scholarly journals Review of Rhinitis: Classification, Types, Pathophysiology

2021 ◽  
Vol 10 (14) ◽  
pp. 3183
Author(s):  
Georgia A. Liva ◽  
Alexander D. Karatzanis ◽  
Emmamuel P. Prokopakis
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Health Care Systems ◽  
Financial Burden ◽  
Treatment Options ◽  
Neural System ◽  
Complete Characterization ◽  
Care Systems ◽  
Considerable Morbidity ◽  
Non Allergic Rhinitis

Rhinitis describes a pattern of symptoms as a result of nasal inflammation and/or dysfunction of the nasal mucosa. It is an umbrella entity that includes many different subtypes, several of which escape of complete characterization. Rhinitis is considered as a pathologic condition with considerable morbidity and financial burden on health care systems worldwide. Its economic impact is further emphasized by the fact that it represents a risk factor for other conditions such as sinusitis, asthma, learning disabilities, behavioral changes, and psychological impairment. Rhinitis may be associated with many etiologic triggers such as infections, immediate-type allergic responses, inhaled irritants, medications, hormonal disturbances, and neural system dysfunction. It is basically classified into three major clinical phenotypes: allergic rhinitis (AR), infectious rhinitis, and non-allergic, non-infectious rhinitis (NAR). However, this subdivision may be considered as an oversimplification because a combined (mixed) phenotype exists in many individuals and different endotypes of rhinitis subgroups are overlapping. Due to the variety of pathophysiologic mechanisms (endotypes) and clinical symptoms (phenotypes), it is difficult to develop clear guidelines for diagnosis and treatment. This study aims to review the types of allergic and non-allergic rhinitis, providing a thorough analysis of the pathophysiological background, diagnostic approach, and main treatment options.

scholarly journals On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions

2011 ◽  
Vol 49 (4) ◽  
pp. 474-478
Author(s):  
M.B. Soyka ◽  
G. Nikolaou ◽  
K. Rufibach ◽  
D. Holzmann
Keyword(s):  
Retrospective Cohort ◽  
Health Care Systems ◽  
Financial Burden ◽  
Treatment Options ◽  
University Hospital ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The World ◽  
Care Systems ◽  
The University

Background: Epistaxis represents one of the most common emergencies in ENT clinics around the world. It creates great physical and emotional stress to the patient as well as a financial burden on health-care systems. A lot of research has been performed with regard to aetiology and possible treatment, however, not much effort has been put into analysing the effectiveness of common treatment forms. It is the objective of this study to clarify which of these treatment forms is reliable. Study design: Retrospective cohort study. Level of evidence: 2b. Methods: Between 03/2007 and 04/2008, all epistaxis therapies including relapses and treatment failures at the University Hospital of Zurich have been documented using a computerised questionnaire. Different treatments were compared to each other. Results: An analysis of 678 interventions in 537 patients was performed with emphasis on failure proportions and time to occurrence. The estimated failure proportions of coagulation in anterior epistaxis accounts for 14%. Successful treatment of epistaxis in posterior bleedings could be achieved in 62% by packing and in 97% by surgery with a statistically significant difference between the respective groups. Conclusion: Using our treatment options, anterior epistaxis can be cured reliably by cauterisation. Surgical therapies in posterior bleedings are able to successfully salvage failed packing therapies.

Bước đầu đánh giá hiệu quả hệ thống theo dõi SpO2 từ xa ở bệnh nhân Covid-19 mức độ nhẹ - trung bình

2022 ◽  
Author(s):  
An Vinh Bui-Duc
Keyword(s):  
Monitoring System ◽  
Clinical Symptoms ◽  
Health Care Systems ◽  
Care Center ◽  
Vital Role ◽  
Blood Oxygen Saturation ◽  
Runny Nose ◽  
Care Systems ◽  
The Mean ◽  
D Dimer

