clinical efficacy and quality of life were assessed at days 43 and 85.ResultsThirty-six patients were randomised (n=12, placebo/open-label GSK2982772; n=24, GSK2982772/open-label GSK2982772). Most adverse events were mild, with headache reported the most frequently across groups (placebo/open-label GSK2982772, n=2 (17%); GSK2982772/open-label GSK2982772, n=8 (33%)). GSK2982772 was well distributed into colonic tissue, with generally higher concentrations in colonic biopsy samples versus plasma. No apparent differences between treatment groups were observed for PD, histological disease activity, clinical disease activity or quality-of-life measures. At screening, all patients had Mayo endoscopic scores of 2 or 3. At day 43, no patients in the placebo/open-label GSK2982772 group achieved Mayo endoscopic scores of 0 or 1 vs 3/24 (13%) for GSK2982772/open-label GSK2982772. At day 85, 1/9 (11%) achieved scores of 0 or one for placebo/open-label GSK2982772 vs 3/22 (14%) for GSK2982772/open-label GSK2982772.ConclusionGSK2982772 was generally well tolerated, with no treatment-related safety concerns identified. However, no significant differences in efficacy were observed between treatment groups, suggesting that GSK2982772 as monotherapy is not a promising treatment for patients with active UC.Trial registration numberNCT02903966.


Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 501-505
Author(s):  
Maoting Ye ◽  
Jia Guo ◽  
Caiping Song ◽  
Feiyu Zheng

AbstractObjectiveThis paper aims to explore specific effects of out-of-hospital continuing nursing on schizophrenia patients’ health rehabilitation and quality of life, and further improve application and popularization of out-of-hospital continuing nursing.MethodsThe 180 schizophrenia patients discharged from our hospital from March 2014 to March 2016 were selected as the subjects. The patients were divided into two groups according to the randomized double-blind method. Both groups received routine discharge guidance, and the observation group received out-of-hospital continuing nursing on this basis. Questionnaires and scales were used to compare differences of the two groups after discharge from hospital, such as medication compliance, recurrence rate of schizophrenia, awareness of health knowledge and quality of life.ResultsAfter 6 months of nursing for the observation group, complete medication compliance rate was 71.11% (64/90), awareness rate of schizophrenia-related health knowledge was 96.67% (87/90), and recurrence rate was 8.89% (8/90). For the control group, complete medication compliance rate was 45.56% (41/90), awareness rate of schizophrenia-related knowledge was 46.67% (42/90) and the recurrence rate of disease was 26.67% (24/90). Hence, the observation group enjoys significant advantages compared with the control group. Statistical analysis (P <0.05) showed statistical significance; In addition, life quality scores showed that the quality of life of the observation group was obviously better than the control group; the difference was statistically significant (P <0.05).ConclusionOut-of-hospital continuing nursing for schizophrenia patients after discharge can effectively improve medication compliance, awareness rate of health knowledge, effectively reduce incidence of schizophrenia and improve the quality of life of patients. Thus, the nursing concept and related methods are worthy of publicity and application in a wider range.


2021 ◽  
Author(s):  
Shu-guang Yang ◽  
Xue-qing Yu ◽  
Jiansheng Li ◽  
Yang Xie ◽  
Wei Zhang ◽  
...  

Abstract Background Idiopathic pulmonary fibrosis is a critical disease with poor prognosis. Although different studies have been conducted for the treatment of idiopathic pulmonary fibrosis, limited treatments are available. Jin-shui Huan-xian granule, which is a Chinese medicine herbal compound, has shown a promising efficacy in reducing frequencies of acute exacerbations, improving exercise capacity the quality of life of patients for idiopathic pulmonary fibrosis. Subjects and Methods: This is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 312 idiopathic pulmonary fibrosis patients will be enrolled and randomly allocated to one of the two groups with 1:1. After a 2-week washout period, 52-week treatment will also be performed for all the patients. Patients in experimental group will be given Jin-shui Huan-xian granule with Jin-shui Huan-xian placebo for control group. Outcome measures including acute exacerbations, pulmonary function, dyspnea, exercise capacity, quality of life will be evaluated in this study. Discussion Based on our previous study, it is hypothesized that JHG will reduce the acute exacerbations, improve exercise capacity, pulmonary function, quality of life, delay the disease progression-free. High-level evidence-based support for TCM in IPF will also be obtained in this study. Trial registration: http:www.clinicaltrials.gov : NCT04187690. Register data: December 11, 2019.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Yu-Wei Chang ◽  
Tsia-Shu Lo ◽  
Hsin-Ning Chang ◽  
Yi-Hsien Shiao ◽  
Yuan-Chieh Yeh

Objective. The aim of this study was to investigate the clinical efficacy of laser acupuncture for the treatment of women with overactive bladder (OAB) in Taiwan. Methods. A double-blind randomized controlled trial was conducted on female patients with OAB symptoms referred from gynecologists, and subjects were divided into two groups using blocked randomization. LaserPan (RJ-Laser, Germany) was applied to seven selected acupuncture points. The subjects received laser acupuncture 3 times per week for 3 weeks, 9 sessions in total. Basic patient data, Overactive Bladder Symptom Score (OABSS), Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores were recorded prior to first treatment and at the end of 3rd, 6th, and 9th treatments. Results. Thirty patients were enrolled, and twenty-seven patients completed all treatments in this study. The OABSS total score of the experimental group decreased significantly by 3.13 (p≤0.001), 4.60 (p≤0.001), and 3.79 (p≤0.001) after 3rd, 6th, and 9th treatments, respectively, compared with that of the control group. The IIQ-7 score declined significantly from baseline by 4.57 (p=0.003) and 3.63 (p=0.023) after 3rd and 6th treatments, respectively, compared with that of the control group. Similarly, the UDI-6 score of the experimental group exhibited a significant decrease from baseline by 1.90 (p=0.042) and 2.25 (p=0.025) after 6th and 9th interventions, respectively, compared with that of the control group. Conclusions. This study demonstrates that laser acupuncture can alleviate OAB symptoms and improve quality of life. This noninvasive device could be an effective therapy for women with OAB.


2014 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Arie Monoarfa ◽  
Chaidir Arif Mochtar

Objective: This study aims to validate the Indonesian version of International Prostate Symptom Score (IPSS)to ensure similar purpose and quality as the original version. Material & method: Validation and reliability of IPSS-Ina was performed on 174 subjects divided into 87 benign prostate hyperplasia(BPH) patients and 87 non-BPH subjects as a control group. A total of 33 patients in the BPH group then underwent TURP. Validation was assessed by correlating the IPSS score-Ina with a quality of life score (QoL). Reliability was tested by internal consistency with Cronbach α and test-retest trials. Sensitivity to changes in IPSS-Ina post-therapy was tested by comparing the mean IPSS before and after transurethral resection of the prostate (TURP) therapy. Results: Correlation between IPSS-Ina score with quality of life (QoL) was 0.85 (p <0.001),showing strong correlation.Results of Cronbach's α 0.93; while test-retest trials with the intraclass correlation coefficient (ICC) 0.99; which indicates a very good reliability. The mean initial IPSS-Ina (20.97 ± 4.4) with post-TURP (4.82 ± 1.77) differed significantly (p <0.001). Conclusion: IPSS-Ina proved excellent validation and reliability and was sensitive to symptomatic changeafter therapy. IPSS-Ina have the same goals and the quality of the original version.Keywords: International prostate symptom score, Indonesia, validation, reliability. 


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