TÓM TẮT Đặt vấn đề: Đại dịch COVID-19 (coronavirus disease of 2019) do chủng vi rút Corona mới SARS-CoV-2 vẫn đang bùng phát trên toàn thế giới, gây gia tăng gánh nặng lên Hệ thống chăm sóc Y Tế các quốc gia. Chính vì vậy, việc phát triển hệ thống giúp hỗ trợ chẩn đoán và theo dõi bệnh nhân COVID-19 từ xa được xem là vấn đề cấp thiết hiện nay. Trong đó, chỉ số SpO2 có vai trò quan trọng đối với bệnh COVID-19 và được lựa chọn để theo dõi bệnh nhân tại các Cơ sở Y tế cũng như tại nhà. Nghiên cứu này được chúng tôi thực hiện với mục đích đánh giá hiệu quả ban đầu của hệ thống theo dõi SpO2từ xa trên các bệnh nhân COVID-19 mức độ nhẹ - trung bình. Đối tượng, phương pháp: Nghiên cứu cắt ngang, theo dõi dọc ngắn hạn các bệnh nhân COVID-19 mức độ nhẹ - trung bình điều trị tại Trung tâm Hồi sức Tích cực điều trị bệnh nhân COVID-19 trực thuộc Bệnh viện Trung Ương Huế tại TP. Hồ Chí Minh. Kết quả: Trong giai đoạn từ 8/2021 - 10/2021, 32 bệnh nhân COVID-19 được gắn thiết bị theo dõi chỉ số SpO2, trung bình là 34,2 ± 12,0 tuổi. Các yếu tố nguy cơ bao gồm: BMI xếp loại béo phì 25%, hút thuốc lá (18,8%), tăng huyết áp (15,6%) và đái tháo đường (12,5%). Phần lớn bệnh nhân vào viện do khó thở (71,9%) và chuyển từ tuyến dưới (62,5%). Triệu chứng lâm sàng chủ yếu là ho, hắt hơi, chảy mũi nước (40,6%), theo sau đó là giảm hoặc mất khứu giác, vị giác (25%). 81,3% có D-Dimer ≤ 500ng/mL. 62,5% bệnh nhân được phân độ COVID-19 mức trung bình. Tổng cộng 3.161 lượt đo SpO2, trong đó có 8 lượt cảnh báo SpO2 < 93%. SpO2 trung bình 98,1 ± 0,2 %. Tất cả bệnh nhân xuất viện thành công. Kết luận: Hệ thống theo dõi SpO2 từ xa bước đầu có hiệu quả giúp theo dõi các bệnh nhân COVID-19 mức độ nhẹ - trung bình. ABSTRACT INITIAL EFFECTIVENESS EVALUATION OF THE REMOTE SPO2 MONITORING SYSTEM IN PATIENTS WITH MILD - TO - MODERATE COVID-19 DISEASE Background: The COVID-19 pandemic affected by the new Coronavirus SARS-CoV-2 continues to spread globally, increasing the burden on countries’ Health Care systems. Therefore, generating a platform to help diagnose and monitor COVID-19 patients remotely is considered an essential issue today. In particular, the SpO2 index plays a vital role in COVID-19 disease and is selected to monitor patients at health facilities and homes. This study aimed to evaluate the initial effectiveness of the remote SpO2 monitoring system in patients with mild - to - moderate COVID-19 diseases. Methods: This cross - section study was conducted on mild - to - moderate COVID-19 patients treated at the COVID-19 Intensive Care Center operated by Hue Central Hospital in Ho Chi Minh City, Vietnam Results: From August 2021 to October 2021, 32 COVID-19 patients were applied with SpO2 monitoring smartwatches. The mean age was 34.2 ± 12.0. Risk factors including obesity (25%), smoking (18.8%), hypertension (15.6%), and diabetes (12.5%). Most patients were admitted to the center due to shortness of breath (71.9%) and transferred from lower - level hospitals (62.5%). The main clinical symptoms are coughing, sneezing, runny nose (40.6%), followed by a decrease or loss of smell and taste (25%). 81.3% of patients had D-Dimer ≤ 500 ng/mL. 62.5% of patients had moderate COVID-19 grades. A total of 3,161 SpO2 measurements, including 8 alarms < 93%. The average SpO2 was 98.1 ± 0.2 %. All patients were discharged successfully. Conclusion: A remote SpO2 monitoring system is considered to have preliminary effectiveness in monitoring mild - to - moderate COVID-19 patients. Keywords: COVID-19, blood oxygen saturation, smartwatch, health monitoring system.

scholarly journals A 2019. évi ARIA kezelési irányelvek magyar adaptációja és a hazai alkalmazás lehetőségei allergiás rhinitisben

2020 ◽  
Vol 161 (49) ◽  
pp. 2059-2071
Author(s):  
Helga Kraxner ◽  
Andor Hirschberg ◽  
Kristóf Nékám
Keyword(s):  
Health Care ◽  
Allergic Rhinitis ◽  
Mobile Health ◽  
Health Care Systems ◽  
Cost Effective ◽  
Allergic Diseases ◽  
The European Union ◽  
Sentinel Network ◽  
Intranasal Corticosteroids ◽  
Care Systems

Összefoglaló. Az allergiás betegségekben szenvedő emberek száma világszerte, köztük Magyarországon is növekszik. Az egészségügyi ellátórendszerek azon dolgoznak, hogy minél hatékonyabban tudják felhasználni a rendelkezésre álló forrásokat. Az Allergic Rhinitis and its Impact on Asthma (ARIA) szervezet célja az allergiás náthában szenvedő betegek ellátásának javítása, szakmai ajánlások készítése, aktualizálása. Ennek egyik módja integrált betegellátási utak kidolgozása. Célunk ezek hazai elérhetővé tétele, az ajánlások széles körű elterjesztése az Európai Unió (EU) többi tagállamához hasonlóan Magyarországon is. Az ARIA más nemzetközi innovatív szervezetek bevonásával olyan integrált betegellátási utakat fejlesztett ki, amelyek allergiás nátha, esetleg társbetegsége, az asztma esetén támogatják a kezelést. Ezeket újgenerációs irányelvek kidolgozása útján alkották, amelyekhez felhasználták a mobiltechnológiából és pollenkamra-vizsgálatokból származó valós evidenciákat is. A gyógyszeres terápia optimalizálásához a vizuális analóg skálán alapuló, úgynevezett Mobil Légúti Figyelő Hálózat algoritmusát digitalizálták, és valós evidenciák felhasználásával tovább finomították. Allergén immunterápiára az ARIA a világon elsőként dolgozott ki integrált betegellátási utakat 2019-ben. A kezelési irányelvekhez való adherenciaszint alacsony, a betegek a tüneteik erőssége alapján módosítják a kezelést. A flutikazon-propionát–azelasztin kombináció hatása erősebb az intranasalis kortikoszteroidokénál, míg az utóbbi hatásosabb az oralis H1-antihisztaminoknál. A mobiltelefonokban tárolt elektronikus napló vagy más ’mobile health’ (mHealth) eszközök használata segíti a betegek kiválasztását allergén immunterápiára. Az ARIA által javasolt algoritmus megfelelőnek mutatkozott az allergiás rhinitis kezelésére, ezért ezek az irányelvek bekerülnek integrált betegellátási utakba, és részét fogják képezni az EU Egészségügyi és Élelmiszer-biztonsági Főigazgatósága digitalizált, személyközpontú gondozási anyagainak. Az allergén immunterápia hatékony az inhalatív allergének által okozott allergiás betegségekben, alkalmazását azonban korlátozni kell gondosan válogatott betegekre. Orv Hetil. 2020; 161(49): 2059–2071. Summary. The number of allergic patients is increasing all over the world, also in Hungary. Delivering effective and cost-effective health care is essential for all health care systems. ARIA (Allergic Rhinitis and its Impact on Asthma) aims to improve the care of patients who suffer from allergic rhinitis by setting up guidelines and updating them. Development of ICPs (integrated care pathways) can play an essential role in attaining this goal. Our aim is to make ICP-s developed by ARIA available also in Hungary, as is already the case in other countries of the European Union (EU). Together with other international initiatives, ARIA has worked out digitally-enabled ICPs to support care in allergic rhinitis and comorbid asthma. ICPs are based on new-generation guidelines using RWE (real-world evidence) from chamber studies and mobile technology. The MASK (Mobile Airways Sentinel NetworK) algorithm – based on visual analogue scale – was digitalized to support pharmacotherapy, and was refined by using RWE. ARIA was the first to develop ICPs for allergen immunotherapy (AIT) in 2019. Based on MASK data, patients did not follow guidelines and their adherence to treatment was poor. Patients would modify their treatments, depending on the disease control. The effect of fluticasone propionate–azelastine combination is superior to intranasal corticosteroids which are superior to oral H1-antihistamines. Electronic diaries obtained from cell phones and other ’mobile health’ (mHealth) devices help select patients for AIT. The ARIA algorithm for AR was found appropriate and no change is necessary. These guidelines will inform ICPs and will be included in the DG Santé digitally-enabled, person-centred care system. AIT is an effective treatment for allergic diseases caused by inhaled allergens. Its use should, however, be restricted to carefully selected patients. Orv Hetil. 2020; 161(49): 2059–2071.

scholarly journals Non-Allergic Rhinitis with Osteopathic Treatment Techniques

2020 ◽  
pp. 16-20
Author(s):  
Omar Bukhari ◽  
Grant Phillips ◽  
Kathleen Sweeney
Keyword(s):  
Allergic Rhinitis ◽  
Head And Neck ◽  
Treatment Options ◽  
Symptom Relief ◽  
Family Physicians ◽  
Treatment Techniques ◽  
Osteopathic Treatment ◽  
Non Allergic Rhinitis

Rhinitis is generally classified as allergic or non-allergic and is differentiated from conditions that mimic symptoms of rhinitis. This article reviews the non-allergic forms of rhinitis highlighting signs, symptoms and diagnosis. An in-depth overview of osteopathic treatment options for the head and neck are outlined to assist osteopathic family physicians in providing symptom relief to their non-allergic rhinitis patients.

scholarly journals Role of inflammation in non-allergic rhinitis

2014 ◽  
Vol 52 (2) ◽  
pp. 142-149
Author(s):  
E. de Corso ◽  
M. Battista ◽  
M. Pandolfini ◽  
L. Liberati ◽  
S. Baroni ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Diagnostic Algorithm ◽  
Inflammatory Cell Infiltrate ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Significant Difference ◽  
Nasal Cytology ◽  
Non Allergic Rhinitis

Objective: To investigate the role of inflammation in non-allergic rhinitis (NAR) patients in a large series to establish the prevalence of different NAR-subtypes, clinical features and the role of nasal cytology in the diagnostic algorithm. Methodology: Patients were selected out of 3650 individuals who spontaneously presented at our institution. We consecutively enrolled 519 NAR-patients in an analytical cross-sectional study between November 2007 and June 2013 (level of evidence: 3b). All patients underwent rhinological evaluation including symptoms questionnaire, endoscopy, CT scan, allergy tests and nasal cytology. Results: The inflammatory cell infiltrate affects the severity of symptoms differently, allowing for identification of different phenotypes of NAR. We distinguished two groups: “NAR without inflammation”(NAR-) and “NAR with inflammation”(NAR+), in addition to different NAR-subtypes with inflammation. A significant difference was observed in terms of clinical symptoms and association with comorbidities (previously diagnosed asthma and aspirin intolerance) between NAR–, NAR+ and between different NAR+ subtypes. Conclusion: Our data suggest that NAR- and NAR with neutrophils behave similarly, showing lower symptom score values and a lower risk of association with comorbidities compared to NAR with eosinophils and mast cells (singularly or mixed). In our belief it is very important to establish the presence and type of inflammation in non-allergic rhinitis patients and nasal cytology is a very useful test in correct differential diagnosis.

Role of estrogen in the management of COVID – 19 in females

2020 ◽  
Vol 10 (3) ◽  
pp. 67-70
Author(s):  
Keerthi Chadam Venkatesulu ◽  
Shaik Habeeb Jan ◽  
Harika Sree Gaddam
Keyword(s):  
Health Care Systems ◽  
Treatment Options ◽  
Adverse Outcomes ◽  
Older Individuals ◽  
Therapeutic Benefits ◽  
Age Related ◽  
Disease Condition ◽  
Care Systems ◽  
The Difference

With the increase, the spread of COVID-19 its effect can be seen on health care systems seek innovative treatment ways as the need of the hour. The suspected leading cause of COVID-19 is due to the response to inflammations and the cytokine storm, which majorly damages the lung tissue. The difference in response to the vaccine can be seen due to different sex. Moreover, age-related decrease in sex steroid hormones like Estrogen as well as testosterone can promote pro-inflammatory raise in older individuals which in turn increases the risk of COVID-19 related adverse outcomes. Such sex hormones have the capacity of mitigating inflammatory response and can also provide promising therapeutic benefits for patients suffering from COVID-19. Moreover, over above the effects of on any ERS, these drugs showed useful ancillary properties. Most showed to highlight broader roles in mitigating viral replication by the ER-independent mechanisms as mentioned. Data simplifies ER modulation an apt pharmacological approach for restricting storm and thus prevents the inflammation due to COVID-19. Mainly the application of or tissue-selective estrogen complex can provide a pharmacological response. Such treatment options can be fruitful for both sexes in the early phase of such disease condition to prevent further progression of the disease to severe forms.

scholarly journals Economic evaluations of peritoneal dialysis and hemodialysis: 2004-2012

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 273 ◽  
Author(s):  
Frank Xiaoqing Liu ◽  
Tiffany P. Quock ◽  
John Burkart ◽  
Les L. Noe ◽  
Gary Inglese
Keyword(s):  
Peritoneal Dialysis ◽  
Cost Effectiveness ◽  
Health Care Systems ◽  
Treatment Options ◽  
Developed Countries ◽  
Economic Evaluations ◽  
Original Research ◽  
Use Of Resources ◽  
Care Systems ◽  
Stage Renal Disease

Background: End-stage renal disease (ESRD) is a debilitating condition resulting in death unless treated. Treatment options include conservative care, transplantation, and dialysis. Major alternative dialysis modalities include peritoneal dialysis (PD) and in-center hemodialysis (ICHD), which have been shown to produce similar outcomes and survival. The need to provide dialysis treatment for patients with ESRD represents a significant financial challenge for global health care systems. Changes in clinically-appropriate dialysis delivery leading to more efficient use of resources would increase health systems’ ability to meet that challenge. The purpose of this paper is to evaluate the economic literature of PD and ICHD within the context of continued economic uncertainty and pressure on healthcare resource use.Methods:A systematic literature search was conducted for studies published between 2004 and 2012.  Articles are included if they were original research studies in English which reported costs and/or cost effectiveness associated with PD and ICHD.Results:Twenty-four articles are included in our review, six of which are cost effectiveness studies comparing PD and ICHD.Conclusions:Our findings echo those of prior published reviews, showing that PD is significantly cost-saving compared to ICHD therapy in most developed countries and some developing countries. Increasing the use of clinically-appropriate PD would substantially reduce healthcare costs.

scholarly journals Novel strategies for the prevention of dementia from Alzheimer's disease

2009 ◽  
Vol 11 (2) ◽  
pp. 129-134
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Detection ◽  
Disease Progression ◽  
Clinical Symptoms ◽  
Health Care Systems ◽  
Detection Methods ◽  
Health Crisis ◽  
Care Systems ◽  
Treatment Research

As the world's population continues to age, Alzheimer's disease presents a looming public health crisis that, left unchecked, threatens to overwhelm health care systems throughout the developed world. In order to significantly tackle the most catastrophic and devastating symptom of Alzheimer's disease (AD)--dementia--we must be able to detect the disease prior to the onset of clinical symptoms, and be able to offer patients preventative treatments that block or significantly slow disease progression. This review summarizes a variety of the most promising early detection methods for Alzheimer's disease (AD) and mild cognitive impairment (MCI) that could be used to identify those at high risk of developing the disease and used for monitoring disease progression and response to investigational treatments. In addition, treatment research programs that could be developed into disease-modifying treatments that significantly delay the development of dementia are highlighted. These potential treatments target many different pathways, and may one day be dosed in combination to increase efficacy and prevent cognitive deterioration in patients with AD. While we still face numerous challenges, AD researchers have made great progress in understanding disease mechanisms. As we have seen in the treatment of heart disease, even modest preventative treatments can have hugely significant clinical outcomes and drastically reduce disease prevalence on a population scale. Therefore, there is hope that the development of prophylactic treatments, combined with improved early detection methods, will provide dramatic relief for millions of aging individuals threatened by the specter of Alzheimer's disease.

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.

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